End stage arthritis may severely affect your ability to perform regular activities. Medical treatments, including surgery, may help reduce symptoms and improve quality of life.

Arthritis is a group of conditions that cause inflammation and joint pain. Arthritis is sometimes called “end stage arthritis” when joint damage becomes severe.

The most common type of arthritis is osteoarthritis. Osteoarthritis is also called “wear and tear arthritis” because it’s characterized by the breakdown of your joint tissue from repetitive stress over many years. Experts estimate osteoarthritis affects more than 32.5 million adults in the United States.

Arthritis symptoms usually don’t appear in the early stages of joint damage. As the damage gets worse, you may develop joint symptoms such as:

  • swelling
  • loss of mobility
  • pain
  • warmness

Read on to learn more about end stage arthritis, including what it means, symptoms, and when you may want to speak with a doctor.

Experts typically define end stage arthritis as when the affected joints have experienced a severe decline in function and are causing severe pain. On X-rays, it often shows up as bone-on-bone.

You’ll probably have significant pain and stiffness when you move your joint if you have end stage arthritis. Pain and stiffness are often worse in the morning. Walking and climbing stairs may be difficult if arthritis affects your ankle, hip, or knee.

Other symptoms include:

  • loss of mobility through your joint
  • swelling around the joint
  • crackling or other noises when you move
  • trouble performing daily activities such as opening jars or grasping objects

When to contact a doctor

The Arthritis Foundation recommends making an appointment with a doctor if you have joint symptoms, such as pain or swelling, lasting 3 days or more. They also recommend seeing a doctor if you have several episodes of joint symptoms within a month.

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If you have symptoms of end stage arthritis, a doctor may recommend surgery.

While there are several surgical options, the preferred procedure for end stage disease is total joint arthroplasty. This surgery involves replacing the joint with an artificial joint.

Many people benefit from total joint arthroplasty, but a 2021 study notes that not everyone experiences improvements.

Medications for managing symptoms of end stage arthritis include:

Home management of symptoms of end stage arthritis may include:

  • keeping an active lifestyle to reduce stiffness
  • using cold and heat therapy
  • eating a balanced diet
  • resting your joints when they become inflamed

Learn more about osteoarthritis treatment.


Doctors often use the Kellgren-Lawrence system to classify the severity of osteoarthritis into 1 of 5 categories, based on the following features as seen with an X-ray:

  • Joint space narrowing: Joint space narrowing occurs when the cartilage between the two bones in your joint wears down, and the bones move closer together.
  • Bone spur formation: Bone spurs are bony growths that form in your joint from damage related to osteoarthritis.
  • Subchondral sclerosis: Subchondral sclerosis is a thickening of the ends of your bones under a layer of cartilage.

The following chart explains the features of each grade:

0normal• no evidence of osteoarthritis on X-rays
1minor or questionable• unlikely joint space narrowing
• some possible bone spurs
2mild• possible joint space narrowing
• definite bone spurs
3moderate• moderate degree of multiple bone spurs
• definite joint space narrowing
• some thickening of the bone under the cartilage of your joint
• possible structural changes in the ends of your bones
4severe• large bone spurs
• narrowing of joint space
• severe thickening of the bone under the cartilage of your joint
• definite structural changes of your bones

Doctors sometimes refer to grade 4 arthritis as “stage 4” or “end stage” arthritis.

Learn more about the stages of osteoarthritis.

Other types of arthritis

Experts have identified more than 100 types of arthritis. Several types may cause severe symptoms.

The second most common type of arthritis is rheumatoid arthritis (RA), which develops when your immune system affects healthy cells in your joint by mistake.

RA has its own staging system, using stages 1–4. In stage 4, or “end stage RA,” your joints no longer work as they should. You may also experience joint pain that you can’t manage with nonsurgical treatments.

Psoriatic arthritis (PsA) is another type of inflammatory arthritis that affects people who have psoriasis. Advanced stages of PsA can also cause severe pain, loss of joint function, and structural changes to your joints.

Here are some frequently asked questions people have about end stage arthritis.

Is end stage arthritis a disability?

A disability is a condition that limits your ability to move, sense things, or perform activities. In severe cases, arthritis can make it difficult to perform daily activities.

Osteoarthritis leads to moderate to severe disability in 43 million people worldwide, which, according to experts, makes it the 11th most debilitating disease in the world.

Can you walk with stage 4 arthritis?

If you have end stage arthritis in your lower body, walking may be difficult. You may need assistive devices such as a cane or walker. People consistently report that osteoarthritis affects their quality of life.

How long does it take to develop stage 4 arthritis?

Osteoarthritis generally progresses slowly over many years. However, about 1 in 7 people have an abrupt progression to advanced stage in less than 4 years and, in many cases, in less than 1 year.

What is the most severe type of arthritis?

RA can cause more widespread symptoms than osteoarthritis, but both conditions can range from mild to severe in different people.

Septic arthritis can also be very severe. It’s a complication of some bacterial, viral, and other types of infections. The chances of death in the hospital due to septic arthritis are about 7–15%. About one-third of people with this kind of arthritis have permanent complications.

Why has my arthritis suddenly gotten worse?

Osteoarthritis symptoms may flare up if you suddenly increase your physical activity. Other common flare-up triggers include:

  • cold weather
  • changes in the atmospheric pressure
  • infection
  • weight gain

End stage arthritis often causes chronic pain and other symptoms, such as stiffness and loss of mobility. If your arthritis occurs in your lower body or spine, you may find it challenging to walk.

Osteoarthritis often progresses slowly, but some people have rapid development in only a few years. It’s important to contact a doctor if you develop potential arthritis symptoms that don’t resolve in a few days or if your symptoms get worse.