Arthritis prevention

Subchondral Sclerosis - Symptoms and Treatment

Max. D Gray
By Max. D Gray. Updated: March 24, 2022
Subchondral Sclerosis - Symptoms and Treatment

Subchondral sclerosis is a disease that affects the bones and specifically the joints, of people who have osteoarthritis. Subcrondal sclerosis causes joint pain and numbness due to increased bone density and mass, producing a thin layer of bone beneath the cartilage in the joints. This disease is chronic and painful, but it is easy to detect and includes several different treatments. At oneHOWTO we'll explain a bit more about the symptoms and treatment of subchondral sclerosis. We go further into the causes of subchondral sclerosis here.

This article is dedicated to Jano Galán, who in 2012, was diagnosed with amyotrophic lateral sclerosis (ALS). He is a friend of us at oneHOWTO and created an amazing project called DGENERACIÓN after being diagnosed. Don't forget to check it out. Many thanks.

You may also be interested in: Causes of Subchondral Sclerosis


  1. Subchondral sclerosis - causes
  2. Subchondral sclerosis symptoms
  3. External signs of subchondral sclerosis
  4. Treatment for subchondral sclerosis

Subchondral sclerosis - causes

There are three main ways of contracting subchondral sclerosis and there are varying degrees of prevention:

Genetic factors

Although it is difficult to tell or predict from birth, studies claim that there is a genetic predisposition to contracting osteoarthritis and subchondral sclerosis. As subchondral sclerosis derives from compressed joints and often malformation of joints, this can happen at the developmental stage. While it might be occurring throughout your entire life, in barely recognizable ways, it is often not until later that it is diagnosed. Women are more likely to get subchondral sclerosis more than men, with about 18% of women over 60 suffering from the condition. However, men are more likely to develop subchondral sclerosis under the age of 50.

Excess weight and obesity

One of the leading causes of subchondral sclerosis is obesity. As would happen with any vehicle carrying a load, the human body is put under a lot of strain if the person has a high BMI (body mass index). This means the extra weight people can carry on their bodies exerts pressure on the joints. This weight degrades the synovial fluid between the joints and causes more friction between bones. This friction leads to inflammation, in turn leading to osteoarthritis. Under x-ray, people who develop subchondral sclerosis will see increased bone formation round the joint. This is exacerbated by excess weight and a sedentary life. Also, obesity has secondary factors which may contribute to subchondral sclerosis. Toxins from overeating and a weakened immune system can both be contributing factors.

Physical exercise and injury

While everyone is encouraged to exercise as best they can, some exercise can lead to subchondral sclerosis. Going on long runs where joints rub together or weight lifting where a lot of heavy strain is put onto joints can both contribute to its development. Over exercise can result in a rapid degradation in bones and ligaments. An injury sustained either during exercise or due to some other complication, can result in osteoarthritis. It could be not giving the joints enough time to heal, especially if further exercise is carried out too soon after an injury. This is why many sportspeople and athletes develop osteoarthritis later in life.

Subchondral Sclerosis - Symptoms and Treatment - Subchondral sclerosis - causes

Subchondral sclerosis symptoms

While osteoarthritis is a term which encapsulates a wide range of joint disease, subchondral sclerosis is something a little more specific. The "itis" in osteoarthritis means inflammation and inflammation of the joints can happen before subchondral sclerosis sets in. When the acetabular cartilage and the femoral head begin to diminish, it produces subchondral sclerosis, causing the bones to react to the lack of hyaline cartilage. At about 55 years of age, ulcerations and erosions can be observed in the subchondral bone without its cartilaginous lining. This can happen even without any known pathological alteration and simply due to normal wear and tear (aging joints). Another symptom of subchondral sclerosis is a decrease in height due to degenerative changes, that results in joint space narrowing. In X-rays, this appears as a sharp white line (increased bone density) in the weight bearing joints, such as the hip socket and the femoral head.

Unfortunately, subchondral sclerosis can be very hard to detect, especially in younger patients. While many may develop it after developing osteoarthritis, younger people who contract the condition my have it and not be aware. They might only detect it after pain or limited mobility in their joints presents. It might only be confirmed via and X-ray, so if you are feeling any limited mobility or similar pain, you should seek a physician's advice.

Subchondral Sclerosis - Symptoms and Treatment - Subchondral sclerosis symptoms

External signs of subchondral sclerosis

Subchondral sclerosis can be detected with radiology, i.e. it's visible in X-rays of the joints and is the result of a reactive bone response, resulting in increased bone density of the underlying articular cartilage bone (that's underneath the joint).

It's typical of osteoarthritis, but can also occur in other diseases. Osteoarthritis is a degenerative disease which affects most of the mobile joints (hip, spine, hand, knee) and is produced by alterations in the cartilage and subchondral bone and is the result of several diseases with similar symptoms due to the wear and tear of aging.

Subchondral Sclerosis - Symptoms and Treatment - External signs of subchondral sclerosis

Treatment for subchondral sclerosis

Treatment for subchondral sclerosis can be varied depending on the affected area and intensity of the disease. Below we list some treatment options, but remember to always consult a specialist who will prescribe the appropriate treatment:

  • Physical exercises such as swimming and using an exercise bike
  • Weight reduction
  • Physiotherapy
  • Electrotherapy
  • Movement therapy
  • Orthotics
  • Thermotherapy
  • Acupuncture
  • Ozone therapy
  • Supplement your diet with glucosamine, condroiton and methylsulfonylmethane
  • Do strengthening exercises and stretch the muscles that support the back
  • Avoid bad posture and improper body mechanics

While there is no reversing the effects of osteoarthritis or subchondral sclerosis, there are treatments which can help. These include non-steroid anti-inflammaotry drugs (NSAIDs), particularly in advanced stages of the condition. They work both as an anti-infñlammatory as well as an analgesic (painkiller). However, side effects of NSAIDs can be painful and even life threatening in acute cases. Diclofenac is purported to be one of the most effective in treatment of subchondral sclerosis.

As identified in the list above, the best treatment of subchondral sclerosis is management. This involves moderate exercise which will keep the joints supple without causing more damage to them. This is a hard balance to strike and can often result in a difficult trial and error process. If subchondral sclerosis is caused by obesity, then weight loss is advised. This will involve a change to diet as exercise alone might be difficult thanks to limited mobility.

This article is merely informative, oneHOWTO does not have the authority to prescribe any medical treatments or create a diagnosis. We invite you to visit your doctor if you have any type of condition or pain.

If you want to read similar articles to Subchondral Sclerosis - Symptoms and Treatment, we recommend you visit our Diseases & secondary effects category.


  • If the pain is very acute, your best option may be surgery to replace the joints. This will eliminate the symptoms.
Write a comment
What did you think of this article?
Jean Smart
I have one leg much shorter than the other due to my hip moving upwards. It causes pain and unbalance. I have had my shoes sorted to help with height but there is still a difference even with my shoes on and worse when no shoes on.
Cheryl Ferreira
I am allergic to NSAID's. What would be my other alternative?
OneHowTo Editor
Hi Cheryl
Alternatives to NSAIDS include Acetaminophen such as Tylenol, Tramadol or natural remedies such as acupuncture or massages. If, however, you do choose to try a different medication, we suggest checking this with your doctor beforehand.
Margaret L. Osmers
Very good article, may be the answer to 4 years of severe pain that the doctors are ignoring because of my age - even tho my BMI is very good and I am active - and exercise. Was a swimmer until asthma and chlorine downed me.. Wish I could find a doctor who would take appropriate xrays, and institute treatment instead of just passing it off as "old age". Not one doc has done any real testing, X-rays, or treatment. -I guess they feel I'll die anyway - but there is a lot of good I can do for others yet - I cook, keep house and drive and am alert and competent. MLO
OneHowTo Editor
Glad to hear you are doing well despite your problems, Margaret.
What joint is bothering you? Is it several joints due to RA? I have a bad knee due to an operation 14 years back where they removed the cartilage (I'm 69 now). You should get a new specialist and get an x-ray. I got a corticosteroid shot in my knee (which is completely painless BTW) and it feels WAY better now. You can get these 3 times a year. My bone is DJD and not quite bone on bone yet, so no knee replacement yet for me. I will get one when the time comes too. I pray you will have the right wisdom and doctor in the future.
Hi. After having an xray and scans, the GP advised my son today that he has subchondral sclerosis and cyst in his wrist. He referred him to a specialist and my son has to make an appointment. He has only just turned 22. Isnt he too young for this to happen? There isnt a history of osteoarithritis in our families. Can anything else cause this?
OneHowTo Editor
Hi Janine,
The specialist will be able to look further into the causes of your son's subchondral sclerosis and clarify what has caused it.
However, you should know that it can also be caused by Osteochondrosis, which can affect children and adolescents and in turn can occur for a number of reasons which are not directly related to family medical history. On the other hand, arthrosis can be caused by hormonal imbalances too.
Again, only a specialist can give you a final diagnosis.
Wish you and your son the best and hope this helped.
Thank you.
Jayne Owens
Hi, I have osteoarthritis, brought on by tamoxifen which I have been taking for 4 years now, a recent cat scan has shown some abnormal bone thickening and so a bone scan is being done next week....obviously I am incredibly worried about it all = I'm wondering, could OA cause the bone to behave abnornally and thicken?
Jane Bertin (oneHOWTO editor)
Yes, it could be that. According to the University of Washington, osteoarthritis is the result of higher bone density, which can also be reflected in bony growths.
Jayne Owens
Thank you for taking the time to comment. I will hope and pray it is related to arthritic conditions rather than cancer. Thank you again.
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Subchondral Sclerosis - Symptoms and Treatment