What Does “Wear and Tear” Really Mean?

Written by Julian Newhill, Registered Osteopath (M.Ost, B.A.(Hons), Dip S.M.). Julian has 14 years of clinical experience specialising in spinal musculoskeletal conditions. Read his full profile.

“Wear and tear” is the everyday name for the normal, age-related changes that build up in our joints and spine over the years. It is extremely common, it is not a sign that your body is crumbling, and it very often causes no pain at all.

If those words have turned up on a scan report, or been mentioned to you by a health professional, they can sound worrying. Here is what they actually mean – and why they are rarely cause for alarm.

What is “wear and tear”, really?

“Wear and tear” is a plain-English label for what doctors call degenerative or age-related change – and, when it affects a joint, osteoarthritis. It covers things like slightly worn cartilage, small bony spurs, and discs in the spine that have lost a little of their height or water content. In short, it is the inside of the body showing its age, in much the same way that grey hair and lines on the skin show it on the outside. It is a normal part of getting older, not a disease you have caught.

Does it mean my joints are damaged or “crumbling”?

No – and this is the part worth holding on to. The language can sound alarming, conjuring up an image of a joint wearing away to nothing, but that is not what is happening. These are gradual, everyday adaptations, and a joint with some wear in it can carry on working well for many years. The changes on their own are rarely the whole story, and they very seldom mean a joint is beyond help or heading for disaster.

If it shows on a scan, why doesn’t it always hurt?

Because these changes are so common that they appear on the scans of huge numbers of people who have no pain whatsoever. If you were to scan a room full of comfortable, symptom-free adults in their fifties and sixties, a large proportion would show worn discs or joint changes without ever having felt them. That is why a scan finding on its own does not explain pain, and why we treat the person in front of us rather than the picture. Pain and “wear and tear” are related, but far more loosely than most people assume.

Should I stop exercising or take it easy?

Quite the opposite – movement is one of the best things for a joint with some wear in it. Joints are built to be used: gentle, regular activity keeps them nourished, mobile and comfortable, while long spells of rest tend to leave them stiffer and the surrounding muscles weaker. Strengthening the muscles around a worn hip, knee or back takes load off the joint and often eases the ache. You do not need to push into sharp pain, but staying active is protective, not risky.

Can anything actually be done about it?

Yes, even though the changes themselves cannot be reversed. The aim is not to “fix” the wear, but to help the area around it work as well as it can – easing stiffness and muscle tension, improving how the joint moves, and building up the muscles that support it. For many people that makes a genuine difference to comfort and to what they can do. At Newhill Osteopathy in Horley we see this every week with worn hips, knees, necks and backs, and we are honest about when something is likely to need a specialist opinion.

When should you get it checked?

If a joint or your back is painful, stiff, or getting in the way of everyday life, it is worth having it assessed – whatever a scan may or may not have shown. An osteopath can examine how the area moves and work out what is actually driving your symptoms.

Please see your doctor first if joint or back pain comes with unexplained weight loss, a fever, pain that is severe at night or steadily worsening, or new numbness, tingling or weakness. These need medical attention rather than being put down to wear and tear.

“Wear and tear” is a normal companion of getting older, not a verdict. With the right movement and support, most people carry on doing the things they enjoy for years. If a worn joint or an achy back has been slowing you down, we would be glad to help.

Book an appointment

Related pages

• Hip pain
• Knee pain
• Neck pain
• Lower back pain

You can also see everything we treat on our conditions page.

Frequently asked questions

Does “wear and tear” mean I have arthritis?

In a joint, yes – osteoarthritis is the medical term for the age-related changes people call wear and tear. It sounds more serious than it often is, though. These changes are extremely common as we get older, frequently cause little or no pain, and generally respond well to staying active and looking after the muscles around the joint.

If it shows on my scan, why doesn’t it always hurt?

Because these changes are so common that they appear on the scans of large numbers of people who have no pain at all. A scan finding on its own does not explain symptoms, which is why the person and how they move matter far more than the image. Pain and wear and tear are related, but only loosely.

Will exercise make my wear and tear worse?

No – for most people the right movement helps rather than harms. Joints are designed to be used, and gentle, regular activity keeps them mobile and comfortable while strengthening the muscles that support them. Complete rest tends to leave a joint stiffer and weaker. Staying active within comfort is one of the most useful things you can do.

Can osteopathy reverse wear and tear?

No treatment can reverse the underlying changes, and any that claims to should be treated with caution. What osteopathy can do is ease the stiffness and muscle tension around a worn area, improve how it moves, and help you strengthen and stay active – which often makes a worthwhile difference to comfort and function.

Does wear and tear always get worse with age?

The changes may progress slowly over time, but your symptoms do not have to follow suit. Many people find their pain stays stable or even improves with the right activity, strengthening and management, and plenty live comfortably for years with joints that show significant wear on a scan.

Is It My Hip or My Back?

If you are not sure whether your pain is coming from your hip or your back, the location is the biggest clue. As a rule of thumb, true hip problems are usually felt in the groin, while back problems are more often felt in the buttock and down the leg. The two overlap more than you might think, though, which is why they are so easily confused.

It is one of the most common questions we are asked at Newhill Osteopathy in Horley, and it matters, because a hip problem and a back problem are treated quite differently. Here is how to tell them apart.

The quick answer: where is your pain?

Point to where it hurts, and you are already halfway there:

• Groin, or the front of the hip or thigh – more likely the hip joint.
• Buttock, or pain travelling down the back of the leg – more likely the lower back.
• The bony point on the outer hip, sore to lie on – usually a tendon or bursa, not the joint itself.

None of these is a hard-and-fast rule, but taken together they usually point you in the right direction.

Where does hip pain usually sit?

Genuine hip joint pain is most often felt as a deep ache in the groin, and it sometimes spreads to the front of the thigh or even the knee. It tends to be worse when you put weight through the leg – walking, climbing stairs, or getting out of a car – and the hip often feels stiff, especially first thing in the morning. A classic giveaway is discomfort putting on socks or shoes, because that movement squeezes the joint. You can read more on our hip pain page.

Where does back-related pain usually sit?

Lower back problems are usually felt across the back itself and in the buttock, and they often change with your position – worse after sitting, bending or lifting, and sometimes eased by walking about. If a nerve is irritated, the pain can travel down the leg, and you may notice pins and needles, numbness or a heavy, weak feeling. A jolt down the leg when you cough or sneeze points firmly to the back rather than the hip. There is more on our lower back pain page.

What about sciatica?

Sciatica is a back problem, not a hip one, even though people often feel it around the hip and buttock. It happens when a nerve in the lower back is irritated and sends pain, tingling or weakness down the leg, sometimes as far as the foot. So if your “hip” pain runs down the back of your thigh and below the knee, the source is almost certainly your back. Our sciatica page explains it further, and we bust a few common myths in this article.

A few simple self-checks

These are pointers rather than a diagnosis, but they can help you get a sense of what is going on:

• Where can you press to find the sore spot? Groin suggests the hip; the buttock or spine suggests the back.
• Does putting on a sock or getting out of the car catch you? That leans towards the hip.
• Does sitting, bending or coughing make it worse? That leans towards the back.
• Does the pain travel below the knee? That points to a nerve coming from the back.

If your answers are mixed, do not worry – pain coming from both is common, and it is exactly the sort of thing an assessment is designed to sort out.

When should you see someone?

If your pain is not settling, is stopping you sleeping or working, or you simply are not sure what is causing it, it is worth getting it assessed. An osteopath can examine the hip and the back together and work out where the trouble really lies, rather than guessing from where it hurts.

Please seek urgent medical help if your pain comes with numbness around the back passage or genitals, difficulty passing or controlling urine, loss of bowel control, or numbness or weakness spreading into both legs. These need prompt medical attention rather than osteopathy.

At Newhill Osteopathy in Horley we assess hips and backs day in, day out, and untangling which is which is one of the most common things we do. If yours has been grumbling, we would be glad to take a look.

Book an appointment

Related pages

• Hip pain
• Lower back pain
• Sciatica

You can also see everything we treat on our conditions page.

Frequently asked questions

Can a hip problem cause back pain, or a back problem cause hip pain?

Yes, both happen, which is part of why they are so easily confused. A stiff or painful hip can change the way you move and load your back, while a back problem can refer pain into the hip and buttock. This is why it helps to have both assessed together, rather than assuming the pain is coming from exactly where you feel it.

Why does the outer side of my hip hurt when I lie on it?

Pain on the bony point of the outer hip, sore to lie on at night, usually comes from the tendons and the small cushioning bursa there rather than the hip joint itself. It is very common, particularly from around midlife onwards, and it generally responds well to the right loading, treatment and a few changes to how you sleep and sit.

Can a bad back really cause pain all the way down my leg?

Yes. When a nerve in the lower back is irritated, it can send pain, tingling or weakness down the leg, sometimes as far as the foot – this is what people call sciatica. Pain that travels below the knee, especially with pins and needles, points to the back rather than the hip as the source.

Should I see a GP or an osteopath?

For most everyday hip or back pain, an osteopath can assess you and start treatment without a referral. See your GP first, or seek urgent care, if you have red-flag symptoms such as loss of bladder or bowel control, numbness around the saddle area, or weakness in both legs, or if you feel generally unwell alongside the pain.

Can the pain be coming from both my hip and my back?

It can, and it is more common than people expect, particularly as we get older and a little wear appears in both areas. Having pain in both places does not mean something is seriously wrong. A proper assessment can tease apart how much each is contributing and target treatment accordingly.