Osteoarthritis of knee

 

What is osteoarthritis?

Osteoarthritis is a condition that can affect any joint in your body. It occurs when the surfaces within your joint becomes injured resulting in the joint not moving as smoothly as it should. When a joint develops osteoarthritis some of the cartilage covering the joint surfaces can gradually roughen and become thin. The bone underneath the cartilage then reacts by growing thicker and becoming broader, which can result in swelling and restricted joint movement.

These changes in and around the joint are partly the result of the inflammatory process and partly your body’s attempt to repair the injured area. In many cases the body can repair the injured area with time. However, in other cases the body repair doesn’t work as well, leading to more pressure on other parts of the joint, which can gradually worsen over time.

What are the symptoms of osteoarthritis in the knee?

The main symptoms of osteoarthritis are pain and sometimes stiffness, which can affect one or both knees. The pain tends to be worse when you move the knee joint. You may have pain all around your knee or just in a certain places such as the fronts or sides. It may also be worse after a particular movement, such as kneeling or going up and down the stairs. The pain normally reduces when you rest.

You will probably find that your pain will vary and that you can have good days and bad days, sometimes depending on how busy or active you have been the day before or during that day. Sometimes there can be no obvious reason for changes in your pain.

The knee may feel stiff at certain times, often in the mornings or after a period of rest. Walking for a few minutes can ease the symptoms although depending on how much of the joint is affected. Walking long distances can increase your symptoms. Many people don’t have any stiffness at all.

In some cases, you may feel that you are not able to move the knee as freely or as far as normal and it may creak or crunch as you move. This is normal and is due to the joint surfaces having undergone changes during the body’s repair process of the early injury.

Sometimes the joint can give-way suddenly because the muscles have become weak or because the knee joint has become less stable because of the osteoathritis. You may notice the muscles at the front of your thigh look thinner than the other side, this can cause the giving-way sensation.

 

What causes knee osteoarthritis?

There are many factors that can increase the risk of osteoarthritis and it is often a combination of these that leads to getting symptoms:

Age

Knee osteoarthritis usually starts from the late 40s onwards. We don’t fully understand why it is more common in ageing individuals, but some research indicates that getting older can weaken muscles that can contribute to the process. As we get older the body can become slower at healing or some research indicates that the way we live our life can lead to gradual wearing out of the joint with time which is similar to the wearing of the brake pads in your car.

Gender

Knee osteoarthritis is twice as common in women as in men. Researchers believe that female hormones have an effect on the cartilage that sits between and cushions the bones. After the menopause women’s hormone levels can reduce meaning they lose the protection on the cartilage, and the risk of developing changes in the knee joint is increased.

Overweight

Research shows that individuals who have a Body Mass Index (BMI) classified as ‘obese’ are up to four times as likely to develop knee osteoarthritis. Being overweight can increase the load of the joint, which can speed up the wear in the cartilage that helps cushion the joints, increasing the risk of developing osteoarthritis. Gradually managing weight can slow down the changes occurring in the knee and can make the symptoms less painful. Follow this link to a BMI calculator for guidance on whether you need to consider weight management. For more information, advice and groups you can join to improve your weight management, click here.

Joint Injury

Normal movement and exercise don’t cause knee osteoarthritis. However, very hard and repetitive activities or physical jobs can increase the risk. High intensity activities such as kneeling when at work can lead to joint injury. As we get older this may not heal or it may affect the cartilage which cushions the joint leading to changes occurring in the joint. Modifying repetitive movements or reducing the duration during physically demanding activities can help slow the rate of change in the knee.

Genetic

Genetics, known as the genes inherited from your parents can play a role in osteoarthritis of the knee. If you have a parent, brother or sister with knee osteoarthritis you will have a higher chance of developing it yourself. However some researchers claim this is due to environmental factors such as dietary intake, physical activity levels and occupations that families tend to share.

The future

More often osteoarthritis is a slow process that develops over many years and results in very small changes in just one part of the joint. This doesn’t mean it won’t be painful, but it is less likely to cause severe disability.

Changes in lifestyle can greatly reduce the risk of osteoarthritis of the knee progressing. Regular aerobic, flexibility and strengthening exercises can protect the joint from further injury. In addition, maintaining a healthy weight will help to control your symptoms.

 

What can I do for my knee osteoarthritis?

There is no cure for osteoarthritis, but there is a lot that you can do to improve your symptoms. Self-help or self-management is very important to relieve the pain, stiffness and reduce the chances of your arthritis becoming worse. The one professional who can best you manage your symptoms is you!

Weight management

This is seen as the main long-term management approach for knee osteoarthritis. The only person that can maintain a healthy weight is you! Researchers’ say that being overweight or obese can not only increase your risk of developing osteoarthritis, but will also make it more likely that your arthritis will get worse over time. Losing even a small amount of weight can make a big difference to the strain on your joints when walking, running, or going up and downstairs. There is no special diet shown to help osteoarthritis but you should follow a balanced, low calorie-diet combined with exercise (such as walking, swimming or cycling).

If you need help with weight-control, click here to access our weight management pages where you can find information, advice and groups you can join to help you management your weight better . Click on this BMI calculator for guidance on whether you need to consider weight management.

Exercise

If you don’t need to lose weight it is still very important that you keep moving. You will need to find the right balance between rest and exercise. It is common that being over active can increase your pain but too little can stiffen up the joint. Two types can help your symptoms: strengthening and aerobic.

Strengthening

Strengthening exercises will improve the strength and tone of the muscles that control the affected knee. Pain and swelling from the arthritis process can weaken your thigh muscle (know as your quadriceps) resulting in your knee taking more force. By regularly doing strengthening exercises this will help protect the joint and can be shown to reduce your pain and slow the osteoarthritis process.

Local NHS Ayrshire & Arran physiotherapists have devised exercise clips to help with strengthening the correct muscles, please click on the exercise tab above to view the exercises to help your symptoms

Aerobic

Aerobic is any low to high impact physical exercise that makes you short of breath. This can help reduce pain by stimulating your pain relieving hormones called endorphins. There are a variety of different types of exercise that you can do such as swimming, cycling or walking. If you are not used to being physically active, it is best to speak with your GP to make sure your health allows you to undertake this type of self-management. If you are ok to participate in aerobic exercise you may need to take a painkiller before to avoid increased pain. If you want to find out what exercises are local to you the contact the XX.

Painkillers

Simple painkillers such as paracetamol or ibuprofen may help to reduce the pain in the knee and allow you to perform the exercises properly. Do not exceed the daily allowance of these medicines, even if your pain is high. Always consult a GP before taking any new medication. If you are unsure what medication you can take, speak with your local pharmacist, practice nurse, or GP for guidance.

Reducing the load - there are other important ways to reduce the strain on your knees:

Pace yourself

If you are in pain don’t tackle all your activities of daily living, such has housework, at once. Break the harder jobs down into smaller time frames and do something gentler in between. Sometimes a short rest when your knee starts to feel painful can be helpful over the course of a day. It is recommended to pace rather than to fully stop all forms of movement or exercise. You may find that taking simple painkillers as previously mentioned may help you to keep active.

High heels

Avoid high heels. This will alter the position of your leg and it can increase the strain into your knee and big toe.

Handrail

When climbing stairs you may need to consider using handrails and go up one leg at time until your muscles become stronger. It is better to go upstairs leading with the non-painful leg one step at a time. If coming down the stairs then lead with the sore leg one step at a time and use the handrail.

Heat/Ice

A hot water bottle or ice pack can also be used regularly to help control pain after you have been overactive. If using ice, wrap the cold compress in a towel and apply to the painful area for 10 minutes every two hours. If you are using heat, wrap the warm compress in a towel and place it on the painful area for 20 minutes every two hours. If you have any concerns about the sensation or feeling on the skin where you are placing any of the mentioned compresses, ask a GP to assess this before following this advice.