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Knee Osteoarthritis

Knee Osteoarthritis

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Osteoarthritis can affect various joints in the body causing them to become stiff and painful. The knee joint is particularly at risk because, in addition to being the largest, it is also the most complex joint. The symptoms of the condition can develop slowly, and can be different at different times of the day or when you are engaging in different activities.

Who is most likely to suffer from osteoarthritis?

Women are twice as likely as men to have the condition. Usually both knees are affected. People in their late 50s are more commonly affected than younger people. There are certain factors that make it more likely that you will get knee osteoarthritis — the most important of which is being overweight. Other risk factors include previous injuries such as a torn ligament or meniscus that might have occurred during sporting activities and having undergone a menisectomy, which is a surgical procedure to remove damaged cartilage.

People, particularly women, who have nodal osteoarthritis, a condition that runs in families, often develop knee osteoarthritis and require a knee brace as they get older. Finally, people who lift heavy weights and athletes whose activities place a lot of stress on the knees are at a higher risk of developing the condition.

Diagram showing osteoarthritis of the knee

Symptoms

Symptoms of knee osteoarthritis may be different from person to person. The level of damage does not appear to correlate to the severity of symptoms. Sometime mild damage can lead to significant symptoms, while more noticeable damage causes few issues. Of course the reverse can also be the case. Many people with knee osteoarthritis may need to wear a knee brace.

Low level damage will normally occur in the joints on a daily basis. Symptoms of this are rarely experienced however, as the body is able to easily repair itself. Where the body cannot repair this damage, osteoarthritis can develop. There are a number of factors that are understood to increase some people’s chances of developing the condition osteoarthritis, although not much is known about the precise causes.

Problems that can be a precursor include:

  • Those with tendon or ligament issues
  • Cartilage damage which prevents the smooth movement of the joint
  • The presence of inflammation in the bone or without the bone itself
  • Knee osteoarthritis may cause bony lumps or osteophytes to form, causing the bones to stick out and the joints to become misshapen. Pain and stiffness develops as the bones become thick and broad, movement becomes difficult. Inflammation can also cause a build-up of fluid within the knee joint, which can subsequently swell.

Elderly man holding knee in pain

Some things that are known to contribute to the development of knee osteoarthritis are:

Injury to the knee joint: Sometimes overusing the joint following an operation or injury can prevent proper healing and may contribute to osteoarthritis.

Pre-existing condition: Those who have gout, rheumatoid arthritis or another similar condition can be at a greater risk of developing osteoarthritis.

Age: Older people are at an increased risk of developing osteoarthritis as muscles weaken and there is wear and tear within the joints.

Genetic factors: A pre-disposition to osteoarthritis can be seen to run in families. So far however, no specific gene has been identified. Scientists believe that there may be a number of smaller genetic factors responsible, which means a definitive genetic test is unlikely in the near future.

Weight: Being very overweight can put a lot of extra strain on the knee joint and may eventually lead to osteoarthritis.

Diagnosis

If someone suspects they have developed knee osteoarthritis, then a visit to their GP can help to establish a diagnosis. The chances of developing this debilitating condition increase with age, especially after 45 years, so age will be one of the biggest factors taken into consideration before a diagnosis is normally made. Having said that, young people can still get knee osteoarthritis, but it is much less common.

Medical assessment

There is no one single test to diagnose knee osteoarthritis, so risk factors and symptoms are assessed, together with a physical examination. Your doctor will look to see if there are any bony growths on the knee, any swelling or creaking sensations, as well as how stable the joint appears and how easy it moves.

In some cases, your doctor may decide to refer you for an X-ray. This can help to determine if there is any reduced space between the knee joints as a result of cartilage loss. An X-ray may also show if there is any extra bone growth or unusual appearances on the surface of the joint, as well as calcification of the cartilage. Blood tests may also be taken to rule out other conditions.

Whilst knee osteoarthritis can be very painful and there is no cure, fortunately there are different forms of treatment that can be used by sufferers to assist with relieving symptoms. Medication to reduce inflammation and pain is commonly used and knee support bands can help to increase mobility.

Doctor holding up an x-ray of a knee joint

Managing inflammation

Although there is no cure for knee osteoarthritis, there are a number of things that sufferers can do to manage the condition and reduce pain and inflammation in the joint. The most important factor in minimising the effects of osteoarthritis is to achieve and maintain an appropriate weight so as not to put too much stress on the joint.

Exercise

Exercise may seem counter-intuitive when knee osteoarthritis is causing severe pain, but in fact the more the joint is kept mobile, the better the results will be. Inactivity allows the joint to seize up, so you should use an appropriate knee brace and take part in some gentle exercise. A sports physiotherapist can guide you through some practical exercises which will increase mobility and reduce pain and inflammation.

Wearing appropriate footwear

Many sufferers find that pain management is helped through appropriate footwear. Flat shoes with thick, cushioned soles act as shock absorbers and protect the knee joint from jarring and jolting. When they are used in conjunction with a good-quality knee brace, many sufferers are able to participate in gentle low-impact exercise routines.

Pain relief

Doctors can prescribe pain relief in severe cases where knee osteoarthritis is keeping sufferers awake at night with pain. Generally, most sufferers are able to manage the condition with over-the-counter painkillers such as paracetamol and ibuprofen. Stronger painkillers such as codeine can help with more severe pain, but the benefits must be weighed against the side effects, as these medicines can cause drowsiness and interfere with the patient’s ability to drive.

Steroid injections

People with very severe osteoarthritis can benefit from a steroid injection into the joint which can dramatically reduce inflammation. Your medical practitioner will advise you if this is the case. More extreme cases may require surgical intervention to clean the affected joint, or even replace it entirely, but this is relatively rare.

Osteoarthritis knee brace

There are now a number of knee brace products on the market which are designed to manage osteoarthritis, working to unload the pressure on the affected side of the joint which can reduce pain levels and enhance mobility, as well as delaying the potential need for surgery.

Braces such as the Unloader One have been clinically proven in their attempts to slow down the degradation of cartilage within the knee joint, improve the mobility of a patient and delay the need for surgery. It is worth noting that these types of products are dependent on the type of osteoarthritis suffered and you should consult with a medical professional before making a purchase.

Most sufferers of knee osteoarthritis find that gentle exercise, a sensible diet and a good knee brace allows them to manage the condition without too much pain or discomfort.

Reducing the risk

Unfortunately, there is little that can be done to prevent arthritis from developing. However, people are able to significantly reduce their level of personal risk and minimise their chances of developing the condition through various means.

Knee osteoarthritis, hip, spine or other area cannot be entirely prevented, but through maintaining good health and activity, its symptoms and onset can be delayed. Looking after the body’s joints and taking care not to put unnecessary strain on them is perhaps the leading method of prevention.

The onset of knee osteoarthritis can be minimised by taking part in activities which do not create such a level of pressure in the joint, such as swimming or walking over running or weight lifting. When running, the pressure on the knee is at its highest, whereas during swimming and other gentler forms of exercise the weight is more evenly distributed and the load is better controlled and supported. Wearing a knee brace can help to compress the joint and offer support during activities, too, even for those already affected by knee osteoarthritis.

Maintaining proper posture is crucial and you should ensure that you move regularly. You should try to avoid sitting in the same position for extended periods of time. Desk users in particular are susceptible to bad posture, so it is important to ensure that the chair and desk are arranged at the proper height for the individual and if you work at a desk you should regularly get up for a break.

Maintaining a healthy lifestyle

As well as ensuring that the body is well taken care of, building good muscle tone and ensuring the body has sufficient strength can also help to minimise the risk of impact and strain on the joints. Health guidelines recommend that an individual carries out two and a half hours of medium intensity exercise activity per week. These exercises promote fitness and wellbeing, but you should take care to ensure that the joints are not overtaxed.

Swimming, walking, cycling and dance are low impact choices which build muscle without harming the body or putting it to excessive strain. Choose an exercise which is enjoyable and which can be sustained throughout the week, or pick a variety of activities to help maintain interest levels. It is also important to make sure that the body is at a healthy weight, as carrying an unexpectedly large load puts unusual strain on joints and can trigger problems later in life.

Knee osteoarthritis, hip, hands or other areas cannot be totally avoided but can be managed and the risks reduced. For example, wearing a knee brace for strenuous activities, eating healthily to maintain a good weight and taking part in activities which promote muscle use all contribute to making the body as strong as possible and best able to deal with any problems which occur.

Elderly couple hiking in the woods

The importance of self-care

The person who must take the most responsibility for managing knee osteoarthritis is you. This means that you should never ignore the importance of managing your long-term condition properly and dealing with even minor ailments effectively and as they occur to ensure that they do not get any worse.

Self-care is about you looking after yourself, while being supported by professionals who are involved in your care. It is not simply about managing your condition, either. It involves maintaining general emotional and physical health, staying fit, and doing all you can to prevent accidents and illnesses. You should try to eat healthily and exercise, both to maintain or reduce your weight and to keep your muscles strong.

You should not be expected to do this without adequate support, however, even if you just need someone to talk to or advice on the best knee brace to wear to ease your discomfort. In fact, it has been proven that this expert support can provide huge benefits to sufferers of knee osteoarthritis, allowing them to live more independent, active, and fulfilled lives. It can also help people to suffer less pain, tiredness, depression, and anxiety, and even help them to live longer.

Medication and reviews

Stay in regular contact with the medical team responsible for your care to ensure that any changes in your condition are noticed and managed effectively. This may involve changes to your medication but, whatever you are prescribed, remember to take it even if you start to feel better. Some medicines will only need to be taken when you are suffering pain but others will only work properly if you take them continuously.

Always try to read the information leaflet supplied with your medication to check that it will not react badly with any other drugs you are taking and, if in doubt, check with your healthcare team. Remember that even over-the-counter medicines and painkillers can have effects, as can some nutritional supplements and even herbal remedies.

Problem prevention

If you suffer from knee osteoarthritis you should always have an annual flu jab and a one-off pneumococcal injection to protect you against pneumococcal pneumonia. You should also consider wearing a good quality knee brace to give you added strength and security and to minimise pain.