Knee osteoarthritis

What is Osteoarthritis (OA)?

Arthritis is a general term that describes inflammation of the joints. Osteoarthritis (OA) is a form of Arthritis that is associated with the wear and tear of the joint cartilage and commonly occurs in the large weight-bearing joints of the body such as the knee, hip and spinal joints.

What causes Knee OA?

The most common cause of Knee OA is aging. As you get older, the cushioning layer between the two bones of the knee joint degenerates due to repetitive use. This can lead to swelling, stiffness and pain in the joint. A majority of people will develop some degree of Knee OA. However, several other factors can increase the risk of developing significant arthritis at an earlier age. These include:

• Obesity/Overweight – Being heavier increases stress on your knee joint
• Repetitive stress – Repetitive loading of the knee joint during activities such as long-distance running, kneeling, squatting can increase the risk of joint degeneration. This may be exacerbated by incorrect posture as this leads to abnormal loading on the joint
• Previous injuries and damage to the knee joint
• Heredity
• Gender – Women aged 55 or older are more likely to develop Osteoarthritis of the knee

Symptoms of Knee OA

• Stiffness especially first thing in the morning or when you have been sitting for a while but gets better after movement
• Pain that is worse after activity and towards the end of the day
• Feeling of warmth in the joint
• Creaking, crackly sound when the knee moves
• Decrease in the function of the knee, making it difficult to get in and out of chairs or cars, climb stairs, or walk

How is Knee OA diagnosed?

Your doctor or physiotherapist can make a diagnosis of your Knee OA based on your symptoms and physical examination. X-Ray Imaging is also used to observe structural changes such as narrowing of joint space and bone spurs. It is important to be aware that extensive changes on X-Ray do not always mean a person will experience a high level of pain and vice versa. Besides physical changes that occur within the joint, other factors such as your mood, levels of stress and anxiety, quality of sleep, fatigue and too much focus on your knee pain can have an effect on how much pain you are feeling. Therefore, learning to manage all of these factors will help you combat your Knee OA more effectively.

Management of Knee OA

For a majority of people, OA is characterised by stable periods interspersed with flare-ups. It is important to understand that not all Knee OA will worsen over time and there are positive, active things that you can do to help manage the pain and carry on with your normal life.

During flare-ups you should have a short period of rest for the pain to settle. A long period of rest, however, has been shown to be detrimental to a person’s joint health and their ability to return to activities and therefore should be avoided.

The goal of managing Knee OA is to minimize pain, improve joint flexibility and the ability to return to daily activities and hobbies. It usually requires a multi-faceted approach and your healthcare team will be able to assist with this.

• Weight-loss – This is achieved through maintaining a healthy diet and regular exercise habit.
• Individualized exercise program – Resistance exercise is critical in strengthening the muscles around your knee and help unload the burden on the joint. This will help reduce pain and improve your ability to carry on with normal daily activities. Your physiotherapist can assist with prescribing an exercise program that works for you.
• Medications – Generally pain relief medication such as PanadolOsteo and Non-steroidal Anti-inflammatory medication can help relieve symptoms of knee OA. Your local doctor or pharmacist will be able to assist with this.
• Aids or support – braces or walking aid may help unload the knee joint. Your physiotherapist can assist with prescribing you with the correct aid.
• Counseling – as we know stress, anxiety and low mood can affect your level of pain and therefore talking to a clinical psychologist may be useful.

In cases where conservative approach shows no improvement, Total Knee Replacement surgery performed by an Orthopedic surgeon may be considered.