Early Signs Of Arthritis In The Knee
Arthritis refers to the redness and swelling of the joints. It usually develops slowly over 10 to 15 years, interfering with daily life activities. Knowing the early signs of arthritis can help you take appropriate treatment and incorporate modifications in your diet and lifestyle.
The knee joint is the largest and the most complex joint in the body. Depending on the cause, the early signs and symptoms of arthritis in the knee joint may vary amongst individuals. Typically, these include:
- Pain while climbing stairs or walking
- Joint stiffness after sitting for prolonged periods with bended knees
- Difficulty in straightening the knee after getting up in the morning
- Swelling over the knees that gets worse on walking
- Bones in the knee joint rub against each other giving rise to the sound of creaking, clicking or snapping, or grinding
- Many people with arthritis experience increased joint pain during rainy weather
What Questions Might A Healthcare Provider Ask To Diagnose Arthritis Of The Knee
Your healthcare provider will interview you when you report your symptoms. Some questions might include:
- Does anyone in your family have arthritis of the knee?
- Does your knee swell up?
- Is your skin often red?
- Is your skin often warm?
- Do you have symptoms in one knee or both?
- How long have you had these symptoms?
- What medications do you take?
- How severe is your pain?
- Do you struggle to walk?
- Do the symptoms interfere with your daily activities?
Injuries That May Lead To Knee Swelling
- Sprains
- Strains
- Meniscal tears
- Tumors
- Infections
Needless to say, the gravity of some of these conditions is worse than others. For instance, malignant tumors are far worse than mild sprains, osteoarthritis is a localized issue whereas rheumatoid arthritis involves your entire immune system, and so on and so forth.
Now that weve got the basics covered, lets move on to why youre really here.
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What Is Knee Arthritis And How Can It Be Treated
Osteoarthritis is the most common joint disease and a leading source of chronic pain and disability in the United States. Knee osteoarthritis comprises over 80% of the diseases total burden and affects almost 20% of Americans over the age of forty-five.
The knee is the largest and most solid joint in the body. It is the connector between the lower end of the femur , the upper end of the tibia , and the kneecap.
Joint Or Bursal Aspiration
When a patient has a swollen knee, a doctor may want to verify or rule out certain diagnoses by analyzing the accumulated fluid. To do this, the doctor will remove fluid from the affected knee joint capsule or bursa using a needle and syringe. When performed on a joint capsule, this process is called joint aspiration or arthrocentesis. When performed on a bursa, this process is called bursal aspiration.
The doctor will take note of the aspirated fluid’s color and viscosity and may send it to a lab for further analysis. Determining the contents of the fluid can lead to an accurate diagnosis. For example, uric acid crystals in the joint fluid indicate gout, and bacteria in the fluid indicate infection.
See The Joint Aspiration Procedure
Aspiration and examination of the fluid are important diagnostic steps because the underlying cause of knee swelling will determine the appropriate medical treatment.
Aspirated fluids are not always sent to a lab for analysis. If a diagnosis is already known, a physician may perform an aspiration to improve joint function and patient comfort.
See Diagnosis through Synovial Fluid Analysis
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Possible Nonsurgical Treatment Options
You may have heard of new, cutting edge treatments for knee arthritis – but do they work, and are they safe?
There has been some recent evidence that Platelet Rich Plasma or stem cell injections have reduced inflammation in an arthritic knee but this treatment is still new and most insurance companies wont cover it so it can be expensive, said Dr. Rosen.
Stem cell treatment has also been quite controversial. There are no studies confirming long term effectiveness, explained Dr. Rosen, and most importantly, no standards as to which cells are used, what dose and where the cells come from. Dr. Rosen also said that the Food and Drug Administration has recently cracked down on stem cell clinics for false and misleading claims and products that were neither safe nor effective.
If youre suffering from knee arthritis, your doctor can help you navigate possible treatment options that would be best for you. To find a Banner Health orthopedic or sports medicine specialists, go to BannerHealth.com.
To learn more about your knee and hip health, take our free Joint Pain Test.
Special Devices And Footwear
Walking sticks can help to reduce the load on your knees and reduce pain when moving about. Other ways to improve symptoms of osteoarthritis include taping the joint, wearing braces, or using shoe insoles that improve your body alignment when standing and walking. Check with your physiotherapist for advice about using aids or supports.
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What Type Of Doctor Treats Knee Arthritis
Osteoarthritis of the knee may be treated by a sports medicine physician or an orthopedic surgeon, depending on your particular condition. A physical therapist may be able to treat less severe cases to help reduce pain and increase your mobility. If you knee pain is a result of rheumatoid arthritis, gout or other form of inflammatory arthritis, you should consult a rheumatologist.
How Is Oa Treated
There is no cure for OA, so doctors usually treat OA symptoms with a combination of therapies, which may include the following:
- Increasing physical activity
- Medications, including over-the-counter pain relievers and prescription drugs
- Supportive devices such as crutches or canes
- Surgery
In addition to these treatments, people can gain confidence in managing their OA with self-management strategies. These strategies help reduce pain and disability so people with osteoarthritis can pursue the activities that are important to them. These five simple and effective arthritis management strategies can help.
Physical Activity for Arthritis
Some people are concerned that physical activity will make their arthritis worse, but joint-friendly physical activity can actually improve arthritis pain, function, and quality of life.
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Do: Wear Comfortable Knee Joint
There are a fair number of studies that suggest shoe choice matters if you have knee osteoarthritis, Pisetsky says. In fact, flat, flexible shoes that mimic the foots natural mobility can decrease the force placed upon the knee during daily activities, according to a study published in the May 2013 issue of Arthritis and Rheumatology.
Risk Factors For Knee Arthritis
- Age. Osteoarthritis is a degenerative, wear and tear condition. The older you are, the more likely you are to have worn-down knee joint cartilage.
- Heredity. Slight joint defects or double-jointedness and genetic defects may contribute to osteoarthritis in the knee.
- Excess weight. Being overweight or obese puts additional stress on the knees over time.
- Injury. Severe injury or repeated injury to the knee can lead to osteoarthritis years later.
- Overuse. Jobs and sports that require physically repetitive motions that place stress on the knee can increase risk for developing osteoarthritis.
- Gender. Postmenopausal women are more likely to have osteoarthritis than men.
- Autoimmune triggers. While the cause of rheumatoid arthritis remains unknown, triggers of autoimmune diseases are still an area of active investigation.
- Developmental abnormalities. Deformities such as knock knee and bowleg place higher than normal stress on certain parts of the knee joint and can wear away cartilage in those areas.
- Other health conditions. People with diabetes, high cholesterol, hemochromatosis and vitamin D deficiency are more likely to have osteoarthritis.
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What Causes Arthritis In The Knee
All kinds of arthritis are characterized by wear and tear of the cartilage followed by a reduction in the joint space.
Three types of arthritis affect the knee mainly:
- Osteoarthritis : This type of arthritis is also known as degenerative joint disease, primary OA, wear-and-tear arthritis, or age-related arthritis. It is a leading cause of disability in the United States and worldwide. Though more common in older people, it can affect young people, including children as well.
- Rheumatoid arthritis : This is an autoimmune and chronic kind of arthritis that affects multiple joints in the body. Autoimmune means the body attacks its own healthy cells. Over time, the inflammation causes degeneration of cartilage along with the softening of the bone.
- Posttraumatic arthritis: This kind of arthritis is preceded by a traumatic event that impacts the knee joint. The injury damages the knee and arthritis develops after a few to several years in the knee joint.
Factors that increase your risk for developing osteoarthritis include:
- Old age
- Overweight or obesity
- A family history of arthritis
- Aggressive workouts/sports
Tips For Managing An Arthritis Flare
Use these tips to manage arthritis flares when they arise.
1. Tips for Managing an Arthritis Flare
2. Plan ahead with your rheumatologist.
3. Plan ahead at home, too.
4. Watch the signs
5. Guard against infection
6. Give it a rest.
7. Care for your emotions
8. Slow down dont stop.
9. Apply the heat and the chill.
10. Exercise your mind.
11. Ask for help.
12. Practice good sleep hygiene
Managing Pain
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How Is Osteoarthritis Managed
There is no cure for osteoarthritis, but most people with osteoarthritis can manage their symptoms, continue with daily activities and live healthy and enjoyable lives. Be careful of any products or treatments that claim to cure osteoarthritis completely your doctor will help to find the right treatment for you.
The Australian Commission on Safety and Quality in Health Care has developed a guide to help you discuss the main treatment options for osteoarthritis of the knee with your doctor.
Imaging For Diagnosing Advanced Knee Osteoarthritis
X-rays are very helpful in diagnosing advanced knee osteoarthritis because the joint will have specific characteristics, including:
- Bones that are closer to each other than they should be: As cartilage wears away, the joint space between them often narrows.
- Cysts: As the body responds to cartilage destruction and attempts to stabilize the joint, cysts or fluid-filled cavities can form in the bone.
- Increased bone density or uneven joints: When bones are no longer cushioned by cartilage, they can rub against one another, creating friction. The body responds by producing more bone tissue, which increasing bone density. Increased bone creates uneven joint surfaces and bone spurs at the joint.
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Gradual Increase In Pain
Arthritis pain usually starts slowly, although it can appear suddenly in some cases.
At first, you may notice pain in the morning or after youve been inactive for a while.
Your knees may hurt when you:
- climb stairs
- stand up from a sitting position
- walk on a flat surface
- sit down for a while
Knee pain that wakes you up from sleep can be a symptom of OA.
For people with RA, the symptoms often start in the smaller joints. They are also more likely to be symmetrical, affecting both sides of the body. The joint may be warm and red.
With OA, symptoms may progress rapidly or they may develop over several years, depending on the individual. Symptoms can worsen and then remain stable for a long time, and they can vary day to day.
Factors that may cause worsening of symptoms include:
- cold weather
- stress
- excessive activity
With RA, symptoms usually appear over several weeks, but they can develop or worsen in a few days. A flare can happen when disease activity increases. Triggers vary and can include changes in medication.
How Is The Knee Designed And What Is Its Function
The knee is a joint which has three parts. The thigh bone meets the large shin bone forming the main knee joint. This joint has an inner and an outer compartment. The kneecap joins the femur to form a third joint, called the patellofemoral joint.
The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint as well as crossing within the joint . These ligaments provide stability and strength to the knee joint.
The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for the joint to move on. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. There is a large tendon which envelopes the knee cap and attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee . The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend, or straighten, the knee joint by pulling on the patellar tendon. In the back of the thigh, the hamstring muscles flex, or bend, the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.
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Switch From The Sidewalk To The Treadmill
Walking or jogging on a sidewalk made of concrete can be hard on the knees. A treadmill has a little more spring and decreases the overall compressive load on the knees. When walking on a treadmill, resist the urge to walk at an incline.
Walking on a groomed earthen trail will have a similar positive effect.
What Are The Treatments For Arthritic Knee Pain
After determining that your knee pain is, in fact, caused by arthritis, Dr. Williams and the caring staff at Interventional Orthopedics of Atlanta will recommend an appropriate treatment plan to help you as quickly and reliably as possible. Some of the most widely known and used treatments for arthritis and arthritic knee pain include:
- NSAIDs
- Knee injections
- Fluid drainage
- Surgery
- Weight loss
- Physical therapy
In addition to these methods, Dr. Williams is proud to offer the breakthrough Regenexx family of nonsurgical treatments, which are designed to use a patients own stem cells to treat common and degenerative conditions without the need for going under the knife. While there are certainly some cases in which surgery may be unavoidable, Regenexx treatment has proven to be highly beneficial for chronic pain relief caused by a large number of conditions.
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What Are The Risk Factors For Oa
- Joint injury or overuseInjury or overuse, such as knee bending and repetitive stress on a joint, can damage a joint and increase the risk of OA in that joint.
- AgeThe risk of developing OA increases with age.
- GenderWomen are more likely to develop OA than men, especially after age 50.
- ObesityExtra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of OA in that joint. Obesity may also have metabolic effects that increase the risk of OA.
- GeneticsPeople who have family members with OA are more likely to develop OA. People who have hand OA are more likely to develop knee OA.
- Race Some Asian populations have lower risk for OA.
Ligament Injury Of The Knee
Trauma can cause injury to the ligaments on the inner portion of the knee , the outer portion of the knee , or within the knee . Injuries to these areas are noticed as immediate pain, but are sometimes difficult to localize. Usually, a collateral ligament injury is felt on the inner or outer portions of the knee. A collateral ligament injury is often associated with local tenderness over the area of the ligament involved. A cruciate ligament injury is felt deep within the knee. It is sometimes noticed with a “popping” sensation with the initial trauma. A ligament injury to the knee is usually painful at rest and may be swollen and warm. The pain is usually worsened by bending the knee, putting weight on the knee, or walking. The severity of the injury can vary from mild to severe . Patients can have more than one area injured in a single traumatic event.
Ligament injuries are initially treated with ice packs and immobilization, with rest and elevation. At first, it is generally recommended to avoid bearing weight on the injured joint and crutches may be required for walking. Some patients are placed in splints or braces to immobilize the joint to decrease pain and promote healing. Arthroscopic or open surgery may be necessary to repair severe injuries.
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How To Get Moving Every Day
In addition to physical therapy, its critical to incorporate regular exercise into your daily routine.
Joints are built to move, says Dr. Day. The evidence shows that people who are least active have more arthritis pain than people who do some form of exercise. Choose lower-impact activities, such as bicycling, swimming or exercising in a pool.
Knee Arthritis Treatment Options
If you have knee arthritis, you know it can be painful and require you to restrict normal activities. The pain associated with inflammatory arthritis can be treated with anti-inflammatory medications like ibuprofen or naproxen, but those medications treat the symptom, not your actual arthritis, said Dr. Rosen. You should avoid extended use of these medications because if taken in excess they can cause kidney failure, stomach bleeding, or liver disease.
Inflammatory arthritis of the knee can be treated with disease-modifying antirheumatic drugs which slow down the progression of the arthritis and can help prevent joint deformities. Other treatment options for inflammatory arthritis include corticosteroid injections or hyaluronic acid injections.
In addition to the above treatment options, your doctor will likely give you tips to help you self-manage your knee arthritis, including remaining active, maintaining a healthy weight, and protecting your joints by avoiding repeat activities with the affected joint.
There is no treatment for osteoarthritis of the knee, so your doctor will treat your symptoms, likely with a combination of therapies including having you increase your level of physical activity, doing exercises to strengthen the affected muscle, physical therapy, losing weight, recommending over-the-counter or prescription medication, using aids like crutches or canes, or surgery.
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