How To Manage Arthritis In The Knee

What Is Knee Osteoarthritis

4.1million people in England have osteoarthritis of the Knee. 18% of the population aged over 45 years old has the condition.

Arthritis Research UK suggest that only 18% of people with arthritis have a care plan to help them manage their symptoms. Sub-optimal management of osteoarthritis permits people to suffer symptoms unnecessarily.

Not everyone who has arthritis will suffer with symptoms, but those that do can experience pain, stiffness, reduced mobility and function. The experience of OA is often unique to each individual.

Some people may just have pain, whereas others may simply have stiff joints. Typically, symptomatic people with knee OA will have a combination of symptoms. Stiff knees often hinder daily functional tasks like walking, getting in and out of the bath or car, and putting on shoes .

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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.

Rheumatoid Arthritis Of The Knee

Rheumatoid arthritis is an autoimmune disease in which the immune system attacks healthy tissue in several joints of the body, including the knee. It causes inflammation of the synovial membrane, the capsule surrounding the knee joint. Inflammatory cells release substances that break down knee cartilage over time. Rheumatoid arthritis can affect people of any age.

Radiographic Findings Of Oa

• Joint space narrowing

• Advice on weight loss
• Knee bracing

• The first-line treatment for all patients with symptomatic knee osteoarthritis includes patient education and physiotherapy. A combination of supervised exercises and a home exercise program have been shown to have the best results. These benefits are lost after 6 months if the exercises are stopped.
• Weight loss is valuable in all stages of knee OA. It is indicated in patients with symptomatic OA with a body mass index greater than 25. The best recommendation to achieve weight loss is with diet control and low-impact aerobic exercise.
• Knee bracing in OA can be used. Offloading-type braces which shift the load away from the involved knee compartment. This can be effective when there is a valgus or varus deformity.

Other non-physiotherapy based interventions include pharmacological management:

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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.

Osteoarthritis Of The Knee

Knee OA is a very common source of pain that can limit your mobility.

Causes of Knee OA

The cause of OA is unknown. These risk factors make it more likely you will develop knee OA:

• Age: OA can occur at any time of life, but it is most common in older adults.
• Sex: Women are more likely to have knee OA than men.
• Obesity: Being overweight adds stress to your knees. Fat cells also make proteins that can cause inflammation in and around your joints.
• Injuries: Any knee injury, even old ones, can lead to knee OA.
• Repeated stress: Frequent stress on your knee from your job or playing sports can increase risk for OA.
• Genetics: You can inherit a tendency to develop OA.
• Bone deformities: If you have crooked bones or joints, you are at higher risk.
• Some metabolic diseases: Diabetes and hemochromatosis, a condition in which your blood has too much iron, have been linked to OA

Symptoms of knee OA develop slowly and worsen over time.

• Pain: Movement causes pain. Sometimes your knee will ache while sitting still.
• Stiffness: Your knees may be stiff first thing in the morning or after sitting for a long time.
• Loss of motion: Over time, you may lose the ability to bend and straighten your knee all the way.
• Creaking and grating : You may hear crackling noises or feel a grating sensation.
• Instability: Your knee may give out or buckle, or feel like it could.
• Locking: The knee may lock or stick.
• Swelling: Your knee may get puffy all around or on one side.

Your doctor will check for:

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Coping With Low Mood And Sleep Problems

You might find that osteoarthritis of the knee makes you feel depressed or anxious. Speak to your doctor if youre feeling low as they may be able to recommend psychological therapies to help you, such as cognitive behavioural therapy and stress-relieving techniques.

If your sleep is disturbed because of osteoarthritis of the knee, this could make your pain feel worse. However, there are things you can do for yourself that might help, such as:

• Keep a sleep diary to work out if there are any patterns to your sleep problems
• Sleep at regular times to get your body into a routine
• Avoid phones and other screens in the bedroom to help you wind down before bed.

If youre still having problems, speak to your doctor or an occupational therapist who can give you other tips and techniques to try, known as sleep hygiene.

Can Imaging Exams Detect Arthritis

Imaging exams can help your healthcare provider get a clear picture of your bones, joints and soft tissues. An X-ray, MRI or ultrasound can reveal:

• Bone fractures or dislocations that may be causing you joint pain.
• Cartilage breakdown around your joints.
• Muscle, ligament or tendon injuries near your joints.
• Soft tissue inflammation.

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What Is Osteoarthritis Of The Knee

Osteoarthritis is the most common form of arthritis, and the knee is one of the most commonly affected joints.

Everyones joints go through a normal cycle of damage and repair during their lifetime, but sometimes the bodys process to repair our joints can cause changes in their shape or structure. When these changes happen in one or more of your joints, its known as osteoarthritis.

A joint is a part of the body where two or more bones meet in your knee, its the thigh and shin bones. There is also a small bone at the front of the knee called the patella or kneecap.

The ends of our bones are covered in a smooth and slippery surface, known as cartilage . This allows the bones to move against each other without friction, and protects your joint from stress.

Your knee also has two other rings of a different type of cartilage known as menisci or meniscus, which help to share weight evenly across your knee joint, and theres also cartilage underneath your kneecap.

Osteoarthritis causes the cartilage in your knee joint to thin and the surfaces of the joint to become rougher, which means that the knee doesnt move as smoothly as it should, and it might feel painful and stiff.

Osteoarthritis can affect anyone at any age, but its more common in women over 50.

Injuries or other joint problems, such as gout, can make people more likely to get osteoarthritis. The genes we inherit from our parents can also increase the risk of the condition developing.

How Can I Manage Oa And Improve My Quality Of Life

CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms.

• Learn self-management skills. Join a self-management education class, which helps people with arthritis and other chronic conditionsincluding OAunderstand how arthritis affects their lives and increase their confidence in controlling their symptoms and living well. Learn more about the CDC-recommended self-management education programs.
• Get physically active. Experts recommend that adults engage in 150 minutes per week of at least moderate physical activity. Every minute of activity counts, and any activity is better than none. Moderate, low impact activities recommended include walking, swimming, or biking. Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease, stroke, and diabetes. Learn more about physical activity for arthritis.
• Go to effective physical activity programs. For people who worry that physical activity may make OA worse or are unsure how to exercise safely, participation in physical activity programs can help reduce pain and disability related to arthritis and improve mood and the ability to move. Classes take place at local Ys, parks, and community centers. These classes can help people with OA feel better. Learn more about CDC-recommended physical activity programs.

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Orthoses And Patellar Taping

Lateral wedge insoles and valgus-directed braces have been prescribed for patients with medial compartment knee OA. However, the evidence generally does not support their use. Conversely, medial patellar taping has been shown to be useful for patients with patellofemoral OA. This simple intervention exerts a medially directed force to realign the patella in the intertrochlear groove, thereby reducing pain. During application, the patient should be lying down with the knee extended and thigh muscles relaxed. Tape is applied to the superior aspect of the patella, pulled medially and fixed to the medial side of the knee. Additionally, a second and third tape is applied to the tibial tubercle and pulled to the medial and lateral joint lines, respectively . This unloads the infrapatellar fat pad, which can be aggravated by stretching of tissue. A commercially available adhesive, non-stretch sports tape is typically used. A hypoallergenic underlay tape can be applied in combination.

Taping can be performed regularly by a physiotherapist, but self-taping is recommended, as it empowers patients to care for their own knees.

How Is Osteoarthritis Of The Knee Diagnosed

The diagnosis of knee osteoarthritis will begin with a physical exam by your doctor. Your doctor will also take your medical history and note any symptoms. Make sure to note what makes the pain worse or better to help your doctor determine if osteoarthritis, or something else, may be causing your pain. Also find out if anyone else in your family has arthritis. Your doctor may order additional testing, including:

• X-rays, which can show bone and cartilage damage as well as the presence of bone spurs
• magnetic resonance imaging scans

MRI scans may be ordered when X-rays do not give a clear reason for joint pain or when the X-rays suggest that other types of joint tissue could be damaged. Doctors may use blood tests to rule out other conditions that could be causing the pain, such as rheumatoid arthritis, a different type of arthritis caused by a disorder in the immune system.

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Transcutaneous Electrical Nerve Stimulation

Transcutaneous electrical nerve stimulation uses a machine that sends electrical impulses through sticky patches, called electrodes, attached to the skin. This may help ease the pain caused by your osteoarthritis by numbing the nerve endings in your spinal cord which control pain.

Treatment with TENS is usually arranged by a physiotherapist or doctor, who can advise you on the strength of the pulses and how long your treatment should last.

What Are The Signs And Symptoms Of Arthritis Of The Knee

There are many signs and symptoms of arthritis of the knee:

• Creaking, clicking, grinding or snapping noises .
• Difficulty walking.
• Joint pain that changes depending on the weather.
• Joint stiffness.
• Knee joint pain that progresses slowly or pain that happens suddenly.
• Skin redness.
• Your knee locks or sticks when its trying to move.
• Warm skin.

Pain and swelling are the most common symptoms of arthritis of the knee. Some treatments might reduce the severity of your symptoms or even stall the progression. See your healthcare provider if you have symptoms of knee arthritis.

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Where Can Arthritis Occur In The Knee

Cartilage loss can occur between the thighbone and the shinbone in the medial portion , lateral portion and under the kneecap.

• Thinning of the cartilage under the kneecap is called patellofemoral arthritis .
• Some patients have cartilage loss in one, two or all of these areas. When all three areas are affected, this is called tricompartmental arthritis.

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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Can Arthritis Pain Be Controlled

There are many things you can do to help control your arthritis pain. The goals of these methods are to control pain by:

• learning new ways to reduce pain
• taking as few pain medicines as possible
• changing pain habits that disrupt your normal lifestyle
• increasing your physical and social activity so you can return to an active life as much as possible

The methods listed here will work differently for different people. So some methods may work for you but some may not. Some methods are things you can do for yourself. Others require help from your doctor or other health professionals. Talk to your doctor about these methods. With a little practice you will find the right ones for you.

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 Help Arthritis In Knees: The Basics

Your knees are the largest, strongest joint in the body. Knowing a bit about the anatomy can help to appreciate not only their strength but also their unique vulnerabilities.

Knee joints consist of three bones. The femur connects to the tibia and the patella . Cartilage wraps around the end of each bone to protect and smooth movement where the three bones meet.

Two wedges of cartilage called the meniscus act as shock absorbers as the femur presses down into the tibia. Synovial fluid lubricates all of the cartilage in the joint and helps with smooth movement.

In addition, stabilizing ligaments and tendons include:

• Lateral and medial collateral ligaments: Stabilize side-to-side movement
• Posterior and anterior cruciate ligament: Frames movement forward and backwards

Knees absorb the impact of your upper body coming down on the lower leg: every day, all day. This means that everything you dowalking, running, hiking up a mountain, or simply standing up from a seatrelies on healthy knees.

When our knees are not healthy, the resulting knee pain can make it challenging to go about our normal daily activities or even get to sleep at night.

What Is Osteoarthritis

Osteoarthritis, commonly known as wear-and-tear arthritis, is a condition in which the natural cushioning between joints — cartilage — wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, decreased ability to move and, sometimes, the formation of bone spurs.

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Tips For Using A Cane

When using a cane, remember the following tips:

• Ensure the cane isnt too tall or short. You shouldnt slump or slouch over when using a cane. Its height should come to the top of your wrist.
• Use the cane on your strong side. If your affected hip is your right one, hold the cane with your left hand. When you step forward with your right leg, the cane will provide support. Practice moving your affected leg and the cane at the same time.
• Advance the cane an appropriate distance. Move the cane about 2 inches to the front or side of you. If its too far from your body, you might lose balance.

A physical therapist can help you develop a safe technique.

Your insurance company may cover the cost of these aids. Your healthcare provider can write a prescription for these mobility aids to help in the reimbursement process.