Knee Osteoarthritis

Symptoms of knee osteoarthritis

The main symptoms  are pain and stiffness in the knee joints, which can make it difficult to walk and perform certain activities. The symptoms may come and go in episodes, related to daily activity, but in more severe cases the symptoms can be there all the time.

Other symptoms of knee osteoarthritis may include:

• joint tenderness
• increased pain and stiffness when you have not moved your joints for a while
• joints appearing slightly larger or more 'knobbly' than usual
• a grating  sensation in your joints - this is called “crepitus”
• loss of normal range of movement in the knees
• weakness and muscle wasting around the knees

Osteoarthritis of the knee

If you have osteoarthritis in your knees, it is likely that both of your knees will be affected over time, unless it has occurred as the result of a specific injury or another condition affecting only one knee. Your knees may be most painful when you walk, particularly when walking up or down hills or stairs. Sometimes, your knees may 'give way' beneath you or make it difficult to straighten your legs. You may also hear a soft, grating sound when you move the affected joint.

When to seek medical advice

Dr Allfree has had a lot of experience in treating patients with osteoarthritis, and you should seek help if you have persistent symptoms. To help determine whether you have osteoarthritis, Dr Allfree will ask you about your symptoms and examine your knees.

Diagnosing osteoarthritis

There is no definitive test to diagnose osteoarthritis, so Dr Allfree will ask about your symptoms and examine your knee joints to help determine whether you have the condition.

Further tests, such as X-rays or blood tests, are not normally necessary to confirm a diagnosis of osteoarthritis, although they may be used to rule out other possible causes of your knee pain, such as rheumatoid arthritis or a fractured bone. If you need x-rays, Dr Allfree will be able to arrange them for you. X-rays can be useful in assessing the level of damage to your knees, but this is not always as helpful as you may think because the extent of damage visible on an X-ray isn’t a good indicator of how severe your symptoms are. X-rays can be quite misleading because you cannot see the cartilage lining of a joint on an X-ray.

What causes knee osteoarthritis?

Osteoarthritis occurs when there is damage in and around the knees that the body is unable to fully repair. It is not clear exactly why this happens, although the chances of developing the condition can be influenced by a number of factors, such as age and weight.

Osteoarthritis usually develops in people over 45 years of age, although younger people can sometimes be affected, especially if there has been an injury to the knee joint in the past. It is commonly thought that osteoarthritis is an inevitable part of getting older, but this is not altogether true. You may in fact be able to reduce your chances of developing the condition by doing regular, gentle exercises and maintaining a healthy weight.

Managing knee osteoarthritis

Osteoarthritis is a long-term condition and cannot be cured, but it doesn't necessarily get worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms.

Mild symptoms can sometimes be managed with simple measures such as taking regular exercise, losing weight, wearing suitable footwear and using special devices to reduce the strain on your knees during your everyday activities.

If your symptoms are more severe, Dr Allfree may recommend using additional treatments such as:

• painkilling medication 
• a structured supervised exercise plan
• steroid injections into the knee joints
• in osteoarthritis of mild to moderate severity, hyalgan injections into the knee may be beneficial
• In a small number of cases, where the above treatments haven't helped or the damage to the joints is particularly severe, surgery may be required to replace the knee joint. Dr Allfree will be able to help with the referral arrangements if a surgical opinion is needed.

Lifestyle changes that help

Exercise

Exercise is one of the most important treatments for people with knee osteoarthritis, whatever your age or level of fitness. Physical activity should include a combination of exercises to strengthen the muscles around the joint, and exercises to improve general fitness. If osteoarthritis causes you pain and stiffness, you may think exercise will make your symptoms worse, but this is not always the case. Usually, regular exercise that keeps you active and mobile and builds up muscle around the knees will improve symptoms.

Exercise is also good for losing weight, improving your posture and relieving stress, all of which will help to ease symptoms. Dr Allfree will discuss the benefits you can expect from your exercise programme and can give you an exercise plan to follow at home. It is important to follow this plan because there is a risk that doing too much exercise too quickly, or doing the wrong sort of exercise, may cause more damage to your knees.

Losing weight

Being overweight often makes osteoarthritis in the knees worse as it can place them under increased strain. If you are overweight, it is really important to try to lose weight by doing more physical activity and eating a healthier diet.