Best Treatment For Arthritic Knees

How Common Is Osteoarthritis

Women are more likely to develop osteoarthritis than men. Australian studies show that about 1 in 10 women report having the condition, compared with about 1 in 16 men.

Osteoarthritis can develop at any age, but it is more common in people aged over 40 years or in those who have previously injured a joint. One in 5 Australians over the age of 45, and one in 3 over 75 years have osteoarthritis.

Treatment For Knee Osteoarthritis

Theres no cure for osteoarthritis but there are things you can do to manage the condition and control your symptoms. The main aim of treatment is to reduce your pain and stiffness, which will improve the way your knees function and restore your quality of life.

Your GP may refer you to various health professionals, which will include a physiotherapist. If you have severe pain and stiffness, your GP may refer you to an orthopaedic surgeon .

Symptoms Of Knee Osteoarthritis

Osteoarthritis of the knee usually affects both knees, although you may only notice symptoms in one.

• You may have knee pain thats in and around your knee, which becomes worse when youre active. You wont usually feel pain in your knee when youre in bed at night, unless you have severe osteoarthritis.
• Your knee may be stiff for a while after youve been resting or when you first get up in the morning. If you have it in the morning, it will be for less than 30 minutes after you get up.
• You may find that your knee sometimes gives way, or locks and you cant straighten it.
• Because of the pain, stiffness and swelling, you might not be able to move your knee as much or as easily as you would usually.
• Your knee may creak or grind when you move it this is called crepitus.

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What Is Arthritis Of The Knee

Arthritis is a disease that causes pain, swelling and stiffness in your joints. It can affect the largest and strongest joints in your body. Its common in knees. Arthritis of the knee can be a serious, debilitating disease.

Although there is no cure for knee arthritis, there are steps you can take that might ease your symptoms and potentially slow the progression of your disease.

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.

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I Have Knee Arthritis: Is Surgery My Only Option

According to the Centers for Disease Control and Prevention , arthritis affects 23% of all adults, making the condition one of the most common ailments affecting older Americans. If youre living with arthritis, you know how debilitating it can be.

To learn more about knee arthritis, we spoke with , MD, an orthopedic surgeon with Banner Health Clinic in Glendale, AZ, who sees many patients affected by the condition.

Arthritis of the knee falls into one of two general categories: inflammatory or degenerative, explained Dr. Rosen. Inflammatory arthritis is systemic, meaning it can affect your whole body and target organs within your body, one of which is your knee. Examples of inflammatory arthritis include rheumatoid arthritis, lupus and arthritis associated with psoriasis.

Degenerative arthritis is localized to primarily a specific joint and is a wear and tear phenomenon that we all experience as we age, said Dr. Rosen. If you have degenerative arthritis of the knee, things that can worsen your arthritis include smoking, obesity and trauma to the knee, like a damaged cartilage or ligament. Osteoarthritis is the most common type of degenerative arthritis.

How Can A Physical Therapist Help

Once you have received a diagnosis of knee OA, your physical therapist will design an individualized treatment program specific to the exact nature of your condition and your goals. Your treatment program may include:

Range-of-motion exercises. Abnormal motion of the knee joint can lead to a worsening of OA symptoms when there is additional stress on the joint. Your physical therapist will assess your kneeâs range of motion compared with expected normal motion and the motion of the knee on your uninvolved leg. Your range-of-motion exercises will focus on improving your ability to bend and straighten your knee, as well as improve your flexibility to allow for increased motion.

Muscle strengthening. Strengthening the muscles around your knee will be an essential part of your rehabilitation program. Individuals with knee OA who adhere to strengthening programs have been shown to have less pain and an improved overall quality of life. There are several factors that influence the health of a joint: the quality of the cartilage that lines the bones, the tissue within and around the joints, and the associated muscles. Due to the wear and tear on cartilage associated with knee OA, maintaining strength in the muscles near the joint is crucial to preserve joint health. For example, as the muscles along the front and back of your thigh cross the knee joint, they help control the motion and forces that are applied to the bones.

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What Treatments Are Not Supported By Evidence

For some treatments, available evidence shows no effect, or even harm.

Across most guidelines, nutritional supplements, including glucosamine and chondroitin, which were thought to be promising, are either not recommended, or it is acknowledged that the evidence supporting their use is not sufficient to make recommendations . However, a recent RCT evaluating 800 mg/day pharmaceutical-grade chondroitin sulphate compared with celecoxib and placebo in more than 600 patients found chondroitin to be similar to celecoxib and superior to placebo in reducing pain and improving function, with low risk for adverse events.61 Nutraceutical- grade chondroitin, however, has been shown to be ineffective in numerous studies, likely owing to variations in preparation, composition and purity. Primary care physicians may consider the use of oral pharmaceutical-grade chondroitin sulphate in the treatment of knee osteoarthritis.

Acupuncture, transcutaneous electrical nerve conduction, knee tape,62 lateral wedge insoles63 and naturopathic or homeopathy alternatives are commonly used nonpharmacologic approaches that are not supported by evidence.

Acetaminophen is widely available and often used, given its presumed safety profile and low cost. Clinical guideline recommendations regarding its use are variable, and results from a network meta-analysis comparing various nonoperative treatments found acetaminophen to be one of the least efficacious treatment options .64

Learn How To Manage It

Patient education is high on the list of most medical societies.

The main point here is that the medical professionals handling your case should teach you how to self-manage the knee osteoarthritis symptoms you will experience now and in the future.

Because this condition is irreversible, you may have to do some lifestyle changes to delay its progression.

This is also why its key to learn how to self-manage osteoarthritis. To that end, your physio and/or occupational therapist will teach you how to :

• Perform everyday tasks without straining your knee
• What to do if and when the knee pain gets worse
• Give you any other recommendation you may need

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Hyaluronic Acid Or Hyaluronate Injections

Also called viscosupplements, this treatment tries to restore synovial fluid, which is a slippery substance that helps lubricate joints.

A major component of synovial fluid is called hyaluronate. For more than 20 years, doctors have tried to restore mobility and curb pain by injecting hyaluronate directly into the knee joint.

The Most Important Piece Of The Puzzle

If youre overweight or obese, the most effective treatment is weight loss. This isnt surprising. Every extra pound of weight adds two to four pounds of excess pressure on your knees.

Losing weight is probably the most difficult part of the treatment puzzle, but its also the most important, says Dr. Day.

A weight loss program should include both diet and exercise. Some people have difficulty exercising to lose weight because their knees hurt. But any type of exercise can help, even strengthening the upper body.

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Dont: Ignore New Or Worsening Knee Osteoarthritis Symptoms

Knee osteoarthritis is a chronic condition, which means that pain is always possible, Pisetsky says. However, if pain grows more severe and occurs at rest instead of after periods of activity, or if it awakens you from sleep, it could mean that your knee osteoarthritis is progressing, he says. Other symptoms such as swelling, a locked knee, or one that just gives way are concerning, too. Let your doctor know about new or worsening symptoms, as an adjustment to your treatment plan may be necessary.

Ial Knee Replacement 110

Like total knee replacement surgery, partial or uni-compartment knee replacement surgery is a surgical procedure to resurface a knee damaged by arthritis to reduce pain and improve function. However, unlike a total knee replacement surgery, a partial knee replacement is only performed when damage exists in one compartment of the knee.During the procedure, your surgeon removes the cartilage from the damaged compartment of your knee and then replaces that cartilage and bone with metal coverings that recreate the surface of the joint. Just like in a total knee replacement, these metal parts are typically held to the bone with cement. To finish the procedure a plastic insert is placed between the two metal components to create a smooth gliding surface. The benefits of a partial knee replacement surgery are that its less invasive than a total knee replacement surgery and has a quicker recovery time. Also, because healthy parts of your knee are left in place, partial knee replacements are said to feel more natural than a total knee replacement. Downsides of a partial knee replacement are that another surgery may be needed in the future if damage to another compartment occurs. Also, because over half of people with knee osteoarthritis have damage and deterioration to more than just one compartment of the knee, fewer people are good candidates for this surgery.

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Protection Rest Ice Compression And Elevation

Rest, ice, compression, and elevation may help treat mild knee pain that results from a soft tissue injury, such as a sprain.

Protection refers to protecting the knee from further injury, for example, by taking a break from the activity that caused it.

Rest can reduce the risk of further injury and give tissues time to heal. However, stopping all movement is not advisable, as this can lead to stiffness and, in time, muscle weakness.

Ice can help reduce swelling and inflammation. It should be wrapped in a cloth and applied for 20 minutes several times on the first day of injury. Never put ice directly the skin, as this can lead to further damage.

Compression with a knee support, for example, can increase comfort levels. The support or bandage should be firm but not tight.

Elevation, or keeping the leg raised, will encourage circulation and reduce swelling. Ideally, the knee should be above the level of the heart.

How To Use Pain Medications Properly

There are two types of over-the-counter pain medications that can be used for osteoarthritis. Acetaminophen is a pain reliever but not an anti-inflammatory. It may help with mild knee pain.

NSAIDs can be more effective because they both relieve pain and reduce inflammation. However, they come with potential side effects and risks. NSAIDs can irritate the lining of the stomach, which may lead to an ulcer or other stomach problems. They also can impair kidney function. Some NSAIDs can increase blood pressure. And theyve been linked to an increased risk for heart disease.

Because of the risks, Dr. Day cautions against using NSAIDs regularly over long periods of time. Instead, she uses NSAIDs for her patients in two ways. First, people who have a flare-up of pain can take them regularly for three to five days and then stop. Second, they can be used over the long term, but only occasionally, maybe a couple of times a week as needed.

If youre taking NSAIDs several times a day for long periods of time, Dr. Day advises reducing their use by maximizing the other treatment strategies. She also suggests trying a topical NSAID, such as diclofenac , which has fewer potential side effects.

Opioid pain relievers are discouraged for long-term treatment of chronic knee pain. The milder narcotic tramadol might be appropriate for occasional use in some people, says Dr. Day.

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Why The Treatment Gap For Younger Patients

The relatively young and active individual with osteoarthritis presents a challenging clinical scenario for several reasons. Such patients often seek to remain involved in sporting activities. However, as degenerative changes involving the cartilage and meniscus progress, nonoperative treatment options are often exhausted relatively quickly. The time between exhaustion of nonoperative treatment options and definitive surgical management has been described in the literature as a treatment gap.4 Those who fall into the gap are frequently younger than 60 years with early- to midstage knee osteoarthritis , yet may include any individual who is symptomatic and for whom nonoperative management is no longer effective.6 Such patients make up about 20% of all those affected by knee osteoarthritis, which has been estimated as 3.6 million Americans and projected to increase to 5 million by 2025.4 A recent small survey of orthopedic surgeons found that 84% perceived a need for improved treatment options for patients younger than 60 years who have osteoarthritis, and 68.4% of surgeons perceived that there is a treatment gap for these patients.6

Living With Osteoarthritis Of The Knee

Osteoarthritis is a prevalent condition in which joint surfaces degrade and change in function, leading to pain and dysfunction. Conventional medicine involves both non-surgical and surgical management. No known drug or intervention stops the process of OA progression, although some suggest surgical techniques are more effective than non-surgical methods.

OA is the most common chronic condition and a leading cause of activity limitation and disability. The pain intensity has a direct effect on difficulty walking upstairs and sitting for prolonged periods. It is difficult to live with OA hence you should consult with your doctor as soon as possible. When people do not get proper treatment, the problem becomes severe.

If the non-surgical treatments do not work for you, then you should consult the doctor for new surgical treatments. Technological advancements have made these treatments very easy and the joints get healed quickly. If you are facing minor issues with your knee then you should get checked for arthritis. It is a common joint disease characterized by the degradation of articular cartilage.

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Use A Transcutaneous Electrical Nerve Stimulation Device

A TENS unit is a small, portable device that sends a low-voltage electric current. This current can inhibit some pain signals, which can provide short-term relief.

It has adhesive patches electrodes that are placed around the painful area. You can regulate the level of intensity of the current and customize it to your liking.

This makes for a great device to self-manage knee pain at home. But, make sure to talk to your doctor/physiotherapist before using it so they can teach you how to use it properly.

People with pacemakers shouldnt use TENS, though. It can interfere with the electrical function of the heart.

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Walking With An Assistive Device

Assistive devices can ease pain while walking. Medical associations recommend them for people with pain and/or stability problems.

They include canes, crutches, walkers, and similar devices.

Some people like using a cane and find relief with it. Others, prefer wearing a knee brace that keeps their knee stable. So, its often a matter of personal preference.

Whatever you choose, its essential that you feel comfortable with it.

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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.