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.
How Does Physiotherapy For Knee Arthritis Work
After examining your knee, the physiotherapist will work with you to make a treatment plan that fits your exact problem and your needs. The goals can include reducing your pain and swelling, and increasing your flexibility, strength, balance, and endurance.
Your therapist may use:
- Manual therapy. Manual therapy includes massage and manipulation.
- Ultrasound. This uses sound waves to treat muscle spasms and pain.
- Electrical stimulation. This uses a mild electrical current to treat pain.
He or she may also use heat and cold and may teach you how to use these techniques.
Physiotherapy almost always includes exercise. It can include stretching, doing core exercises, building strength, and walking. You may learn exercises that help in surprising waysâstrong core and hip muscles can help control knee pain and make you more able to be active. Your therapist will also teach you exercises that you can do at home.
Your therapist may consider whether some type of knee brace may help you.
Dont: Be Afraid To Use Assistive Devices If You Have Knee Osteoarthritis
Canes and knee braces can play a role in decreasing knee osteoarthritis pain and improving function, Pisetsky says. There can be a period of time when knee pain is disabling but its not the right time for surgery, so thats when assistive devices can make a difference, he explains. An occupational therapist can work with you to choose appropriate assistive devices.
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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.
Cortisone Shots In The Knee Do They Really Work
Are you considering getting cortisone shots in your knee? Although cortisone injections have been used for the past fifty years, some physicians are concerned that they may have adverse long-term side effects. Despite this, many patients experience significant pain relief from corticosteroid shots depending on your circumstances this treatment may be right for you.
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Are There Any Complications
Osteoarthritis can develop over just a year or two, but more often its a slow process over many years that only causes fairly small changes in just part of the knee.
But in some cases, the cartilage can become so thin that it no longer covers the ends of the bones. This causes them to rub against each other and eventually wear away.
The loss of cartilage, the wearing of the bones, and the bony spurs can change the shape of the joint. This forces the bones out of their normal positions, making your knee feel unstable and painful.
Some people with osteoarthritis find a lump appears at the back of their knee. This is called a Bakers cyst or popliteal cyst.
A Bakers cyst is fluid-filled swelling at the back of the knee that happens when part of the joint lining bulges through a small tear in the joint capsule. This can then cause joint fluid to be trapped in the bulge.
It can happen on its own, but is more likely in a knee thats already affected by arthritis. A Bakers cyst doesnt always cause pain, but sometimes they can burst so the fluid leaks down into your calf, causing sharp pain, swelling and redness in the calf.
Osteoarthritis in the knee might change the way you walk or carry your weight, and this could cause you to develop the condition in other joints, such as your hips.
How Is Arthritis Of The Knee Treated
Healthcare providers can’t cure knee arthritis. But they have some tips that might reduce the severity of your symptoms and possibly stop the arthritis from getting worse, including:
- Maintain a healthy weight.
- Exercise using low-impact activities instead of high-impact activities . Aim for about 150 minutes of exercise per week.
- Wear shock-absorbing inserts in your shoes.
- Apply heat or ice to the area.
- Wear a knee sleeve or brace.
- Physical therapy exercises that help with flexibility, strength and motion.
- Use a cane.
Most people have stage 4 arthritis when they get surgery.
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How Will It Affect Me
If you have osteoarthritis of the knee, you will probably feel your knee is painful and stiff at times. It may only affect one knee, especially if youve injured it in the past, or you could have it in both. The pain may feel worse at the end of the day, or when you move your knee, and it may improve when you rest. You might have some stiffness in the morning, but this wont usually last more than half an hour.
The pain can be felt all around your knee, or just in a certain place such as the front and sides. It might feel worse after moving your knee in a particular way, such as going up or down stairs.
Sometimes, people have pain that wakes them up in the night. Youll probably find that the pain varies and that you have good and bad days.
You might find you cant move your knee as easily or as far as normal, or it might creak or crunch as you move it.
Sometimes your knee might look swollen. This can be caused by two things:
- Hard swelling: when the bone at the edge of the joint grows outwards, forming bony spurs, called osteophytes .
- Soft swelling: when your joint becomes inflamed and produces extra fluid, sometimes called an effusion or water on the knee.
Sometimes osteoarthritis of the knee can cause the muscles in the thighs to weaken, so your leg may look thinner. This weakness can make the joint feel unstable and could cause the knee to give way when you put weight on it.
Are There Different Types Of Knee Osteoarthritis
The knee has three contact zones, also known as compartments where osteoarthritis usually occurs. A common way to classify knee osteoarthritis is by which of the three compartments of are affected:
- Medial Tibiofemoral Compartment the inside part of the knee where the tibia meets the femur .
- Lateral Tibiofemoral Compartment The outside part of the knee where the tibia meets the femur .
- Patellofemoral compartment The front of the knee between the patella and femur .
Estimates of how common osteoarthritis is in each compartment of the knee vary quite widely. A study published by Oxford University found that of a group of subjects with radiographic knee osteoarthritis :
- 59% had osteoarthritis in both the patellofemoral compartment and at least one tibiofemoral compartment.
- 35% had osteoarthritis only in the patellofemoral compartment
- Only 6% had osteoarthritis in one or both of the tibiofemoral compartments.
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Have You Tried The Thessaly Test
A meniscus tear can be tested for by using a diagnostic exam called the Thessaly test. You can do this yourself while resting your hands on a counter or another person for support.
If you experience a catching or locking feeling during the test, you may have a torn meniscus.
Exercise And Other Knee Arthritis Remedies
For both OA and inflammatory knee arthritis patients, exercise is a key component of treatment, particularly if youre overweight or obese
Physical therapy may be a necessary first step for some to strengthen the muscles surrounding your knee joint and improve range of motion. Low-impact exercises walking, cycling, or swimming are usually best for those with arthritis of the knee, but you may be able to do higher-impact exercises if dont have much joint damage.
To help make activity more comfortable, your doctor may recommend using assistive devices such as a cane or a knee brace or sleeve. Wearing well-cushioned, shock-absorbing shoes or inserts is also key unsupportive styles such as flip-flops and flimsy flats only exacerbate knee joint pain. High heels, which throw off your alignment and place added stress on your knees, should also be avoided.
Its also a good idea to talk to your doctor about how to get more rest, since many people with arthritis experience sleep disturbances that studies suggest can lead to pain, depression, and greater disability. Simply practicing good sleep hygiene sticking to a regular bedtime, keeping your bedroom quiet and dark, exercising during the day, etc. can help in many cases.
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What Other Symptoms Are Linked With Knee Joint Pain
Symptoms of osteoarthritis of the knee are generally limited to the joint itself, whereas inflammatory arthritis causes a wider array of issues. Unlike OA, inflammatory arthritis is a systemic disease, which means it affects the whole body, says CreakyJoints Medical Advisor Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida.
In fact, it would be less common for someone with a form of inflammatory arthritis to experience pain in just one knee. Thats because symptoms are usually symmetrical whats more, inflammatory arthritis symptoms usually dont start in the knee.
For example, rheumatoid arthritis generally strikes the small joints in the fingers and toes first, while someone with ankylosing spondylitis is more likely to complain of low back and buttock pain, with knee arthritis pain developing later.
Depending on the type of inflammatory arthritis you have, you may experience other symptoms beyond knee joint pain. People with psoriatic arthritis exhibit the telltale scaly rash and plaques of psoriasis eye inflammation can be a problem for those with psoriatic arthritis as well as ankylosing spondylitis, and people with rheumatoid arthritis may experience weight loss and fevers.
How Can Physiotherapy Help Knee Arthritis
The goal of physiotherapy is to make daily tasks and activities easier. For example, it may help with walking, going up stairs, or getting in and out of bed.
Physiotherapists provide treatments you may need when knee pain makes it hard to move around and do everyday tasks. These treatments may help you move better and relieve pain.
You might only be able to have a couple of visits with a physiotherapist. But you can learn a lot, including:
- How your knee works and what arthritis does to the joint.
- Ways to put less stress on your knee, such as carrying lighter loads, losing extra weight, or using a cane.
- How to use heat or cold at home to help your pain.
- Ideas for activities and exercises that will make your knee stronger.
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Dealing With Knee Arthritis At Home
Complementary And Alternative Therapies
Some people with osteoarthritis try complementary or alternative therapies such as acupuncture and aromatherapy and find them helpful.
However, there’s a lack of medical evidence to suggest they’re effective and they generally are not recommended by the National Institute for Health and Care Excellence .
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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.
What Age Does Knee Arthritis Strike
Its possible to develop either category of knee arthritis at virtually any age. However, osteoarthritis of the knee most commonly occurs in people over age 40. Thats because its most often caused by the wear and tear that occurs in your knee joint as you age. As a result, the cartilage that cushions your knee begins to break down.
When we do see knee osteoarthritis in younger people its usually because they experienced trauma to the knee that triggered cartilage loss, says Dr. Domingues.
Certain types of inflammatory arthritis, in contrast, are more likely to develop earlier in life. Ankylosing spondylitis frequently develops between ages 20 and 40, while the age of onset of psoriatic arthritis is usually between 30 and 50.
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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.
Explore Supplements And Natural Remedies
Supplements for knee osteoarthritis may increase production of synovial fluid in the knee joint. This helps smooth out rough movement that could be causing knee pain. Talk to your doctor before adding these into your regimen.
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Is Surgery Used To Treat Knee Osteoarthritis
If your doctor wants to treat the osteoarthritis in the knee with surgery, the options are arthroscopy, osteotomy, and arthroplasty.
- Arthroscopy uses a small telescope and other small instruments. The surgery is performed through small incisions. The surgeon uses the arthroscope to see into the joint space. Once there, the surgeon can remove damaged cartilage or loose particles, clean the bone surface, and repair other types of tissue if those damages are discovered. The procedure is often used on younger patients in order to delay more serious surgery.
- An osteotomy is a procedure that aims to make the knee alignment better by changing the shape of the bones. This type of surgery may be recommended if you have damage primarily in one area of the knee. It might also be recommended if you have broken your knee and it has not healed well. An osteotomy is not permanent, and further surgery may be necessary later on.
- Joint replacement surgery, or arthroplasty, is a surgical procedure in which joints are replaced with artificial parts made from metals or plastic. The replacement could involve one side of the knee or the entire knee. Joint replacement surgery is usually reserved for people over age 50 with severe osteoarthritis. The surgery may need to be repeated later if the prosthetic joint wears out after several years. But with today’s modern advancements, most new joints will last over 20 years. The surgery has risks, but the results are generally very good.