How Is Osteoarthritis Diagnosed
There is no specific test for osteoarthritis. Your doctor will confirm or rule out osteoarthritis based on your symptoms and a physical examination. Some signs they may look for are:
- swelling around the joints in your body
- damage to joint cartilage cartilage is the smooth, cushion-like surface that covers the ends of your bones to allow them to move smoothly
- spurs extra bone growing around the edge of a joint
- weakness in the ligaments and tendons the connective tissue that holds your joints together or attaches muscles to bones
Your doctor may refer you for an x-ray to look for narrowing and changes in the shape of your joints. A blood test may help to rule out other types of arthritis .
Introduction To Knee Arthritis
Have your knee arthritis symptoms become so severe that your current medication and management regimen is no longer working for you? Do you want more information to help you better manage your knee health and mobility? We have found that for many people in this situation, good information is hard to come by. It is either too basic for someone who has been living with arthritis for a number of years, or focused on medical professionals and too complicated and full of jargon. This guide will provide simple, reliable information to help you better understand what happens in your knee as your joint degenerates during the later stages of arthritis as it progresses towards tricompartmental osteoarthritis. For advice on how to deal with these symptoms it is best to seek professional medical opinion. If you plan on seeing a doctor to assess your knee health and changing needs, but want to become more informed this would be a good place to start! This guide is based on common questions about severe knee arthritis. We answer them where possible, and guide you to the best people to answer specific questions you have about your condition.
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.
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Visit A Physical Therapist
Physical therapists work with your doctor to design specific exercises for knee rehabilitation. Many of these will focus on lengthening and strengthening the supporting muscles of the upper and lower legs, such as quadriceps, hamstrings, and calves.
Even one visit to learn the proper form for knee arthritis exercises can help support your recovery.
What Hurts In An Arthritic Knee
Believe it or not, the bone on bone arthritis of the knee may not be a pain generator. There are no nerve endings in the bone itself. So if two bones are rubbing together and all else is well, they wont hurt. The cartilage in the knee also does not have nerve endings in it. So thinning cartilage will not hurt in and of itself.
There are three main contributors to the pain experienced by people with osteoarthritis of the knee. The first is the periosteum. The periosteum is a thin tissue that wraps around the bone. It supplies blood to the bone, and it does have nerve endings. Anyone who has broken a bone knows this very well. It is the tearing of the periosteum that leads to a lot of the pain.
The second issue that can cause knee pain and swelling is the synovium. The synovium is the lining of the knee joint. Its like a balloon that surrounds the bones of the knee. There are many nerve endings there. Synovitis is inflammation of that lining tissue or synovium.
Synovitis can be a very painful process. As an aside, for people with pain due to synovitis that does not respond to time, ice, heat, medications, ,etc a relatively new procedure called a genicular artery embolization has shown significant promise at eliminating that cause of knee pain. You can read about a knee embolization procedure here.
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Common Medications To Treat Arthritis Flares
OA patients might just need some OTC pain-relieving medication such as acetaminophen, ibuprofen, or naproxen. Dr. Bose also recommends topical gels and lotions like diclofenac gel or 2 Old Goats. If that doesnt work, Dr. Ashany says joint injections of steroids may be given. RA flares are more complicated. In inflammatory arthritis, steroids are often used to try to quickly bring a flare under control, Dr. Ashany says. If only one joint is involved a steroid can be given by injection, but otherwise it can be taken orally .
In inflammatory arthritis, if flares continue to occur, this indicates that the patients regimen of maintenance medication is not adequate, Dr. Ashany says. This may lead to addition of a medication, switching one drug for another or increasing the dose of medication that the patient is currently taking.
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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Treating And Managing Flare
Talk to your doctor about how to handle flare-ups, and let them know if they happen a lot. They may need to change your treatment plan.
Some flare-ups get better after you rest and take over-the-counter pain meds for a couple of days. Call your doctor if they last longer than that, or if your symptoms are intense.
Medication changes. You might need to adjust your medication temporarily, or add a new one. Medicines that can help with flares include nonsteroidal anti-inflammatory drugs , either prescription or over-the-counter. You may take them as a pill or put them on your skin. Acetaminophen helps some people. Your doctor may also inject steroids into your joints.
Rest. One of the best ways to deal with a flare is to take it easy. Take a sick day if you need to. Ask family members to help out with chores. But try not to stop moving completely. Do a few gentle stretches to keep yourself from getting stiff.
Hot and cold therapies. Moist heat around your joints boosts blood flow and relaxes muscles. A warm paraffin wax dip may make your hands or feet feel better. A special machine heats the wax, which is the same type used in candles.
If too much exercise causes flare-ups for you, use an ice pack right after your workout to ease pain. A cold compress may help at other times, too. Cold constricts your blood vessels, which decreases blood flow. That leads to less pain.
Limit the use of either of these methods to two to four times a day, for no more than 15 minutes at a time.
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.
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How Does The Condition Change Over Time
The Kellgren-Lawrence Classification of Osteoarthritis is a common system for describing the stages of knee osteoarthritis. Kellgren-Lawrence classification measures the progression of knee osteoarthritis in terms of joint space narrowing . The stages range from 0 to stage 4 . When discussing late stage or advanced knee osteoarthritis, it is usually in reference to those at stage 3 or 4 of the Kellgren-Lawrence classification system.In late stage knee osteoarthritis, there is little to no separation between the bones remaining. This can lead to very different symptoms from those experienced by people at earlier stages of the condition. When these bones freely grate together they often cause more severe pain and stiffness. This also leads to reduced mobility in many cases.
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.
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How Is Severe Osteoarthritis Diagnosed
Medical professionals can diagnose osteoarthritis in a number of ways but X-Rays and MRI machines are two of the more common methods. X-rays and MRIs are both used to help see the distance between the bones in the affected joint, and in the case of MRIs, the state of the cartilage. X-Rays are fantastic at producing images of bone by using light that is invisible to our eyes but can pass through skin and other soft tissue but cannot pass through bone. This effect is also why the cartilage cannot be seen in an X-ray so medical professionals will instead measure the space between the bones in the affected area. MRI Machines use powerful magnets that face different levels of resistance from the different materials in the body to deliver detailed slices of the observed area. These slices are high-resolution images that can show cartilage, bone and other types of tissue in much greater detail than an X-ray. MRIs are however much more costly so their use is much less common depending on the severity of the condition as well as access.
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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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.
Complementary And Alternative Medicine
There is a wide variety of traditional, nutritional, herbal, naturopathic, and homeopathic medicines used to treat osteoarthritis. Many of these have little evidence to support their use.
Even popular supplements like chondroitin and glucosamine were not shown to improve outcomes, according to a large study conducted by the National Institutes of Health.
With that being said, there a number of complementary treatments that the National Center for Complementary and Integrative Health believes may offer benefits. Among them:
- Acupuncture has been shown to provide modest arthritis pain relief, particularly of the knee.
- Boswellia serrata, an herb used in Ayurvedic medicine, is believed to have anti-inflammatory effects beneficial to osteoarthritis.
- S-adenosyl-L-methionine is a chemical naturally produced in the body that is sold as a dietary supplement. There is some evidence that SAMe may be as effective as over-the-counter NSAIDs in treating arthritis pain.
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What Are The Types Of Arthritis Of The Knee
There are around 100 types of arthritis. The most common types that might affect your knees include:
- Osteoarthritis is the most common of the types on this list. Osteoarthritis wears away your cartilage the cushioning between the three bones of your knee joint. Without that protection, your bones rub against each other. This can cause pain, stiffness and limited movement. It can also lead to the development of bone spurs. Osteoarthritis gets worse as time passes.
- Post-traumatic arthritis is a type of osteoarthritis. The cartilage starts thinning after trauma to your knee . Your bones rub together, and that causes the same symptoms as osteoarthritis: pain, stiffness and limited movement. Your knee arthritis symptoms might not start until years after the trauma.
- Rheumatoid arthritis is an autoimmune disease. A healthy immune system causes inflammation when it’s trying to protect you from an infection, injury, toxin or another foreign invader. The inflammatory response is one way your body protects itself. If you have rheumatoid arthritis, you have an unhealthy immune system that triggers inflammation in your joints even though theres no foreign invader. The inflammation causes pain, stiffness and swelling of the synovial membrane, which can also wear away your cartilage.
How Can I Ease Arthritis Pain
If you are looking for ways to reduce arthritis pain or maintain your knee surgery results, there are a number of things you can do to help alleviate pain. While there is no true cure for arthritis, there are many things you can do to help reduce arthritis pain. Some of those things include:
- Maintain a healthy weight
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Does Knee Replacement Get Rid Of Arthritis
Knee replacement is an excellent way to reduce pain in the knees and can solve a number of issues, and is often ideal for people who have tried alternative pain-relief methods to no avail. However, it is not a permanent solution for arthritis. Knee surgery may temporarily relieve pain from arthritis, but it does not cure the condition. Managing your arthritis will still be necessary to reduce pain in the knees, even after joint surgery.
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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