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Managing Chronic Pain in Knee Osteoarthritis

27th January 2022

Chronic pain is more common than we think. A 2016 study showed that more than one-third of the UK’s population suffered from some form of chronic pain [1]. Other studies revealed that more than 20% of chronic pain cases in the UK were caused by osteoarthritis [2].

As the knee OA progresses, it can cause tremendous pain that affects the quality of life. Even the tiniest movement or change in temperature could trigger excruciating pain. While mild knee OA is associated with pain that only worsens with movement, you can feel pain even when resting in severe knee OA cases. This not only affects your functionality during the day but also reduces your sleep quality. Studies point to the fact that pain arising from advanced knee OA could lead to sleep disorders and depression [3].

The pain is considered chronic if it has impacted your life for over 3-6 weeks.

So, how can you manage chronic pain? While chronic pain is one of the warning signs that a surgery may be required, there are measures you can take to manage the pain until then.

Weight Management

Knee pain in osteoarthritis is due to increases in bone spurs caused by the rubbing of leg bones when the cartilage wears away. Excessive weight is one of the main factors, as it increases pressure on your bones. So, one of the first steps in managing chronic pain is weight management.

A healthy diet is non-negotiable for losing excess weight. By speaking to a dietician, you can optimize your diet in a way that serves your knees. The key is to remove processed food, red meat, and added sugar while adding antioxidant-rich fruits - vegetables, low-fat dairy, and healthy sources of fat like fish. You can refer to our blog articles and downloadable guides for detailed information on food.

Exercise

You may be demotivated to exercise if you’re experiencing pain, but perseverance will result in positive outcomes. With the correct type of exercise, you can strengthen your muscles connected to the knee while improving blood circulation and lubrication around the joint.

When dealing with chronic pain, you should always warm up your legs with low-impact activities, such as cardio, walking, or cycling. Then, you can try knee-strengthening exercises targeting the quadriceps, hamstrings, and glutes. You should finish your practice with leg stretches to reduce muscle pain and improve flexibility.

Before starting a particular exercise, you should consult with your physician about the right way to conduct the exercise and how often. Exercising incorrectly could cause further damage to your knee and worsen your pain.

Supportive Devices

If chronic knee pain prevents you from carrying out everyday tasks like shopping, supportive devices could assist you.

One way of dealing with chronic pain is by reducing knee load via canes or crutches. When you lean on a cane or crutch with your arm, you transfer much of your weight onto your arms and reduce the knee load significantly. They also reduce the risk of falling.

Supportive device

Knee splints or braces support the knee by either stabilizing the joint or shifting the weight away from the damaged area. That way, they prevent your knee from turning in an awkward position that would trigger more pain.

You can check our blog posts for detailed guides on selecting the proper supportive devices for your knee. Or visit www.ossur.com/en-gb/bracing-and-supports/unloader

Medication

While over-the-counter medication can help relieve mild-to-moderate pain, prescription drugs might be necessary for chronic pain. Your doctor might either increase the dose of your NSAIDs (i.e., ibuprofen), or prescribe more powerful painkillers - opioids (e.g., tramadol). Another possible solution to chronic pain is knee injection with corticosteroids to reduce inflammation and reduce pain.

Drugs used for chronic knee pain are very powerful and can have adverse effects. That’s why you should always use them with precaution and under your doctor’s supervision.

Surgery

At very advanced stages of knee osteoarthritis, knee pain is almost unstoppable and unresponsive to all treatments. In that case, it might be time to consider knee surgery.

The best type of surgery is different for everyone and depends on the person’s age, lifestyle, and pre-existing conditions. If you are young and physically active, the surgery focuses on shifting your body weight away from the damaged part of the joint. In severe knee OA cases, partial or total knee replacement might be necessary, meaning the damaged parts of the joint with a prosthetic joint.

Your practitioner can guide you through the decision-making process for knee surgery. In the meantime, you can check out our blog post about the types of knee surgeries to find out about the specific procedures, the recovery period, and the pros-cons.


[1] Fayaz, A et al. “Prevalence of chronic pain in the UK: asystematic review and meta-analysis of population studies.” BMJ open vol. 6,6 e010364. 20 Jun. 2016, doi:10.1136/bmjopen-2015-010364

[2] Neogi, T. “The epidemiology and impact of pain in osteoarthritis.” Osteoarthritis and cartilage vol. 21,9 (2013): 1145-53. doi:10.1016/j.joca.2013.03.018

[3] Parmelee, Patricia A., Caitlan A. Tighe, and Natalie D. Dautovich. "Sleep disturbance in osteoarthritis: linkages with pain, disability, and depressive symptoms." Arthritis care & research 67.3 (2015): 358-365.

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