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Where Can I Turn to For Support For OA Knee Pain

4th April 2019

Below we examine some of the measures you can take if you are experiencing knee pain due to osteoarthritis.

What is osteoarthritis?

Arthritis describes degenerative joint pain, swelling and stiffness. It is not a single illness and encompasses a variety of disorders. Osteoarthritis (OA) is the most common type of arthritis. It occurs when the cartilage that cushions the joints wears away, so the bones ultimately grate on each other, leading to inflammation and a change in the shape of the joint.

Osteoarthritis causes loss of movement and flexibility which worsens over time. It usually affects the joints in your legs and arms and the lower back. Women and those aged over 45 are more likely to suffer osteoarthritis.

Knee osteoarthritis

In knee osteoarthritis, the cartilage becomes thin and rough. The bone underneath may react by becoming broader, while bony spurs called osteophytes can form. Extra fluid may be produced in the knee, making the joint swell.

These changes are a result of both the natural inflammatory process and your body attempting to repair the damage.

Causes of knee osteoarthritis

The following factors may increase your likelihood of developing the condition:

knee injury

age

existing conditions such as gout or rheumatoid arthritis

family history of osteoarthritis

careers involving repetitive bending or heavy lifting

obesity - this strains your joints.

Symptoms of knee osteoarthritis

Symptoms in the knee include:

pain

crepitus (a grinding sensation when the joint moves)

stiffness

hard swellings (a result of osteophytes)

soft swellings (due to extra fluid).

your knee failing to move freely

your knee giving way

your knee looking bent

muscles around your knee appearing wasted.

Osteoarthritis knee pain

Osteoarthritis causes increasing joint pain and stiffness in the knee. Tenderness and swelling are also likely to be present. This may be particularly the case immediately after you wake up, after overusing your knee, or when resting.

The pain can vary - you will probably have good and bad days. Some people find that changes in the weather make their symptoms worse. In the later stages of the disease, the pain can be severe enough to impact your ability to carry out daily activities and may wake you at night.

Left untreated, osteoarthritis knee pain can adversely affect your family, social and work activity. Problems associated with long-term pain include:

sleep problems

finding it hard to concentrate or remember

diminished physical activity

weight gain

fatigue

side-effects of medications.

Knee pain can significantly affect your quality of life. If you’re finding osteoarthritis pain hard to deal with, consult your GP or a physiotherapist for advice and ask about support groups. If you have difficulty coping emotionally, confide in a health professional or counsellor. It is important to not become depressed.

While there is no cure for the condition, it is beneficial to start treatment as soon as possible, so a timely diagnosis is important.

Diagnosing knee osteoarthritis

You need to tell your doctor:

details of when the pain began

information about other medical conditions

details of the symptoms

location of the stiffness and pain

how daily activities are affected

details of current medicines.

The doctor will examine your knee joint and its range of motion, looking for areas that are tender or swollen. They will also note excess fluid, restricted movement and thinning muscles.

X-rays

X-rays can reveal changes such as osteophytes, whether the space is narrowing between your bones and deposits of calcium.

MRI

You may get a magnetic resonance imaging (MRI) scan of your knee. This can show soft tissues such as cartilage, tendons and muscles and can reveal changes to the bone which can’t be seen on X-ray.

Joint aspiration

With joint aspiration, the doctor inserts a needle into the joint to extract fluid. The fluid is examined for proof of joint deterioration.

Non-surgical treatments

With the right therapies, you should be able to successfully manage your pain. A variety of non-surgical treatments are available which can bring about an improvement. You may have to experiment with different treatments before you get the right combination of therapies for you. Mild symptoms may be managed with simple measures, but if you have severe symptoms, you may need to be supervised by a physiotherapist and take pain-killing medication or look at knee bracing to offer support when active.

Lose weight

A knee problem can make you adopt a sedentary lifestyle, resulting in weight gain. If you lose weight, you will reduce the strain on your knee, feel better and have more energy. To determine if you are a healthy weight, check out a BMI calculator online.

Exercise

Exercise is an excellent way to manage osteoarthritis of the knee. Just simple walking or attending an easy exercise class will help you reduce pain and maintain a healthy weight. Building muscles around your knee will ease the burden on the joint and greater joint flexibility helps to reduce stiffness. By taking exercise, you will relieve stress, ensure wellbeing and combat the symptoms of depression.

Simple exercises you can do at home include standing up from a chair where you have been sitting and repeating the action (don’t use your arms). Alternatively, do step-ups on the stairs. Steer clear of exercise that strains your joints, such as running, weight training, tennis and squash. Instead, undertake exercises where your joints are more supported.

Recommended exercise includes:

hiking

cycling

swimming

water gymnastics

cross-country skiing

yoga

gentle stretching

tai-chi

Occupational therapy

Physical and occupational therapists are experts on pain relief. They will help you with:

advice on using joints properly

cold and hot therapies

flexibility and motion exercises

assistive devices such as walkers, scooters, knee braces and splints.

A physiotherapist will devise an exercise programme for you, Always consult a doctor before beginning a new exercise regime.

Nutrition

To reduce inflammation and pain and encourage weight loss, eat more vegetables and fresh fruit. Steer clear of carbs such as sugar and consume fatty acids including Omega-3. Lower your alcohol intake, and avoid crisps and deep-fried foods. You can also reduce your intake of meat and purchase fat-reduced dairy products.

Wear a brace

Patients with unicompartmental knee osteoarthritis - where only one part of the joint is affected - may benefit from knee braces which take the pressure off the worst affected areas.

Footwear

Good footwear will support your body, while reducing inflammation and discomfort. Wedges and insoles may suit patients with unicompartmental knee osteoarthritis.

Alternative therapies

Natural therapies such as massage, acupuncture, relaxation techniques and hydrotherapy improve wellbeing and can supply pain relief.

Medication

Medicines for osteoarthritis come in the form of syrups, pills, lotions or creams. Some are injected into your knee. Drugs can help with pain and stiffness but they won’t fix the joint damage. Use painkillers sparingly for when you’re feeling pain, or when you’re about to exercise. Paracetamol is available over the counter. Most people try this first.

Analgesics

These medicines include tramadol and acetaminophen. Co-codamol is a compound analgesic; morphine and codeine are stronger opioid analgesics.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These drugs are most often used to control inflammation and pain. NSAIDs include ibuprofen, aspirin, celecoxib and naproxen.

Corticosteroids

You may be injected with these powerful anti-inflammatory medicines, or take them by mouth.

Hyaluronic acid

Hyaluronic acid occurs naturally in joint fluid as a lubricant. The acid is injected by a doctor.

Stronger painkillers carry a bigger risk of side-effects.

Surgical treatments

An orthopaedic surgeon can replace or repair damaged knee joints. Surgery is usually only considered if other measures have failed.

Arthroscopy

Arthroscopy is keyhole surgery which sees an arthroscope - a fine metal tube with a camera - inserted inside your knee. Pictures are transmitted to the surgeon who will carry out a procedure preserving joint function.

Osteotomy

If your leg is bowed, osteotomy may help. The femur (thigh bone) or tibia (shin bone) will be cut and reshaped, taking pressure off the knee joint. This can delay the need for a total knee replacement.

Partial knee replacement

This can take place if you have unicompartmental osteoarthritis. It involves replacing the damaged bone with metal or plastic parts.

Arthroplasty

In this operation, an entire artificial knee joint is put in place of a damaged one. Replacement knees can last for over 20 years.

Knee revision

This is follow-up surgery for those who have had a total or partial knee replacement, but need their prosthetics replaced.

In conclusion, in choosing a combination of suitable therapies, it should be possible to control and treat osteoarthritis knee pain successfully.

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