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Everything You Need To Know About Knee Osteoarthritis




Osteoarthritis of the knee is one of the most common form of arthritis. While osteoarthritis can affect anyone at any age, it is most common in women aged 50 and above. In this blog post we will take a deeper look at knee osteoarthritis and what you can do to help.


Osteoarthritis is a normal part of ageing, just the same as grey hair and wrinkles. Everyone's joints go through a normal cycle of damage and repair and this leads to the reshaping and restructuring of the joint. The cartilage in the knee joint can gradually thin over time and so the protective space between the bones of the knee decreases and can become rougher. As a result the knee can become painful and stiff.


How to manage knee osteoarthritis?


There is no cure for osteoarthritis but there are some things you can do to help manage how it affects you, including helping your pain and/or stiffness.


1.Exercise


Exercise is crucial for joints to help maintain healthy joints. Verhagen et al (2019) reviewed over 42 studies which involved close to 7000 patients. They found that exercise that was supervised by a physiotherapist was effective in reducing pain for people with knee osteoarthritis. Exercise for knee osteoarthritis would include strengthening the muscles around the knees, hips and ankles as well as aerobic activity. It is important that you do not do too much too soon as this can lead to a flare up of your symptoms. A physiotherapist can help you get the balance right between exercising and rest. We will provide you with an individualised exercise programme depending on your level and needs and gradually increase this over time to ensure you get the most benefit.


Man Squatting with a kettlebell
Squats are an example of an exercise your physiotherapist may give you to strengthen your legs


2. Weight Management


Being overweight can increase the stress placed upon your joints, especially your knees. If you are overweight you are more likely to develop knee osteoarthritis and if you have knee osteoarthritis it is more likely to be made worse. Walking and going upstairs can increase the force going through your knees by 2 - 3 times your body weight, so even losing a small amount of weight can have a significant impact on your knees. Current guidelines recommend completing 2 and half hours of moderate physical activity or 75 minutes of vigorous activity, alongside completing 2 strength sessions each week. At Pure Performance Physiotherapy, we have a background in exercise and personal training. If you are interested in finding out more about how to increase your physical activity levels and lead a more healthy lifestyle with the support of a physiotherapist get in contact with us!


3. Pain Relief


If you haven't already tried pain medication then it may well be worth you getting in touch with your GP or local pharmacist to see if pain medication may be appropriate for you. Your GP may may also deem you appropriate for a steroid injection, which for some people can provide some some pain relief to their symptoms. A study by Dayle et al (2020) found those with knee osteoarthritis who received and injection reported similar improvement to those who went received physiotherapy after a 4 week period. HOWEVER those who received physiotherapy continued to improve one year later in relation to their symptoms of pain and stiffness as well as their ability with walking and managing stairs whereas those who received a steroid injection stayed about the same after one year as they were after 4 weeks.


You could also try the use of a heat or ice pack placed on your knee, but be careful not to put heat/ice packs or hot water bottles directly on your skin – wrap them with a cover or tea towel.


4. Surgery


A combination of exercise, maintaining a healthy weight and conservative measures usually improve the symptoms of knee osteoarthritis. But if these treatments have not worked for you, or you are having severe difficulty moving your around with your knee then you may benefit from having surgery on your knee. The most common type of surgery for knee osteoarthritis is a knee replacement. Even those who require surgery on their knee will benefit from taking part in physiotherapy led exercise. Strengthening muscles prior to surgery has been associated with a faster post operative recovery time and can help get you back to doing what you love quicker.



In conclusion, knee osteoarthritis is a normal part of the ageing process but for some people it can lead to pain and stiffness. Physiotherapy has been shown to be effective at reducing pain and improving function in those with knee osteoarthritis. There are several things you can try to help manage your knee osteoarthritis, including optimising your pain relief.



References


Doyle EC, Wragg NM, Wilson SL. Intraarticular injection of bone marrow-derived mesenchymal stem cells enhances regeneration in knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2020 Dec;28(12):3827-3842. doi: 10.1007/s00167-020-05859-z. Epub 2020 Jan 31. PMID: 32006075; PMCID: PMC7669782.


Verhagen AP, Ferreira M, Reijneveld-van de Vendel EAE, Teirlinck CH, Runhaar J, van Middelkoop M, Hermsen L, de Groot IB, Bierma-Zeinstra SMA. Do we need another trial on exercise in patients with knee osteoarthritis?: No new trials on exercise in knee OA. Osteoarthritis Cartilage. 2019 Sep;27(9):1266-1269. doi: 10.1016/j.joca.2019.04.020. Epub 2019 Jun 17. PMID: 31220609.




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