Rehab Articles

There are three different types of arthritis that can occur in your knees. The most common type is osteoarthritis (OA), a progressive condition that slowly wears away joint cartilage. OA is most likely to occur after middle age.

Rheumatoid arthritis (RA) is an inflammatory condition that can strike at any age.
Post-traumatic arthritis develops following an injury to the knee. It can occur years after a torn meniscus, ligament injury, or knee fracture.

It’s possible to have more than one type of arthritis at a time. See your doctor for a diagnosis and to discuss a successful treatment plan for the specific type or types of arthritis you have.

Gradual increase in pain
Arthritis pain can begin suddenly, but it’s more likely to develop slowly. At first, you may notice pain in the morning or after you’ve been inactive for a while. Your knees may hurt when you climb stairs, stand up from a sitting position, or kneel. It may hurt just to go for a walk.

You may also feel pain when you’re simply sitting down. Some people with arthritis say that damp weather or other changes in weather can bring on pain. Knee pain that wakes you up from sleep can be a symptom of OA.

Swelling or tenderness
Arthritis of the knee may cause periodic inflammation. This can be due to the formation of bone spurs (osteophytes) or extra fluids in the knee. Swelling may be more pronounced after a long period of inactivity, like when you first wake up in the morning.

The skin on your knee may look red or feel warm to the touch. In time, you may experience chronic knee inflammation that doesn’t get better with over-the-counter (OTC) medications or anti-inflammatory drugs.

Buckling and locking
Over time, your knee muscles may weaken and the entire joint structure can become unstable. Overall weakness in the knee can cause it to give way or buckle. The joint can also stick or lock up so that you can’t bend it or straighten it out. You may find that these symptoms come and go.

Cracking or popping sounds
You may feel a grinding sensation in your knees as you move. You might even hear cracking or popping sounds coming from your knees. These symptoms can occur when you’ve lost some of the smooth cartilage that helps with smooth range of motion. If you have arthritis in your knee, the noises and grinding are the result of rough surfaces and bone spurs rubbing against each other as you move your joints.

Poor range of motion
Arthritis can make it increasingly challenging for your knee joints to glide as they should, making previously simple movements difficult or impossible. You’re most likely to notice a restricted range of motion when you climb stairs or participate in athletic activities.

OA progressively wears away at cartilage. As arthritis worsens, it becomes harder for joints to function normally and it can become more and more difficult to perform everyday tasks. In time, you may have trouble walking without a cane or walker.

Loss of joint space
Knee X-rays are an excellent diagnostic tool because they clearly show the loss of joint space that causes sounds and poor range of motion. The space which is normally occupied by cartilage is worn away and exposed bone is present. Bone spurs develop along the edges of the joint and reflect the body’s attempt to repair itself. They’re a common symptom of OA.

Deformities of the knee
As arthritis progresses, you may notice changes in your knee’s appearance. Arthritis can create a sunken appearance as muscles surrounding the knees thin and weaken. Your knees can start to point toward each other or bend outward. Knee deformities range from barely noticeable to quite severe and debilitating.

Treatment for arthritis in the knee
Several types of treatment can help your knee arthritis. Taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, can temporarily soothe arthritis pain and decrease inflammation in your knee joint.

Talk to your doctor about taking NSAIDs, as they can affect your kidneys or cause you to develop an ulcer if taken too frequently.

Other medications for arthritis include:
•    analgesics, which help with pain and may be recommended as an alternative to NSAIDs
•    corticosteroids, which help with inflammation
•    biologic response modifiers, which can help prevent your immune system from causing joint inflammation
•    disease modifying antirheumatic drugs (DMARDs), which can specifically help with RA

Injections that can help with knee arthritis include:
•    hyaluronic acid supplements, which relieve arthritis inflammation and pain by lubricating the knee joints to allow them more smooth motion
•    corticosteroid injections, which are injected into your knee to soothe inflammation and pain
•    arthrocentesis, in which fluid is removed from the joint by a needle for testing (it can also relieve pain)

You may need surgery for your arthritis, even if other treatments help with your pain. Three types of surgeries are most common for treating knee arthritis:
•    total joint replacement, the most common type, in which your doctor replaces your knee with a prosthetic made of plastic, ceramic, or metal
•    osteotomy, in which your doctor modifies your knee bones to control damage and pressure in your knee
•    arthroscopy, in which your doctor makes an incision in your knee in order to remove or repair damaged parts

Talk to your doctor about which treatment or procedure is best for you, based on your level of pain, how much your arthritis affects your daily life, and the damage done to your knee.

Home remedies and lifestyle changes
Certain types of exercise can help preserve your knee function and relieve pain, including water aerobics, strength training, and tai chi. Losing weight, especially if you’re overweight, can help relieve OA by lessening the pressure on your knees.
Some studies have suggested that the following supplements may help relieve inflammation and pain caused by knee arthritis:
•    capsaicin, which helps with OA and RA
•    turmeric (curcumin), which helps with OA and RA
•    chondroitin sulfate
•    glucosamine
•    avocado soybean unsaponifiables (ASU), which are made from oils

When to see your doctor
See your doctor if your pain or inflammation is not responding to any kind of treatment. Also see your doctor if the pain interferes with your daily life, especially if you can’t sleep or the pain affects your walking or movement.

In order to diagnose your knee arthritis, your doctor will first assess your overall physical health. They may ask you to stand while they take X-rays to discern whether you have arthritis. They may also order a bone scan or an MRI to examine your knees for the presence of arthritis.

Knee pain can indicate that you have osteoporosis, in which your bones lose their density and become more fragile. This condition can cause pain and discomfort similar to that caused by arthritis. Your doctor may order a bone mineral density test to rule out osteoporosis as a cause of your pain.

Your doctor may also test you for lupus, a chronic condition in which your immune system attacks your body. Lupus can cause joint pain and other symptoms that can affect your body’s functioning.

Diagnosing your knee arthritis early can help you seek out treatment and therapies that relieve pain and preserve your ability to move without pain or difficulty. If knee pain is interfering with daily activities, see your doctor as soon as possible.

Written by Ann Pietrangelo and Tim Jewell