Arthritis in the knee joint can be caused by a number of conditions. The most common are osteoarthritis and rheumatoid arthritis.
- Osteoarthritis causes the breakdown of cartilage in a joint. When cartilage is damaged, the bone ends rub together. Over time, this rubbing can permanently damage the joint, leading to pain and stiffness.
- Rheumatoid arthritis occurs when your immune system mistakenly targets your own body. It especially affects the lining of the joints between your bones and causes symptoms such as swelling, pain and stiffness.
Who gets knee arthritis?
Knee arthritis becomes more common as people age. You are also more likely to get it if you:
- are female
- are overweight
- have a family history of arthritis
- have had previous knee injuries
- have a job which puts stress on your joints.
What are the symptoms of knee arthritis?
- Pain that increases when you are active, but gets a little better with rest.
- Swelling and warmth in the joint.
- Stiffness in the knee, especially in the morning or when you have been sitting for a while.
- Limited movement – making daily activities such as getting into a car or crouching down difficult.
- A creaking, crackly sound when the knee moves.
How is knee arthritis diagnosed
Your doctor will talk to you about your symptoms and will do a physical examination of your knee.
Before your appointment, take note of what things make your knee better or worse and when you notice the pain. Also, try to find out if anyone else in your family has experienced arthritis.
To assist with the diagnosis, you doctor may order additional testing, including:
- X-rays, which can show bone and cartilage damage as well as the presence of bone spurs
- blood tests, which can detect rheumatoid arthritis.
How is knee arthritis treated?
There is no cure for knee arthritis, but there are many ways you can relieve your symptoms and help prevent these from getting worse. Of the following strategies for managing knee arthritis, exercise and weight loss (if overweight) are seen as particularly important.
Exercise – staying active
- Taking part in an exercise programme which includes a mix of stretching, strengthening and cardiovascular exercises can reduce pain, improve movements and delay the need for surgery.
- Regular exercise keeps your muscles strong and your joints flexible. It is also important for balance.
- For those who are overweight, weight loss reduces stress on the joints.
- Loosing even a small amount of weight, if needed, can greatly reduce knee pain.
- Your doctor or other healthcare professional can help you develop a self-management plan.
- This will provide you with practical advice on how to increase your skills and confidence in managing your symptoms.
- Read more about self-management support.
Physiotherapy & occupational therapy
- If you are having trouble with daily activities, physiotherapy or occupational therapy can help.
- Physiotherapists can show you ways to strengthen your muscles and improve flexibility.
- Occupational therapists teach you things such as how to pace your activities through the day. Spreading physically hard jobs (such as housework, mowing the lawn) throughout the day, rather than trying to do them all at once.
Pain relief medications, or painkillers, are often recommended by your doctor or pharmacist to reduce pain and stiffness. However, they do not treat arthritis itself. The types of pain relief medications to start with include:
Read more about pain relief medications.
Other treatments and tips
- Tape or a brace for your knee: There are lots of devices, including joint braces, splints and tapes.
- Wear shoes with thick soft soles that act as shock absorbers for your knees. Avoid high heels.
- Use a walking stick to reduce the weight and stress on a painful knee. A physiotherapist can advise on the correct length of the stick and how to use it properly.
- Apply a hot or cold pack to reduce pain and inflammation
- Practice relaxation techniques to help your body relax when you are not being active to help relieve pain.
- Most people do not need surgery for knee arthritis; symptoms can be managed by a combination of the measures listed above.
- Joint surgery may be recommended for some people if the joint wears out over time.
Knee Arthritis Oxford University Hospitals, NHS (UK)
Knee pain Arthritis Foundation (US)
Osteoarthritis of the knee WebMD (US)
- Systematic management of osteoarthritis BPAC NZ (2008)
- OARSI guidelines for the non-surgical management of knee osteoarthritis Osteoarthritis Research Society International, Osteoarthritis & Cartilage Vol. 22 (2014).
- Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee American College of Rheumatology, Arthritis Care & Research, Vol. 64 (2012)
European League Against Rheumatism (EULAR) and the American Academy of Orthopaedic Surgeons
Management of osteoarthritis
Systematic management of osteoarthritis BPAC NZ (2008)
AAOS guidelines for the treatment of osteoarthritis of the knee American Academy of Orthopaedic Surgeons
OARSI guidelines for the non-surgical management of knee osteoarthritis Osteoarthritis Research Society International, Osteoarthritis & Cartilage Vol. 22 (2014).
Extracts from summary of recommendations
||"Recommendation 1. We recommend that patients with symptomatic osteoarthritis of the knee participate in self-management programs, strengthening, low-impact aerobic exercises, and neuromuscular education; and engage in physical activity consistent with national guidelines. Strength of Recommendation: Strong
Recommendation 2. We suggest weight loss for patients with symptomatic osteoarthritis of the knee and a BMI ≥ 25. Strength of Recommendation: Moderate
Recommendation 7. We recommend nonsteroidal anti-inflammatory drugs (NSAIDs; oral or topical) or Tramadol for patients with symptomatic osteoarthritis of the knee.
Recommendation 9. We cannot recommend using hyaluronic acid for patients with symptomatic osteoarthritis of the knee. Strength of Recommendation: Strong
Recommendation 12. We cannot recommend performing arthroscopy with lavage and/or debridement in patients with a primary diagnosis of symptomatic osteoarthritis of the knee. Strength of Recommendation: Strong"
Extract from Treatment of Osteoarthritis of the Knee, Summary of recommendations, 2nd edition See full summary of recommendations.
"The new (Osteoarthritis Research Society International) guidelines recommend a set of non-pharmacological core treatments as appropriate for all individuals (listed in order from highest benefit-to-risk score to lowest): land-based exercise, weight management, strength training, water-based exercise, and self-management and education. For weight management, the OARSI guidelines make a specific recommendation of achieving a 5% weight loss within a 20- week period to be effective at treating knee OA."
Extract from Non-Surgical Treatment of Osteoarthritis of the Knee, Physician Summary March 2014. See full summary
Guidelines Can Help Doctors Choose the Best OA Treatments Consensus from American College of Rheumatology stresses exercise and weight loss, but are doctors following the guidelines? Arthritis Foundation (US), accessed August 2016