Knees

How does arthritis affect the knees?

The knee is commonly affected by arthritis, particularly osteoarthritis (OA). You may notice pain and stiffness in your knee, particularly when you first get out of bed in the morning, after sitting for a long period, climbing stairs, walking, kneeling or even when you’re just sitting still. Your knee might look swollen, or feel like it might give way or buckle.

There are many things that can help you manage arthritis of the knee. The first steps are regular exercise, weight loss and using medicines wisely.

What can I do?

There are many treatments that can be helpful for arthritis of the knee. Here are some tips.

Find out what type of arthritis you have

Learn about the type of arthritis you have and your treatment options. Ask your doctor about creating a tailored management plan (GPMP) and team care arrangement (TCA) for you. This includes subsidised care from a team of healthcare professionals such as physiotherapists, dietitians, and others. Your local Arthritis office may also run self management courses to help you develop skills to manage your symptoms, communicate with your healthcare team and lessen the impact of arthritis on your life.

Weight loss

Being overweight can lead to more pain and damage to knees affected by arthritis. Even modest weight loss (eg. eight percent reduction in body weight) can noticeably reduce pain and other symptoms of knee OA. You may find it useful to see a dietitian for advice about healthy eating and weight loss if you are finding it difficult to maintain a healthy body weight.

Exercise

Regular exercise is one of the most important treatments for arthritis of the knee. It helps to reduce pain and maintain your general health. To protect your sore joints, try low-impact activities, where there is less force or weight going through your knees. Examples of low-impact activities include swimming, cycling and walking. You could also try:

• Water exercise: buoyancy of the water takes pressure off your knees and you may find you can move more freely than you can on land. See Water exercise for more information.
• Strengthening exercises: Exercises to strengthen the muscles around your knee can also help reduce pain. See Strength training for more information.
• Tai chi: Studies show that tai chi can help reduce pain and stiffness for people with arthritis. See Tai chi for more information

If you have knee pain, you are more likely to have weakness and tightness of certain muscles in the knee, hip and leg. If possible, consult a physiotherapist or exercise physiologist for advice about a program to suit you.

See Physical activity for more information about exercise.

Medicines

Your doctor may recommend certain medicines to help reduce your knee pain, depending on what type of arthritis you have and your medical history. Talk to your doctor or pharmacist about medicines and the best way to use them for your condition. See Medicines for more information.

Understanding pain

Recent research has shown that understanding how pain works and how you respond to it can help you prevent pain controlling your life. Activities such as pain coaching, cognitive behavioural therapy from a psychologist, or mindfulness are effective for many people. See Dealing with pain for other tips for coping with pain.

Heat and cold

Cold therapy such as ice packs or ice massage may help reduce pain in knee OA. There have been no studies testing the effects of heat therapy for OA, however some people may prefer it to cold therapy.

Aids or supports

Walking sticks or canes may help reduce the load on your knee and lessen pain. Always use the walking stick on the opposite side to your sore joint (if your right knee is affected, use the walking stick in your left hand). Your physiotherapist may also suggest the following treatments to reduce pain from knee OA:

• taping the kneecap (patella)
• knee braces
• orthoses (small wedges placed in your shoe to improve the alignment (position) of your knee when standing and walking).

See a physiotherapist for advice about any of these aids or supports.

www.MyJointPain.org.au

This interactive website is for people with osteoarthritis and provides information and tools to help you manage your condition. Experts provide information via text and videos and its weekly check-ups can help you track your osteoarthritis so you can see what works for you.

Surgery

If your knee pain is severely affecting you quality of life, despite trying the treatment options listed above, your doctor may recommend knee surgery.  See Surgery for arthritis for more information.

Unproven treatments

There are many other treatments for knee arthritis that are either untested or have been shown to provide little benefit.

• Glucosamine and chondroitin. The results from studies of glucosamine sulfate and chondroitin sulfate are unclear. See Glucosamine and chondroitin for more information
• Herbal therapies. There isn’t much evidence to prove that certain herbal therapies are useful for arthritis of the knee. See Complementary therapies for more information
• TENS, ultrasound, laser. These treatments may be used by a physiotherapist. TENS or laser treatment are unlikely to provide benefit for knee arthritis. See a physiotherapist to trial a TENS machine (a machine that applies very mild electrical pulses to block pain messages going to your brain) before buying one as not all people will find it beneficial. Ultrasound may provide some small benefit for some people.
• Acupuncture. The latest evidence does not support the use of acupuncture for knee arthritis.
• Platelet-rich plasma (PRP) and stem cell injections. Trials are underway to assess whether these have any benefit. At this time, there is not enough evidence to recommend their use due to their cost, risks, and the lack of standards and understanding about their use.