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Wednesday, 12 March 2014 00:00

Managing Your Osteoarthritis of the Knee

What Is Osteoarthritis?

Osteoarthritis (degenerative joint disease) is an illness in which joints become red and swollen (inflamed), painful, and stiff. Most often, the knees, hips, and spine are involved, but other joints, such as those in the hands, can also show signs. These joints contain cartilage, the substance that provides a cushion where two bones touch. During osteoarthritis, cartilage breaks down and loses the ability to cushion the joints. In the knee, the protective barrier between the thigh bone (femur) and the knee is lost. Bones rub together, and joints swell and become sore and painful. Movement becomes limited. In advanced osteoarthritis, cartilage in the joints is completely worn away.

What Causes Osteoarthritis of the Knee?

Osteoarthritis is caused by aging, injury, trauma, and other factors. Osteoarthritis is very common when people reach their 70s. It can occur at a younger age in overweight patients. It affects both men and women.

What Are the Symptoms of Osteoarthritis of the Knee?

Osteoarthritis develops gradually. The first symptom may be pain. Pain gets worse with exercise and stops during rest. Over time there is limited movement and less flexibility. Morning stiffness may occur but goes away during the day, as the knee warms up.

As osteoarthritis gets worse, the knees lose their ability to bend. They become tender, and a grating sensation may be felt during movement.

How Is Osteoarthritis of the Knee Diagnosed?

The doctor’s diagnosis is based on symptoms and a physical examination. An x-ray can confirm the diagnosis.

More tests may be done to rule out other illnesses that can affect joints, such as gout and infections. These tests include blood tests and removing a sample of knee joint fluid. Magnetic resonance imaging (MRI) of the knee may be done if surgery is being considered or if other disorders such as a torn knee ligament are suspected.

How Is Osteoarthritis of the Knee Treated?

Treatment goals are to control pain and prevent joint destruction. The type of treatment depends on lifestyle and the degree of osteoarthritis.

Keeping to a healthy weight is very important. In people with mild osteoarthritis, occasional pain medicine and exercises to protect the knees may be all that is needed. The doctor may prescribe nonsteroidal antiinflammatory drugs. They reduce pain and swelling (inflammation) but can have side effects (e.g., stomach pain and bleeding, or kidney, liver, and heart problems). Over-the-counter products, such as glucosamine and chondroitin, are popular but their effectiveness has not been proven.

Heating pads, warm soaks, and cold packs may help relieve symptoms.

The doctor may prescribe physical therapy and medicines (pain relievers, antiinflammatory drugs, or cortisone injections of the knee) for more severe disease. Low-impact exercises, such as swimming or cycling, may improve muscle strength and flexibility.

Devices such as canes or braces may minimize stress on the knees.

If these approaches don’t work, surgery may be offered. Knee replacement surgery is a last resort.

DOs and DON’Ts in Managing Osteoarthritis of the Knee:

  • DO take your medicines as prescribed.
  • DO physical therapy to maintain muscle strength and knee flexibility.
  • DO make lifestyle changes to reduce discomfort and stress on the knees. Try swimming, walking, or riding a bicycle rather than running or jogging.
  • DO lose weight if you are overweight.
  • DON’T take part in work or sport activities that stress your knees.

For more information, see the attachments below.

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