My parent is struggling with knee osteoarthritis - what treatment options do they have?
This is a question we heard in the clinic recently, from a patient who was seeking treatment for their own injuries.
And boy, it’s a tough one. It’s really hard to see someone you care about in pain and not able to do what they’d like to do.
Read on for our best advice. If you need more in-depth information, please don’t hesitate to get in touch with the clinic and speak to one of our experienced Physiotherapists.
What is knee arthritis?
Knee Arthritis is a common injury, affecting 10% of people over 50 years old. Knee arthritis is the most common type of arthritis.
Knee arthritis involves damage to the cartilage in your knee joint, which happens gradually over time with stress to the area.
The problem with damage to the cartilage is that it has a poor blood supply, which affects its potential for healing and recovery. Once cartilage is damaged and begins to break down, it has little ability to repair itself.
With continued stress on the knee joint from daily activity, the joint can then become inflamed, resulting in pain and stiffness.
Who is at risk of getting knee arthritis?
People with increased risk of developing osteoarthritis include those with:
Of female sex
Family history of arthritis
Physical trauma to the knee (including ACL injury / repair)
Misalignment of the knee joint
Symptoms of knee arthritis
Stiffness that is worst in the morning or after long bouts of sitting, and then warms up
Redness or swelling of the knee.
Difficulty squatting down or using stairs.
Less commonly, bony enlargement of the area.
How is knee arthritis diagnosed?
While a person’s history of pain and other symptoms provide good clues, a diagnosis can only be confirmed using imaging. The main scan your Doctor will send for is an X-Ray, but sometimes MRI’s are used as well. This also helps to rule out other causes of your knee pain.
The X-Ray is usually done standing up (‘weight bearing’), so that we can see how narrow the joint space has become in the knee joint.
However, many people may have signs of arthritis on an X-ray, but no pain whatsoever. This is why it’s important to ensure you have the symptoms that fit the picture of arthritis before going ahead with the imaging.
Can I exercise with knee arthritis?
Yes! In fact, exercise is the main treatment for arthritis, and research has shown this to improve pain, stiffness, physical function and quality of life. Strengthening the muscles around the knee joint, helps to reduce the forces that go through the cartilage and bones.
However, the first thing you need to do is see your Physiotherapist. They will be able to discuss with you what types of exercises will be best to get started with, without flaring up your symptoms.
Treatment of knee arthritis
As mentioned above, exercise is the main treatment for arthritis. It can be difficult to know what exercise you should and shouldn’t do to get started, so it’s important to see a physiotherapist for guidance.
Importantly, research has shown that people who exercise more consistently have improved physical performance and reduced measures of disability and pain.
Another large part of treatment is education, which involves you learning about how to best manage your arthritis, so it doesn’t affect your ability to reach your goals.
Many physiotherapists are specifically trained in the GLA:D exercise program for arthritis. This is something that you can discuss with your physiotherapist.
For people that have gone through a GLA:D type program for arthritis, and are still experiencing significant symptoms, there is the later option for a total joint replacement of the knee. This involves surgery to remove the damaged cartilage and replace it with a (usually titanium) fake knee joint.
Getting a knee replacement does not mean you don’t need to do the exercise rehabilitation. In fact, those who do exercise after a total knee replacement have better results than those who do not.
There are other types of surgery that are sometimes used to preserve the joint surfaces or replace only one compartment of the knee. However, these sometimes result in failed surgeries or continued symptoms. Furthermore, the evidence for these surgeries is not as strong as a total knee replacement.
Other treatments that are used alongside these treatments include foot orthoses or changing shoes, using a knee brace, and reducing jumping/running when the knee is sore.
When a person with arthritis has a flare-up of pain, anti-inflammatories can help to get things calmed down, and get the person back into exercise. However, these treatments are small when compared to the mainstay treatment - exercise!
Hussain, S., Neilly, D., Baliga, S., Patil, S., & Meek, R. (2016). Knee osteoarthritis: A review of management options. Scottish Medical Journal, 61(2), 7-16. doi:10.1177/0036933015619588
Heidari, B. (2011). Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian Journal of Internal Medicine, 2(3), 205.
Zampogna, B., Papalia, R., Papalia, G. F., Campi, S., Vasta, S., Vorini, F., ... & Denaro, V. (2020). The role of physical activity as conservative treatment for hip and knee osteoarthritis in older people: a systematic review and meta-analysis. Journal of clinical medicine, 9(4), 1167.
Roos, E. M., Grønne, D. T., Skou, S. T., Zywiel, M., McGlasson, R., Barton, C. J., ... & Davis, A. M. (2020). Outcomes following the glad program for patients with symptomatic knee and hip osteoarthritis in Denmark, Canada and Australia. A longitudinal analysis including 28,370 patients. Osteoarthritis and Cartilage, 28, S31-S32.
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!