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Knee Arthritis

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Last updated May 31, 2022

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What is knee arthritis?

Knee arthritis is when the rubbery cartilage that lines the knee bones becomes damaged and wears away. Normally, cartilage is smooth, allowing the bones to slide past one another with very little friction when you move the knee. When you have knee arthritis, the cartilage gets rough, and the joint may grind, crack, or pop with movement. This type of arthritis is called osteoarthritis.

The most common symptoms of knee arthritis include pain, swelling, and stiffness in the joint. It often causes a dull, aching pain that feels worse when you’re active. Sometimes, the pain is sharp and it may be difficult to put weight on the leg.

There is no cure for knee arthritis, but you can treat joint pain and stiffness with rest, ice, compression, elevation, and OTC pain relievers. Knee replacement surgery may be recommended when the arthritis is severe and all other treatments haven’t worked.

Pro Tip

80% of arthritis cases affect the knee and almost 20% of adults over the age of 45 will develop knee arthritis.  By 2030, it is estimated that over 67 million Americans will experience some form of arthritis pain. —Dr. Ben Schwartz

Symptoms

Knee arthritis can cause knee pain, swelling, and stiffness. Symptoms usually start off mild and slowly worsen, but sometimes they happen suddenly. They may come and go, with periods of time when you may not have any symptoms.

A buildup of fluid inside the knee, called an effusion or “water-on-the-knee,” can make the knee swell, limiting its movement. Arthritis can also cause the muscles around the knee, like the quadriceps (thigh) muscle, to weaken. The knee may buckle (give out) without warning.

The muscles at the back of the knee (hamstrings) may tighten and stop the knee from fully straightening. If the arthritis is severe, the knee may become bowed or knock-kneed as the cartilage wears away unevenly.

Main symptoms

  • Pain (usually dull and aching but can be sharp and severe)
  • Swelling
  • Stiffness (hard to fully bend and straighten)
  • Cracking, popping, grinding when moving
  • Bowing or knock-kneed deformity
  • Buckling, giving way, and instability in the knee

Causes

Knee arthritis often develops for no known reasons but some risk factors include:

Pro Tip

It is usually safe to participate in regular low-impact exercise with an arthritic knee. In fact, studies have shown that doing so can help reduce the pain and limitations caused by knee arthritis. —Dr. Schwartz

At-home treatment

Knee arthritis symptoms can often be treated at home, but it may take 2–6 weeks of regular treatment to notice an improvement.

  • Rest
  • Ice the knee
  • Elevate the knee
  • Compress the knee with an ACE wrap or nylon knee sleeve (available at drugstores and online)
  • Wear a brace, which has metal hinges on the sides to provide additional support. Braces don’t prevent arthritis from getting worse, but they may make it easier to walk and be active.

OTC medications

  • Ibuprofen (Advil, Motrin) and naproxen (Aleve) are anti-inflammatory drugs (NSAIDs) that relieve pain and reduce the inflammation from arthritis.
  • It’s important to take NSAIDs regularly—not only when the pain is very bad. The biggest mistake many people make is giving up on OTC medication too soon. It can take 1–2 weeks of regular use to notice an improvement. While most people can take OTC medications safely for a few weeks, you should check with your doctor.
  • You can also try a topical NSAID, such as diclofenac (Voltaren), which you apply directly to your knee.

Herbal supplements

There are many different types of supplements available for arthritis, but there’s limited evidence showing that they work.

The most commonly used supplements for arthritis include glucosamine/chondroitin, turmeric, and MSM (methylsulfonylmethane). Some studies show they may help symptoms, but there isn’t any evidence that they reverse or prevent arthritis from getting worse.

Topical pain relievers that you apply to your skin, such as CBD oil, arnica gel, and Biofreeze, are also available over the counter.

Medical care

Prescription NSAIDs

You may need to take a prescription pain reliever. See a healthcare provider if at-home care doesn’t improve your symptoms or if the pain and swelling are severe. Prescription NSAIDs include:

  • Meloxicam (Mobic)
  • Celecoxib (Celebrex)
  • Diclofenac (Voltaren)
  • Nabumetone (Relafen)

Knee X-rays help confirm the diagnosis of arthritis and determine how severe the arthritis is. You may be referred to an arthritis specialist—usually an orthopedic surgeon—to discuss treatment options.

If your arthritis is caused by an autoimmune disease, you’ll be referred to a rheumatologist, who can prescribe other types of medications.

Injections

Cortisone injections and hyaluronic acid injections (“gel shots”) can help with pain and inflammation that doesn’t improve with medication or for people who can’t take NSAIDs.

Physical therapy and exercise

Your doctor may recommend physical therapy to help reduce stiffness and strengthen the muscles around the knee joint. Therapy includes strength and flexibility exercises and cold and hot therapy.

Low impact exercise can also help reduce symptoms and improve mobility, and it is safe for knees.

If you’re overweight, losing weight can be a really good way to relieve pain. Every pound lost takes 3-4 pounds of pressure off of the knee.

Surgery

Surgery for knee arthritis—total knee replacement—may be necessary if your symptoms don’t improve with other treatments and you can no longer tolerate your symptoms. The damaged cartilage is removed and replaced with metal and plastic parts. When the knee is replaced, you no longer have arthritis in the joint.

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Is walking good for arthritis in the knee?

In general, low-impact exercise, like walking, keeps arthritic joints from getting too stiff and helps maintain your strength and conditioning. Try not to walk on uneven ground and avoid steep hills or inclines. Other low-impact activities, like riding a bike (stationary or road) and swimming, can help you stay active without putting too much stress on the knee.

Being active will not necessarily damage the joint or make arthritis worsen more quickly. But a good rule of thumb is: If it hurts, don’t do it.

Dr. Rx

In general, we recommend considering knee replacement when the X-rays show advanced arthritis, extensive non-surgical treatment has failed to give you lasting relief, and you can no longer tolerate the knee and the limitations it causes. —Dr. Schwartz

Preventive tips

While knee arthritis is usually not preventable, there are a few things you can do to help keep your knee joint healthy.

  • Do regular low-impact activity. Varying your activities can help lower the chance that you’ll aggravate the arthritis or cause a flare-up of symptoms.
  • Maintain a healthy weight, which can reduce the amount of stress on your knee.
  • Avoid high-impact activities such as running and jumping. These put more pressure on the joint and can worsen swelling and inflammation.
Share your story
Dr. Schwartz is a board-certified Orthopedic Surgeon and Member of the Buoy Medical Advisory Board. He graduated Magna Cum Laude from the College of William and Mary (1998) with a B.S. in Biology, then obtained his medical degree from the Medical College of Virginia (2002) where he was elected to the Alpha Omega Alpha Medical Honor Society. After completing his Orthopedic Surgery Residency at Bost...
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