What Is the Best Treatment for Osteoarthritis In The Knees?

Our bodies wear and tear as we grow old. This fact of life gives rise to complications that reduce the body's functionality. Arthritis is one such complication.

Arthritis affects our muscles and joints, and there are different types. Although osteoarthritis is the most common type among older generations, it can also develop in young people.

This article will explain the risk factors, signs and symptoms, causes, and recommended treatment for osteoarthritis.

What is osteoarthritis?

Osteoarthritis (OA) is a common joint disease that is most prevalent among elderly and middle-aged people. It affects one in seven US adults, bringing the total number of OA patients in the US to 32.5 million.¹ It is also known as "wear-and-tear" arthritis or degenerative joint disease.² It can affect any joint in the body but is most commonly found in the knees, hips, and spine.

This form of arthritis breaks down your bone's cartilage (the protective tissue that cushions the end of the bones), causing the bones to rub together. The rubbing causes pain, swelling, and stiffness in your joints.

This condition usually develops over time and deteriorates when left untreated. Sometimes it intensifies to the point where you are unable to perform daily tasks, or in the worst cases, become disabled.

What causes osteoarthritis of the knee?

Osteoarthritis usually occurs due to degeneration of the cartilage that cushions the end of the knee bones. It causes the bones underneath to change and the connective tissues that hold the joints and attach muscles to the bone to deteriorate.

Cartilage is a firm, slippery tissue that reduces friction during joint motion. When the cartilage is broken down, the bones and joints become exposed, grinding on each other during movement.

What are the signs and symptoms of OA?

The common signs that point to OA include:

Pain

Sharp or mild pain around the knee joints during or after movement.

Grating sensation

If you begin to feel a grating sensation like your knee bones grinding against each other when walking, it might signify you have OA. Cracking and popping sounds in your knee joints can also point to OA.

Tenderness

OA causes tenderness around the knee joint and can be identified when light pressure is applied around the knee.

Swelling

Swelling around the knee joint is another indicator of OA. This might result from the inflammation of soft tissues around the joints.

Loss of flexibility

Another sign you might have OA in your knee is the inability to move your joint through its full range of motion.

Bone spurs

Having extra bits of bone that feel like hard lumps around the knee joint can also indicate that you should seek confirmation of OA.

What are the risk factors for OA?

Several factors can increase your chance of getting OA.

Age

OA is more common among middle-aged and elderly folks than younger people.

Gender

Though the reasons are not yet identified, OA affects more women than men, especially women past the age of 50.²

Joint injuries

Joint injuries on the knees, such as from a sport or a motorbike accident, increase your risk of developing OA. Even accidents that happened long ago from which the wounds have healed can put you at risk of developing OA.

Knee overuse

Overusing the knee places repetitive stress on it and can damage it, leading to OA. If your job or hobbies involve constantly putting pressure on the knee, you might be at more risk of developing OA.

Obesity

The more you weigh, the higher the risk of developing osteoarthritis. Increased weight puts more stress on the joints, especially those that bear weight like the hips and knees.

Obesity might also have metabolic effects that increase the risks of OA. For instance, proteins produced by fat tissues can cause harmful inflammation around or in the joints, leading to OA.

Genetics

People with a family history of osteoarthritis may inherit the condition. Additionally, if you have osteoarthritis of the hand, you might be at risk of developing knee osteoarthritis as well.

Other metabolic diseases

Other metabolic diseases can propagate the development of OA. Diabetes or hemochromatosis – a condition in which your body has too much iron – can put you at a higher risk of OA.

Bone deformities

Some people are born with defective cartilage and malformed joints, giving them OA from birth.

How is osteoarthritis diagnosed?

A rheumatologist is a doctor who specializes in treating arthritis and other related conditions. Your doctor will look for signs of tenderness, redness, swelling, and flexibility to test for OA. They may also request the following imaging and lab tests to get an accurate diagnosis.

X-rays

Your doctor might take an x-ray to detect cartilage loss. Cartilage is not visible in an x-ray image, but cartilage loss can be seen as narrowing space between the bones. Bone spurs are also visible in an x-ray, pointing to the presence of OA.

Magnetic resonance imaging (MRI)

MRI is not needed to diagnose OA, but it is essential in providing more information in complex cases. MRI uses strong radio waves and a magnetic field to produce images of the soft tissues, bones, and cartilage.

Blood tests

Your doctor might request blood tests to rule out other causes of joint pain, like rheumatoid arthritis.

Joint fluid analysis

This test involves the extraction of fluid from an affected joint to test for inflammation to determine other possible causes of pain besides OA, like gout or an infection.

Which treatments are recommended for OA?

Osteoarthritis is not curable, but treatment can reduce pain and relieve the symptoms. Treatment includes medication, therapy, surgery, and other procedures.

Medication

Medication administered in OA treatment is aimed at relieving the symptoms and primary pain.³ It includes:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These are over-the-counter meds to relieve pain, such as ibuprofen and naproxen sodium. These NSAIDs, however, have side effects like:

• Inflammation

• Cardiovascular issues

• Kidney problems

• Liver problems

It is advisable to use NSAIDs that you can apply to the skin of the affected area as they have fewer side effects.

Acetaminophen

Acetaminophen is used to treat mild to moderate pain associated with osteoarthritis. However, you are advised not to take more than the recommended amount as it can lead to liver damage.

Duloxetine (Cymbalta)

Though this medication is often used as an antidepressant, it is also approved to treat chronic pain like osteoarthritis.

Therapy

Occupational therapy

Everyday tasks can be strenuous when you have OA. Sometimes, the stress you exert on the already painful areas can worsen the condition.

An occupational therapist can guide you to make routine tasks less strenuous. For instance, they may recommend putting a bench in the shower to help relieve the pain of standing if you have knee osteoarthritis.

Physical therapy

Physical therapy can help increase your flexibility, strengthen the muscles around your joints and reduce pain.¹ A physical therapist can show you gentle exercises to help with osteoarthritis. Additionally, daily activities like walking, bike riding, and swimming can be equally effective.

Transcutaneous electrical nerve stimulation (TENS)

This form of therapy works by using mild electrical currents to relieve pain. A small TENS machine is attached directly to the skin using pads to offer short-term pain relief for people with OA of the knee.⁴

Surgical procedures

In extreme cases where conservative treatment doesn't work, you might consider surgical procedures.

Lubrication injection

Getting hyaluronic acid injected into your knee can help relieve the pain by cushioning your knee.⁵ Hyaluronic acid is similar to a lubricating fluid component in the joint.

Cortisone injections

Getting a cortisone shot in your knee can help relieve the pain for a couple of days or weeks. The injection is composed of a local anesthetic and corticosteroid medication.⁶ The number of shots you can get per year is restricted to three or four, as this medication can cause detrimental effects over time.

Bone realigning

If osteoarthritis has damaged one side of your knee, you can decide to have a knee osteotomy to shift your weight from the worn-out part of the knee by adding or removing a wedge of bone.

Joint replacement

This type of joint surgery corrects your worn-out joints by replacing them with plastic or metal parts. Research shows that joint replacement has tremendous results in improving health-related quality of life (HRQOL).⁷ The artificial joints might need to be replaced over time as they can wear out or come loose.

Other procedures

Besides the procedures mentioned above, that can help correct OA, there are several other methods you can try.

Braces or shoe inserts

Wearing braces or shoe inserts while walking can help support your joints by taking off the pressure, which will reduce the pain.

Movement therapies

Activities like yoga or tai chi that involve stretches, gentle exercise, and breath awareness can help reduce OA pain and improve movement.

Assistive devices

Assistive devices like a cane can help relieve stress on your joint by taking weight off your knee as you walk.

Acupuncture

Acupuncture is another pain-relieving method that can be instrumental for OA treatment.⁸ Thin needles are inserted into specific pressure points in the body to help reduce pain.

How can I manage OA?

You can live an everyday happy life with OA by making small adjustments to your lifestyle. Below are a few tips for living with osteoarthritis.

Lose weight

Losing excess weight will reduce the stress on your joints, thus alleviating the symptoms. It will also ease inflammation, thus reducing the risk of getting other diseases like cardiovascular diseases, blood pressure, and type 2 diabetes.

Exercise regularly

Non-strenuous activities are crucial if you have knee OA. Exercise like cycling, yoga, swimming, and walking can help you stay mobile, reduce weight, and build your knee joint muscles.

Learn more about OA

Finding out as much as you can about OA can help you navigate life with the condition. You can join a class to learn how to manage the symptoms of osteoarthritis.

Join a support group

Connecting with other people with OA, whether online or in your community, can help you get more tips on living a healthy lifestyle to manage OA. It will also help you cope and provide you with emotional and psychological support from others.

Avoid straining your knee

If you have osteoarthritis of the knee, it would be best to quit activities that strain the knee, such as certain sports.

The lowdown

Osteoarthritis of the knee is not curable but there is no reason why you can’t live a happy, healthy, and fulfilling life. There are various medications, treatments, and homemade recipes that you can try out. For instance, exercise regularly, eat healthily, and lose excess weight. You can also take supplements like glucosamine and chondroitin.  Omega-3 fatty acids in oily fish and fish oil supplements can also help relieve your pain and improve your function.

The first step to receiving treatment for OA is visiting a doctor to get a diagnosis. If you are experiencing pain and inflammation in your joints, or stiffness, swelling, bone spurs, and loss of flexibility, maybe it's time to make an appointment.