Knee Arthritis or Knee Osteoarthritis (Knee OA) is a major cause of disability. It can drastically affect a person’s mobility and quality of life.
Knee arthritis is commonly known as a degenerative, wear and tear, age related condition.
While it is usually not a dangerous knee problem, this description reflects the idea that knee osteoarthritis is a condition that gets worse with time, often leading to knee replacment surgery.
Knee arthritis is associated with knee injury due to trauma, infection, and excessive body weight.
Natural History – It Usually Gets Worse
Knee arthritis often develops over many years. In the initial stages, there can be periods of relatively little knee symptoms, interspersed with “flare-ups” of inflammation and pain. Patients learn to “live with” or ignore the occasional symptoms during this stage. The eventual progression to more severe and frequent pain can make the condition appear to have developed quickly.
A person’s lifestyle can also affect the progression of knee osteoarthritis. Repetitive stress injuries from squatting, kneeling, and lifting heavy objects can put more pressure on the knees, resulting in more frictional degeneration.
Athletes tend to place more stress on their knees, and also face the increased risk of traumatic knee injuries which predispose to knee arthritis.
3 Common Misconceptions About Knee Arthritis
- My pain is persistent. I’ve tried gels, painkillers, injections, and alternative treatments which did not work. There is no choice except for surgery.
- My pain is due to wear and tear, age related degeneration. Nothing much can be done, while it gets worse with time.
- My physical therapist and doctor both tell me to exercise more but I am not feeling any better. I am just not trying hard enough.
How Does Knee Arthritis Affect Us?
The usual symptoms of Arthritis in the Knees include:
- Knee swelling
- Knee pain which increases with activity but gets better after resting
- Stiffening of the knees, especially in the morning or after a period of sitting
- Decreased mobility of the knee, making it particularly difficult for a person to use the stairs, get in and out of the car, and even walk
- Crackling sounds during knee movements
How Do We Diagnose Knee Arthritis?
The diagnosis of knee arthritis is usually quite straightforward to a doctor who knows about the history of your knee condition and performs thorough physical examination. The difficulty is almost always the “what to do” part after a diagnosis is made.
Imaging investigations such as an X-ray and MRIs can be helpful in assessing the severity of your condition, and also for evaluating other co-existing knee conditions.
Blood investigations and a knee aspiration can also be helpful if an infection or another cause of knee inflammation is suspected.
It is worthwhile to note that in Singapore, CPF Medisave can often be used to help pay for diagnostic scans of knee arthritis.
Standard Treatments for Knee Arthritis
If the problem is not severe, appropriate medication can be utilised to treat and manage the symptoms of arthiritis.
It is one of the best recognized therapeutic management options for arthritis knees.
Under the supervision of a professional therapist, a patient can improve the motion and strength of the joints.
Exercise therapy, electrotherapy, mechanical aids like splints and braces, joint mobilisation techniques, hydrotherapy and gait re-education are all useful and effective methods available to help sufferers of knee pain.
Indian Yoga, Chinese Tai Chi, Homeopathic medicines, acupuncture, mind-body medicines and the traditional treatment balneotherapy and many more holistic treatments are becoming increasing popular.
Knee Arthritis Injections
Viscosupplementation is a type of treatment, in which ‘hyaluronic acid’ or artificial joint fluid is injected to the knee, so that it can act as a cushion the joint. Unfortunately this treatment gives the patient only short term relief and comes with possible risks.
Surgery For Knee Arthritis
Among the surgical options for treating knee arthritis, arthroscopy, osteotomy and knee replacement surgery are among the most common. As they differ in terms of potential risks and benefits, it is important to discuss with an experienced doctor your specific condition before deciding whether this is an option to consider.
A Practical Approach To Managing Knee Arthritis
Based on what medical science has to offer today, the majority of patients can enjoy active lives free from knee pain and avoid the need for knee replacement surgery.
In patients with knee aches, pain and stiffness, it is important to first consult a doctor for a clear diagnosis.
If your current treatment choice is based on a clinical diagnosis without any imaging investigations, it is a good idea to consider doing an X-ray or an MRI if your current treatment is not working.
Patients who have milder arthritis can focus physical therapy and prevent deterioration with nutritional solutions.
Where access to frequent physical therapy is difficult, analgesic rubs, plasters and gels can also be good options.
Patients with more severe knee arthritis can benefit from the non-invasive treatments available in many Singapore clinics.
Dr Terence Tan, MBBS,GDFM , The Pain Relief Clinic