Knee osteoarthritis – causes, diagnosis, and treatment
Overview of osteoarthritis in the knee
In knee osteoarthritis (Latin: gonarthrosis), the cartilage in the knee has started to wear down. This makes it more difficult for the joints to slide against each other and they cannot support the same load without causing pain. A good way to counteract the progression of osteoarthritis in the knee is to train the surrounding muscles. This makes the knee more stable and allows the muscles to take the strain that would otherwise have been exerted on the joint. It also gives the cartilage the opportunity to repair itself. Training should be coordinated by a physiotherapist in osteoarthritis classes. You can attend these classes via your local health center or digitally with Joint Academy.
Signs of knee osteoarthritis
A common sign of osteoarthritis in the knee is pain in the knee joint. Walking, standing and getting up can be painful. Over time, you may also have pain in the knee when you are resting. However, the first sign of osteoarthritis in the knee is stiffness. If you notice that your knees are starting to be stiff, it may be time to start training as a preventive measure. Fatigue and depression are also common signs of osteoarthritis. This is because chronic pain takes a lot of energy out of the body. In the long term this can lead to despondency and depression.
● Stiffness in the knee joint
● Pain in the knee, mainly under strain
● Pain when resting, meaning that it may be painful at night or after physical activity
● Recurring swelling of the joint after physical activity
● Abnormal fatigue and depression
If you recognize any or all of these points, you may have osteoarthritis. It is time to talk to a doctor or physiotherapist. You can read more about how osteoarthritis in the knee is diagnosed here or further down.
Causes of osteoarthritis in the knee
Just as in osteoarthritis in other joints, there is not just one cause of osteoarthritis but several contributory factors. Osteoarthritis develops when the joint cartilage wears down faster than the body can repair it. The result is that the articular cartilage becomes thin and is less effective as a shock absorber in the joint. Risk factors (things that may accelerate the development of osteoarthritis), in brief, are that the knee is under more strain than it can manage over a long period of time. This may be caused by excess weight, i.e. more body weight than the muscles can support, or a repetitive working position, but research has also shown that previous knee injuries (for example a meniscus injury or damage to the cruciate ligament) may accelerate the development of osteoarthritis in the knee.
Diagnosing knee osteoarthritis
Traditionally, osteoarthritis has usually been diagnosed using an X-ray. Unfortunately, it is still a widespread belief that it should be diagnosed this way. But, according to the National Board of Health and Welfare in Sweden’s guidelines and international research, osteoarthritis should be seen as a clinical diagnosis. This means that diagnosis should be determined by looking at the medical history, joint function and pain levels. In reality, the severity of the symptoms does not always match the findings of the X-ray.
Therefore, a diagnosis is made by asking questions about your symptoms and risk factors, for example if you have a job which puts excessive strain on your knees or if you have damaged your knee in the past. The key is that the cartilage in your knees has been put under too much strain.
If you recognize your own situation in the description of osteoarthritis, you should speak to a doctor or physiotherapist to get a diagnosis. You can either contact your local health center or download the digital Joint Academy osteoarthritis treatment to book an appointment with an orthopedic specialist.
Treating osteoarthritis in the knee
The first stage of treatment for osteoarthritis in the knee should be specific training coordinated by a physiotherapist. This should also be combined with education about the disease. This treatment is in line with both the National Board of Health and Welfare in Sweden’s guidelines and international research on osteoarthritis.
You can get basic osteoarthritis treatment from osteoarthritis classes that you can attend in groups at your local health center or individually in the on-line version from Joint Academy. If you choose Joint Academy, you have continuous contact with a personal physiotherapist. You will be given exercises that can be directly adapted so that they are easier or more difficult depending on your symptoms.
Training in combination with information works for most people as treatment of osteoarthritis, but for a few people a knee prosthesis operation may be advisable. Although this is a very common operation, it is not entirely without risk.
If training is difficult because of the pain, pain relievers could be an option. But this should not be seen as a complete treatment in itself, because medicines only treat the pain, not the actual disease.
Other treatment methods for osteoarthritis in the knee
Cortisone injections are also sometimes used to reduce the pain of osteoarthritis in the knee. Injections of this kind may work well, but like pain-relieving medicines, the effect is short-term and they only treat the symptoms, not the disease. So this treatment can complement training but not replace it.
It has also become increasingly common to use orthoses, or braces, for osteoarthritis in the knee joints, these are soft bandages with stabilizing side bands that can correct the angle and stabilize the knee joint. Using a brace may relieve the pain and improve the function of the joint, making it possible it carry out crucial daily activities at more advanced stages of osteoarthritis. Braces can also be used to help people who actually meet the criteria for an operation but, for various reasons, do not want to or cannot undergo an operation.