Knee Osteoarthritis – symptoms, diagnosis and treatment

In osteoarthritis (OA) of the knee, the whole knee joint (cartilage, menisci, ligaments, bones and muscles) is affected by the disease, causing joint pain and joint stiffness. The knee is a weight-bearing joint and symptoms are mainly experienced when putting stress on the joint. If you experience symptoms of knee osteoarthritis, you should primarily focus on strengthening the muscles around the knee joint to increase function and decrease joint pain. Doing individualized exercises provided by a physical therapist is a great way of strengthening your muscles and relieving osteoarthritis symptoms.

Symptoms of knee osteoarthritis

Common symptoms of osteoarthritis in the knee are knee pain and stiffness.  Walking, standing and getting up may become difficult and painful. Over time you may even feel pain whilst resting.

The most common symptoms of knee osteoarthritis include:

  • Pain located in the knee, mainly during or after knee loading
  • Knee stiffness
  • Knee pain when resting, for example at night or after physical activity. 
  • Swelling of the knee joint after physical activity
  • Walking difficulties
  • Abnormal fatigue

If you experience any of these symptoms you should schedule an appointment with a physical therapist or a doctor to get a diagnosis.

Several risk factors play a part

There is no single cause for the development of osteoarthritis. Several risk factors tend to contribute to the development of the joint disease. Some of them, for instance occupational activities, excess body weight and joint injuries can often be influenced. However, risk factors such as genetics, female sex and age cannot. It is common that osteoarthritis in the knee joint develops as a result of excess stress on the joint.

Research has shown that knee injuries such meniscus tears and ligament tears are risk factors for developing knee osteoarthritis.

Diagnosing osteoarthritis of the knee

Traditionally, osteoarthritis was diagnosed by X-ray. Today, it is still a widespread belief that this method is necessary for diagnosis. However, according to the World Health Organization and extensive international research, osteoarthritis should be diagnosed by a physical therapist or a doctor through an assessment based on the patient’s medical history, joint function and pain level. The healthcare professional will also take any risk factors for osteoarthritis into account and keep them in mind when establishing the diagnosis. If you experience knee pain or stiffness and suspect that you may have osteoarthritis, a good first step is to contact your primary healthcare center and schedule an appointment with a physical therapist or a doctor to receive the right diagnosis. 

First-line treatment is physical exercise

First-line treatment for knee osteoarthritis is physical exercise, patient education about the disease and lifestyle changes. Individualized exercises for the knee should be coordinated by a physical therapist, either physically or digitally. These exercises should consistently be adapted to the patient’s abilities based on pain and function level. As a complement to first-line treatment, if the pain becomes unbearable, non-prescription painkillers may be used for short periods of time. You should always discuss the use of painkillers with your doctor to avoid side effects and drug interaction.

Other treatment methods for knee osteoarthritis

If first-line treatment isn’t enough to manage your symptoms, other treatments can be offered in addition to exercise.  On occasion, cortisone injections are used as a complement to treat severe knee osteoarthritis. These injections only offer short-term symptom relief and should be administered by an experienced orthopedic specialist. Cortisone injections should be used with caution and only when symptoms are not alleviated by physical exercise as excessive injections may further damage the joint. 

Some patients find that orthoses (or braces) for osteoarthritis of the knee help to reduce pain and increase knee function, making it possible to carry out everyday activities.

In rare cases, joint replacement surgery may be necessary. It is estimated that only 10-20% of all patients with knee osteoarthritis require surgery. Although surgery can provide good results for many patients, it is never risk-free. All surgery comes with the risk of developing blood clots and infections.

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