Arthritis Knee Pain

Knee pain is a very common complaint among older men and older women. There are many causes, one  of which is osteoarthritis which affects  27 million Americans. Some of the most common causes of knee pain are osteoarthritis, ligamental injuries, cartilaginous injuries, patellar tendinitis, dislocated kneecap, bursitis and Baker’s cyst. Less common conditions like gout, Osgood-Schlatters and osteochondritis –  will cause knee pain. (1)

 

The knee is a hinge joint that is formed by two bones  held together by four ligaments. The kneecap covers the ventral side of knee and enables a friction free pain free movement. The joint is surrounded by a membrane that produces  fluid which helps to feed the cartilage and also keep the area slippery. Between the bones from the upper leg and the lower leg, which both meet at the knee, is cartilage. This cartilage  cushions  the joint and  also creates a friction free motion.

 

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If you are only  overweight, it places excessive forces on the knee and will cause  wear and tear that can result in osteoarthritis. Research  shows that during walking the hips, knees and ankles will cater for up to five times a person’s total weight in force. What this means is that for every pound of extra weight a person carries another 5 pounds is an added to each knee during walking. Think of this in a different way – if a person was to lose 10 pounds in  weight  then this is  equivalent to 50 pounds of extra stress being removed from the joints.

 

Arthritis in the knee usually appears in people over the age of 50 and is much more common in people who are overweight or who may have suffered  knee injuries in their earlier years. Research has also found there is a genetic predisposition, which means that arthritis tends to run in families. (2)

 

The pain of having knee arthritis will only progress as the condition gets worse. It is  Interesting that  arthritis does not always progress steadily over time.  Many  people report that the symptoms fluctuate with the weather and  they have good months and bad months.

 

The most common symptom that is report is and increase in  pain with activity. They also have a  limited range of motion and  experience swelling in the joints, it sometimes feels as if the knee “gives out”. Individuals report having  stiffness in the joints with a tenderness when they press on the knee and sometimes the knee can become deformed. (3,4)

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According to a study done at the University of Iowa researchers discovered that women who had strong thigh muscles and quadriceps, were 50% less likely to develop knee pain compared to those who had the weakest muscles. This backs up previous research that found having strong quadriceps muscles protects against cartilage loss but the increased muscle strength does not prevent osteo arthritis but decreases the pain and symptoms that the woman experienced. The X-ray evidence from these women showed that 10% of the women with strong muscles who had no pain did have evidence of arthritis on x-ray. (5)

 

The aim of treatment is to decrease the pain in the joints through a multidisciplinary team approach. Patients are  evaluated and treated by physical therapists, who help develop programs to improve muscle strength, function and range of motion. Physicians and pharmacists work together to then find adequate  pain control while the social services  help individuals find support in the community and act as a liaison in the workplace. (6)

 

 

People who have arthritis in the knee will also  benefit from using a cane which is held in the hand opposite from the side with the arthritis. The cane must be of correct height which a medical supply company can adjust. Weight loss is of course another significant part of treatment in order to decrease the load bearing on the knee.

 

Some individuals find relief from mild to moderate pain by using cortisone injections into the joints. It is not however recommended more than every two to three months. While an ace bandaged could be helpful to control the swelling and give some psychological benefit, knee braces are generally not that helpful. Recent special braces developed specifically for people with osteo arthritis in the knee as well as wedged shoes have been successful in  decreasing the load bearing on the joints and subsequently the pain and degeneration of the cartilage.

 

 

 

Many who suffer from osteo arthritis of the knee  find that their lifestyle changes over time and as the disease progresses they start to lose more and more function. However, with some  dietary changes, weight loss, exercise and the support using a cane many people are able to continue to function well in their daily lives with only minor adjustments.

 

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Resources

(1) Medline Plus: Knee Pain
http://www.nlm.nih.gov/medlineplus/ency/article/003187.htm
(2)Trends in Molecular Medicine: Recent Advances in the Genetic Investigation of Osteoarthritis
http://www.ncbi.nlm.nih.gov/pubmed/15823757

 

(3) NHS Choices: Osteoarthritis – Symptoms
http://www.nhs.uk/Conditions/Osteoarthritis/Pages/Symptoms.aspx

 

(4) Johns Hopkins Medicine health Library: Osteoarthritis
http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/arthritis_and_other_rheumatic_diseases/osteoarthritis_85,P00061/

 

 

(5) American College of Rheumatology: Women with Strong Thigh Muscles Protected from Symptomatic Knee Osteoarthritis
http://www.rheumatology.org/about/newsroom/2009/2009_08_06.asp

 

 

(6) Annal of Rheumatic Diseases: Aerobic Walking or Strengthening Exercise for Osteoarthritis of the Knee
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1755453/