Knee arthritis affects 6% of the population with the NHS reporting 10 million suffers in the UK. With varying symptoms from none at all to hot swollen joints that are constantly stiff and painful, every person with arthritis manages their condition as best they can. There is no cure, however, there is a lot that you can do to help living with arthritis knee pain. Let’s explore arthritis in the knee some more.
Osteoarthritis in the knee is the most common form of arthritis. It is what most people refer to when they talk about arthritis in the knee, a long term form of wear and tear damage over time. Most commonly affecting those over 50 years old but can affect those younger. Referring most commonly to the wearing of the cartilage and surfaces of the joint, including a narrowing of the joint space between the two bones that make up the knee.
There are 3 bones that make up the knee; the top of the knee is formed by the femur (the thigh bone) which has two rounded surfaces that are joined by ligaments to the tibia (shin bone) which is flatter surface. To allow the bones to move on one another the top of the tibia is covered in more fibrous, thicker connective tissue known as the meniscus, we have one for each surface of the femur. This is the hinge joint of the knee which gives us the ability to bend and straighten our knee. Sitting on top of this joint is one with the kneecap (patella), it sits within the tendons that come from the quadriceps muscles (front of thigh) to the top of the tibia to straighten our knees.
There is a lot going on in this joint! And over time that activity causes wear and tear, some people may have accidents or damage over time that leads to tears in the cartilage which thins over time, particularly with knee arthroscopy surgery (removing tears in the meniscus). You can begin to get symptoms with mild changes to the joint, particularly if you’re not a person who is regularly active. Others may begin to develop more pain when sitting and coming downstairs, this would indicate to more of a knee cap related problem.
Stage 0 - Healthy
When there are no signs and symptoms of arthritis, this is given a score of stage 0 knee arthritis, a healthy knee. There is no need for treatment or manage. A simple knee x-ray would be normal.
Stage 1 - Minor
In stage 1 arthritis of the knee there are small and mild changes, minor wear and tear changes might be seen, with occasional or no symptoms. Low level bone changes may occur, like very small bone spurs which may or may not be easily seen on an x-ray. It’s likely that you still wouldn’t need any treatment at this stage, but now is a good time to think about creating a leg based strength and exercise programme.
Stage 2 - Mild
Worsening of the symptoms are seen in Stage 2 arthritis, with perhaps more frequent pain or discomfort. You’re likely to feel more stiffness in the joint and symptoms that are worse at the start and end of the day, particularly if being active. On x-ray there may be further bone growth but the joint space will still be maintained.
Stage 3 - Moderate
With moderate arthritis, in an x-ray may start looking now that there is less space between the bones. Your pain may be more frequent or severe and you might be experiencing painful swelling. The behaviour of your knee may also be less predictable, it may flare up with the slightest use and take days to settle. At these stages you would want to consider strategies around pain management, wearing support to reduce joint strain and regular hot and cold packs.
Stage 4 - Severe
In severe knee arthritis your joint space is particularly narrow and there is some bone-to-bone contact which is audible when moving. There is likely to be a loss of cartilage and pain and stiffness with moving around. At this point you might be talking to a consultant about looking at surgical options and we’d definitely recommend exercise under the supervision of a physiotherapist and activities that you can manage to keep you healthy.
The most common symptom you might have with arthritis is pain, it may be occasional at first, only feeling it after strenuous activity or exertion. We all suffer from wear and tear just being alive! And being active doesn’t mean that arthritis is more likely to happen for you than people who are less active. If fact active people are better off when it comes to wear and tear than those who are less active.
Pain is different for everyone with arthritis and it can be hard to hear advice from everyone who’s ever had knee pain and what helped then, as there are so many of us! If you knee pain has started suddenly and related to an accident or fall or if you find that your knee has got significantly worse in a short space of time, you may need to visit your GP or physiotherapist for assessment.
Pain in knee arthritis is due to the wear and tear on the joint surfaces than narrow the joint space over time. In severe arthritis or grade 4, there is likely to be bone-on-bone contact, where minimal or no joint space is maintained, so all movements may be painful. At this point, pain is to be managed and wearing a support on a daily basis may be one of the few things you can do to cope.
A reduction or difficulty in your knee movement is another common symptoms in arthritis. It may be that you wake up in the morning with a feeling of stiffness around the knee and knee cap, a feeling that you know you haven’t moved all night. This type of stiffness commonly eased within the first few hours of waking and can be helped by a good morning routine of gentle exercises before you get out of bed and a warm shower or bath.
Others with knee arthritis may find that their stiffness begins to set in later in the day and is related to how much activity they do during the day. If you suffer with this type of stiffness then looking at your overall fitness and exercise routine should help you knee cope better with the stresses and strains on the day as being stronger and fitter will reduce the joint pressure. Remember not just to rest your knee at the end of a long day but gently keep it moving throughout the evening so it doesn’t stiffen more overnight.
If you are finding that your stiffness is caused a reduced range of movement, especially if you are unable to fully straighten your knee then do see your GP or physiotherapist for additional advice and support to get your knee range of movement back, which is essential for your walking and day to day activities.
Over time, pain can result in you doing less and moving your knee less. You may have even cut down on activity believing this will help manage the symptoms - this strategy can be greatly effective in the short term however of months and years this can lead to your knee becoming weaker and the knee muscles gradually weaken over time.
This can also happen suddenly, that you don’t trust your knee or it begins to feel like it will give way if you put too much pressure onto it, if this is the case it is often caused by the pain you are struggling with. As the brain responds to signals from the knee, and you feel pain, the brain switches the thigh muscles off almost as a protective or reactive mechanism. This means the knee gives way and you might have even had a few ‘near-miss’ falls because of it. Its unsettling and unfortunately can lead to those with arthritis being even less active!
For weakness and giving way, a regular exercise routine is recommended for the long term strengthening of the muscles and protecting of the knee joint. Before your knee feels strong enough to cope with this by itself we recommend using a knee support to avoid any knee giving way.
If you have stage 2 knee arthritis, you would benefit from wearing the Essential Wellness Knee Supportfor any increase in your usual activity, gym exercises and strenuous activity. This will give you all round comfort and protection from giving way and reduce any additional strain going into the knee. For stage 2 arthritis you are less likely to need to wear a knee support for the rest of the time but you may find that it helps you feel confident and keep going rather than fatigue making your knee pain worse.
If you have stage 3 or 4 arthritis or have pain more constantly and it’s stopping you from doing the things you love, then wearing a knee support will return the freedom to your knee and increase your happiness. At this stage you might feel like coming down the stairs is painful and can feel unsteady or other everyday tasks like kneeling, squatting and getting out of your car. If these are hurting you then an Essential Wellness Knee Supportcan be with you every step of the way.
We’re sorry for those who have to deal everyday with giving way at weakness stage 3 or 4 of arthritis, where you don’t trust your legs to carry you about. Or if giving way means you are falling, we hate to think anyone is having to live daily with knee arthritis like this, lacking the support their knee requires. That’s why we also have a more rigid brace that can give stability and confidence where you need it most. The Essential Wellness Hinged Knee Brace prevents strain from side to side, keeps your knee aligned as much as possible, even if your knee shape has changed. It can be worn snuggly all day to keep you on the go.
Another common symptom in knee arthritis, even in early staging the body will be trying to protect the joint with swelling. If you find your knee is getting hot after activities this is also a sign of more active swelling and inflammation. At these times we’d always recommend reverting back to a cold pack routine to reduce the heat and ease the pressure of the swelling. You might also want to measure your knee swelling to see if it changes over time, it may even be a warning sign of periods of more pain with your arthritis.
Swelling can be defined as, an abnormal enlargement of the body, typically as a result of an accumulation of fluid. In the knee this fluid could be a build up to protect the joint surfaces, it may come on as a reaction to something or gradually stir up over time. Or it could be an active inflammation that has happened as a result of a fall or injury, more commonly this is associated with heat in the knee as well.
Regardless of what it causing your inflammation it can make the knee joint even more painful! If it’s stopping you from moving your knee within the usual range of movement think about using the Essential Wellness Compression Knee Sleeve and get that swelling under control. If it hasn't settled in 2-3 weeks please get advice from your local Pharmacist, GP or physiotherapist who will be able to advise you in the ways you can get it under control.
If you are experiencing early symptoms of mild arthritis with mild pain and some stiffness you are one of many who tries to continue living life as normal. Good news is there are several things you can do to improve your symptoms.
You may not always feel like exercising if your knees are sore, however getting up and moving them will help.
Everybody's knee arthritis symptoms can vary and it's common to go through flare ups. At these times we might have to adapt your life to manage having knee arthritis. What do you do? Can you remember a flare up you've had this year?
Flare ups can come on due to suddenly increasing your activity and sometimes it can feel like it's for no reason at all. It can creep up suddenly or you might see warning signs.
Have a think, what are your warning signs?
Some people start feeling uneasy several days before the pain gets significantly worse, perhaps you are experiencing a lack of concentration or you’re finding it more difficult to get to sleep.
Other symptoms can include a more intense feeling of stiffness or heat coming from the knee. If you feel that the joint is changing then this again can be an early warning that something, some activity, or the weather or your condition has changed so your symptoms can resurface, feeling worse than previously.