Living with Knee Arthritis - Ultimate Guide

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.

Walking is the simplest way to get into exercise for your arthritis. Starting at a steady pace and build up 3 key things: frequency, time and speed. When you first start walking you may find that you get a few more aches and pains, you’ll build off up time, first of all, perhaps starting with a weekly walk and then begin to build up in frequency. How many walks are you doing at the moment?

As you build up stamina and are able to walk in regular 20 minute or longer intervals you may want to start thinking about speed. If you quicken your pace you’ll find you begin to get out of breath and your pulse quickens. Brisk walking helps your heart so your general health will improve, stairs will be easier and you may find daily tasks become easier too.

The food we choose to eat cannot be underestimated. What we put into our mouths keeps our bowels, muscles and brains healthy. Getting a variety of foods in our diet can sometimes be challenging, but reducing our intake of processed and salty foods can greatly support the body to keep the joints healthy. Some people benefit from turning to supplements to boost essential vitamins and minerals.

Eating well is good for all of us, and if you are carrying extra weight then losing some of it means less load going through the knee every time you take a step. Your GP or physiotherapist can help you work out what is realistic for you, and small sustainable changes tend to beat dramatic ones.

We also can’t talk about diet without talking about hydration. Drinking enough through the day is sensible general health advice, and hot drinks count towards it. We are not going to tell you it loosens your joints, because that is not a claim we can stand behind. It is simply an easy habit to get right while you work on the things that do change how your knee feels.

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.

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.

Managing a long term condition like knee arthritis you are likely to experience a flare up from time to time. Perhaps in the initial onset of your symptoms you may find the knee are more irritable and tend to flare up more easily with a change or increase in activity. For this reason we’d advise everyone to have their own unique ‘flare up kit’ to hand. Whether put together as you need it or stored in the bathroom ready to go, here are a few essentials to consider:

If you feel like your symptoms are more persistent or your knee has started feeling more sore than usual then a knee support can often go some ways to dealing with your symptoms. If you find your symptoms can be flared up easily then it’s highly worth considering the investment. Finding your perfect knee support that matches the level of support you need can be the difference between living life as normal or still feeling like things are a struggle. Even at times when your knee pain might be better.


On a good day, a knee support can allow you increased freedom of movement and the enjoyment of getting things done that you might have otherwise struggled with. Whether increasing your level of walking, heading to the gym or simply getting out into the garden. Depending on the level of support you need would depend on the type of support that would support you best.


A compression sleeve is great for all round support for arthritis in those that find they are getting through their usual tasks but any increase in speed or having a busy day can cause your knee to feel more sore towards the end of the day. Some of you may find that you need something extra both the knee support and hinged knee brace offer extra tiers of support so depending on your symptoms you may find that you move between using 2 supports to manage your symptoms more easily and limit the impact flare ups have on your life.

Many people are reluctant to take pain killers, you might be one of them, but when flare ups strike they can be vital at helping you get through the first few days without taking to your bed. When you have a flare up it’s best to keep moving and not take to your bed, or the sofa and rest more that 24 - 48 hours, after this period the benefits of resting are outweighed by the loss of muscle and the stiffness that can begin to set into the knees.

It might be hard to believe you lose muscle after just 3 days of bed rest, we don’t recommend anyone takes to their bed unless completely necessary. This is where pain relief can come in handy. Whether you have already been prescribed something by your GP or if you can speak to your local pharmacist about pain relief, starting on a course for a few days of taking tablets to manage your flare up can be far more effective that waiting until you pain has reached a 10/10 unbearable score. Once your pain has reached this difficult level is quite unrealistic to take 2 paracetamol and expect a huge relief.

If you aren’t a fan of taking tablets, perhaps reserve these for your flare up times and talk to your local GP or pharmacist about how you can use them effectively to manage a flare up if you feel it coming and for the weeks afterwards. Many people with arthritis go through a boom and bust cycle of flare up and recovery, pain and relief, activity and inactivity. The goal of pain management is to use this as a tool to maintain our activity, keeping our bodies healthy and gradually, if we can. Build more activity and exercise into our routine over time. This is the opposite sentiment to racing out into the garden on our first summer’s day and doing 6 hours of gardening and no expecting to feel the consequences the following day!

Don’t forget pain relief for knee arthritis can also come in other forms, TENS is a non invasive treatment for pain relief taking advantage of the way the body uses nerves to send messages that are interpreted by the brain as pain. The TENS acts to interrupt these messages using different receptors so that you feel the TENS sensation rather than your pain.

Experiences of using TENS for pain relief in the knee varies from person to person in terms of success and tolerance so do seek medical advice before making this purchase.

Another two items that can be invaluable for managing your symptoms during a knee arthritis flare up are hot and cold - mainly in the form of a hot water bottle and an ice pack. There is much debate on which should be used when and I usually try to keep it simple. What brings you the most relief?

If you feel that your knee is affected by cold, damp weather. That you wear extra layers to keep the joint warm, if you often feel stiffness in the joint or if you have a persistent deep ache that is unrelenting - try heat. Use a hot water bottle, wrapped in a towel to protect your skin and let it sit over the sore knee for 20-30 minutes. Try to move the knee gently from fully straight to fully bent (as pain allows) at the end of the time and free up any stiffness in the joint.


Heat can be a great easier of pain, and if you feel benefits from this, then good news there are other ways to incorporate this into your management - hydrotherapy, hot tubs, steam rooms and hot baths can all bring similar relief (please ensure that it is medically safe for you to use a steam room/sauna etc) your local physiotherapist or GP may be able to refer you to a hydrotherapy facility.

A great relief to those joints that feel warm to touch, that may also be swollen and stiff due to this. If you’re feeling that your joint feels warm then consider using an ice pack or most simply, a frozen bag of peas wrapped in a towel, for up to 20 minutes at a time. Similar to using heat, stretch and move the knee after applying the cold treatment. The key to healthy joints is movement so keep that going whenever you can. You may also find that it works well for you to use cold preemptively. That applying a cold pack after a day in the garden, on the trails or a session at the gym can help rehabilitate the joint and prevent any big reaction of the arthritis from the activity.