Knee Osteoarthritis is a natural degenerative process where the cartilage that spaces a joint start to change and thin over time, meaning the bones gets closer together, and can occur in any joint in the body. Osteoarthritis is a part of the normal ageing process and is most commonly seen in people over the age of 40.
Knee Osteoarthritis can also be impacted by your occupation or your sporting hobbies. Past injury/trauma to your knee such as a fracture, dislocation, infection cartilage tears can also impact osteoarthritis.
The most common symptoms of Knee OA are:
- Limited function in daily tasks
- Pain
- Reduced movement of the knee joint
- Pain is worse with or after activity
- Stiffness worse with inactivity
- Symptoms can flare or settle with changing seasons
- The knee has gradually changed in shape and size over time
Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
An X-Ray is generally not needed to confirm osteoarthritis. One may be performed if the Health Care Professional needs further information to finalise the diagnosis or if surgery is being considered.
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.
Once your pain is under control, working on the movement and strength of your knee is what will help long term.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your knee to get you started.
The Osteoarthritis Self-management and Independent-living Support (OASIS) group is a programme with appropriate and progressive exercise at its core, alongside key education about OA to heighten your confidence in self-management through learning and understanding to create a holistic approach to treatment. This programme is now available in the community in certain locations. Please speak to a Health Care Professional to find out if the OASIS Group is available in your area.
Download the OASIS guidebook for help and advice on managing osteoarthritis.
Pease see the video below for more information about OASIS in the community.
It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.
The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.
Heel raises
Hold on to a solid object with your legs hips width apart. Keeping your knees straight, rise up on to your toes, and control the movement as you lower back down.
Single-leg stand
Balance on one leg. Remember to stand tall, with weight evenly on your foot and toes pointing forwards.
Seated knee extension
Sit upright on a chair. Slowly straighten your affected knee, pointing your toes towards the ceiling. Control the movement as you slowly lower the leg back down.
Gentle Squat
Stand behind a chair or table and place your hands onto the back rest.
Keeping your back straight, bend both knees into a semi-squatting position, allowing your hands to slide forwards.
Your hips should travel backwards as you counterbalance by leaning your chest forwards.
Push through your buttock and thigh muscles as you return to standing, and repeat.
Sit to Stand
Sit in a chair with your feet flat on the floor.
Cross your arms in front of your chest so you are not tempted to push off of your thighs for momentum.
Stand up, then slowly sit back down and repeat a number of times.
Step Ups
Stand facing a step.
Place your affected leg up on the step.
Step up bringing your other leg onto the step and then step back down to the start position using the same leg.
Make sure your knee travels forwards over your toes during this exercise.
Your affected leg will stay on the step throughout this exercise.
Unless you have a serious injury or have sudden continuous severe pain, you can usually treat your knee pain without having to see your doctor. If after 2 weeks of treating yourself you feel the pain isn’t any better or is worsening, you should see a Health Care Professional
You should also see a Health Care Professional if you:
- Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
- Have pain that has rapidly deteriorated or suddenly worsened despite self help
- Have pain, tingling, numbness or weakness in your legs and feet
- Develop sudden stiffness in the knee resulting in a complete loss of movement (also known as locking)
- Are noticing changes to your balance or walking pattern
- Are feeling clumsy or are falling more often
- Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
- Feel unwell, have a fever, or unexplained weight loss
- Are experiencing significant and regular changes to your usual sleeping pattern
- Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of knee surgery
- Have a new and visible deformed or misshapen knee
- Your knee is giving way
If you do not have any of the above, you may be able to effectively self-manage your condition
Decision support tools, also called patient decision aids, support shared decision making by making treatment, care and support options explicit. They provide evidence-based information about the associated benefits/harms and help patients to consider what matters most to them in relation to the possible outcomes, including doing nothing.
These decision support tools are designed to support shared decision making between people and a clinician. People may find they are useful before, during or between consultations depending on their care pathway.