Know the Warning Signs of Knee Osteoarthritis

Cartilage is a smooth but tough tissue that stops the bones from rubbing together and prevents damage. It allows the bones to move pass smoothly over each other. As people get older, the weight they carry can cause the cartilage to wear away.

As the cartilage breaks down and the bones rub together, osteoarthritis (OA) can result.

OA is the most common type of arthritis. The symptoms include swelling, pain, and stiffness. When it affects the knee, it can be difficult for a person to exercise, to climb stairs, or even to walk.

Early signs and symptoms

OA usually affects people who are over 50 years of age, but it can happen earlier, too.

Symptoms that can appear at the early stages of knee OA are:

• pain, especially on bending and straightening the knee and with weight bearing
• swelling, caused by a buildup of fluid in the joint, or by bony growths called osteophytes that form as the cartilage breaks down
• warmth in the skin over the knee, especially at the end of the day
• tenderness when pressing down on the knee
• stiffness when moving the joint, especially first thing in the morning or after a period of inactivity or walking
• creaking or cracking on bending, known as crepitus

Activity can make symptoms worse, leading to pain at the end of the day, especially after a long time of standing or walking.

If the knee is red, the person has a fever, or both symptoms occur, the problem is probably not OA.

Treatment

Treatment of OA depends on how severe the symptoms are.

Home treatment

Some remedies and over-the-counter treatments for OA of the knee can be used at home and are readily available from the pharmacy.

These include:

• Applying heat or cold: Heat relieves stiffness, and cold can ease pain and swelling. The heating pad or ice pack should be covered with a towel so as not to burn the skin.
• Using an assistive device: A cane or walker can help take some of the weight off of the knees. Holding the cane in the opposite hand to the painful knee is most effective.
• Pain relief medications: These are available over the counter, but people should use them with caution as they can cause side effects.

Medical treatment

If home or over-the-counter remedies do not help, the person should see a doctor.

They may prescribe one of the following:

• steroid injections in the knee joint to reduce inflammation
• physical therapy, with exercises to improve flexibility and range of motion in the joint

If these solutions do not work and damage is severe, the physician may recommend surgery to replace the joint.

When to see a doctor

For some people, pain and other symptoms are severe enough to interfere with daily life, and over-the-counter medications do not help.

The next step is to consult a general physician, who may refer the person to a rheumatologist or orthopedic surgeon.

To find out whether a patient has OA, the doctor may ask:

• When and how did the pain start?
• Where does it hurt?
• Is there any stiffness, creaking, warmth, or swelling?
• What makes it better? What makes it worse?
• How have you treated it? Did home treatments work?
• How have the symptoms affected daily activities?

The doctor will examine the knees, moving them forward and back to note the range of motion and to find out which movements cause pain.

They will look for areas of tenderness, check the warmth and see if any swelling is present. The physician will also check the ligaments for stability.

Diagnosis