Osteoarthritis (OA) is the most common joint disease in the world. And the joint it affects the most? Knees.
Your knees bear a lot of weight. They have diverse functionality and support numerous movements and activities. This is why, knee OA patients struggle to perform their day-to-day activities and experience a reduced quality of life.
However, OA symptoms are manageable. With the right treatment methods, you may experience a significant reduction in pain, which may help you get back to a better, more active lifestyle.
In this article, we will discuss some common treatment methods to help you manage knee OA. But first, let’s discuss what osteoarthritis is.
What is Osteoarthritis?
Osteoarthritis is a degenerative joint disease. It breaks down the cartilage (a tissue that acts as a shock absorber between the bones within a joint) and affects the underlying bone. Once the cartilage is damaged, bones start to rub against each other. This may result in the patients experiencing discomfort, pain and/or stiffness in the affected area.
Image source: Australian Orthopaedic Association
Osteoarthritis can be asymptomatic. People may continue to live with depleting cartilage without realizing it. However, more often than not, it does present some very clear symptoms.
In the case of knee osteoarthritis, you may experience pain and/or stiffness (mainly morning stiffness less than 30 minutes) in one or both of your knees. Knee OA may also reduce the range of motion of your knee which means you may not be able to move your joint too far. OA may also produce muscle weakness, though this symptom alone may not necessarily hint towards developing osteoarthritis.
Managing Knee Osteoarthritis
You cannot rebuild the cartilage between your joints. Once it’s gone, it is likely gone forever. This is why, osteoarthritis tends to be an irreversible condition. And no treatment is yet available to restore cartilage and undo the damage that has been done.
But before you despair, here’s the good news: you can manage the symptoms of your knee osteoarthritis and feel likely your knee is perfectly normal!! And doing this can help you reduce pain, improve the quality of your life, and get back to your normal day-to-day activities.
We outline some of the exercise-based and non-exercise methods for managing your knee OA below.
Aerobic and Strengthening Exercise
Exercise is the primary non-surgical management strategy for treating knee OA. You can choose from a wide variety of exercises to work on managing your OA symptoms. These exercises may include strength training, aerobic and aquatic exercises, and yoga.
Select a group of exercises that you enjoy. Then perform them consistently to potentially reduce pain and move towards a better lifestyle.
Remember, a little bit of pain and discomfort in the affected area is common while exercising. However, if your knee pain exceeds your usual levels, it may be a sign that your knee is not yet capable of bearing the load you are exerting on it. At this point, it may be best to tone down your exercise instead of giving it all up.
If you feel too much discomfort or pain, you can try to slow down the movement, decrease the range of motion, use lighter weight,, or reduce the duration, frequency or intensity of your workout.
Some exercises you can perform at home to improve your OA symptoms include:
Squats
Slowly lower yourself into a chair and stand back up. Be sure to keep your back straight.
You can perform this exercise with or without upper body support.
If going all the way down to the chair feels difficult, consider putting a cushion on the chair. This will help elevate the surface so you don’t have to bend all the way down.
Step Ups
Step-ups are very simple. You can easily do them at your home or in the office.
To perform step-ups, stand in front of the stairs. Place your left foot on the step. Tighten your left thigh muscles to engage them. Then step up and touch the right foot on the step. Keep your muscles engaged as you lower yourself back and touch the right foot on the ground before repeating.
Bridges
Bridges help you engage and strengthen multiple muscle groups including your core, thighs, and legs.
To perform a bridge, lie flat on the ground with your knees bent and feet rested flat against it. Raise your hips towards the ceiling until they are in line with your knees and shoulders.
If this is too easy, you can increase the difficulty by doing more repetitions. You can also make a bridge more difficult by keeping one leg off the ground and then raising your hips so your body is supported by one leg only.
Calf Raises
To perform a calf raise, stand tall. You can hold the back of a chair or a countertop for support. Lift your heels off the ground and rise on your toes. Hold for a few seconds. Then gradually lower your heels to the ground.
You can start with 2 sets of 10 repetitions and adjust if this feels too much or too little.
Split Squats
Stand two feet in front of a sturdy bench or chair. Place your feet hip distance apart. Pick your right foot up and place it on the bench behind you. Now bend your left knee and allow your right knee and ankle to bend naturally as you go down. Lower until your left quadriceps is parallel to the ground. Stand back up and repeat.
Hamstring Stretch
This exercise can help you keep your hamstring loose and flexible, which in turn can help make daily activities like walking and bending over easier.
There are multiple ways you can stretch your hamstrings. One simple method is to do it while standing.
Stand with your back straight and extend one leg out. Bend from your hip joints to bring your chest towards your thighs. The non-extended leg may bend at the knee. Go only as far as you can without pain. Hold the position for a few seconds. Then switch legs and repeat 2 to 4 times.
Non-exercise Methods
Exercise should always be your go-to approach for managing OA. However, there could be times when exercising may not be possible, such as if your pain is far too severe for you to move about. In these cases, non-exercise methods can help bring down the pain. Once the pain is under control, you might be able to start exercising.
Here are a few non-exercise methods that can help manage knee OA:
Weightloss
Weight loss is possibly one of the best approaches to managing your OA symptoms. You may have to lose at least 5 to 7.5% of your body weight for effective management of knee osteoarthritis [1].
Losing weight, however, is not easy. Therefore, it may be better if you focus on developing healthy habits that promote overall health. Weight loss may come as a bonus and help reduce OA pains.
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
Taking NSAIDs orally and tropically is strongly recommended to help manage pain and discomfort from knee osteoarthritis. These drugs can help reduce pain. This may also enable you to continue your daily activities and do some exercise that can further alleviate those OA symptoms.
Make sure to talk to your doctors before starting any oral or topical NSAIDs to avoid any unnecessary side effects.
Corticosteroidal Injections
CSIs do help improve knee OA symptoms. However, the risks of taking steroids may outweigh its benefits. They may provide short-term relief. However, using them long-term may present severe adverse side effects that may be irreversible [2]. So, try and manage your OA symptoms with other methods and only go for CSIs as a last resort.
Total Knee Replacement Surgery
You don’t want to get your knees replaced unless you have tried everything else and have seen no improvement. Your doctor may also only recommend a total knee replacement surgery if you are suffering from end-stage osteoarthritis and your quality of life has reduced greatly.
Takeaway
Living with knee osteoarthritis is hard. And while the condition may be irreversible, it can be managed with simple methods.
Exercise is the best approach to managing your knee OA symptoms. There are many simple but effective exercises that you can easily do at home.
Your healthcare team may also suggest CSIs and knee replacement when you are looking for a treatment plan. But please note that CSIs only offer short-term relief, and surgery should be considered for end-stage osteoarthritis.
The effectiveness of Stem cell injections and knee arthroscopy procedures are still controversial. There are clinical practice guidelines that present strong recommendations against these procedures. So be sure to do your research before going for either of these two methods.
Always consult with a qualified health professional before starting any treatment plan.
References
[1] Guideline for the management of knee and hip osteoarthritis. Royal Australian College of General Practitioners.
[2] Corticosteroid Adverse Effects. National Center for Biotechnology Information.