Knee osteoarthritis

Osteoarthritis is a degenerative condition of the joints. Generally speaking, it occurs as a consequence of joint wear and tear. Knee osteoarthritis can cause no symptoms; alternatively it can cause pain, swelling and locking of the knee.

It is important to note that knee arthritis does not always get worse. Progression of symptoms is more likely if:

you are overweight
you smoke
you have had a knee injury causing permanent damage to the supporting structures of the knee.

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Causes and symptoms

What causes knee osteoarthritis?

Several factors normally combine to cause symptoms of osteoarthritis:

Previous joint damage (from trauma or other conditions such as such as gout and rheumatoid arthritis)
Increased bodyweight
Reduced physical activity

What are the symptoms of knee osteoarthritis?

The main symptoms of osteoarthritis are:

Pain
Stiffness
Swelling

Pain can be felt anywhere around the knee, or in one place such as the front or the sides. Your pain may get worse after certain activities, such as going up or down stairs. Knee pain is often worse after activity and at the end of the day. Sometimes you may feel your knee creak or crunch as you move it; this is nothing to worry about. The knee joint often feels stiff in the morning, this should settle within 30 minutes.

Diagnosis of knee osteoarthritis

A diagnosis of knee arthritis can be made during a physical examination. An X-ray maybe requested to look for osteoarthritis in the knee. However, it is important to note that the severity of arthritis on an X-ray does not correlate well with the severity of symptoms.

Self management of knee osteoarthritis

Footwear

Poor ankle support is a common cause of knee pain, therefore ensuring you wear well maintained footwear that supports the ankle is important in the management of knee pain. Some people will find orthotics beneficial. Speak to your healthcare team to arrange this.

Weight loss

If you are overweight you are putting extra load through your knee. This will be contributing to your arthritis/degenerative meniscus, therefore losing weight will improve your symptoms.

There are useful tools to find out if your weight is contributing to your arthritis and advice on losing weight on the NHS website:

BMI calculator Weight loss plan Exercise advice

Warm and cold compresses

Warm compresses can be useful for your day to day pain, whereas cold compresses are useful to manage swelling and pain as a result of that swelling.

Walking aids (e.g. Nordic walking poles)

Using walking aids in both hands can significantly reduce the load through your knees, allowing you to keep mobile for longer.

Painkillers

Various over the counter pain killers are available for the management of pain. It is important to note these will not cure the condition, only numb the pain. It is therefore important to continue with all other aspects of treatment. If you have any questions your local pharmacy will be able to advise about what is safe.

Knee exercises

When starting an exercise for the first time it is important to ‘start low and go slow’. This means start with gentle exercises concentrating on the movement and slowly progress through weight bearing to resistance exercises.

It is important to note that exercise with arthritis/degenerative meniscus is completely safe and will not make your condition worse.

Pain killers can be used to help you do the exercises. Talk to your doctor for more specific advice regarding pain killers.

There are many other options which can improve your pain including appropriate footwear and weight loss (if you are overweight).

Exercise 1: seated knee extension

Sit upright with your thighs supported on a chair.
Bend your target knee as far back as possible.
Straighten your target knee as far as possible and hold for a few seconds, then relax and lower.
Don’t lift your thighs off the chair.

Exercise 2: heel slides

Lie on your back with your knees bent.
Slide one heel out to straighten your knee.
Hold in this position, feeling a gentle stretch in the back of your thigh, then return to the starting position.

Exercise 3: inner range quads in supine

Place a rolled up towel or other object under your knee.
Slowly straighten your knee as you raise your foot.
Keep your knee on the towel at all times.
Lower back down and repeat.

Exercise 4: step up

Slowly step up and down on a step.
Lead with your affected leg both ways.

Exercise 5: chair squat

Stand in front of a chair of an appropriate height (a lower chair increases the difficulty and a higher chair is less difficult).
With your feet about a shoulder width apart, sit with your hips back as if to sit into a chair whilst raising your arms in front of you.
Touch the chair with your bottom and then return to standing whilst lowering your arms.

What next?

If you are still experiencing symptoms despite following the above advice, it is important you seek advice from your GP. Your GP may decide to refer you to the musculoskeletal clinic or to a physiotherapist.

Page updated 01/12/2020. Review date 01/01/2024

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