OSTEOARTHRITIS OF THE KNEE – Simple ways to reduce the pain

Dr Christopher Vertullo MBBS FRACS

Introduction

Osteoarthritis (degeneration) of the knee is unfortunately a very common cause of debilitating pain. The cartilage lining at the ends of the thigh bone (femur), shin bone (tibia) or knee cap

(patella) have become worn down. The cartilage is a padding that absorbs stress. Osteoarthritis is usually due to overuse, injury, deformity or excessive strain over prolonged periods of time.

In some cases the cartilage has completely worn through, resulting in bone rubbing on bone. Bones may also bulge or stick out, which is called a bone spur. This causes the pain, clicking,

heat, stiffness and swelling you may experience. There is no ‘miracle cure’ for arthritis, so beware. Clinically proven non-surgical treatments for knee osteoarthritis exist that can be used

safely in combination to give you significant pain relief and improved function. The more informed you are about your knee arthritis, the better you will be able to manage and cope with it.

Weight Loss

Losing excess weight is a sure and safe way to reduce arthritis pain and it can even stop it from getting worse. Obesity is an enormous factor in the development of osteoarthritis. Losing just 5kg halves your chance of knee osteoarthritis. The best way to lose weight is to eat less and exercise more. Talk to your family doctor, exercise specialist or a dietician for weight loss advice.

Non-Steroidal Anti-Inflammatory Drugs

(NSAID’s) & Paracetamol

NSAID’s decrease pain by blocking the pain pathway in your knees. Unfortunately all NSAID’s can cause stomach ulcers in some people. One good method of decreasing your chance of side effects is to take paracetamol regularly (1g every 4-6 hrs, max. 4g per day) and the NSAID just before you need it, such as prior to golf.

Glucosamine and Chondroitin Sulfate

These two nutritional supplements decrease the pain from knee arthritis in up to two thirds of patients and may actually prevent the progression of osteoarthritis. They are safer than NSAID’s and are available together in capsules at pharmacies. Current recommendations are to take 1500mg/day of the glucosamine and 1200mg/day of the chondroitin sulfate (3 tablets). Stop taking it if you have no improvement in pain after 8 weeks. Herron Osteoeze is a well recognised brand.

Regular Exercise

An active lifestyle if very important. Low impact exercises (swimming, bike riding and walking) are the least likely to cause knee pain. High impact exercises such as jogging and aerobics may increase your knee pain, but will not make your arthritis progress faster – so do whatever doesn’t hurt.

Knee Braces

Wearing a knee brace when you are active has been proven to decrease arthritic knee pain. The simplest brace is a neoprene brace with a patella cutout and are available from pharmacies and sports  stores. Depending on your demands, more expensive braces are also available, which alter the load across your knee.

Surgery

A knee replacement can give good results in severe cases of osteoarthritis. This is only advocated when conservative measures have been exhausted and are no longer helpful. Knee Arthroscopy can help some associated problems such as meniscal tears or loose bodies.

Strength, Flexibility and Balance Exercises

Specific exercises have been proven to reduce stress on the knee joint, resulting in less pain and stiffness. Stronger and more  flexible thigh, hamstring and calf muscles will provide enormous support and relief to the knee. Balance exercises are also crucial in protecting the knee when walking. Examples are included and illustrated on the PDF download.

For more information

Contact Arthritis and Osteoporosis NT

Download this fact sheet with references for further reading