There is no cure for osteoarthritis (OA) of the knee, but various strategies can help reduce the risk, slow the damage, and manage symptoms.
Options range from staying active to total knee replacement surgery.
Before considering surgery, you’ll want to meet with your doctor to explore all of these options.
Prepare for your appointment by bringing this list of questions with you.
To help your doctor understand your needs, be ready to explain the following:
- How severe is your pain and stiffness on a scale from 1–10?
- Can you bend your knee and walk without assistance?
- Is OA impacting your quality of life?
- Do you exercise?
- Are you missing out on activities you enjoy?
- Is OA affecting your work?
- Have you previously had treatment for OA of the knee?
- Have you ever had a knee injury?
- Do you take any prescription drugs, dietary supplements, or over-the-counter (OTC) medications?
- How long have you been taking them, and in what doses?
- Do you have any allergies or other medical conditions?
You’ll be more likely to remember all these points if you make a list before your visit.
After updating your doctor on how you feel and how your knee pain is affecting your life, you may want to ask the following questions.
You may eventually opt for surgery, but, in the meantime, a few lifestyle changes can help improve symptoms.
Do I need to lose weight?
Your knees have to support the weight of your body, and extra weight creates additional stress.
Experts recommend weight loss as a way for people who are overweight or have obesity to reduce the symptoms of OA.
If you are overweight or have obesity, your doctor can give you some tips on how to lose or manage your weight in a healthy way, and how much weight you should aim to lose.
Do I need to exercise?
Knee pain and stiffness can make exercise daunting, but it’s still vitally important for your joints and your overall health.
Research has shown that walking, cycling, strengthening, and neuromuscular training can help. Experts also recommend tai chi and yoga.
A doctor or physical therapist can suggest exercises that will help with flexibility and increase your range of motion. If you build up your leg muscles, they’ll help support your knees.
A physical therapist may design a program for your particular needs.
Talk to your doctor about your lifestyle and daily activities, and ask what else you can do to avoid putting stress on your knees.
If you are going to have surgery, strengthening your knee muscles beforehand can be beneficial. Get some tips on exercises that can help.
Should I use an assistive device?
Certain assistive devices may help ease OA knee pain, but purchasing the wrong product or using it incorrectly can hurt more than help.
Your doctor may recommend or prescribe:
- a knee brace
- kineseo tape, a type of supportive dressing that allows maximum flexibility
- cane or walker
It’s a good idea to get a professional opinion on what to use and how to use it.
Medications that can help manage pain include:
- oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- topical NSAIDs and capsaicin, for rubbing onto the skin
- prescription drugs, such as duloxetine
In some cases, a doctor may prescribe tramadol. However, tramadol is an opioid, and opioids can be addictive. For this reason, they will likely try other options first.
Your doctor can advise you on the best option for you. Remember to follow the instructions precisely. Taking too much of any drug can lead to adverse effects.
If your current medication isn’t working, ask your doctor if there are any stronger alternatives.
Other options that may help reduce inflammation and ease pain include:
- heat and cold therapy
- radiofrequency ablation, which uses electrical current to heat nerve tissue
The American College of Rheumatology and Arthritis Foundation does not recommend the following treatments, as there is not enough evidence to show that they are effective. However, they may help provide relief from pain and improve function for some people.
- transcutaneous electrical stimulation (TENS)
- platelet-rich plasma cell injections
- botox injections
- hyaluronic acid
Further studies are needed to confirm that these therapies work.
Sometimes, OA can cause fluid to build up on the knee.
In a procedure called arthrocentesis, the doctor inserts a hollow needle into the joint space to remove fluid.
This can provide relief from pain and swelling, but
Ask your doctor if this is an appropriate therapy for you.
Corticosteroids are anti-inflammatories that your doctor can inject directly into your knee joint. Steroid injections can be done in your doctor’s office in a few minutes.
Glucocorticoids are a type of steroid. Injections can ease symptoms in many people, but their effect can vary between individuals.
In 2018, one
In 2019, however, experts recommended glucocorticoid injections. Despite possible damage to cartilage, they concluded that steroid use did not appear to worsen pain and joint function.
Viscosupplementation involves injecting a thick fluid called hyaluronate, or hyaluronic acid, into your knee.
However, according to guidelines issued in 2019, there is not enough reliable evidence to support the use of hyaluronic acid for OA of the knee.
A doctor will usually recommend surgery only if other treatments have not worked.
Surgical options include:
- Arthroscopic chondroplasty: Through small incisions, the doctor will trim and smooth damaged cartilage so that new cartilage can grow.
- Cartilage grafting: The surgeon takes healthy cartilage from another part of the knee to fill in where cartilage is damaged.
- Osteotomy: The surgeon will cut and reshape bone on the shin or thigh and take pressure off of the knee.
- Arthroplasty: The surgeon will carry out a partial or total knee replacement. They will remove the damaged bone and cartilage and replace the joint with a plastic or metal joint.
Questions about surgery
Questions to ask your doctor about surgery:
- How might this procedure help?
- What are the potential risks and complications?
- Is it an outpatient or inpatient procedure?
- How long will it take to return to work and my normal routine?
Click here for more questions to ask your doctor.
The approach for treating OA of the knee usually changes over time. A doctor will probably start by recommending lifestyle changes, such as weight loss and exercise. If symptoms progress, however, you may need to start thinking about surgery.
The more open and honest you are with your doctor about your symptoms, pain level, and mobility constraints, the better chance you’ll have of finding the treatment that’s best for you.