Osteoarthritis (OA) is the most common type of arthritis. OA of the knee happens when the cartilage — the cushion between the knee joints — breaks down. This can cause pain, stiffness, and swelling.
There is no cure for OA of the knee, but treatment can help relieve discomfort and slow the damage. It can improve also your quality of life and help you better keep up with your day-to-day activities.
Your treatment options will depend on your individual needs. These include your medical history, level of pain, and the impact of OA on your daily life.
Treatment usually includes a combination of therapies and lifestyle choices. Experts from the American College of Rheumatology and the Arthritis Foundation (ACR/AF) issue guidelines on which options are most likely to help — but be sure to talk to your doctor before making any changes, big or small, to your treatment plan.
If you are currently overweight, losing even a few pounds help with OA. Losing weight can reduce the strain on your joints and, in doing so, help alleviate symptoms.
Weight loss may also help reduce inflammation and the risk of other health issues, such as high blood pressure, type 2 diabetes, and cardiovascular disease.
If you have OA of the knee and you are considered overweight or obese, it is likely your doctor will suggest coming up with a plan to help you lose weight.
Exercise is crucial if you have OA of the knee. It can help you:
- manage your weight
- build up muscle strength to support your knee joint
- stay mobile
- reduce stress
Suitable activities include low-impact aerobic exercise, including:
- swimming or other water aerobics
- tai chi
- stretching, strengthening, and balancing exercises
Riding a stationary bike can also help maintain strength in the quadriceps and hamstring muscle groups without putting pressure on your knee joints. You use these muscles, at the front and back of your thighs, when you stand up from a sitting position. They also help to stabilize the knee.
A doctor or physical therapist can help you prepare a suitable program.
Experts suggest working with a trainer or exercising with other people to help you stay motivated. It can be as simple as inviting a friend, neighbor, or family member to join you on a daily walk. This will make exercise a social event as well as a workout.
Over the counter (OTC) and prescription medications can help relieve pain and other symptoms associated with OA of the knee.
Some OTC options that may help you manage mild pain and discomfort include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin)
- acetaminophen (Tylenol), if you cannot tolerate NSAIDs
- topical preparations that contain NSAIDs or capsaicin
If OTC remedies are not effective, your doctor may prescribe:
- duloxetine (Cymbalta)
Tramadol is an opioid drug. The ACR/AF do not recommend using opioid drugs, as there is a risk of developing a dependency. However, if the other medicines do not work, a doctor may eventually prescribe an opioid.
In addition to exercise and medication, other non-medical therapies may help you better manage OA of he knee. These include:
- stress management activities, such as yoga and tai chi
- heat and cold packs for relieving pain and inflammation
- occupational therapy, which can teach new ways to manage everyday activities
- cognitive behavioral therapy, which can help you manage pain, discomfort, and the stress of living with a chronic condition
The ACR/AF do not recommend massage, manual therapy, or the use of transcutaneous electrical stimulation (TENS) for OA of the knee. The research has not shown that these alternative therapies are beneficial. That said, massage may have benefits beyond those directly relate to OA discomfort, including reducing your stress level.
Some people use colchicine, fish oil, or vitamin D for OA, but experts do not recommend these either, as they have not shown benefits in scientific studies. In addition, colchicine may have adverse side effects like diarrhea and vomiting.
The ACR/AF advise people to avoid medications like glucosamine, chondroitin sulfate, hydroxychloroquine, Botox injections, and hyaluronic acid injections, as there is not enough evidence to show they are safe or effective.
For severe pain and inflammation, a doctor may inject glucocorticoids or corticosteroids directly into the joint.
These can provide temporary relief, but they do not offer
If joint pain becomes severe, and other therapies don’t help, a doctor may recommend surgery. There are various surgical options for treating OA of the knee.
This is a minimally invasive procedure in which a surgeon uses an arthroscope, a type of camera, to view the inside of the knee.
While they do so, they can also repair an injury or clean out debris, such as bone fragments, from the joint to better preserve healthy joint tissue.
This can help relieve symptoms, and it is less invasive than total knee surgery. However, if you have OA of the knee, you may still find that you will need a total knee replacement in the future.
According to the American Academy of Orthopaedic Surgeons (AAOS), osteotomy may help if you have early-stage OA of the knee that affects the bone on only one side of the joint.
In this procedure, the surgeon will cut and reshape the bone. This will take pressure off the injured part and correct the alignment of the bones.
It may be suitable if you:
- are active, under the age of 60 years, and are not overweight
- have pain on just one side of the knee
- have OA mostly due to activity or standing for a long time
This type of surgery may help stop or slow the progress of joint damage.
Total knee replacement
In a total knee replacement, a surgeon removes the damaged tissue and bone and replaces the knee joint with an artificial joint.
They can do this through open or minimally invasive surgery. Factors such as activity level and the overall health of the individual help doctors to determine whether this is the best surgical option.
If OA is causing pain and stiffness in your knee joint, the first step is to ask your doctor to help you come up with an individualized treatment plan. Early intervention is the best way to stop joint damage from getting worse — and more painful — over time.
Ask your doctor about best options for exercise and medication. It is also beneficial to discuss whether a weight loss program is right for you. These, as well as other lifestyle changes, can usually postpone the need for surgery for several years.
With the right treatment, you can get the relief you need to better manage your symptoms and stay active.