Knee Osteoarthritis: Knee Pain Causes, Exercises and Care

7 min read · Conditions · By the Asthra Health Care team

What is knee osteoarthritis?

The ends of the bones in the knee are covered by smooth, slippery cartilage that lets the joint move easily. In osteoarthritis, this cartilage slowly thins and becomes rough. The bone underneath reacts by thickening and forming small bony spurs, and the joint lining can become inflamed. The result is pain, stiffness and sometimes swelling.

Knee osteoarthritis is very common in India, especially after the age of 50 and more so in women. It is a long-term condition, but it does not always get worse, and many people manage it well enough to walk, work and enjoy daily life.

Knee osteoarthritis: causes and risk factors

Osteoarthritis is not simply wear and tear. It results from a mix of age, weight, joint shape, past injury and genes. Everyday habits common in Indian homes, such as sitting cross-legged on the floor, squatting and climbing many stairs, can make symptoms worse in a knee that already has arthritis. Risk factors include:

• Older age
• Being female, especially after menopause
• Being overweight, which puts extra load on the knees
• Past knee injury, such as ligament or meniscus tears
• Bow legs or knock knees
• Jobs involving heavy lifting or kneeling
• Family history of osteoarthritis

Symptoms of knee osteoarthritis

The main symptom is knee pain that gets worse with activity, such as walking, climbing stairs or getting up from a chair, and eases with rest. The knee may feel stiff in the morning or after sitting, usually for less than half an hour. There may be a grinding or crackling feeling, swelling, and a sense of the knee giving way.

Over time, the knee can become bent or bowed and it may be hard to straighten it fully. Pain may come in flares, often after a lot of activity or in cold, damp weather, and then settle again. Keeping a simple diary of what worsens your pain can help your doctor.

How knee osteoarthritis is diagnosed

Doctors can often diagnose knee osteoarthritis from your age, symptoms and a physical examination. An X-ray of the knee, taken while standing, shows narrowing of the joint space and bony spurs. The X-ray findings do not always match the pain; some people with bad X-rays have little pain and the other way round.

Blood tests are not needed to diagnose osteoarthritis, but they may be done to rule out other types of arthritis, such as rheumatoid arthritis or gout, if there is marked swelling, several joints are involved or symptoms are unusual. An MRI is rarely needed.

Exercise and self-care

Exercise is one of the most effective treatments. Strengthening the thigh muscles (quadriceps) takes load off the knee and reduces pain. Simple exercises such as straight leg raises, pressing the knee down into a rolled towel, and sitting-to-standing from a chair help. Low-impact activities like walking on flat ground, cycling and swimming keep the joint moving. A physiotherapist can design a safe plan.

If you are overweight, losing weight reduces knee pain and load. Use a chair and a western-style toilet instead of squatting, avoid sitting cross-legged for long periods, and use handrails on stairs. A walking stick in the hand opposite the painful knee and cushioned footwear can also help.

Medicines and injections

Pain-relief gels containing anti-inflammatory medicines applied to the knee are a good first choice, especially for older people, as they have fewer side effects. Paracetamol may help some people. Follow the label or your pharmacist's advice for over-the-counter products. Anti-inflammatory tablets should be used for the shortest time needed, because they can harm the stomach, kidneys and heart.

For a painful flare, a doctor may give a steroid injection into the knee. Supplements like glucosamine and other injections have mixed or limited evidence; discuss them with your doctor before spending money. People with kidney disease, stomach ulcers, heart disease or who take blood thinners need special care with painkillers.

When surgery is considered

If pain is severe, affects sleep and daily life, and does not improve with exercise, weight loss and medicines, knee replacement surgery may be considered. It replaces the damaged surfaces with metal and plastic parts and can greatly reduce pain in the right person. Rehabilitation and exercises after surgery are essential for a good result.

The decision depends on your overall health, age and wishes. Keep up your exercises even after surgery. Do not rely on oil massages or remedies that promise to regrow cartilage. Talk to your doctor or pharmacist about the best combination of treatments for you.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.