Arthritis in Knee

What is arthritis of the knee?

Arthritis is a disease that causes pain, swelling and stiffness in your joints. It most often affects the larger joints in your body that take the most stress — like your knee joints. So, it’s common to get arthritis in one or both of your knees, especially as you get older. Arthritis of the knee can be a serious, debilitating condition. But treatments can help ease your symptoms and slow down the progression of the disease.

What types of arthritis occur in your knee?

Arthritis causes inflammation and damages the cartilage in your knee joint. Different types of arthritis do this in different ways. There are over 100 different types of arthritis that can affect your knees.

The most common types of knee arthritis include:

• Osteoarthritis of the knee. This is the most common type of knee arthritis. Osteoarthritis is a wear-and-tear condition. It happens when the cartilage in your joint starts to wear down.
• Rheumatoid arthritis of the knee. Like other inflammatory types of arthritis, rheumatoid arthritis is an autoimmune disease. It may affect multiple joints, including your knee.
• Juvenile idiopathic arthritis. This is the most common type of arthritis in children. It’s also an autoimmune disease. In the U.S., about 1 in 1,000 children develop arthritis, often in the knee.

Other types of arthritis that might affect your knee include:

• Spondyloarthritis
• Gout
• Post-traumatic arthritis
• Infectious arthritis
• Reactive arthritis

What are the signs and symptoms of knee arthritis?

There are many signs and symptoms of arthritis of the knee:

• Creaking, clicking, grinding or snapping noises (crepitus)
• Difficulty walking
• Joint pain that varies with the weather
• Joint swelling
• Skin warmth and discoloration
• Knee stiffness and locking
• Knee weakness and buckling

Early knee arthritis symptoms usually include pain and swelling. Other symptoms may develop later in the course of the disease. Treatment can help relieve your symptoms and stop them from progressing.

What does arthritis knee pain feel like?

Knee pain has many causes, and not all knee pain is arthritis. For example, you can strain your knee by working it too hard. Repetitive strain injuries, like runner’s knee, may cause similar pain and swelling. But you can often connect these types of injuries to a recent event or activity. In contrast, knee arthritis symptoms often start so gradually that you're not sure when they started or where they came from.

Soft tissue injuries and sports injuries don’t cause clicking and creaking noises or cause grating and grinding sensations when you move. These symptoms come from the bones in your joint. Some people say that climate conditions like temperature, humidity and barometric pressure affect their joint pain. Whatever the reason for this, you might notice your arthritis knee pain more on cold, rainy days.

What causes arthritis in the knee?

Different types of knee arthritis have different root causes, but they all lead to the same end. Inflammation in your joint tissues causes pain and swelling. Damage to the cartilage in your joint makes things worse. Cartilage is what cushions the bones in your joints and allows them to move smoothly against each other. When the cartilage wears away, you're left with bone grinding against bone.

Arthritis of the knee is either degenerative or inflammatory. Osteoarthritis is degenerative. This means that regular use of your knee over time has begun to wear the cartilage down. The loss of cartilage causes inflammation. On the other hand, inflammatory arthritis (like RA) starts with inflammation in your joint. The inflammation causes the cartilage to break down. Your immune system causes the inflammation.

What are the risk factors for developing arthritis of the knee?

You may be more likely to get arthritis in your knee if you:

• Are over the age of 50
• Have obesity or carry extra weight when you walk
• Have a job that puts stress on your knees
• Have injured your knee badly or more than once
• Have an anatomical difference in your knee joint
• Have a family history of autoimmune disease

How is knee arthritis diagnosed?

A healthcare provider will start by physically examining your knee joint and asking about your symptoms. Then, they’ll order a knee X-ray. They’ll usually see evidence of knee arthritis on the X-ray.

In some cases, your provider might want to order an MRI or CT scan to take a closer look. If they suspect you have an inflammatory type of arthritis, they might order blood tests to help make the diagnosis.

What is the treatment for arthritis in the knee?

While there’s no cure for arthritis of the knee, treatment can help ease your symptoms and slow the progression of the disease. Healthcare providers take a multipronged approach to treating knee arthritis, including things like medications, lifestyle changes and surgery when necessary. Some treatments vary by the type of knee arthritis you have, but many treatments are for all types.

Suggested lifestyle changes for arthritis of the knee include:

• Low-impact exercise. If your job, sport or habits put too much stress on your knee, you’ll need to make changes. But don’t stop moving altogether: Swap high-impact for low-impact activities.
• Physical therapy. A physical therapist can prescribe specific exercises to strengthen the muscles that support your knee. This can take stress off the joint, stabilize it and preserve your balance.
• Losing weight. Your knees bear a large portion of your body weight, so weight gain and weight loss matter to them. Even losing a little weight can make a big difference for knee arthritis.
• Orthotics and orthoses. Wearable devices like shoe inserts or a knee brace can help support your joints when you walk. Specific types of knee braces help with arthritis in different areas.
• Using a cane. Assistive walking devices can take stress off your knee and provide extra balance, especially if you’ve lost muscle around your joint. A healthcare provider can help you pick one.
• Acupuncture. Some people feel that acupuncture helps relieve arthritis knee pain. While they aren’t proven to help, complementary therapies like acupuncture are low-risk and may be worth trying.

Knee arthritis medications include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs are an important part of your pain relief toolbox. But you can’t rely on them too much without side effects.
• COX-2 inhibitors. These are a subtype of NSAIDs (selective NSAIDs) that you can use as an alternative. They seem to cause fewer gastrointestinal side effects than non-selective types.
• Topical pain relievers. Topical treatments may include hot/cold therapy, herbal treatments like arnica or topical NSAIDs lotions, which may be safer for treating arthritis than the pill kind.
• Acetaminophen. Acetaminophen is an alternative over-the-counter pain reliever that’s not an NSAID. You may want to use it on rotation with other nonprescription pain relievers on this list.
• Cortisone shots (steroid injections). While oral steroid medications (corticosteroids) don’t help much with knee arthritis, periodic injections into the joint can offer temporary pain relief.
• Therapeutic injections. Other injections for knee arthritis include platelet-rich plasma and viscosupplementation (knee gel shots). These may be helpful alternatives to cortisone shots.
• Glucosamine and chondroitin supplements. These dietary supplements are some of the building blocks of cartilage. While they aren’t proven to help arthritis, some people feel they do.
• Disease-modifying anti-rheumatic drugs (DMARDs). This class of drugs treats inflammatory types of knee arthritis. They work in different ways to suppress autoimmune inflammation.

Many people can successfully treat their knee arthritis without surgery for years, if not forever. Even if you do eventually need surgery, these treatments will continue to be important to your treatment plan. When other treatments aren’t doing enough, your healthcare provider might suggest surgery for your knee arthritis. Surgical treatments for arthritis in your knee range from minor to major procedures.

Knee arthritis surgeries include:

• Knee arthroscopy. Arthroscopy is a minimally invasive joint surgery. Surgeons make small repairs, using only small incisions. For example, they might remove damaged tissues from your knee.
• Knee osteotomy. Osteotomy means surgery on your bones. If the bones in your joint are misaligned, an osteotomy can realign them. This is one contributing factor in knee arthritis.
• Partial knee replacement. Your knee joint has three different compartments that arthritis might affect. If it only affects one, you might be a candidate for partial knee replacement surgery.
• Total knee replacement. When arthritis has damaged too much of your knee, it might be time to replace the whole joint with a prosthesis. This can relieve pain and restore your mobility.

What can I do to reduce the risk of getting arthritis in the knee?

While arthritis isn’t an inevitable part of aging, some wear and tear on your knees is. And some people’s occupations and lifestyles put more stress on their knees than others. If you have risk factors for developing knee arthritis, you might be able to reduce those risks by making certain changes. For example, you might want to reconsider the way you exercise, the work you do or the weight you carry.

Does knee arthritis ever go away?

There’s no cure for arthritis of the knee. It’s a lifelong condition. But the good news is that treatment can relieve some of the symptoms. Treatment might even slow down or stop the disease from getting worse. While knee damage from arthritis isn’t reversible, surgeons can remove and replace damaged tissues if necessary. Joint replacement surgery can reduce the effect arthritis has on your knee, and on your life.

How can I take care of myself while living with arthritis in the knee?

Healthcare providers agree that regular, low-impact exercise is the most important thing you can do to take care of your knee when you have knee arthritis. Walking, biking, yoga and swimming are all good options. Exercise keeps blood flowing and fluids moving through your tissues to help prevent stiffness. Specific exercises can help strengthen your supporting muscles to stabilize and take stress off your knee.