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Non-Surgical Treatments for Knee Osteoarthritis

Sports Medicine e-Newsletter

October 2013 edition

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Orthopedics and Rehabilitation

 

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Knee arthritis affects ten to twenty percent of adults over the age of 60. While surgery may seem inevitable, there are non-surgical treatments that may provide pain relief and manage the symptoms.

 

Osteoarthritis is a chronic degenerative joint disease that is characterized by changes to the whole joint, including the loss of cartilage, growth of bone spurs, changes to the bone, meniscal tears and inflammation.

 

Those at a greater risk of developing knee osteoarthritis include women, individuals over the age of 50, those who have experienced a previous knee injury, and are overweight.

 

There are two classifications of knee osteoarthritis – primary and secondary. The cause of primary knee osteoarthritis is unclear and often involves several factors. Age and hereditary conditions are often the two underlying causes. Secondary knee osteoarthritis results from issues such as injury to the knee from a fall or fracture, congenital conditions, or even infection.

 

When determining the underlying cause of knee pain, physicians consider the following factors:

  • Is the patient age 50 or older
  • Does the patient experience stiffness in the morning for less than 30 minutes
  • Is there crepitus (crunching) with knee motion
  • Is there bony tenderness or enlargement, such as bone spurs
  • Is there palpable warmth, which can be a sign of inflammation or infection

Among the other factors that physicians consider are:

  • A history of knee pain that gets worse with activity but better with rest
  • Joint stiffness that improves with activity
  • Swelling or stiffness at the knee
  • Instability
  • Limping
  • A grinding sound at the knee
  • Visible changes to the knee

While there are many treatments available to help manage the pain and discomfort associated with knee osteoarthritis, the best management techniques include a combination of non-pharmacological (non-medication) and pharmacological methods.

 

A few non-medication based treatment methods include:

 

Exercise

 

When patients are experiencing pain or discomfort, it might be surprising that exercise is one of the best recommendations for knee osteoarthritis. Strengthening and aerobic exercise are actually associated with pain relief and improved knee function.

 

Weight Loss

 

For patients who are overweight, losing weight and maintaining a healthy body weight can help manage and even improve the symptoms of knee osteoarthritis.

 

Walking Aids

 

Walking aids such as canes or crutches have been shown to be helpful for patients, however, it is important that individuals receive proper instruction on how best to use them. For individuals with osteoarthritis in both knees, a frame walker may be preferable.

 

Knee Bracing

 

Some individuals may benefit from knee bracing, particularly in cases where the knees are becoming deformed as a result of the condition.

 

Footwear and Orthotics

 

Insoles can reduce pain and improve walking for certain patients.

 

Ice and Heat

 

While effective only for the short term, heat and ice therapy can help provide some relief from symptoms.

 

Medication-Based Therapies

 

When non-medication based treatments aren’t enough, physicians may prescribe some pain relievers including Acetaminophen, NSAIDs, topical medications, cortisone shots and hyaluronic acid injections. Glucosamine and/or chondroitin sulphate, which are commonly advertised as promoting joint health may be used, but if there’s no benefit seen after six months, it’s usually best to discontinue.

 

When the combination of medicine and non-medicine based treatments doesn’t provide enough relief or improvement of knee function, joint replacement surgery may be an option. Depending on the severity of the arthritis, either a total knee or partial-knee (unicompartmental) replacement may be recommended.

 

If you experience knee pain, UW Health’s sports medicine, and orthopedics and rehabilitation experts can help you get back to the activities you enjoy.