Osteoarthritis of the Knee

Feeling stiffness in the knee? Or difficulty getting in or out of the chairs? I don’t know about you but as soon as I reached 30s, these feelings started to emerge. But, it’s not old news since musculoskeletal issues usually bug people like us—ageing individuals.

Typically considered as a “wear and tear” kind of arthritis, knee osteoarthritis is pretty common. It’s a degenerative disease of the joints which could potentially lead to progressive degradation of that very special connective tissue in your joints known as the articular cartilage.

The ligament injuries, overuse of joints, malalignment of the varus or valgus, and trauma are common causes of ortho conditions of the knee. But these causes are not commonly attributed to the inescapable repercussions of growing old. Remember: growing old doesn’t mean you are already exposed to a myriad of sicknesses and diseases. While most people think that such a condition is an age-related disease, let’s debunk that misconception, eh? Old age is only a risk factor and not a prime cause of osteoarthritis. 

Although it is considered as one of the most common forms of arthritis, this should not be taken lightly because if left untreated, the symptoms brought forth from this disease could get worse and may lead to catastrophic consequences. You don’t want to end up waking up every morning for the rest of your life with the grace of a newborn deer now, would you? So, it’s about time to fight the good fight against this disease that slowly deteriorates you each day.  

What is the difference between arthritis and osteoarthritis?

Before proceeding, it is best to differentiate osteoarthritis from the general term, arthritis. One may easily get confused between the two terms as some may tend to interchange the two. However, they are two different conditions. While both of them belong to the same class of pathology which is rheumatism, each of them is 2 separate diseases with varying symptoms.

Arthritis means inflammation of joints. It is often triggered by a lot of risk factors such as heredity and other autoimmune disorders. Joint pain is the prevalent symptom of arthritis coupled with swelling and redness. The pain can be significantly reduced if the joints are always at work. This explains why persons suffering from arthritis feel pain during nighttime because it is often that time of the day where the joints are at rest. Treatments would include taking medications, therapy, and other lifestyle changes such as exercise and weight loss.

On the other hand, osteoarthritis is a wear and tear kind of arthritis which differs from arthritis that is categorically not the wear and tear kind. In OA, the cartilage which serves as a cushion that prevents the adjacent bones from rubbing off each other, wears away between the joints. This could lead to the formation of bone spurs and other discomforts. Unlike arthritis, which is commonly triggered by heredity and other pre-condition, osteoarthritis is often triggered by aging which is one of the most common risk factors. Its treatment may have significant similarities with arthritis.  But in osteoarthritis, the joint pain gets worse when they are active and lessens if they are at rest, which is quite the opposite for arthritis.

What are the four stages of osteoarthritis (OA) of the knee?

It can take years for osteoarthritis to worsen. Being a degenerative disease, osteoarthritis develops into progression which is divided into four different stages.

Stage 1: The minor stage

People who suffer from knee osteoarthritis do not normally feel any form of discomfort or pain in Stage 1. If they have their joints checked on an X-ray exam, they would likely appear to be normal with no significant findings at all. 

However, be wary though as this is the beginning stage where osteophytes may start to develop in the knee. Osteophytes are bone spurs or lumps that may form around the joints or on the spine for some time. Its formation and growth may cause minimal injury to the cartilage. But since the damage is slight, the narrowing of the space between the bones is not so apparent as there is no disintegration of the cartilage.

Treatment for the minor stages of OA only recommends patients to take special supplements. In most common cases, doctors generally advise maintaining a healthy lifestyle.

Stage 2: The mild stage

This is the part where an affected individual would start to feel the signs of the wear and tear of the cartilage. Although such symptoms are tolerable, this is the best time to see a doctor. Symptoms include joint stiffness which may lead to pain and discomfort. This usually happens especially if a person sits for a very long time. 

Several medical tests would show the growth of osteophytes causing the cartilage to wear thin. Although the spaces between the bones may appear to be normal, there will be a hardening of the area between the tissues and the bones which naturally causes tissues to harden as well. The hardening effect will make the bone denser which will soon produce another thin layer of bone under the joint cartilage. This explains the joint pain and joint stiffness.

Physicians may require a stricter exercise regimen to hasten the progress of the disease. In some cases, several supports such as braces or shoe inserts may be used for the patients to shield the knee from further possible trauma or stress.

Stage 3: The moderate stage

The aches and stiffness may tend to occur more frequently than usual. If an affected person may only feel discomfort from sitting for too long, now, performing one’s daily activities like walking, bending, kneeling, or running may already cause discomfort and pain. On several occasions, one might hear a crunching or snapping sound when one walks. The person may even start to feel the initial symptoms of inflammation of the joints.

The injury done to the cartilage has already worsened. The narrowing of the gap between the bones has significantly narrowed, and an X-ray exam will already show a notable loss of cartilage. Upon the continuous thinning of the cartilage, the natural reaction of the bones is to make itself denser by growing outward. This ultimately causes the formation of lumps.

This may involve aggressive treatment by injecting hyaluronic acid for a couple of months directly into the joint of the knees. Results may show after several weeks and pain relief would last for 6 months. Other common treatments may also involve the prescription of therapies that promote pain relief. It may also include weight loss programs and physical therapy.

Stage 4: The severe stage

The quality of life is greatly affected by the onset of the severe stage. Aside from experiencing stiffness of the joints, a person may constantly feel inflammation in the joints. Pain and discomfort may already be constant and excruciating. There may also be visible deformation and angulation of the bones.

In this stage, the cartilage further breaks down due to the narrowing of the spaces between the bone joints. There is a complete disintegration of the cartilage, or one may be lucky to have a little left. And because of this, an x-ray exam will show a bone to bone image leaving no space in between them. As the cartilage further breaks down, there is a higher chance of experiencing chronic inflammation.

At this advanced stage, the best and the only treatment here would have to be surgery. Osteotomy and arthroplasty are the common major surgical procedures that are performed. Osteotomy is a procedure for knee realignment while arthroplasty is a procedure for knee replacement. Recovery from such procedures may take several weeks to a month. 

What is the best treatment for osteoarthritis in the knee?

The best way to treat this disease is to alleviate the pain and immobility that comes with it. Such treatment plans may vary from one patient over the other. But they usually involve one or a combination of the following treatment options:

Exercise

If you think that the more you exercise, the more it could harm your joints, you are mistaken. Research shows exercise to be one of the most effective and least invasive treatments for osteoarthritis. The following are the most recommended forms of exercise especially for people who are 40 years of age and above:

• Walking
• Jogging
• Gentle stretching
• Range of motion exercises
• Aquatic exercises
• Swimming
• Bicycling
• Use of elliptical machines

Maintaining a healthy weight

This doesn’t necessarily mean losing weight. However since most adults are vulnerable to obesity, then the best way to maintain a healthy weight, in this case, is by losing weight. There are a lot of benefits offered when one maintains a healthy weight, this includes providing relief for OA through the following:

It lowers the pressure off your joints.

A study has shown that for every one pound of weight that has been lost, especially from overweight people, there is a collateral four pounds decrease of the pressure from the knees. So, imagine then if you lose 10 pounds! That would also significantly reduce the pressure on the knee joints.

It alleviates pain.

Another research shows that obese people losing 10% to 20% of their weight experienced significant pain relief from their condition.

It reduces inflammation.

Most fats, which include trans fat or saturated fats, are linked to inflammation. Unfortunately, these are the kinds of fat that also cause obesity.  To stop the release of chemicals in the body that can lead to inflammation of the joints, a simple weight loss program provides a simple solution.

Use of prescribed drugs

Most orthopaedic doctors recommend their patients to take prescribed anti-inflammatory drugs or pain relievers to alleviate the usual discomforts of OA. They include but are not limited to naproxen, ibuprofen, or acetaminophen. These over the counter medications should be strictly referred to your doctor especially if you take them for more than a week for your OA. 

Sometimes, the use of corticosteroid injections or hyaluronic injections is also used as treatment. A corticosteroid is a form of steroid that is shot directly into the affected joint. They are prescribed anti-inflammatory drugs that help alleviate inflammation of the joints. Hyaluronic acid injections are injected into the sore joints because such a condition causes the thinning of hyaluronic acid supply in the affected joints. Think of hyaluronic acids as a lubricating fluid of the joints that cushions them and allows them to work well. It helps reduce joint pain as it adds to the body’s natural supply of hyaluronic acid. No wonder doctors call these injections “viscosupplementation”.

Use of different therapies

Occupational and physical therapies are also used to help treat osteoarthritis. They provide simple day to day exercises that help in preserving the use and strength of knee joints. It is focused on building muscle strength, especially the muscles that surround the joints. Having stronger muscles helps in stabilizing weakening joints. They help the affected person modify his workplace or home environment so that risky motions and movements which would further worsen the condition may be significantly reduced.

There are other alternative therapies as well for osteoarthritis. This includes yoga, acupuncture, tai chi, and massage therapy. Although no known research proves the effectiveness of these alternative therapies, there is related evidence which has indicated a significant short-term improvement of overall physical functioning and reduced pain by individuals who have OA.

Use of assistive devices

Several assistive devices have been developed so that everyday activities will be made less stressful for the joints. The use of these devices intended for ambulation allow persons suffering from osteoarthritis to better live a quality life. Canes, shoes with shock-absorbing features, inserts are considered helpful to remedy the discomfort brought about by osteoarthritis of the knee.

In most cases, braces are commonly used to better promote function and stability. They are the right assistive device to use especially if the person is suffering from OA only on one knee. There are two kinds when choosing the right brace. There are unloader braces that help in keeping the weight away from the affected area; and there are support braces that provide support for the whole knee itself. 

What foods should be avoided if you have osteoarthritis?

Since osteoarthritis is a pro-inflammatory disease, it is best to avoid foods that could contribute to such inflammation. Here are 6 of the most common food culprits that must be avoided or minimized as they could worsen the condition.

Dairy

Dairy is high in saturated fats which can increase inflammation. A study has been conducted and found out that people suffering from arthritis who deliberately avoided dairy showed a significant improvement in dealing with their symptoms.

Sugar

People suffering from osteoarthritis have already an increased level of cytokine. Too much consumption of processed sugar could precipitate the release of cytokine, which is a pro-inflammatory protein.

Omega 6 fatty acids

Omega 6 fatty acids may be considered essential to the body, but they are however associated with increased inflammation. Thus, it is best to avoid foods high in omega 6 fatty acids such as baked potatoes or french fries.

Salt

If sugar is a big no-no, you can also say the same thing with salt. Salt contains sodium which allows the cells in our body to retain water. Too much water retention causes the cells to swell up. Thus, it can also lead to inflammation.

White flour

These are commonly found in wheat products. Based on research, refined carbohydrates contained in white flour have shown a significant increase in inflammation.

Fried foods

Generally, all kinds of fried foods are cooked in oils that create a chemical reaction which significantly increases the level of cholesterol in the body that could also worsen inflammation.

Is walking good for osteoarthritis of the knee?

No small step is considered insignificant for osteoarthritis of the knee. Exercise is considered to be one of the most effective treatments as it alleviates joint pain while promoting general wellness. It doesn’t need to be extreme. Walking is the best form of exercise which is suited especially for adults nearing their prime age.

Walking helps in strengthening the knee muscles while at the same time improving the range of motion. Walking wards off pain and helps boost the flow of the synovial fluid which is considered a lubricant for the cartilage. One can start a few minutes walking on the first and continue to gradually increase the number of minutes per day. Make this your daily routine and feel how it improves your condition.

Is it better to heat or ice a knee with arthritis?

One of the therapies employed in the treatment of arthritis is heat therapy and cold therapy. Both are equally important and helpful to lessen the symptoms brought about by a knee with arthritis.

The heat helps in relaxing the muscles and lubricates the joints at the same time. Heat therapy relieves joint and muscle stiffness. Cold, on the other hand, is known to reduce inflammation and swelling. Cold compress is the best treatment to relieve painful arthritis. 

In most cases, people suffering from arthritis, alternatively apply both cold and heat treatments. Before undergoing any exercise or a physical therapy program, patients may be encouraged to apply heat therapy, so the joints start to warm up before performing any physical activity. This is best done early in the morning. After the therapy or the program, cold therapy may be taken to reduce swelling.

What happens if osteoarthritis is left untreated?

May I remind you that osteoarthritis is a degenerative disease? So, it only gets worse if no form of treatment is administered. Don’t think that pain can simply be ignored and does not make the disease go away. While death and being cripple are rare in osteoarthritis, it can also lead to the following complications especially if it is left untreated:

Bone spurs

The formation of bone spurs is the main reason why there is pain associated with osteoarthritis. This often occurs when the cartilage breaks down as a result of wearing thin.

Damaged ligaments or tendons

Increased pressure and weight develop when the tendons and ligaments try to compensate for the slow deterioration of the cartilage. They will be stretched so unnaturally that it would soon lead to damage and injury.

Septic arthritis

This is a form of infection arising from the deformity of the joints. Not only does such deformity cause extreme pain but it might also be impossible to correct without proper surgery.

Osteonecrosis 

When push comes to shove, there is a certain point where the joints can take so much damage. This is where osteonecrosis starts to develop. This disease results in a massive loss of blood supply to the bone. Without the necessary blood supply, bone tissues start to die leading to the ultimate collapse of the bone.

How can I reverse osteoarthritis?

While osteoarthritis has no known and established cure, there is a way to eliminate or prevent its progression. Substantial evidence has shown that osteoarthritis can be reversible (thank God!). There are already many cases where patients experience spontaneous remission. But this doesn’t come as randomly as you think. It undergoes thorough and careful research and studies to develop a drug or a supplement that will ultimately cease and reverse osteoarthritis. Given the now extensive archive of medical literature supporting the use of new treatment, the total reversal of osteoarthritis holds a promising potential for reality.

In a more doable aspect, anyone can help in their way to gradually reverse the condition. With the help of the right exercise, diet, and maintaining a healthy lifestyle, one would be less likely to succumb to the disease. 

What vitamins should I take for osteoarthritis?

Aside from maintaining a healthy lifestyle, it is best to find the right and suitable supplements to help ward off osteoarthritis. They may not be a quick fix for the disease, but it can provide a significant relief for joint stiffness or pain which will provide individuals with a comfortable and quality life.

Turmeric has been found to reduce pain and inflammation related to arthritis. A good supplement that you can take for osteoarthritis would be Applied Science Nutrition’s Turmeric which is known to support healthy joints and helps in decreasing inflammation to avoid experiencing joint pains. 

Run wild! Walk free! Goodbye to a debilitating knee.

Who says old is mold? No adult should face the inevitability of aging by working with different hospitals just to aid in your knee surgery. No grown person would want that kind of joint venture! With the help of proper diet, exercise, and the right supplements, we can grow old gracefully and not stiffly- bones, joints, and all! 

Some people think that the older you get, the nearer you are to experience the weakening symptoms of osteoarthritis. Let’s surprise them, eh? Let’s show them that we can still move about and run like we used to with our strong and healthy bones—without ever having to complain about our joints.

Now, THAT would be a remarkable iron-knee!