Osteoarthritis of the knee

Overview

Osteoarthritis of the knee is a common condition where the protective cartilage that cushions the ends of the bones in the knee joint wears down over time. This can cause pain, stiffness, and swelling, making it harder to move the knee freely.

Yes, osteoarthritis of the knee is very common, especially as people get older. It is one of the leading causes of disability worldwide.

It most often affects people over the age of 50, but it can also occur in younger adults, particularly if they have had a knee injury or have a family history of the condition. Women are slightly more likely to develop it than men.

Symptoms

Common symptoms

• Pain in the knee that may be worse after activity or at the end of the day.
• Stiffness in the knee, especially in the morning or after sitting for a long time.
• Swelling around the knee joint.
• A grating or grinding feeling when you move the knee (crepitus).
• Reduced range of motion – you may not be able to fully straighten or bend your knee.

Symptoms in children

• Osteoarthritis is extremely rare in children. If it does occur, it is usually due to an injury, a developmental problem, or another medical condition affecting the joint.

Symptoms in older adults

• Symptoms in older adults are similar but may be more persistent.
• Pain may be present even at rest or at night.
• Stiffness may be more noticeable after inactivity.
• Balance and walking may become more difficult.

Causes

Main causes

• Wear and tear of the cartilage over many years – the main cause.
• Previous knee injury such as a fracture, ligament tear, or meniscus damage.
• Repeated stress on the knee from certain jobs or sports over a long time.

Risk factors

• Getting older – the risk increases with age.
• Being overweight or obese – extra weight puts more strain on the knee joints.
• Genetics – a family history of osteoarthritis.
• Gender – women are more likely to develop it.
• Other medical conditions that affect the joints, such as rheumatoid arthritis or gout.

When to see a doctor

See a doctor urgently if:

• If you have sudden severe knee pain and cannot put any weight on your leg.
• If your knee looks deformed or is extremely swollen after a minor injury.
• If you have signs of infection – redness, warmth, and fever.

Book a routine appointment if:

• If you have knee pain or stiffness that lasts more than a few weeks and is affecting your daily activities.
• If over-the-counter pain relief and home remedies are not helping.
• If you are unable to move your knee normally or it feels unstable.

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and any injuries to your knee. They will then examine your knee – checking for swelling, tenderness, and how well it moves. They may also listen for grating sounds.

Tests that may be done

• X-rays of the knee – these can show narrowing of the joint space, bone spurs, and other signs of osteoarthritis.
• Sometimes an MRI (magnetic resonance imaging) if more detail is needed, especially if other knee problems are suspected.
• Blood tests are not usually needed to diagnose osteoarthritis, but they may be done to rule out other types of arthritis.

What to expect at your appointment

The diagnosis is often made based on your history and physical exam alone. X-rays help confirm it and assess how advanced it is. Most people do not need an MRI. Your doctor will explain the results and work with you to plan your care.

Treatment

Treatment for knee osteoarthritis focuses on reducing pain, improving joint function, and helping you stay active. Most people start with simple self-care and lifestyle changes. If symptoms are more severe, medical treatments and sometimes surgery can help.

Self-care at home

• Exercise regularly – low-impact activities like walking, swimming, and cycling can strengthen the muscles around the knee and ease stiffness.
• Maintain a healthy weight to reduce stress on your knees.
• Use hot or cold packs – heat can relax stiff joints, cold can reduce swelling after activity.
• Supportive footwear – wear shoes with good cushioning and arch support.
• Use a cane or walking stick in the opposite hand to take weight off the affected knee.

Medical treatments

Your doctor may recommend over-the-counter pain relievers for short-term relief. For more persistent pain, prescription medications can help reduce inflammation. Joint injections – such as corticosteroids – may be given directly into the knee to calm swelling and relieve pain for several weeks or months. Physical therapy can teach you exercises to strengthen the muscles around the knee and improve flexibility.

When is surgery considered?

If pain and disability become severe and do not respond to other treatments, your doctor may discuss knee replacement surgery. This is a major operation where the damaged joint surfaces are replaced with artificial parts, which can greatly improve mobility and reduce pain for many years.

Living with this condition

Living with knee osteoarthritis means learning to manage your symptoms so you can do the things that matter to you. Listen to your body – rest when you need to, but try to stay as active as you can within your limits. Simple changes, like using handrails on stairs or sitting on a higher chair, can make a big difference.

Lifestyle tips

• Keep moving every day – even gentle activity helps maintain joint health.
• Pace your activities – break up heavy tasks with rest.
• Use assistive devices like a knee brace if recommended by your doctor or physical therapist.
• Consider physiotherapy or an exercise program designed for people with arthritis.

Diet and exercise

Eating a balanced diet rich in fruits, vegetables, and whole grains can help you maintain a healthy weight, which reduces stress on your knees. Omega-3 fatty acids (found in fish, nuts, and seeds) may help with inflammation. Low-impact exercise such as swimming, cycling, and tai chi is excellent for strengthening muscles and improving flexibility without jarring the joint. Always start slowly and warm up before exercise.

Mental health and emotional wellbeing

Chronic pain and limited mobility can sometimes lead to frustration, anxiety, or low mood. It is normal to feel this way. Talking to friends, family, or a counsellor can help. Your doctor can also guide you to resources for managing the emotional side of living with a long-term condition.

Prevention

While you cannot always prevent osteoarthritis, you can lower your risk. Maintaining a healthy weight is one of the most important steps. Staying active strengthens the muscles around the knee, protecting the joint. Avoiding knee injuries by using proper techniques during sports and activities also helps.

Complications

If left untreated

• Chronic pain that limits daily activities and sleep.
• Permanent loss of joint function – difficulty walking, climbing stairs, or getting in and out of chairs.
• Development of bone spurs that can cause further irritation.
• Increased risk of falls due to knee instability and weakness.

Long-term outlook

With proper management, most people with knee osteoarthritis can lead active, fulfilling lives. While the condition may worsen over time, treatments and self-care strategies can help control symptoms for many years. In severe cases, knee replacement surgery has excellent outcomes for pain relief and restoring mobility. Your outlook depends on how well you work with your healthcare team to find the right combination of treatments and lifestyle changes for you.

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