Osteoarthritis knee

Overview

Osteoarthritis of the knee is a condition where the protective cartilage that cushions the ends of the bones in your knee joint wears down over time. This leads to pain, stiffness, and swelling. It is a common form of arthritis.

Yes, osteoarthritis of the knee is very common, especially in people over the age of 50. It affects millions of people worldwide.

It most often affects older adults, but it can also occur in younger people after a knee injury or due to genetics. Women are more likely to develop it than men.

Symptoms

Common symptoms

• Knee pain that worsens with activity and improves with rest.
• Stiffness in the knee, especially when you first wake up or after sitting for a long time.
• Swelling around the joint.
• A grating or cracking sensation when you move the knee — this is called crepitus.
• Difficulty bending or straightening the knee fully.

Symptoms in children

• Osteoarthritis is rare in children. If it does happen, it is usually due to a previous injury or another medical condition. Symptoms are similar to adults: pain, swelling, and stiffness after activity.

Symptoms in older adults

• Pain may be more constant and harder to ignore.
• Stiffness can make it hard to get out of a chair or walk.
• Muscles around the knee may weaken, increasing the risk of falls.
• The knee may feel unstable or give way.

Causes

Main causes

• The main cause is the gradual wearing away of cartilage — the smooth tissue that covers the ends of bones in a joint.
• As cartilage wears down, bones may rub against each other, causing pain and stiffness. The joint may also develop bone spurs.

Risk factors

• Age over 50.
• Being overweight or obese — extra weight puts more stress on the knee joints.
• Previous knee injury, such as a torn ligament or meniscus.
• Repeated stress on the knee from certain jobs or sports (e.g., running, construction work).
• Family history of osteoarthritis.
• Weak thigh muscles, which do not support the knee well.

When to see a doctor

See a doctor urgently if:

• If your knee is hot, red, and swollen, and you have a fever.
• If you cannot put any weight on your leg after a fall or injury.
• If the pain is severe and sudden.

Book a routine appointment if:

• If knee pain lasts more than a few days.
• If pain interferes with your daily activities like walking or climbing stairs.
• If you notice that your knee is getting stiffer or more swollen over time.

Diagnosis

A doctor will ask about your symptoms, medical history, and perform a physical exam to check for pain, swelling, and movement in your knee. They may also order imaging tests.

Tests that may be done

• X-ray — Shows the space between bones and any bone spurs. It can confirm joint damage.
• Magnetic resonance imaging (MRI) — Provides detailed images of cartilage, ligaments, and tendons, but is not always needed.
• Joint fluid analysis — A needle is used to remove fluid from the knee to check for infection or other causes of inflammation.

What to expect at your appointment

The doctor will likely ask how long you have had pain and stiffness, what makes it better or worse, and whether you have had any knee injuries. They will move your knee gently to see its range of motion and feel for swelling or warmth.

Treatment

Treatment aims to reduce pain, improve movement, and prevent further joint damage. Most people find relief with a combination of self-care, physical therapy, and medicines. Surgery is considered only when other treatments have not helped enough.

Self-care at home

• Exercise regularly with low-impact activities like walking, swimming, or cycling to strengthen the muscles around the knee.
• Apply heat or cold packs to the knee for 15-20 minutes to ease pain and swelling.
• Use a knee brace or elastic wrap for support during activity.
• Take breaks from activities that make the pain worse.
• Lose weight if you are overweight — every kilogram lost reduces stress on your knees.

Medical treatments

Your doctor may recommend pain relievers available from a pharmacy or prescribed by them. These may include medicines applied to the skin as creams or gels, or pills taken by mouth. Other options include injections into the knee joint to reduce inflammation or provide lubrication. Physical therapy can also help improve strength and flexibility. All treatment plans should be discussed with your healthcare provider.

When is surgery considered?

If pain is severe and other treatments have not helped, your doctor may talk to you about knee replacement surgery. This involves replacing the damaged joint surfaces with artificial parts. It can greatly reduce pain and improve mobility.

Living with this condition

Plan your day to include rest breaks. Alternate periods of activity with rest. Use a walking stick or cane on the opposite side of your painful knee to take weight off the joint. Keep up with your exercise and pain management routine.

Lifestyle tips

• Stay active — choose gentle exercises that do not jar the knees, like swimming or tai chi.
• Keep a healthy weight.
• Wear supportive shoes rather than high heels or flat shoes with no cushioning.
• Avoid activities that involve kneeling or deep squatting.

Diet and exercise

A balanced diet with plenty of fruits, vegetables, whole grains, and healthy fats (like those in fish and nuts) can help reduce inflammation. Staying a healthy weight is the most important dietary step. Exercise helps keep joints flexible and muscles strong. Aim for at least 30 minutes of physical activity on most days, as your doctor advises.

Mental health and emotional wellbeing

Living with chronic pain can sometimes make you feel sad, frustrated, or anxious. It is normal to have these feelings. Talk to your doctor or a counselor if the emotional burden feels heavy. Connecting with others who understand can also help.

Prevention

You cannot always prevent osteoarthritis of the knee, but you can lower your risk by maintaining a healthy weight, avoiding knee injuries, keeping your thigh muscles strong, and doing low-impact exercises regularly.

Complications

If left untreated

• Pain and stiffness may become worse over time, making it hard to walk or climb stairs.
• Muscle weakness around the knee due to avoidance of activity.
• Decreased balance and higher risk of falls.
• Loss of joint function that leads to disability.

Long-term outlook

Osteoarthritis of the knee is a long-term condition, but most people can manage their symptoms well with the right care. With a combination of lifestyle changes, treatment, and support, many continue to lead active, fulfilling lives. There is hope for improvement.

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