Also referred to as wear-and-tear arthritis, osteoarthritis (OA) is a condition characterised by the wearing away of the cartilage (the joint’s natural cushion). When the cartilage wears away, the bones will rub against each other resulting in stiffness, swelling, and reduced movement. In some cases, osteoarthritis can also result in the development of bone spurs.
While age is considered a primary risk factor for knee osteoarthritis, for some it can be hereditary. Although the chance of developing the condition significantly increases after the age of 55 years, knee osteoarthritis can also occur even in young individuals. For others, the condition can develop from infection, injury, or from being overweight. Osteoarthritis is also more prevalent in women than in men.
Knee osteoarthritis can be attributed to some of the following factors:
- Weight – weight can increase pressure placed on the joints, especially the knees. Every excess pound that is gained can translate to additional 3 to 4 pounds of extra weight on the knees.
- Heredity – certain genetic mutations can make an individual more susceptible to developing osteoarthritis in the knee. In some cases, knee OA is also attributed to inherited abnormalities in the bones surrounding the knee joint.
- Gender – women aged 45 (or older) are more prone to developing knee OA compared to men.
- Stress injuries – individuals with jobs that require repetitive activities that can stress the joint (i.e. lifting weights, squatting, or kneeling) are more likely to develop the condition due to constant joint pressure.
- Athletics – people involved in physically demanding sports like tennis, soccer, and long-distance running have a higher risk of developing knee osteoarthritis.
- Other illnesses – those suffering from other conditions like rheumatoid arthritis become more prone to also developing knee OA. In addition, those with certain metabolic disorders (i.e. excess growth hormone or iron overload) also have a higher risk of developing the condition.
Common symptoms of knee osteoarthritis can include:
- Pain (often increases with activity and gets better with rest)
- Feeling of warmth (in the affected joint)
- Knee stiffness (especially noticeable in the mornings)
- Decreased knee mobility (makes even the most routine of tasks like walking, climbing the stairs, and getting in and out of chairs challenging)
- Creaking sound can often be heard when the affected knee is moved
Treatment plan for knee osteoarthritis will often include a combination of the following:
- Weight loss
- Anti-inflammatory drugs and pain relievers
- Corticosteroid injections
- Alternative therapies
Physiotherapy for Knee OA
While nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to help provide pain relief and can assist in the initial management of the condition, more natural options may be used in conjunction with medication to help manage the condition more effectively. However, following generalized exercise programs without sufficient instruction, education, or warnings can be counterproductive as it may only aggravate the inflammation and increase the pain. In line with this, seeking the help and guidance of a competent and trained physiotherapist is recommended as they have a thorough knowledge and understanding of osteoarthritis and its management.
A physiotherapist will do a series of clinical tests to assess the extent of the condition. In most cases, an X-ray is required to confirm the diagnosis. Once thorough assessment has been carried out, physiotherapists will establish management goals and create a tailored treatment plan. In most cases, treatment will include hands-on therapies like stretching, massage, and passive joint mobilization to decrease muscle tightness and spasm and to encourage full motion range.
Other potential treatment modalities (i.e. acupuncture, dry needling, and hydrotherapy) may also be recommended when necessary. Physiotherapy treatment interventions provide conservative but effective results when it comes to damaged arthritic joints. A comprehensive assessment is conducted so the apt treatment prescription can be given.
To treat knee osteoarthritis, a range of physiotherapy modalities may be used, including:
- Exercise prescriptions
- Electrotherapy modalities
- Joint mobilization
- Support aids
Physiotherapy modalities are designed to help reduce pain, strengthen key muscle groups, and improve the patient’s range of movement. It will also give the patient the luxury to take control of the condition and perform daily tasks with less pain, disruption, and discomfort. In addition, certain exercise programs may also be taught to assist with weight loss, which can be vital in significantly reducing the load placed on the joint. Home exercise programs taught by physiotherapists have also been known to help reduce osteoarthritis flare-ups. However, long-term compliance must be observed.
Unfortunately, some patients discontinue the exercises once function has been partially restored and pain has subsided and only starts exercising again when the next flare-up occurs. While not everyone may be aware of it, the repetitive cycle of exercise and inactivity may only cause more joint deterioration and damage. Ideally, a physiotherapy visit every 4 to 6 weeks is recommended. The setup will allow the physiotherapist time to review, reinforce, and modify prescribed exercises when the need arises.