Can knee osteoarthritis be cured?

There is currently no treatment that reverses established osteoarthritis completely. However, symptoms and function can often be improved through exercise, weight management, medicines and other treatments tailored to the individual.

Does knee osteoarthritis always get worse?

Osteoarthritis is a chronic condition and changes can progress over time, but the course varies between individuals. Appropriate management can help control symptoms and maintain function.

Can I exercise if I have knee osteoarthritis?

Yes. Appropriate exercise is an important part of managing symptoms. Strengthening and low-impact aerobic activities can support muscle strength and mobility. The type and intensity should be adjusted according to your symptoms and physical ability.

Does a higher knee osteoarthritis grade mean more pain?

Not necessarily. X-ray findings and pain do not always correspond closely. Doctors consider symptoms, physical examination and functional limitations along with imaging when deciding on treatment.

Is bilateral knee osteoarthritis more serious?

It means both knees are affected, but it does not automatically indicate a more advanced condition. The severity and impact can differ between the two knees.

Which doctor should I consult for knee osteoarthritis?

An orthopaedic surgeon is best suited to evaluate persistent knee pain, stiffness, swelling or reduced movement and advise whether you need imaging, physiotherapy, medicines or other treatment.

Knee Osteoarthritis: Early Signs & How to Manage the Pain

A knee that aches after a long walk, feels stiff when you get out of bed, or makes a clicking or grinding sound may be easy to dismiss as normal ageing. But when these changes keep returning, they deserve attention.

The knee is the most commonly affected joint in osteoarthritis. Knee is a common joint condition in which the protective cartilage which covers the ends of the thigh and shin bones wears down over time and leads to changes in the bones and other tissues around the knee. It can cause pain, stiffness, swelling, and difficulty in moving.

Recognising the early signs and starting appropriate management can help you stay active and maintain everyday function.

What is knee osteoarthritis?

Although osteoarthritis begins with gradual cartilage thinning and damage, it eventually leads to secondary damage to the whole joint, not just the cartilage. Over time, the results of cartilage loss can be seen in changes to the structure of bones, meniscus, ligaments and even the surrounding muscles. It often is a gradually progressive disease so the initial symptoms may be subtle.

Although age is a risk factor, osteoarthritis is not simply an inevitable consequence of ageing. Previous knee injuries, repeated stress on the joint, excess body weight, the shape of your legs, genetics and certain other joint conditions increase the risk of developing knee osteoarthritis.

Early symptoms of knee osteoarthritis

Pain during everyday activities: Activities which earlier used be routine may slowly start becoming tedious. You may notice discomfort while walking, climbing stairs, getting up from a chair or squatting. Initially, the pain may come and go with activities but over time it may persist throughout the day. Persistent knee pain is one clinical feature doctors consider when assessing osteoarthritis.
Stiffness after rest: Your knee may feel stiff after waking up or sitting for a while, and in early osteoarthritis this stiffness usually improves rapidly once you start moving the joint, usually less than 30 minutes. If stiffness lasts from 30-60 minutes, is persistent, severe or associated with significant swelling, medical assessment is important because other forms of arthritis may need to be ruled out.
Reduced movement: You may find it harder to fully bend or straighten the knee. Activities that were previously easy, such as sitting on the floor, climbing stairs or getting in and out of a car, may become uncomfortable. Avoidance of such activities due to painful restriction of movement are known to happen with progress of knee osteoarthritis.
Clicking, cracking or grinding sensations: While the knees may make an occasional sound like cracking your knuckles, such sounds accompanied with pain or a grating or grinding sensation when moving the knee are associated with osteoarthritis.
Mild swelling or a change in the shape of the knee: The knee may occasionally look swollen or feel tender. As the condition progresses, some people develop enlargement of the bones of the knee and also notice changes in alignment. These symptoms do not always mean osteoarthritis. A doctor may need to examine the joint and consider other possible causes.

What is knee osteoarthritis grading on X-Ray and it’s significance?

If you have had a knee X-ray, you may have come across terms such as knee osteoarthritis grading.

Doctors and radiologists may describe the extent of structural changes using grading systems. One commonly used approach is the Kellgren-Lawrence system, which classifies radiographic osteoarthritis from grade 0 to grade 4 based on features such as presence of osteophytes and narrowing of the joint space.

However, an X-ray grade does not always match the pain a person experiences. Someone with relatively modest X-ray changes may have significant symptoms, while another person with more pronounced changes may have less pain.

What does bilateral knee osteoarthritis mean?

Bilateral knee osteoarthritis means that you find both knees to be somewhat similarly affected. The symptoms do not necessarily have to be identical on both sides. One knee may hurt more, feel stiffer or have limitations of movement more than the other.

If both knees are affected, everyday activities such as walking, climbing stairs and standing for long periods may become increasingly difficult. A personalised treatment plan can help address symptoms while maintaining mobility.

How can you manage the pain?

Treatment depends on the severity of your symptoms, your general health and how much the condition affects daily life.

Stay physically active: Avoiding all movement because of knee pain can lead to weaker muscles and reduced function. Exercise that is appropriate for your condition can strengthen the muscles around the knee and improve mobility.
Low-impact activities such as walking, cycling, swimming and prescribed strengthening exercises may be suitable for many people. If exercises aggravate the pain, speak to a doctor or physiotherapist about modifying the activity.
Consider physiotherapy: A physiotherapist can assess your movement and muscle strength and create an exercise program suited to your needs. Rehabilitation can also help you learn safer ways to perform activities that aggravate your knee symptoms.
Work towards a healthy weight: Even lean people develop osteoarthritis of the knee. However, people with a high BMI suffer more. If you are overweight, gradual and sustained weight reduction can reduce pain and improve physical activities.
This does not mean you need to make drastic dietary changes. A realistic combination of appropriate physical activity and a balanced eating pattern can be easier to maintain over time.
Pain-relief medicines: Over the counter pain relief medications sound attractive. However, medicines like diclofenac, aceclofenac, ibuprofen (all NSAID’s) carry serious risks of side effects such as kidney damage or gastric irritation and more than the occasional use is not recommended.
Doctors may recommend medicines to control pain depending on your medical history and other medications.
Dietary supplements and Nutraceuticals: Plenty of medicines claim regrowth of cartilage especially in the early stages of the disease. Although some benefit has been ascribed, the mode of action of such medication is not well understood. These medications are at best described as debatable.
Intra-articular injections: The role of intra-articular Hyaluronic Acid and Steroids remains controversial and a topic of debate. Presently both could be considered a short-term alternative in early osteoarthritis with nil to serious side-effects.

When should you see an Orthopaedic doctor?

Consider seeing an orthopaedic surgeon if:

Knee pain keeps returning or is getting worse
Pain interferes with sleep or everyday activities
You have persistent swelling or stiffness
You find it difficult to walk or climb stairs
Your knee feels unstable
You have had a previous knee injury
You are unsure whether the pain is due to osteoarthritis or another condition

A timely assessment can help identify the cause and determine whether you need further investigations, lifestyle modifications, physiotherapy, medicines, or other ortho treatment.

If symptoms are bothersome, a hospital with an orthopaedic surgeon with access to imaging, physiotherapy, pain management and advanced orthopaedic care will be able to provide individualised comprehensive evaluation and management.

Conclusion

Knee pain does not have to be ignored simply because it occurs with age. Recurrent pain, stiffness, reduced movement, swelling and changes in how the knee functions can be early clues to osteoarthritis.

The earlier you understand what is causing the pain, the sooner you can work on appropriate exercise, weight management, pain control and other treatment options. The goal is not simply to treat an X-ray finding, but to help you move with less pain and maintain your daily activities.

How PB Health can support you

PB Health Hospital, IFFCO Chowk, Gurgaon can help connect you with an Orthopaedic Surgeon based upon your symptoms and care needs. The doctor can review your medical history, examine the knee and assess existing reports or scans before recommending the next step in treatment.