Osteoarthritis of the knees (knee osteoarthritis) | Cause, symptoms and treatment

Osteoarthritis of the knees, also known as osteoarthritis, means wear and tear changes in the knee joints. This guide on knee osteoarthritis contains everything you need to know.

Cartilage wear, meniscal degeneration and calcifications in the knees can all be signs of osteoarthritis in the knees. Knee osteoarthritis is divided into five stages according to severity, and gets worse as we get older due to several factors, including the body's ability to repair itself. This is precisely why it is so important to take active measures to help the knees in the best possible way before the joint space in the knees becomes so bad that the bones almost rub against each other.

- The knees are particularly susceptible to osteoarthritis

Our knees, like our hips, are what we call weight-bearing joints. This simply means that they are exposed to a lot of stress when we stand and walk. Research has shown that stronger stability muscles, including in the hips, can act as a direct relief for the knees. Which in turn provides better function in the knees and a reduced risk of developing knee osteoarthritis.¹ In addition, it is also well documented that manual treatment techniques, including muscle work and joint mobilization, have a positive effect on osteoarthritis in both knees and hips.²

"The article has been written and quality checked by publicly authorized health personnel. This includes both physiotherapists and chiropractors at Pain clinics Interdisciplinary Health (see clinic overview here). We always recommend having your pain assessed by knowledgeable healthcare personnel."

Tips: Later in this guide on knee osteoarthritis, we show you a training program with recommended exercises (with video). In addition, we go through concrete advice and recommend, such as relief with sleeping pad when you sleep, knee compression supports, shock absorption with heel dampers and training with minibands. Links to product recommendations open in a new browser window.

In the guide you will learn more about:

  1. Symptoms of osteoarthritis of the knees
  2. The cause of osteoarthritis of the knees
  3. Self-measures and self-help against knee osteoarthritis
  4. Prevention of knee osteoarthritis (including video with exercises)
  5. Treatment of osteoarthritis of the knees
  6. Investigation of osteoarthritis in the knees

This is a guide on knee osteoarthritis written by a multidisciplinary team of both physiotherapists and chiropractors. We hope you find it useful, and please contact us or comment below if you have any input or questions. We look forward to hearing from you.

1. Symptoms of osteoarthritis in the knees

Which symptoms we experience with knee osteoarthritis will depend on how extensive the wear and tear changes are. Osteoarthritis is classified from stage 0 to stage 4 - where the first stage indicates no osteoarthritis and the last stage is very advanced osteoarthritis (and then most likely a need for knee replacement). The stages indicate how much of the cartilage between the joints has worn down and how much calcification and bone changes we have in the joint. Common symptoms of osteoarthritis of the knee may include:

  • Feeling of morning stiffness (pain to get the knee going)
  • Pressure tenderness when touching the knee
  • Reduced knee joint mobility
  • Swelling and fluid accumulation in the knee (edema)
  • Feeling that the knee is about to "lock up"
  • Snapping in the knee
  • Walking can cause pain in the knee (in more severe knee osteoarthritis)
  • Increased risk of hip pain and back problems (due to compensation)

Your knees are very important for you to move correctly and have what we call a good movement pattern. By this we refer to the fact that the body is a very complex structure where even the smallest error can lead to pain and problems elsewhere in the body.

For example, painful knees can cause you to sit still, gain weight and lose muscle mass. The consequence of this will mean increased load on the knees due to higher weight and less protection from nearby stability muscles. A vicious cycle that can also lead to your hips and feet trying to do the shock-absorbing job for your knees, and thus we end up with both hip pain and foot ailments - such as tendonitis in the hip or plantar fascite.

Therefore, the knees are extra sore in the morning (and after rest)

When we lie in bed, and are deep in dreamland, there is reduced circulation of blood circulation and synovial fluid. After, hopefully, a good night's sleep, we notice that our knees are both sore and stiff in the first time after we get up. This is due to a reduced content of synovial fluid and blood circulation in the knee. Often such morning stiffness can improve if we have a better sleeping position, and for example use sleeping pad between the knees when we sleep. Less pressure means that we do not cut off the circulation to the knees, which in turn can mean that they do not feel painful and stiff when we get up in the morning.

Recommendation: Sleep with a pillow between your knees

En pelvic floor pillow is designed to relieve the pelvis, hips and knees. Perhaps you have noticed that these are used by pregnant women? That's because they provide the basis for a more ergonomic sleeping position that is really suitable for everyone. The position is beneficial because it puts less pressure on the knees and also leads to a more correct biomechanical angle between the knees and hips. Press here to read more about our recommendation.

In the illustration above, you can see how the pelvic recliner provides increased comfort for the knees, and also ensures an improved ergonomic angle. The result can mean better recovery and rest for both hips and knees.

Osteoarthritis can involve worn cartilage, meniscal degeneration and calcifications in the knee joint

Joint wear in the joints involves degradation of the cartilage, but also a constant attempt at repair on its part. This means that bone tissue is constantly building up in the knee joint which, due to difficult working conditions, can form calcifications and bone spurs.

- Later, more severe osteoarthritis stages can provide a 'virtually impossible repair job'

In later stages of osteoarthritis, it may be that the body does not have the ability to complete the repair because the job is too great. Thus, it also becomes an eternal project on which the body uses a lot of resources and energy. In connection with the body's constant attempt to repair itself, natural inflammatory reactions will also occur in the joint (due to white blood cells and macrophages among others).

Limping and altered gait due to bad knees

As the cartilage in the knees wears down and the surrounding muscles become weaker - we have less to cushion the shock loads with when we walk. Naturally enough, this could lead to pain in the knee joints, as well as a changed gait and, in later stages, also limping.

- Lameness can cause compensatory pain elsewhere

Limping is never optimal – it just leads to more trouble elsewhere (including the hips). When we limp and take shorter steps on one side of the body, this results in a changed load on the rest of the body compared to normal walking. This is because the hips are not allowed to move as they should, and the result is that the muscles become painful and less elastic. If you are limping due to knee pain, it is high time you take active measures. Now. A shock-absorbing measure that is super easy to get started with is the use of heel dampers in the shoes.

Tips: Use heel shock absorbers for better shock absorption

A pair of silicone gel heel cushions is a good and effective way to reduce stress on heels, knees and hips. A simple measure that can have positive ripple effects and provide much-needed relief to your knees. Read more about these here .

2. Reason: Why do you get knee osteoarthritis?

Wear and tear changes in the joint are due to the breakdown exceeding the body's ability to repair itself. The ability to repair cartilage and joint surfaces also gradually deteriorates as we age. You can, to a certain extent, relieve the knee joint by strengthening the stability muscles in and around the knee. The muscles in the hips and thighs in particular can have a relieving effect on the knees.

- When we fail to build up quickly enough, this leads to breakdown

It's a simple calculation. If the joint structures break down faster than they are built up, this will lead to a gradually increasing incidence of osteoarthritis. When the cartilage breaks down, this also results in less space inside the knee joint - and thus also less space for synovial fluid. In addition, there are also several factors that increase the risk of developing knee osteoarthritis:

  • Gender (more common among women)
  • Age (higher incidence as we get older)
  • Genetics
  • Previous knee injuries
  • Congenital scoliosis or altered spinal curvature (due to change in biomechanical load)
  • Overweight
  • smoking (due to impaired blood circulation)

As you can see, there are several things that can lead to an increased risk of osteoarthritis in the knees. And several of these factors cannot be controlled by oneself. But those that you can control yourself should be actively worked on to ensure the best possible knee health and the least possible wear and tear changes.

3. Self-measures and self-help for osteoarthritis of the knee

Active measures can be taken to prevent and reduce the chance of developing osteoarthritis of the knees. Regular movement and exercise ensure good blood circulation to the knee joints and maintain strength in nearby stability muscles. Studies have shown that especially the hip muscles are important for relieving the knees. Many also use knee compression support (opens in new window) to provide locally increased blood circulation and better stability.

Relief and stress management in osteoarthritis of the knees

First, let's start with an important point. If you have pain and knee osteoarthritis in combination, it may be wise to think a little more about relief and supportive self-measures. It may simply make sense to take some relief for a period of time. Daily use of knee compression supports can be particularly important. These knee supports we show in the link are fused with copper, which many, especially rheumatics, feel contributes to an improved positive effect. The supports provide increased stability, relief and circulation, which in turn is good for the knee joints.

Our recommendation: Knee compression support (link opens in new window)

This is a knee support our clinicians are happy to recommend to our patients. Press the image or here to read more about our recommended knee compression support - and how it provides relief for knee osteoarthritis and painful knees in everyday life.

Knee supports like this are good to have available. Especially on days when we feel that the knee needs a little more help and protection.

4. Prevention of knee osteoarthritis

With reference to our list earlier in the article on risk factors for osteoarthritis of the knees, there are certain factors that you can do something about, and others that you cannot. What we do know is that it is beneficial to maintain a healthy BMI and to train the muscles that can relieve the knee joint.

Training of knee stability muscles

By strengthening the muscles in and around the knees, we can reduce the load on the knee joint. Such exercises will also help you to maintain good circulation in the knee, which in turn will lead to improved flow of synovial fluid and supply of nutrients. And even people with significant knee osteoarthritis can do exercises, in fact it is just as important (if not more important) for them. The video below shows chiropractor Alexander Andorff came up with a recommended exercise program, consisting of six exercises, in more severe cases of knee osteoarthritis.

VIDEO: 6 exercises against significant knee osteoarthritis

Feel free to subscribe our YouTube channel for more free training programs and health knowledge.

5. Treatment of osteoarthritis in the knees

Our clinicians know Pain clinics Interdisciplinary Health regularly helps patients with knee osteoarthritis, both with active treatment techniques to provide pain relief and better function, as well as adapted rehabilitation exercises. Here are examples of treatment methods that can provide symptom relief in knee osteoarthritis:

  • Physiotherapy
  • Sports Chiropractic
  • Laser Therapy
  • Joint Mobilization
  • Massage techniques
  • Muscle work
  • Trigger point therapy
  • Shockwave Therapy
  • Dry needle

All our clinic departments offer laser therapy for knee osteoarthritis. Larger research studies have documented that laser therapy can provide less pain and better function in this patient group. In addition, they also showed that the treatment led to a significant reduction in the use of painkillers by the patients.³ Here you can read one guide on laser therapy which our clinic department at Lambertseter in Oslo has written. The article opens in a new reader window. By combining this treatment with other techniques and rehabilitation exercises, we achieve optimal results.

Physical treatment for osteoarthritis of the knee

Both our physiotherapists and chiropractors regularly work actively with active treatment techniques against knee osteoarthritis. Combining muscle work with joint mobilization, as well as the documented effect of laser therapy, can provide good symptomatic relief and functional improvement. In addition, individually adapted rehabilitation exercises are implemented according to clinical and functional findings. Feel free to contact us if you would like help from our clinicians.

Diet and nutrition

Do you have trouble keeping weight at a healthy level? Then we recommend that you contact your GP and get a referral to a public nutritionist. Such a clinician will help you set up a diet plan and give you advice in relation to your eating habits.

Also read: - 6 Early Signs of Osteoarthritis

6 early signs of osteoarthritis



6. Investigation of osteoarthritis in the knees

All investigations into knee osteoarthritis start with a clinical and functional examination. First, you and the clinician will have a conversation about the problems and symptoms you are experiencing. This is known as a anamnesis. The consultation then moves on to testing function, mobility and special knee tests. Based on the symptoms and clinical findings, the therapist will be able to say whether knee osteoarthritis is suspected. To confirm the findings, a doctor or chiropractor can refer you to an imaging examination. When diagnosing osteoarthritis, it is most common to take an X-ray, as this shows bone tissue and wear and tear changes in the knee joint in the best possible way.

Example: X-ray of the knee

X-ray of patellase tear

Summarizeering: Osteoarthritis of the knees (knee osteoarthritis)

Active measures can help slow the progression of knee osteoarthritis. If you are not sure where to start, we strongly recommend that you contact a physiotherapist or chiropractor with an interest in osteoarthritis. If you are near one our clinic departments We would love to hear from you. Remember that you can also send us a message, without obligation, on Our Facebook page.

Read more: – The 5 stages of knee osteoarthritis (how osteoarthritis worsens)

the 5 stages of osteoarthritis

The pain clinics: Your choice for modern treatment

Our clinicians and clinic departments always aim to be among the elite in the investigation, treatment and rehabilitation of pain and injuries in muscles, tendons, nerves and joints. By pressing the button below, you can see an overview of our clinics - including in Oslo (incl Lambert seats) and Akershus (Raw wood og Eidsvoll Sound). Feel free to contact us if you have any questions or are wondering about anything.

 

Article: Osteoarthritis of the knees (knee osteoarthritis)

Written by: Our publicly authorized chiropractors and physiotherapists at Vondtklinikkene Tverrfaglig Helse

Fact check: Our articles are always based on serious sources, research studies and research journals, such as PubMed and the Cochrane Library. Please contact us if you spot any errors or have comments.

Research and sources

1. Neelapala et al, 2020. Hip Muscle Strengthening for Knee Osteoarthritis: A Systematic Review of Literature. J Geriatric Phys Ther. 2020 Apr/Jun;43(2):89-98. [Systematic review study]

2. French et al, 2011. Manual therapy for osteoarthritis of the hip or knee – a systematic review. Man Ther. 2011 Apr;16(2):109-17. [Systematic review study]

3. Alfredo et al, 2022. Efficacy of prolonged application of low-level laser therapy combined with exercise in knee osteoarthritis: A randomized controlled double-blind study. Clin Rehabil. 2022 Oct;36(10):1281-1291.

Youtube logo small- Feel free to follow the Vondtklinikkene Verrrfaglig Helse at YOUTUBE

facebook logo small- Feel free to follow the Vondtklinikkene Verrrfaglig Helse at FACEBOOK

4 replies
  1. Tove says:

    Heisan. Have broken the cartilage in the knees, are there good exercises to strengthen the muscles around the knee without straining the knees? Think then that one does not load so that it is bone to bone. Was told by a doctor that the cartilage in one knee is completely damaged (has and been in the X-ray). Greetings lady 56 who would like to get in good shape again, but who is hampered by a little too much pain.

    SVAR
    • Nicolay v / Does Not Find says:

      Hey Tove! Yes, if you are thinking of exercises that dampen shock loads, then you can e.g. try the one exercise program we show in the article (exercises for significant knee osteoarthritis). Alternatively, you will also find good alternatives our Youtube channel here.

      SVAR
  2. Anita says:

    Is 49 years old, works full time and has osteoarthritis in both knees. At times I have so much pain that I have trouble going up and down the stairs, something I do through work every day. When it is at its worst, the knees swell up to double size. so it becomes difficult to straighten them out. Should one just thin oneself up and down the stairs or? Must preferably keep a somewhat lukewarm pace, to reach the hour.

    SVAR
    • Nicolay v / Vondt.net says:

      Well, uff then… rather than thinning you out, it's probably best to seek expert help for the examination and treatment of your knees. Swelling in the knees does not occur for no reason. Wish you a really good recovery! Can also recommend training the knees with elastic.

      SVAR

Leave a reply

Want to join the discussion?
Feel free to Contribute!

Write a comment

Your email address will not be published. Required fields are marked with *