Stiff, Sore Knees?

by Sheila E. Taylor, D.O. Sports Medicine, ChristianaCare

Chances are good that you or someone you know suffers from achy knees. The pain might come from an injury or overuse. Or, you might have osteoarthritis (OA), the most common form of knee arthritis. A degenerative joint disease, OA develops over time. Fortunately, there are nonsurgical treatments that can ease the symptoms, particularly in the early stages.

What is osteoarthritis?

OA is known as “wear-and-tear” arthritis. It can occur in any joint, but it most often affects the knees, where the femur (thigh bone), tibia (shinbone) and patella (kneecap) meet. The cartilage that covers the edge of the bones creates a cushion, so they don’t rub directly against each other.

Over time, OA causes the cartilage to wear out and roughen. Eventually, the bones rub against each other, irritating both the joint and the surrounding tissue. You may have swelling, stiffness, and pain that flares up after a workout or sitting for a long time. In the later stages, the joint may become unstable, leading to falls. Pain and swelling from OA may come and go, but the disease will get progressively worse.

What are the risk factors?

Age is a risk factor. But not all people over 50 develop it, and some younger patients have it. Other risk factors include:

  • Obesity
  • A joint injury or previous knee surgery
  • Overuse of the joint or engaging in a repetitive exercise or activity like running or squatting
  • Genetics

How is OA diagnosed?

During an examination, your doctor will review your medical history. You will likely need an imaging test, such an x-ray, to reveal any loss of cartilage or bone spurs, which often develop with OA. Sometimes, a blood test is ordered to determine whether you have rheumatoid arthritis instead of OA.

What are some nonsurgical options?

There is no cure for OA, but there are treatment options to reduce the pain and improve your function. Don’t avoid all physical activity; it can help with the stiffness.

  • Lose weight if needed. Just one pound of weight loss takes 4 pounds of pressure off the knees.
  • Replace high-impact exercises, such as jogging, with low-impact activities, such as swimming, walking, and yoga.
  • Learn exercises to improve your range of motion and help strengthen the muscles around the knee joint. Physical therapy can be helpful, or you can start an exercise program. 
  • Apply heat or ice.
  • Wear a knee brace or compression sleeve. There are prescription braces available if your knee is unstable.
  • Try over-the-counter pain relievers, such as topical ointments and oral anti-inflammatories.
  • Tylenol can be effective at the right dose. Advil or naproxen can also be helpful if you can safely take it. Discuss over-the-counter medications with your doctor to make sure they don’t interact with current medications.
  • Ask your doctor about prescription-strength anti-inflammatory drugs.
  • Consider cortisone injections for inflammation or gel shots to cushion and lubricate the joint.

When will I need surgery?

A knee replacement is an elective procedure. You and your doctor can consider it when you have tried all the treatment options, but your arthritis is still debilitating.

It’s essential that you seek medical attention when you begin experiencing knee tenderness or stiffness. Early treatments can significantly improve the quality of your life in the future.


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