November 13, 2014

Knee Arthritis

Knee Pain: An Osteopathic Perspective


Knee Arthritis’


This is the second blog in knee pain series focusing on arthritis of the knee. ‘Arthritis’ is the usual title given to knee pain and stiffness for people over fifty, but exactly what this problematic ‘arthritis’ is, is often overlooked by many people!


‘Arthritis’ is an umbrella term for multiple types of arthritic conditions which involve the inflammation of one of more joints. The disease mechanism and progression is different for each type of arthritis, and each having slightly different symptoms and requiring different treatment approaches. When people complain of ‘arthritis of the knee’, they are usually referring to Osteoarthritis.



Osteoarthritis is a condition where the cartilage lining of the bony surfaces in the knee joint start to breakdown and over time the knee bone itself starts to be affected; narrowing the joint space, causing friction, inflammation, pain and stiffness.


Unfortunately, most people are not diagnosed until the degenerative process affecting the knee joint is at an advancing stage as people often wait until there is moderate pain and stiffness before they seek help. If you notice any of the early signs and symptoms of Knee Osteoarthritis it is important to visit an Osteopath or your GP for further assessment and suitable management.


The early signs of knee osteoarthritis are:

o   50+ years old

o   Family history of Osteoarthritis

o   Knee pain after a long walk or run

o   Knee stiffness after sitting or lying for a few hours

o   Some tenderness when kneeling or bending


Osteoarthritis is the most common cause of knee pain for people of 50, however it can be very effectively managed with significant reductions in pain and stiffness. Current research recommends a combination of manual therapy, such as Osteopathy, with suitable exercise for knee osteoarthritis as the gold standard. Other management plans including changes in diet, supplements and weight loss are also recommended to help reduce the advancement of the condition.


So don’t leave it too late! It’s worth speaking to an Osteopath at Clinic on the Green if you’re concerned about your knee pain or recently been diagnosed with Osteoarthritis of the knee as early intervention is the best way to slow down any progression and alleviate symptoms. Nevertheless, even if you’ve been experiencing knee osteoarthritis for many years, clinical trials have demonstrated that manual therapy and exercise rehabilitation is still highly effective for reducing daily pain and stiffness.


Rheumatoid Arthritis


The second most common arthritic condition to affect the knee is Rheumatoid Arthritis. Rheumatoid Arthritis is considerably different to Osteoarthritis in the way the condition damages the body, but both can have similar symptoms. Rheumatoid Arthritis is an autoimmune disease meaning that a change in the body’s immune system results in immune cells attacking the soft tissue surrounding the knee joint. The offensive on the knee’s soft tissue eventually leads to damage to the bony surfaces of the knee joint. The reason for the change in the immune system is still unclear, but it is expected to be a combined link between genetic, hormonal and environmental factors.


The biggest differences between Rheumatoid Arthritis and Osteoarthritis are that Rheumatoid Arthritis often affects younger individuals (from the age of 25-30) and is three times more common in women. The pain, stiffness and other associated symptoms can develop suddenly or progressively over time, and symptoms can be experience in bouts of weeks to months followed by periods of little to no pain. Other common signs of rheumatoid arthritis are:


o   Fatigue

o   General feeling of ill health

o   Stiffness of the joints in the morning (often in more than one joint)

o   High temperature

o   Joints feel warm

o   Swelling of the finger joints


Like Osteoarthritis, early detection and diagnosis is key for the most effective treatment and management of the condition. If Rheumatoid Arthritis is suspected by an Osteopath at Clinic on the Green it will often involve referral to you GP for further diagnostic testing. If the diagnosis is confirmed, diseases modifying anti-rheumatic drugs (DMARDS) are usually prescribed; these tablets modify the body’s immune system reduce or hopefully stop it attacking the knee joint.


Yet, research has identified that for the most effective management of Rheumatoid Arthritis the combination of medication with manual therapy and exercise rehabilitation is essential for the most significant reduction of pain and stiffness.


Psoriatic Arthritis


If you suffer with Psoriasis of the skin there is a chance that any knee pain or stiffness you experience is linked to your condition. People who suffer from Psoriatic Arthritis tend to experience pain and swelling in their hands or feet as an early sign; knee pain is often due to the disease advancing or the result of an unrelated injury or condition.


If Psoriatic Arthritis is the potential cause of pain and stiffness in any joint of the body, a referral to your GP is essential as the best treatment for managing the condition involves a combination of medication to treat the skin and joint condition together.


Reactive Arthritis


If you experience sudden pain and stiffness in your knee, hips or low back with no recent injury it may be due to an infection. Reactive Arthritis is a condition that causes inflammation in many areas of the body in response to a bacterial or viral infection.


Other symptoms may include pain and redness of the eyes (conjunctivitis), pain on urination (urethritis), general tiredness and a mild temperature. If Reactive Arthritis is the suspected causes of joint pain then treatment of the infection is essential and referral to your GP will be needed.


The arthritic conditions listed above are the most common types of arthritis to result in knee pain, however there are many other forms of arthritis. Due to the differences between each type of arthritis is essential to have knee pain accurately diagnosed for best treatment and management. Help is as hand for all forms of arthritis and Osteopathic treatment and management has been demonstrated to be effective in reducing the pain, stiffness and progression for many of these conditions.


For further information on how Clinic on the Green can help you, book in for an assessment by phoning 01869 351345 or email


Knees, Muscle and Mind
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