How to help your knee arthritis

According to the World Health Organization, osteoarthritis (OA) is the most common arthritic disorder facing the westernized world, and is the single most common cause of disability in older adults. Up to 10% of people over age 55 suffer from osteoarthritis.  Of that, the knee is one of the primary joints affected by osteoarthritis.   

What exactly is osteoarthritis? This is a condition when the cartilage in a joint breaks down, and the body starts to lay down extra bone and tissue in order to stabilize the joint.  OA can be diagnosed by a good physical exam or by x-ray. However, the presence of osteoarthritis on a radiograph does not correlate directly to pain. It is possible to have extensive pain and very little degeneration observed on x-ray, but also possible to have very little pain but extensive x-ray findings. Knee OA can cause pain, stiffness and impaired movement. It accounts for more difficulty climbing stairs and walking than any other disease. Knee OA has a very large impact on quality of life as people age. 

There are some preventable risk factors that can mitigate your chances of developing knee OA, or manage early OA, to have a better quality of life as you age: 
1. Obesity
People who are overweight have a high prevalence of knee OA. If there is any sort of misalignment in the knee, or imbalance in how the muscles are acting around the knee, then the increase in body mass, or obesity, will increase the progression of knee OA. (https://onlinelibrary.wiley.com/doi/abs/10.1002/art.20726).
2. Footwear 
Ensuring that you are wearing proper footwear, or even custom-made foot insoles, will help to support the forces going through the knee joint and minimize the impact that obesity plays on OA of the knee.
3. De-conditioning
Lack of exercise, or maintaining a sedentary lifestyle, will predispose you to developing knee OA. This obviously correlates with being overweight but also helps to prevent injury, decreases your chance of osteoporosis and overall injury. 

Some risk factors pertaining to knee OA that are beyond your control are:
1. Gender
Women are more likely to suffer from knee OA then men. This increase becomes apparent in older women, leading to thinking that estrogen deficiency may play a role in the disease.
2. Genetics
When you have a family history of knee OA, you are more likely to suffer from it too. 
3. Bone Density
As bone density decreases, such as in osteoporosis, OA increases. This can be a genetic issue or, again, due to a sedentary lifestyle.
4. Injury
 When an injury is sustained in the knee, such as damage to the soft tissue structures, meniscus and ligaments, this will increase likelihood of developing OA in the joint.

How to Help Your Knee Arthritis
If you have been diagnosed with OA of the knee, there are a few things that you can do to help your prognosis:
1. Home-based exercise programs will decrease pain experienced by those diagnosed with knee OA. Both aerobic and resistance exercise improve measures of disability in older adults. Many exercises can easily be performed at home, and even simply walking can help your pain. Exercise in the water is beneficial as the force of gravity is removed, and you are better able to go through the full range of motion. Consult a healthcare provider for specific exercises to help determine the exercises that are best for you.
2. Glucosamine and chondroitin sulfate can be helpful. One study suggests the use of 1500mg of glucosamine sulfate daily for 3 years decreased the progression of degenerative changes of the joint cartilage. Consult your medical provider or pharmacist if this is something you are considering.
3. Lifestyle changes such as introducing exercise, decreasing weight, and using proper footwear in the early stages of OA make a bigger impact then seeking out passive treatment from a health care provider.  When the OA becomes symptomatic, specific exercise instruction from a qualified health care provider will be beneficial to decrease pain, and improve functional capacity.
4. Modalities such as TENS (Trans Electrical Neural Stimulation), acupuncture, massage, ultrasound, and heat therapy can help temporarily relieve symptoms.  Consult a health care professional that specializes in muscles and joints to receive these kind of treatments. 
5. Bracing has also been shown to be beneficial in relieving OA pain in the knee. A well-fitted brace can help combat the instability caused in OA due to cartilage breakdown. Custom fitted bracing is often successful in people with advanced knee OA. 
Sometimes OA can progress to a point that requires more invasive interventions, which would need to be managed by your medical provider. OA of the knee is the most common cause of total knee replacement. Specific medications or other medical procedures may be required, such as a scope or knee replacement.  

By maintaining an active lifestyle and maintaining good muscle mass, good body biomechanics, and good health habits, you can reduce your chances of developing knee OA, and prevent knee OA from making a big impact on your quality of life.

Activity fact: One would expect that runners have a higher chance of getting knee OA.  It's actually the opposite! Studies show a lower occurrence and less knee OA pain overall in people who run regularly.