Knee pain

Your knees along with the hip are one the most important joints in the body as when injured/ restricted your function and activities of daily living can be impacted upon considerably

The most common causes of are:

  • Osteoarthritis
  • Anterior knee pain
  • Lateral knee pain
  • Ligament/cartilage injuries

Osteoarthritis (OA) Knee

The knee is a hinge joint with both opposing surfaces of the bones (Femur and Tibia) being covered in cartilage which allows smooth movement when bending or straightening the knee joint.
When the cartilage is gradually worn away, either with age or following injury, the two surfaces rub together which you may hear or feel and the movement is no longer as smooth as it once was.  This usually happens at the points of greatest pressure and can lead to pain, stiffness, loss of movement, swelling and deformity.  As the muscles around the knee become weak you may experience giving way of the knee.

What can I do to help my OA knee?

Look after your feet and choose sensible footwear.  Well fitting supportive shoes with cushioned insoles reduce the impact when walking and minimise the jarring.  Slippers are not supportive footwear so you should avoid them all day

When standing – straighten your knees fully when standing

When Lying – try no tot lie with your knees bent especially if confined to bed for any period of time

Reducing Stiffness – avoid long periods of sitting. Aim to bend and stretch your legs 5 times every 30 minutes and just before you get up.  Please see the lower limb strengthening and range of movement exercise video.

Strengthening – if your symptoms persist you may find yourself doing less which in turn causes the muscles which support the knee joint to weaken and you may experience the knee giving way.  This can be improved by increasing the strength of the muscles around knee joint.  Please see the lower limb strengthening and range of movement exercise video.

Swelling / Inflammation

  • Cold / Ice therapy. Please see information on how to apply Heat and Cold therapy
  • Anti-inflammatory gels – available from most Pharmacists
  • Tubigrip Bandage – for occasional use, it can help control swelling

Pain Relief

  • Heat – this can be soothing and help decrease pain, see information on how to apply Heat and Cold therapy
  • Cold / Ice – this can reduce pain and swelling see information on how to apply Heat and Cold therapy
  • Paracetamol – This is commonly used to treat OA and works well to ease the pain when taken regularly, rather than just taking now and again when pain flares-up.  A normal adult dose is two500mg tablets taken four times a day, there are usually little or no side-effects and can usually be taken longer term without reducing in effectiveness. If you have never taken paracetamol or are unsure as to whether it can be taken with other medication, please speak to a pharmacist in the first instance or GP
  • Co-codamol – This is paracetamol combined with codeine, another painkiller. They are available in different amounts.  Lower doses are available over the counter from pharmacies but codeine can cause side-effects such as drowsiness and constipation. If you have never taken paracetamol or are unsure as to whether it can be taken with other medication please speak to a pharmacist in the first instance or GP
  • Anti-inflammatory painkillers – There are many different brands but are generally ibuprofen based, and can be used in conjunction with paracetamol or co-codamol for effective pain relief.  However, they do have side-effects including gastrointestinal upset / irritation and kidney damage and should be avoided by some people.  If you have never taken paracetamol or are unsure as to whether it can be taken with other medication please speak to a pharmacist in the first instance or GP
  • Transcutanious Electrical Nerve Stimulation (TENS) – This can help ease the pain associated with OA.  TENS works using the ‘pain gate theory’ and the TENS electrical signal serves to block that of the pain signal that is trying to tell the brain that part of the body is in pain.  TENS can be used as part of a longer term pain relief or used to reduce pain enough to allow you to comply with the advice and exercises advised by you physiotherapist.
  • Acupuncture - This is a form of ancient Chinese medicine in which fine needles are inserted into the skin at certain points on the body.  Acupuncture is based on the belief that an energy, or 'life force', flows through the body in channels called meridians. This life force is known as Qi (pronounced 'chee').   Practitioners who adhere to traditional beliefs about acupuncture believe that when Qi cannot flow freely through the body, this can cause illness. They also believe that acupuncture can restore the flow of Qi, and so restore health. Some scientists and acupuncturists believe that acupuncture may stimulate nerves and muscle tissue, and that this may be responsible for any beneficial effects and can be used as part of a longer term pain relief or used to reduce pain enough to allow you to comply with the advice and exercises advised by you physiotherapist.

TOP Tips for OA Knee and Hip;

  • Know your limitations and what aggravates your symptoms
  • When walking up stairs, kerbs etc lead with the best leg first
  • When walking down stairs, kerbs etc lead with the affecting / painful leg first
  • Take care on uneven surfaces
  • Raise the height of chairs if getting out is proving a problem (try a cushion in the first instance)
  • If getting out of bed is difficult try rolling on to your side and lower your legs down at the same time so they act as a counter weight
  • Limit or avoid carrying extra / heavy loads as this increases the strain through the joints
  • Moving your knees up and down can help as can swimming as this is a non weight baring form of exercise. You may need to adapt your swimming stroke as breaststroke may prove painful
  • Avoid putting on weight by remaining active and healthy eating as the more the you weigh the more strain is on the joints
  • Walking is an excellent form of exercise, try to walk at a pace that does not aggravate your symptoms
  • If using a stick ensure it strikes the ground at the same time as the painful leg and use it in the opposite hand to the painful leg

Clinical decision making tool

For you to make a clear, informed decision about how to move forward in the management of your OA of the knee please click here for more information.