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Help for Aching Knees
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Help for Aching Knees

by Susan Flagg Godbey

Published Nov 2008 in weekly_column | 0 Comments, Talk about this article »

Half of all Americans will develop painful and even debilitating osteoarthritis of the knee, as age, injury, overweight, weak muscles, and other factors conspire to wear down the cartilage cushion between joint bones. A recent Canadian study revealed that arthroscopic surgery, long a staple of arthritis treatment, is no better for achy, arthritic knees than a combination of pain relievers and physical therapy. What’s left?

“There’s real scientific evidence that exercise and weight loss can reduce pain by 50 percent and make daily life much easier,” says rheumatologist Patience White, MD, chief public health officer for the National Arthritis Foundation and a professor of medicine at George Washington University in Washington, DC. “Strengthening and stretching your leg muscles and the core muscles in your abdomen and back can make a big difference for many people with arthritis, even if it’s severe. Most important, it can slow the progression of osteoarthritis so that pain and damage don’t become worse.”

Here, Dr. White answers your questions about easing knee pain.

I’m getting twinges in my knees, and I hear a grinding, crackling sound when I go up and down the stairs. Is this the beginning of arthritis?

Yes, it could be. Those are both early warning signs. We want people to take this kind of early knee pain as seriously as they would chest pain. That sounds like an overstatement, but arthritis is the number one cause of disability in America, and much of it can be averted if you take action early. You could begin to notice pain and a grinding sensation in your thirties or forties if you had a knee injury earlier in life, such as while playing sports in your teens or twenties. Once you’ve had a severe knee injury, such as one that required surgery, it’s fairly certain you’ll develop osteoarthritis in that knee within 12 years. So pay attention to the pain and take the steps outlined in this article. 

Won’t exercise do more damage to the bones in my already-painful knees?

You may feel some muscle soreness, but if you see a physical therapist; try the exercise programs at our website (www.arthritis.org); use our exercise DVD; or sign up for one of our Arthritis Foundation-sponsored exercise, aquatics, or tai chi classes available across the country, you should be able to safely strengthen the muscles that support and align the bones in your knee joint so your knee is stronger and there’s less pain. If your knees are extremely painful, talk to your doctor first. He may recommend that you take a pain reliever or use braces or sleeves to support your knees while you’re exercising. You should also be sure you’re eating plenty of vitamin C-rich foods, such as citrus fruit, strawberries, and bell peppers. Your body needs C to keep cartilage healthy. And, because getting adequate vitamin D is also, important ask your doctor to test your blood levels of it. If your vitamin D levels are low, your doctor can recommend how much you should be getting from a supplement each day.

Is there a connection between the 10 pounds I gained this year and my knee pain?

There could be. A recent study from the Centers for Disease Control and Prevention that checked knee pain and people’s body weights at age 18 and again in their forties and sixties found that two out of three people who were overweight at all three times had arthritis. If you started out at a healthy weight but gained pounds as you grow older, your risk is still 1 in 2. The more weight you carry, the more likely you are to see arthritis progress.

The good thing: If you lose even a little bit of extra weight, you can stop the progression. Each pound you lose reduces the force and stress on your knees by 4 pounds; losing 10 pounds reduces the pressure by 40 pounds. You don’t have to get down to your lowest weight ever to see real results. The best combination for reducing pain and stopping arthritis progression is weight loss plus exercise.

I’m having difficulty moving around because of my knees. Wouldn’t surgery be a good idea for me?

Not necessarily. First, talk to your doctor about the best pain relievers: injections that add a cushioning fluid called hyaluronan to your knee joint and knee braces (or elastic sleeves) that help support the knees.

Sleeves can have a second benefit. People with osteoarthritis tend to have more falls, which raises the odds of broken bones. As you lose cartilage in your knees, your body’s sense of their position becomes dulled. Wearing sleeves gives the body more input and seems to help make people steadier.

You can talk with your doctor about knee replacement surgery, too, but it’s important to know that before surgery, you must still strengthen your leg muscles so they can work with your new knee.

By Susan Flagg Godbey and the editors of Better Health & Living®

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