by Olivia O Leary D.C BSc Hons

KNEE OSTEOARTHRITIS: WHAT IS IT?

Also called “wear and tear” arthritis or degenerative joint disease, knee osteoarthritis (OA) is the progressive breakdown of the knee joints’ natural shock absorbers causing knee pain and stiffness.

This causes discomfort or knee pain particularly when you use your knees; or perhaps an ache when you bend your knees, with morning stiffness or creaking joints often observed.

Most people over 60 have some degree of OA, but it also affects people in their 40’s and 50’s particularly if they have participated in activities causing significant knee impaction over time through sports or heavy physical work or if they are significantly overweight.

KNEE OSTEOARTHRITIS: SYMPTOMS
The symptoms of knee osteoarthritis tend to develop slowly. Common symptoms include:

• knee pain that increases when you are active, but gets a little better with rest
• knee swelling
• feeling of warmth in the joint
• knee stiffness, especially in the morning or when you have been sitting for a while, making it difficult to get in and out of chairs or cars, use the stairs, or walk
• creaking, crackly sounds that are heard when the knee moves

KNEE OSTEOARTHRITIS: WHAT CAUSES IT?
Every joint comes with a natural shock absorber in the form of cartilage. This firm, rubbery material cushions the ends of the bones and reduces friction in healthy joints. As we age, our joints become stiffer and our cartilage is more vulnerable to wear and tear particularly as the knee joints represent major shock absorbers in our bodies.

Over time, repetitive use of the knee joints irritates and wears the cartilage. If it deteriorates enough, bone rubs against bone, causing knee pain and stiffness in the knee joints.

RISK FACTORS YOU CAN CONTROL
Because injured joints are more vulnerable to osteoarthritis, doing anything that damages your knee joints can raise your risk of OA causing knee pain including previous injury to the knees which could have been ligamentous or cartilage. Impactive exercise like running or games such as football  also have a high rate of knee injury and jobs that require repetitive motion, such as bending the knees to install flooring over a long period of time, or jumping down off a tractor all increase the likelihood of knee wear and tear.

Being overweight is another risk factor — it has been linked specifically to osteoarthritis of the knees and hips.

IMPACT ON DAILY LIFE

Osteoarthritis affects each person differently. Some people have few symptoms despite the deterioration of their knee joints. Others experience knee pain and knee stiffness that may interfere with daily activities. Osteoarthritis of the knees can lead to a limping gait.

Evidence of the joint wear associated with knee OA is seen with the bones of the femur and tibia too close together

DIAGNOSING KNEE OSTEOARTHRITIS
Making an accurate diagnosis of knee osteoarthritis requires our Gorey Family Chiropractic team or your health professional to ask you questions concerning the knee pain or knee stiffness and you’ll need to describe your symptoms in detail, including the location and frequency of any knee pain.

Our chiropractors will physically examine the affected knee joints and perform standard orthopaedic tests and may also take X-rays to check for osteoarthritic damage as well as ruling out other joint conditions.

LONG TERM COMPLICATIONS
Unlike rheumatoid arthritis, osteoarthritis does not affect the body’s organs or cause illness. But it can lead to deformities that take a toll on mobility. Severe loss of cartilage in the knee joints can cause the knees to curve out, creating a bow-legged appearance worsening knee pain, impeding flexibility and causing compensatory problems requiring treatment potentially in the hips and lower back.

CHIROPRACTIC TREATMENT FOR KNEE OSTEOARTHRITIS
Our Chiropractic team are specialised in the non surgical treatment and management of joint conditions such as knee osteoarthritis. We follow the accepted goal of all medical rehabilitation experts with the patient who has knee osteoarthritis which is to improve your knee function, minimise your knee pain or discomfort, and limit further knee joint injury to prevent premature surgery.

We also concentrate on reducing the pain to also ease patient reliance on anti-inflammatory and pain killers which can cause complications. This is achievable with non surgical treatment if the disease has not progressed to an advanced end stage where then surgery may be the only option. Our team can advise as to what the most appropriate course of action should be and will liase with your GP as necessary.

At Gorey Family Chiropractic the Treatment and Management process is comprised of several elements depending on the individual case and severity of symptoms

1. Patient education,
2. Improving flexibility and reducing pain through the, hip, knee, ankle and foot where necessary through physical hands on treatment.
3. Strengthening of the affected knee joint as well as the hips which has an important bearing on knee function.For example, strengthening the quadriceps your large muscle at the front of your thigh has been shown to reduce pain in the knees.
4. Aerobic exercise which could be water based or non impactive like cycling. People with osteoarthritis may avoid exercise out of concern that it will cause pain. But low-impact activities such as swimming, or bicycling can improve mobility and increase strength.
   

   A programme of non impactive exercises against the resistance of water can be very helpful for strengthening the osteoarthritic knee.

5. The use of assistive devices such as knee braces and custom made shock absorbing and corrective shoe inserts called orthotics as is necessary dependent on the case.
6. Acupuncture has been shown by research to help with pain relief in  some knee osteoarthritis sufferers.
7. Weight management and dietary guidance if appropriate.
8. Some studies have shown benefit from nutritional supplementation for osteoarthritis.

GOREY FAMILY CHIROPRACTIC : A PROACTIVE MANAGEMENT APPROACH TO OSTEOARTHRITIS

Due to the fact that Knee OA is often asymptomatic in its initial stages and later becomes symptomatic as the disease process progresses means that many patients are not seen until they have significant wear. Signs and symptoms of end-stage knee osteoarthritis include severe knee pain, and stiffness surrounding the involved joint, joint swelling, a limping gait pattern.

We encourage clients to take a proactive approach and to control the process using the latest evidence based guidelines in non surgical management of knee osteoarthritis. We are disappointed to hear clients often say that they had been told that nothing can be done for knee osteoarthritis. It is true that some may leave it so late that surgery is the only option but there are helpful non surgical options before this level of severity.

If you or a family member are concerned by knee osteoarthritis we would be pleased to consult with you and following a thorough physical evaluation which may include x rays offer a professional opinion as to the non surgical options available to you.

For your convenience the clinical team at Gorey Family Chiropractic Clinic are covered by all major Irish health insurers.

Contact: info@chiropractor.ie or Tel: 053 94 83338