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Bring pain to its knees
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Bring pain to its knees

Pain in the knee joints can have an adverse impact on normal life and is one of the most common medical problems affecting the ageing population

All over the globe, older people are living longer. According to the World Health Organization, the proportion of the world’s population over 60 years will increase from 12 per cent to 22 per cent between 2015 and 2050, while 80 per cent of the aging population will be living in low- and middle-income countries by then. In such a scenario, it is important that the elderly have access to health care and a social environment that helps them thrive. With many people living well beyond 60 years, health conditions that typically affect older people — such as cataract, hearing loss, diabetes, bone problems and dementia — have become more common. One ailment that troubles many of the elderly is arthritis. While this condition can cause damage to various joints, such as the hip, the wrist, hands and the back, it is most often seen in the knee joint.

knee, arthritis, elderly

How arthritis affects the knee

The knee is the largest joint in our body and one of the main weight-bearing joints. The knee joint has three sections:

  1. the bottom part of the thigh bone or femur
  2. the top of the tibia (shinbone)
  3. the kneecap.

It is also made of articular cartilage that protects the bones of the knee; the meniscus that lies between the femur and tibia acting as a cushion to absorb any friction between the two bones; and the synovium, a thin membrane lining the joint capsule, which contains the synovial fluid that lubricates the knee joint.


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When there is wearing away or disintegration of these structures, it can cause arthritis of the knee, resulting in pain and inflammation. Various studies reveal that more than 350 million people have arthritis globally. According to the US Centers for Disease Control and Prevention, one in four adults in the United States is diagnosed with arthritis and the prevalence increases with age. Arthritis is one of the leading causes of physical disability, loss of work hours and decreased quality of life.

Common types of knee arthritis

*Osteoarthritis (OA) of the knee: This is the most common form of arthritis found in the elderly and starts developing between 50 and 70 years of age. It is a degenerative joint disease caused by wear and tear of the cartilage in the knee joints

*Rheumatoid arthritis (RA): This is an auto-immune disease that can affect multiple joints in the body including the knee. In this condition, the body’s immune system perceives its own tissues as a threat and attacks the cartilage, ligaments and bones in the knee, causing irreversible damage

*Trauma-related arthritis: This type of arthritis occurs because of injury to the knee from an accident or fall or a sports-related injury. The arthritis may develop after many years following a ligament or meniscus tear, fracture in the knee bones or damage to the cartilage

Symptoms

  • Pain and swelling
  • Stability and balance problems
  • Difficulty in walking, sitting, climbing stairs and bending movements
  • Pain and stiffness that worsens at rest and after an activity
  • Redness of the skin
  • Changes in gait.

“Apart from knee pain, most of the elderly people we see with knee arthritis have complaints of not being able to get off the floor without support, limping, need for rest, reduction in distance covered while walking and more discomfort in one knee compared to the other,” Dr PK Raju, orthopaedic surgeon and professor of orthopaedics, Bangalore Medical College and Research Institute (Victoria Hospital), tells Happiest Health. “In both RA and OA, knee pain is a common symptom; additionally in RA, there may be redness of the skin; morning stiffness; involvement of other joints and symmetrical involvement, which means that same joints are affected on both sides of the body.”

How to manage knee arthritis symptoms

  • Maintain an ideal body weight.
  • Eat healthy and avoid saturated, fatty foods.
  • Stay active and exercise regularly.
  • Avoid strenuous activities that may aggravate the pain such as climbing stairs.
  • Take up activities such as walking, swimming and yoga.

“Certain tests such as X-rays and laboratory investigations are necessary to determine the type of arthritis,” Dr Raju says. “In RA, a differential diagnosis may be made based on blood tests and physical examination to check for redness and inflammation. Based on the severity of the disease, medications, physiotherapy, osteotomy or joint replacement surgery may be suggested.”

Treatment options

  • Medications: The treating doctor may prescribe non-steroidal anti-inflammatory drugs, opioids or steroid injections for pain relief. Other medications include anti-rheumatic drugs to slow the progress of RA.
  • Heat or cold therapy: Applying hot or cold compress may help bring down pain and stiffness temporarily.
  • Physiotherapy: The patient may be advised to do exercises that strengthen the muscles around the knee joint and undergo physical therapy to improve balance and flexibility.
  • Alternative therapy: Some patients may find alternative therapies such as acupressure, acupuncture and Ayurvedic treatment give relief in arthritis. These need to be done in consultation with your doctor and under expert supervision.
  • Interventional therapy: This type of therapy includes giving hyaluronic acid, adipose tissue or platelet-rich plasma injections directly into the knee joint to promote mobility and regenerate tissues.
  • Knee braces: An offloading knee brace is a device worn over the joint that helps shift the weight of the body from the affected part of the knee.
  • Surgery: There are different types of surgery that may be done to treat arthritis of the knee, including arthroscopy for repairing the meniscus and ligaments; osteochondral autologous transfer surgery; osteotomy procedure and total knee replacement surgery.
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