The term “arthritis” is defined as an inflammation of single or multiple joints. It may involve any joint of the body, but the knee joints are particularly affected. There are over 100 different types of arthritis, but the most common forms are rheumatoid arthritis and osteoarthritis. Arthritis in the knee joint may interfere with your daily life activities and you may find difficulty in climbing stairs or walking. It is a common reason for unemployment and disability among people.

What Are the Symptoms of Arthritis in Knees?

Knee joint arthritis can cause symptoms of pain and inflammation. Pain may be of sudden onset but it mostly occurs gradually over time. Other symptoms may include the following:

• Stiffness and swelling of joints that may result in decreased range of motion
• Worst swelling and pain when you wake up in the morning or after resting or sitting
• Sudden flare up of pain due to extensive activity
• Smooth and sliding movement of the joint being not possible due to the presence of loose cartilage fragments. This may result in locking or sticking of joint during movement. Consequently, the joint may click, snap or produce grating or crackling sound (crepitus).
• Severe fatigue and weakness
• Increased pain during the rainy season

What Causes Knee Arthritis?

Though the cause of arthritis is idiopathic but according to the Centers for Disease Control and Prevention, there are certain known risk factors associated with it. Some of them are modifiable while others are beyond your control.

Non-modifiable risk factors include:

• Age – With aging, the risk of developing most forms of arthritis increases.
• Gender – Women are commonly affected by this disease and around 60% of the people suffering from arthritis belong to female gender.
• Genetics – Specific genes that are inherited increase the likelihood of getting certain forms of arthritis such as systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and ankylosing spondylitis.

Modifiable risk factors include:

• Obesity – The osteoarthritis (wear and tear) in knees progresses faster with increased weight.
• Joint Injuries – Any trauma to the joint may lead to development of arthritis in knees.
• Infection – Certain microorganisms can invade and infect joint, causing its damage and leading to arthritis.
• Occupation – Occupations that require frequent bending of knees and squatting increase the risk of developing osteoarthritis of the knee joint.

How Can Knee Arthritis Be Treated?

Lifestyle Modification and Alternative Remedies

• Exercises: Several exercises may help in treating the pain as well as improving the function of knees. These include aerobics, strength training, Tai chi, etc. Certain water-based exercises are advantageous in improving the range of motion of both knee and hip joints.
• Weight loss: According to a review published in 2007, there was a marked improvement in pain and disability in patients with knee osteoarthritis due to moderate loss of their weight. For the treatment to work properly, the recommended weight loss is 5% within 20-week duration.
• Acupuncture: It is a traditional method that has been used in Chinese medicine for treating osteoarthritis pain by injecting sharp and thin needles at specific points of the body.
• Balneotherapy: It is characterized by soaking in warm mineral springs and is found to be an effective method in people who have osteoarthritis of more than one joint and other co-existing medical condition that are untreatable.
• Transcutaneous electrical nerve stimulation (TENS): In this method, electrodes are placed on the skin and a weak electric current is transmitted through these electrodes. It works by inhibiting the pain signals to reach the brain. It is still under query that TENS is helpful in treating arthritis in knees and is not recommended for OA involving multiple joints.
• Devices such as knee braces, sleeves, and others: According to a review, knee braces and foot arthroses are beneficial in reducing joint pain and stiffness, and improve function without any side effects. It is recommended to use these devices as per specialist's advice.
• Crutches and canes:Although canes may decrease the pain symptoms in knee osteoarthritis and assist in movement, it may add weight on the hip joint. Crutches can also be used but there is no evidence supporting their superiority over canes.

Treatment Using Medicines

Several medications are helpful in treating the pain and inflammation associated with arthritis in knees. The most commonly used class of drugs is the nonsteroidal anti-inflammatory drugs (NSAIDs), e.g. ibuprofen and aspirin. However, NSAIDs have some side effects that may harm your kidney or cause stomach ulcers. So, always discuss with your doctor before taking them.

Other medications can also be prescribed for treating arthritis. These include:

• Analgesics other than NSAIDs, which work by relieving pain but with fewer side effects
• Corticosteroids which treat inflammation
• Biologic response modifiers, inhibiting joint inflammation by targeting on specific components of your immune system
• Disease modifying antirheumatic drugs (DMARDs) which are often helpful in treating rheumatoid arthritis

Certain injections may also help in relieving symptoms of arthritis. These include:

• Hyaluronic acid supplements or injections that may help in relieving pain and inflammation by cushioning or lubricating the knee joint
• Corticosteroid drug which can also be injected into the joint space to decrease symptoms of pain and swelling
• Arthrocentesis performed to collect a small amount of synovial fluid from the joint for diagnostic purposes. It also helps in relieving pain associated with arthritis in knees.

Surgical Treatment Modalities

Surgery is usually recommended by your doctor when the symptoms of arthritis are not alleviated by non-surgical treatment options and causing severe physical disabilities. However, surgery has its own risks and complications. Before operating, your doctor will inform you about the possible complications that may occur with different knee procedures.

• Arthroscopic surgery is usually performed where arthritis is accompanied by degeneration and tearing of meniscus.
• Cartilage grafting is recommended for younger patients, where damage to articular cartilage involves a small area. In this procedure, healthy cartilage is harvested from another part of the knee or other tissue to fill the defect.
• Synovectomy is a surgery in which there is a removal of defective part of joint lining to reduce pain and inflammation.
• Osteotomy procedure is carried out to cut and reshape the leg bones such as tibia (shinbone) or femur (thighbone) to shift your weight off the damaged knee joints. In addition, osteotomy of the knee is performed when only one side of the joint is affected and osteoarthritis is in its early stages.
• Total or partial knee replacement or arthroplasty is performed to remove the damaged parts of cartilage and bone. These are then replaced by artificial prostheses made of metal or plastic, and thereby the function of joint is restored.