Knee Arthritis

By Cameron Delicato, PTA, Certified

Knee Arthritis

Throughout your lifetime you may experience different pains in your joints. Regardless of whether it’s from some sort of trauma or just a gradual progression of increased joint pain. At the Jacksonville Orthopaedic Institute our expertly trained physical therapists can help determine the best form of treatment for your knee pain. There are a number of different types of arthritis that can impact the many different joints in your body. Watch this VIDEO on why knee pain can’t wait for treatment.

Three of the most common types of arthritis of the knee include:

1. Osteoarthritis
2. Rheumatoid Arthritis
3. Post-Traumatic Knee Arthritis

Osteoarthritis/Arthritis in Your Knees

The main cause of osteoarthritis is normal wear and tear. It is very common that people experience some sort of Osteoarthritis at some point in their life. After repeated wear and tear over a long period of time the cartilage that surrounds and protects the bones around the knee begin to break down. Once enough cartilage has broken down the surrounding bones begin to rub against each other, which leads to increased pain and/or stiffness in the knee.  There are several different symptoms you may experience as a result of Osteoarthritis such as:

• Aching pain
• Stiffness after movement
• Pain during normal daily activities
• Decreased range of motion
• Pain in the back of knee

Knee Arthritis and Painful Knees

If you experience any of these symptoms and they are limiting your day-to-day life then schedule to see an orthopedic surgeon to diagnosis (X-Ray) and review options for conservative vs surgical options.

Exercising is vital to helping with your osteoarthritis, it is important to find a good balance that fits your physical ability. Exercises that are high-impact have the risk of creating more issues for your knee joints. A good way to start is a light walk around your neighborhood to gauge your tolerance. Another area to focus on is maintaining a healthy weight. Those who are overweight or obese have a higher risk of suffering from osteoarthritis because of the added stress to their joints. For further pain relief there are a variety of pain-relieving medications and anti-inflammatory treatments such as corticosteroids that may be taken and prescribed by an MD.

With the help of our therapists at The Jacksonville Orthopaedic Institute they can show you the proper stretches and strengthening exercises that can increase flexibility, mobility, and stability to combat your Osteoarthritis. If the pain does not become more manageable or even increases in intensity, surgery can be used as an alternative, which typically are partial or total knee arthroplasty.

Learn more about total knee replacements here total knee replacement

Rheumatoid Arthritis

Autoimmune Disease

Another source for the pain in your knee could come from an autoimmune disease known as Rheumatoid Arthritis (RA). Those with RA have an immune system that mistakes good healthy cells, for invader cells which leads to the body attacking itself in an attempt to get rid of these “invaders”. In addition, one way to tell if you have Rheumatoid Arthritis versus Osteoarthritis is the occurrence of pain on both sides of your body, such as both knees. A few other symptoms include:

• Tender, warm and swollen joints
• Joint stiffness that is usually worse in the mornings and after activity.
• Fatigue, fever and weigh loss

Treatment of RA

Several of the treatments for each of the previous two types of arthritis are very similar. Exercising can reduce rheumatoid arthritis pain greatly. With the help of regular exercise you can strengthen the surrounding muscles around the joint to aid with support of the joint. Also, there are several medication and anti-inflammatory options for RA. A couple examples of these include:

• NSAIDs (Nonsteroidal anti-inflammatory drugs)
• DMARDs (disease-modifying antirheumatic drugs)
• Steroids

If you want to learn more about RA, please go to this RA ARTICLE. For more severe cases surgery may be recommended to help with pain relief. As with other surgeries, therapy will be utilized to increase mobility and strength after surgery. Many assistive devices are available to help with this issue and can even be custom made. Such devices are braces and splints that support the joint and decrease pressure and pain.

Post Traumatic Arthritis

This type of arthritis can be a result of a few different injuries or trauma. Post Traumatic Arthritis can develop after a bone fracture, a tear of the surrounding ligaments, or a meniscus tear. The result of these injuries can cause the cartilage to deteriorate over time. After the initial surgery for the traumatic injury, many of the same remedies for the other types of arthritis will be used to treat the symptoms.

Treatment for Arthritis in the Knee

Arthritis in the knee can vary in severity, so treatment options will be based on the degree of damage to the cartilage. In addition, early stages of arthritis are conservative with non-operative measures. Some examples are physical therapy or injections. In some cases, arthroscopic surgery has showed significant progress in reducing knee pain and inflammation. Some stages of arthritis can lead to severe deficits in joint mobility and pain, and a joint replacement surgery may be necessary.  Therefore, to learn more about about running and arthritis, please go to: Arthritis or read the Alternative Exercises To Running.

Activity Modification for People With Arthritic Knees

Many of us lead active lifestyles or suffer traumatic injuries to our knees. Because of this you may at some point develop degenerative changes and osteoarthritis in the joint surfaces of our knees. Naturally, we all have smooth articular cartilage at the ends of the femur, tibia, and under side of the patella. This shock absorbing cartilage called menisci between the femur and tibia. Over the course of an active life participating in physical work, recreation, and sports or from unexpected accidents, these surfaces may become worn down or be damaged traumatically. As a result of no longer having adequate cushioning or cartilage being worn down to the bone, many of the activities we previously participated in may be painful and cause inflammation and swelling in the knees.

Alternative Treatments

After a person receives a diagnosis by their physician with Degenerative Joint Disease (DJD) or Osteoarthritis (OA), there are several treatments which may be prescribed to help control these symptoms. Your physician may prescribe anti-inflammatory medication or recommend an over the counter supplement to help reduce pain and swelling. You may receive a referral to a physical therapist for a prescription of an exercise program to work on strength and flexibility and/or modalities to help reduce pain and swelling.

In severe cases a surgical intervention may be necessary. In order to preserve joint health and eliminate or put off the need for surgery, both your physician and physical therapist may recommend modification of certain activities. High impact activities such as running and jumping should be limited or eliminated. For runners and sports enthusiast this may be hard to do, however, choosing alternative physical activities and exercises can help decrease painful symptoms. Typically health professional will recommend taking stairs when available versus using the elevator. However, those of us with DJD of the knees may find stairs to be far to painful to negotiate on a regular basis.

People with Chondromalacia Patella (CMP)

For people with Chondromalacia Patella (CMP), activities which require squatting or kneeling can also be very painful. If someone’s work requires such activities, it may be difficult to totally eliminate them, but using knee pads or a small stool may be helpful. This may also be helpful for those of you who enjoy gardening. Most activities have a likely way to modify them or acceptable alternatives exist. So, if you are having DJD or OA related knee pain take some time to speak with your physician or therapist, and they will be eager to help you get back to whatever your passion may be.

How Do I Know If It’s Arthritis?

An orthopedic doctor would need to diagnose the knee by using X-Rays and a physical examination to determine the extent of arthritis. From their diagnosis, they would determine the appropriate treatment plan for each patient.

It does not matter the type of arthritis. JOI Physicians and JOI Rehab staff have several different state of the art treatment protocols to help you get back to the things you love.

Robotic Total Joint Replacements

Also, if you would like to learn more about robotic total knee surgery, go to Makoplasty robotic total knee replacement.

Jacksonville Orthopaedic Institute has physicians and therapists that provide innovative knee care.  We will customize a rehab program to meet your needs.

• Finally, to schedule a new patient or follow up patient appointment with your MD, please call (904)JOI-2000 or schedule online.
• For Physical Therapy or Occupational Therapy, please call JOI Rehab, 904-858-7045  or any of the 12 area JOI Rehab Centers.
• By: Cameron Delicato, PTA