Knee pain: osteoarthritis overview


Q: I have swelling in my left knee. My doctor says it is arthrittis. Does arthritis make your knee hurt and swell.


A:    Osteoarthritis is not a single disease but rather the end result of a variety of disorders leading to the structural or functional failure of 1 or more of your joints. Osteoarthritis involves the entire joint including the nearby muscles, underlying bone, ligaments, joint lining (synovium), and the joint cover (capsule). The osteoarthritis involves the formation of osteophytes  (bone spurs) or joint space narrowing. The following signs and symptoms may be seen: Aching pain, swelling, stiffness, or difficulty moving the joint may develop in 1 or more joints. The pain may get worse with overuse and may occur at night. With progression of this arthritis, the pain can occur at rest. The knees are also major weight-bearing joints. Repetitive squatting and kneeling may promote osteoarthritis. Some lifestyle changes may delay or limit osteoarthritis symptoms: weight loss:  studies suggested that, for women, weight loss may reduce the risk for osteoarthritis in the knee. Exercise: Regular exercise may help to strengthen the muscles and potentially stimulate cartilage growth. Avoid high-impact sports. The following types of exercise are recommended: range of motion, strengthening, and aerobic. Diet: Antioxidant vitamins C and E may provide some protection. Vitamin D and calcium are recommended for strong bones. The recommended daily dose of calcium is 1000-1200 mg. The current guideline for vitamin D is 400 IU per day. Avoid more than 1200 IU of vitamin D per day. Heat: Hot soaks and warm wax (paraffin) application may relieve pain. Assistive devices are used to improve function of moveable parts of the body or to support, align, prevent, or correct deformities. Splints or braces help with joint alignment and weight redistribution. Other examples include walkers, crutches or canes, and orthopedic footwear. Over the counter  medications (OTC) : Acethaminophen (Tylenol) is the first drug recommended for osteoarthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for arthritis pain. These include aspirin, ibuprofen(Motrin or Advil), naproxen(Aleve), and ketoprofen (Orudis). Newer OTC preparations include chondroitin  and glucosamine sulfate, which are natural substances found in the joint fluid. Chondroitin is thought to promote an increase in the making of the building blocks of cartilage (collagen and proteoglycans) as well as having an anti-inflammatory effect. Glucosamine may also stimulate production of the building blocks of cartilage as well as being an anti-inflammation agent. Glucosamine was found to increase blood sugar in animal studies, so people with diabetes should consult their doctor first. Recent studies showed that glucosamine might slow progression of osteoarthritis in the knee.

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