Almost every week, a patient in their late 40s or 50s tells me, "Doctor, I thought it was just age." Knee osteoarthritis does become more common as we get older, but it is not something you simply have to live with — and the earlier it is recognised, the more we can do without surgery.
What is osteoarthritis?
The ends of the thigh bone and shin bone are covered by smooth cartilage that lets the knee glide. In osteoarthritis this cartilage slowly thins and roughens. The bone underneath reacts, small spurs form and the lining of the joint becomes inflamed. The result is pain, stiffness and swelling.
7 early warning signs
- Morning stiffness that eases after 15–20 minutes of moving around.
- Pain on climbing stairs, especially coming down.
- Difficulty getting up from the floor or from a low chair.
- A grinding or creaking sound (crepitus) when you bend the knee.
- Swelling after a long walk or a day of standing.
- Pain that comes at the end of the day and settles with rest.
- A knee that is starting to look bowed (O-shaped legs).
If you recognise three or more of these, it is worth getting your knee checked. A simple standing X-ray is usually enough to confirm the diagnosis and its grade.
Who is at higher risk?
- People who are overweight — every extra kilo puts about 4 kilos of load on the knee while walking
- Women after menopause
- Those with a previous knee injury, ligament or meniscus tear
- Jobs that involve squatting, kneeling or heavy lifting
- A family history of arthritis
What actually helps
The single best "medicine" for early knee arthritis is a strong thigh muscle.
- Strengthening exercises — straight-leg raises, quadriceps sets and gentle cycling, done daily
- Weight reduction — losing even 5 kg reduces knee pain noticeably
- Sensible footwear — cushioned soles; avoid hard chappals for long walks
- Avoid deep squatting and sitting cross-legged for long periods
- Short courses of medicine when pain flares — not daily painkillers for months
- Injections (including PRP) in selected patients
Knee replacement is needed only when the cartilage is badly damaged and pain stops you from living normally despite these measures.
When to see a doctor
See an orthopaedic surgeon if knee pain lasts more than 3–4 weeks, wakes you at night, the knee swells repeatedly, or it "gives way" while walking. An early visit gives you the most options.
