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Osteoarthritis of the knee – does not mean pain!

Knee Osteoarthritis

Having osteoarthritis (OA) of the knee does not mean a life of pain! Likewise if you are experiencing knee pain this does not mean it is due to arthritis. Even if that is your diagnosis. Osteoarthrtis is often given a bad press. The theory goes that it results from a lifetime of wear & tear. Caused by attrition through the activity of our daily lives. However there appears to be a huge disparity between these assumptions and the true picture.

Normal findings

Changes in the knee joint which are associated with OA occur in pain free populations. In fact they’re very common. 24% of us have cartilage defects on MRI and are blissfully unaware. Over the age of 40 there is a 43% chance of having a defect and under 40 just 11%. But they are all pain free.¬† We see the same pattern¬† for meniscal and bone marrow lesions. Under 40 they occur 4% and 18% respectively. Over 40 prevalence is 19% and 25 %. Every decade there is an increase in these findings on MRI. The implication therefore, is such results are normal age related changes rather than due to wear & tear or degeneration.

Interestingly bone marrow lesions are very common in young sporty adults. This suggests they are normal adaptations of the bones due to physical demands placed on them. Not a pathology. However sensitive MRI scans will pick this out which can be clinically misinterpreted.

What if I have knee pain and OA

Arthroscopic surgery for OA often results in poor outcomes and ongoing pain. Adding weight to the growing evidence that such approaches are ineffective and that ongoing pain is not due to the arthritis. Clinically other more important factors will contribute and maintain pain. Fear of pain, reduction in activity, lack of conditioning and protective behaviours can make the knee region sensitive.

Activity does not wear our joints out – it keeps them healthy. All tissues of the body respond to loading which keeps them in good shape. Some guidance is often required on how to approach and build your exercises. As well as ways to increase your general activity. But knees generally love it!

Physiotherapy is usually very effective in helping knee pain. There’s lots you can also do to help!

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