Osteoarthritis: What do you do if your knee joint aches?

Osteoarthritis is a joint disorder which mostly affects the knees. And contrary to popular opinion, older people are not the only ones affected by osteoarthritis of the knee! Frequently, symptoms begin to appear at an early age. They can result from wear and tear, excessive strain, obesity or a malalignment of the foot. Many people use painkillers to help with the symptoms of osteoarthritis.

In addition to a healthy diet and targeted exercises to strengthen muscles, a brace can help stabilise the joint and reduce the strain on the affected body area. This in turn can alleviate the symptoms of osteoarthritis and help you lower your intake of painkillers. We'll show you what to do to reduce symptoms and enjoy life again.

Orthotic devices for osteoarthritis

If you suffer from osteoarthritis, an Ottobock brace can help alleviate pain and reduce the strain on your knee joints.

What is osteoarthritis?

Osteoarthritis is a degenerative joint disorder which develops progressively. Osteoarthritis of the knee, also known as gonarthrosis, is the most common form of this joint disease, affecting 60 percent of osteoarthritis sufferers. But it can also affect other parts of the body such as the hips, hands or shoulders. People who suffer from osteoarthritis have to come to terms with life-long symptoms. As the disease cannot be cured, people can suffer from pain and inflammation on a daily basis. These are caused by arthritic changes in the joint system and by wear and tear to the joints. However, targeted exercises and supporting braces can help to alleviate osteoarthritis of the knee – even if it is advanced.


What are the symptoms of osteoarthritis of the knee?

There are a number of symptoms which are typical for osteoarthritis of the knee. They can occur individually or in combination. Depending on the level of joint wear, symptoms may be more or less severe. While symptoms of osteoarthritis of the knee are hardly noticeable – or even absent – in the early stages, patients complain of increasing pain and increasingly restricted mobility as the disease progresses. You can take preventive measures to avoid reaching this stage. These include a healthy and balanced diet, and regular activity and sports. Due to the fact that symptoms do not occur straight away, osteoarthritis of the knee often remains undetected for a long time. The first indications of osteoarthritis of the knee become apparent during everyday activities. Joints crackle and grate; climbing stairs and carrying heavy objects causes knee pain. If you observe these symptoms, you should see your doctor and ask to be examined. Doctors can use several methods to determine if your symptoms are caused by osteoarthritis of the knee.


Causes of osteoarthritis

Osteoarthritis of the knee can have many causes. The biggest risk factor for osteoarthritis of the knee is too much strain on the knee joints. Lifting and carrying heavy objects or moving wrongly can place severe strain on your joint cartilage and result in progressive wear and tear. Because they are heavier, people who are overweight place a higher load on their cartilage. This leads to an increased risk of osteoarthritis of the knee. Naturally, age also plays a significant role in the development of osteoarthritis. Cartilage loses elasticity with increasing age and can no longer regenerate as easily as in earlier years, which is why the joint disorder most frequently affects people aged 60 years and over. Nonetheless, young people are most certainly not immune to osteoarthritis of the knee! Genetic predisposition can lead to an early occurrence of the disease. Moreover, joint malalignment (knock knees or bow legs, for example) speeds up the progression of the disease. Accidents or sports injuries which affect the knee joint can also trigger the development of osteoarthritis. These include cruciate ligament ruptures or meniscus injuries. Osteoarthritis develops slowly, so there is often a period of several years between the early stage and severe osteoarthritis. During this time, symptoms intensify gradually as wear and tear increases.


The progression of osteoarthritis

There are four different stages of osteoarthritis of the knee. In the first stage, there is no visible damage to the joint cartilage. At this point, osteoarthritis is virtually impossible to detect via X-ray or arthroscopy. The cartilage is less elastic and less able to regenerate, so strain on the knee can already cause pain. In the second stage, the cartilage deteriorates slowly; irregularities and small cracks appear on the surface of the joint. First osteophytes (bone spurs) start to form. The knee is considerably less able to bear weight. At this point, the progression of the disease can be slowed by exercises, weight loss and medical devices such as braces. In the third stage of osteoarthritis, the cartilage has suffered considerable damage and is worn away in parts. The bones begin to rub against each other in places. X-rays also show pronounced osteophytes (bone spurs) and a narrowing of the joint space. Patients now suffer from significantly impaired joint movement and severe pain. In the fourth stage, the joint space has narrowed considerably and the joint cartilage is almost completely gone. This results in joint deformities and inflammation. There can also be long-term damage to the bones. This last stage frequently requires surgery to replace the cartilage in the affected joint.


Diagnosing osteoarthritis of the knee: How a doctor detects joint wear

If you frequently suffer from knee pain and other symptoms, you may have developed osteoarthritis of the knee. To get to the bottom of the symptoms, you should see a doctor. Only a medical specialist – using a range of examinations – can determine if your symptoms are actually caused by gonarthrosis (osteoarthritis of the knee). In order to get a better overall picture, your doctor will first ask you about your general state of health and existing physical problems. Here it's absolutely essential to be honest! Tell your doctor about any and every physical anomaly you've observed over the past days or weeks. This will enable your doctor to assess if you really have osteoarthritis of the knee, or if your symptoms are perhaps caused by another disease.

Once your doctor has finished asking questions, they will generally turn their attention to the affected joint. Using palpation, they will see how sensitive you are to pressure. They will also look closely at visual anomalies such as swelling, joint effusions and axial malalignment (knock knees or bow legs) to determine whether symptoms are caused by osteoarthritis of the knee. Additional examinations will be required before your doctor can confirm the diagnosis. X-rays are generally used for this purpose. An expert can use X-ray images to determine whether joint cartilage displays irregularities or cracks, or whether osteophytes (bone spurs) have formed. The doctor can also refer you for a CT, MRI or ultrasound examination. Depending on the method used, doctors can detect bone changes, damage to the meniscus or cruciate ligament, and irregularities in the cartilage of your knee joint.


How can osteoarthritis be treated?

Joint-preserving (non-invasive) osteoarthritis treatment

In order to avoid or delay a knee operation, osteoarthritis patients should manage their symptoms with non-invasive, joint-preserving therapy options for as long as possible. These include a healthy and balanced diet and moderate activity and sport on a daily basis. Dietary supplements, creams or tablets for pain relief, special exercises for osteoarthritis of the knee and cold/heat therapy can also contribute to a reduction of the symptoms. In conjunction with therapy, braces are also a judicious option. Combined with other forms of treatment, orthopaedic devices can significantly reduce pain, improve mobility and thus enhance your overall sense of well-being.

Joint-preserving (invasive) osteoarthritis treatment options

There are various invasive joint-preserving methods for treating osteoarthritis; these affect the human organism to a greater or lesser extent. Gentler methods include injecting hyaluronic acid or cortisone into the knee joint. Hyaluronic acid is an important component of connective tissue, and occurs naturally in the body. Thanks to its hydrophilic properties, hyaluronic acid improves the consistency of the joint fluid and provides relief for the joint cartilage. Another form of therapy is so-called corrective osteotomy. This surgical intervention is used to correct axial malalignment, thereby preventing incorrect biomechanical stress on the knee joint.

Surgical joint replacement for osteoarthritis

If osteoarthritis of the knee has damaged the joint cartilage to such an extent that joint-preserving therapy no longer helps, you may have to consider joint replacement. During this surgical operation, the natural joint is replaced either fully (total joint replacement) or partially by an implantable prosthesis (endoprosthesis).


What can I do to relieve osteoarthritis?

Many people with osteoarthritis of the knee ask what they can do to slow down the progression of the disease and keep symptoms in check. Because it is impossible for damaged cartilage to regenerate, any treatment for osteoarthritis can only alleviate the symptoms. The aim of all joint-preserving osteoarthritis therapy options is to retain or improve knee function and minimise knee pain. This in turn will enable you to reduce your intake of painkillers and delay a knee operation for as long as possible. Because once the cartilage is worn down completely, surgery is the only way to treat osteoarthritis. In order to avoid surgery if at all possible, patients should reduce their risk by identifying and combating the factors which contribute to osteoarthritis. A healthy lifestyle, a balanced diet, orthopaedic devices and physical exercise can help alleviate many symptoms of osteoarthritis and slow down the progression of the disease. Depending on the stage to which the disease has progressed, osteoarthritis can be treated in a variety of ways.

The vicious circle of osteoarthritis

When osteoarthritis of the knee develops – due to joint malalignment, an accident, advancing age, obesity or excessive strain – the damaged cartilage is no longer able to fulfil its role as a "shock absorber". The result: reduced flexibility in the knee joint restricts your mobility and causes pain. Recurrent inflammation places additional stress on your body. People with osteoarthritis instinctively adopt an unnatural posture to reduce strain on their knees. They also avoid any unnecessary movement.

However, this lack of movement can have disastrous consequences and cause problems in other parts of the body – the hips, for example. The nutrient supply to the cartilage is promoted by movement, which means that a lack of movement will also have a negative effect on the cartilage, causing it to wear down even more quickly – a vicious circle.

As the disease progresses, the cartilage breaks down even further, while the bone below the damaged area continues to thicken. This restricts mobility even more severely. Ultimately, once the cartilage layer is worn away completely, the bones come into direct contact with each other. This causes joint pain and inflammation which significantly impair daily life. It is often difficult to break this vicious circle.


Pain relief with braces

Painkillers can have lots of side effects. For this reason, you should take as few painkillers as possible. In conjunction with therapy, orthopaedic devices such as braces can assist with this. This is also confirmed by clinical studies. Braces stabilise the affected joints, which in turn alleviates the pain. This means that you can reduce your intake of painkillers and avoid the side effects they cause. It also means you regain your mobility and range of motion. Braces are placed on the outside of the knee joint or the foot and lower leg (Agilium Freestep 2.0), where they relieve the strain on the knee and provide pain relief exactly where it's needed. To help you find the right brace for your symptoms, physical condition and activity level, we have developed Agilium Select . This tool will help you find the exact brace which suits your requirements. Once you've provided your personal details and answered a few questions on your diagnosis, you'll immediately receive a recommendation which is tailored to your symptoms.

A healthy diet for osteoarthritis

Eating a healthy diet will help you alleviate the symptoms of osteoarthritis and slow down the progression of the disease. The food pyramid provides a good overview of how you can eat a healthy and balanced diet. A lower body weight exerts less strain on the joints, so counting calories is explicitly recommended if you have osteoarthritis. Your meals should primarily consist of fruit and vegetables, salads, plant oils, nuts and seeds. Avoid highly-processed foods, convenience products and sugary foods. You should only eat small amounts of meat. A study published in the specialist journal "Scientific Reports" proves that wear and tear to joints is not only promoted by being overweight, but that large amounts of sugar and a high proportion of saturated fatty acids in your diet can also cause direct damage to your joint cartilage. High-fat animal products such as pig's liver, lard, egg yolks and some types of cold meat such as liver pâté also contain high levels of arachidonic acid, which promotes inflammation. This does not mean that you have to avoid all animal-based foods. Rather, choose poultry instead of pork and do not eat more than 300 to 600 grams per week (recommendation of the German Nutrition Society). To ensure your diet is balanced, you should also eat fish twice a week. Mackerel, salmon and herring are rich in nutrients and Omega-3 fatty acids. These can help to curb inflammation in the body. In addition, herbs and spices can help combat osteoarthritis symptoms. Turmeric, nutmeg, cinnamon and coriander have an anti-inflammatory effect and reduce swelling, while chili and ginger can contribute to pain relief. Last but not least, you should avoid alcohol and nicotine.

Movement and sports with osteoarthritis

The nutrient supply to joint cartilage is closely linked to movement, so regular physical activity is essential. This applies to everyone – whether or not you have osteoarthritis. Regular movement strengthens the muscles surrounding the knee, promotes blood circulation in the joint and thus boosts the supply of nutrients to the cartilage. Your blood carries the nutrients from your diet to the joint fluid. For this reason, you should try not to adopt an unnatural posture or completely avoid movement. If you suffer from osteoarthritis, you should try to stay moderately active on a daily basis and strengthen your musculoskeletal system through physical exercise. Swimming, cycling and long walks not only strengthen your leg muscles, but also promote mobility and endurance. The most important rule is to keep moving, without overexerting yourself! This will have a positive effect on your knee joints, and you'll feel better and more mobile in general. Below, we've compiled some exercises which you can use to improve your balance, strength and endurance, and which will help you live a healthy and active life despite osteoarthritis of the knee. Our "Agilium Move" programme is designed especially for osteoarthritis patients. It will help you strengthen the muscles in your legs and around the knee joint, increase the stability of your knee joints and become more mobile as a result. Join Christian Neureuther, the former professional skier, and get moving with Agilium Move!


Agilium Move: Exercises for balance, strength and endurance

Balance exercises

In our Agilium Move balance exercises, former professional skier Christian Neureuther shows you how to target your quadriceps and the muscles that control the knee joint. The exercises for osteoarthritis of the knee will improve your proprioception (self-awareness) of your knee. In turn, this will improve the interplay between the dynamic muscles and the stabilising muscles used in different movement patterns.

Strength exercises

Osteoarthritis of the knee leads to imbalance, not only in the cartilage in your knee but also in the surrounding muscle tissue. Strong muscles provide stability for the bony structures in the joint. So if you have osteoarthritis of the knee, you should focus on exercises which strengthen the thigh muscles. You can use the Agilium Move strength exercises to actively stimulate metabolic processes in the joint and thus help to maintain existing cartilage.

Endurance exercises

The Agilium Move endurance exercise focuses on getting the entire body moving, without placing too much strain on it. As with swimming or cycling, you should try to keep moving for as long as possible. This will stimulate the supply of nutrients to your joints, which also helps maintain the cartilage. If you complete the exercises for osteoarthritis of the knee on a regular basis, you will gradually be able to walk without pain for progressively longer distances.


Frequently Asked Questions


Active again thanks to the Agilium: Four people talk about their lives

Christian with the Agilium Freestep

Rather than undergo surgery, Christian Neureuther wanted to try out all other possible therapy options. He found his own personal answer in the Agilium Freestep brace. An operation can wait.

Gait comparison with Karin

A trained O&P professional herself, Karin is impressed by the effectiveness of the Agilium Freestep. She enjoys showing us how she climbs the stairs with and without the brace, and is proud that her gait pattern is nearly normal as she does so.

Kadri with the Agilium Patella

After a tibial plateau fracture, sportswoman Kadri developed osteoarthritis behind the kneecap. The result: significantly restricted mobility and severe pain. The Agilium Patella helped Kadri return to her old self.

Dirk with the Agilium Reactive

If you have a manual job and suffer from knee pain, you'll need a medical device that offers you as much flexibility as possible. Dirk, who is self-employed and restores mills, found a brace to relieve his pain: the Agilium Reactive.



Agilium Select – which brace suits me best?

Agilium Select helps you quickly and easily find the ideal product for you and your needs. Based on our selection criteria, we’ll take you directly to the right brace.

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Our products for osteoarthritis of the knee

Thanks to products from the Agilium line, many satisfied patients have been able to resume their regular everyday activities. Learn more about the individual braces and how they help people with osteoarthritis of the knee.

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