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

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.

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.

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!