The knee is the joint where the bones of the lower and upper legs meet. The largest joint in the body, the knee moves like a hinge, allowing you to sit, squat, walk or jump. It consists of three bones which are covered with a layer of cartilage, a slick, elastic material that absorbs shock, and allows the bones to glide easily against one another as they move. Virtually any form of arthritis can affect the knee, causing pain and swelling. These include:
Osteoarthritis – This is the most common type of arthritis, and is a chronic condition characterised by the breakdown of the cartilage that cushions the ends of the bones, where they meet to form joints. The breakdown of cartilage causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint. The knee is one of the joints most affected.
Rheumatoid arthritis – A chronic inflammatory disease of the joints, it occurs when the body’s immune system, which normally protects us from infection, mistakenly attacks the synovium, the thin membrane that lines the joints. The result can be joint damage, pain, swelling, inflammation, loss of function, and disability. Additionally, the hands, wrists, feet, elbows and ankles are usually affected.
Juvenile arthritis – The term is used to describe arthritis when it begins at age 16 or before. There are several different types of this condition, including juvenile rheumatoid arthritis (JRA), and juvenile idiopathic arthritis (JIA). Many can cause pain and swelling of the knee.
Gout – It is a form of arthritis that occurs when excess uric acid, a bodily waste product circulating in the bloodstream, is deposited as needle-shaped monosodium urate crystals, in tissues of the body, including the joints. For many people, the first symptom of gout is excruciating pain and swelling in the big toe, often following a trauma, such as an illness or injury. Subsequent attacks may happen off and on in other joints, primarily those of the foot and knee, before becoming chronic.
Reactive arthritis – A chronic form of arthritis, it often occurs following an infection of the genital, urinary, or gastrointestinal system. Features of reactive arthritis include inflammation and swelling of the joints (primarily the knee, sacroiliac joints and joints of the feet), eyes, and structures within the gastrointestinal or genitourinary tracts, such as intestines, kidneys or bladder.
Lyme disease – It is an infectious disease characterised by a skin rash, joint swelling, and flu-like symptoms. The disease is caused by the bite of a tick infected with a bacterium called B. burgdorferi. The knee is often the first joint affected by Lyme disease.
Lupus – Also known as systemic lupus erythematosus, is a chronic autoimmune disease, meaning the body’s immune system creates antibodies that attack healthy tissues. In addition to causing inflammation in the knee and other joints,
Ankylosing spondylitis – It primarily affects the spine, causing inflammation within it, that can lead to chronic pain and stiffening. In some people, particularly younger people, it begins with pain and swelling in the knee, rather than the spine.
Psoriatic arthritis – Another form of arthritis which is accompanied by the skin disease psoriasis, and often precedes it. In a small percentage of persons, the joint disease develops before the skin disease.
Infectious arthritis – Also called septic arthritis, it refers to arthritis that is caused by an infection within the joint. It is often cause by bacteria that spread through the bloodstream to the joint. Sometimes it is caused by viruses or fungi.
Education and self-management – It is recommended that patients learn all they can about their arthritis and its treatment. A self-management course may or may not do much to improve pain, stiffness or physical function.
Exercise – A variety of exercises, such as strength training, aerobics and range of motion, can help with both pain and physical function in knee OA. Strengthening can also help with hip arthritic pain. Water-based exercises may improve function in both knee and hip joints, but not always benefits the pain.
Weight loss – It has been found that weight loss leads to a reduction in pain and disability, in previously overweight patients with arthritis of the knee.
Acupuncture – A form of traditional Chinese medicine involving the insertion of thin, sharp needles at specific points on the body, it has been touted as a treatment that aids in pain reduction.
Transcutaneous electrical nerve stimulation (TENS) – A technique in which an electric current is administered through electrodes placed on the skin, TENS is believed to stop messages from pain receptors from reaching the brain.
Knee braces, sleeves, and other devices – It has been found that knee braces and foot orthoses can be helpful for reducing pain and joint stiffness, and improving function in the knee, without causing any adverse side effects.
Canes and crutches – Using a cane may reduce pain and improve function. However, while it takes the load off the knee, it can add more weight onto other affected joints, such as the hip. There isn’t any evidence that crutches are a good alternative to the cane. There is also the option of supplements, medication, corticosteroid injections or surgery.
Next week we continue to focus on the knee, however, zooming in on injuries that occur.
Your feet mirror your general health . . . cherish them!