Knee Osteoarthritis (OA) is characterised by knee pain and loss of function. A simple way to understand the condition is that while there are structual changes to the knee, the knee has become sensitised and painful.
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There are multiple factors related to knee pain, most of which can be modified to influence your symptoms. They are as follows:
- Osteoarthritis of bone
- Stress, depression, fatigue, anxiety
- Obesity
- Lack of sleep or physical activity
- Genetics
- Muscle Weakness
- Unaccustomed load through sport, work or recreation
- Negative Beliefs, catasrophising and decreased confidence
Some myths about OA are:
- The degree of arthritis seen on scans will predict your pain and function
- Rest is helpful
- Only surgery will provide a fix
- Exercise is dangerous
- Pain means damage
The facts about OA are:
- Scans are poorly related to pain and function
- Rest makes pain worse
- Graded exercise is safe and it helps
- 20% of people do not get significant pain relief from a joint replacement
- Pain does not equal damage
Treatment should include:
- Education
- Exercise (Fitness and Strengthening)
- Weight loss if needed
- Lifestyle changes (Regular physical activity and healthy sleep habits)
- Referral when indicated to GP and/or specialist
Patients need to be encouraged to take charge of their rehab and develop self-management strategies. It’s important to understand that flare-ups are normal and to follow the advice given to help manage the symptoms.
If you have exhausted a non-surgical approach to treatment, then discuss the risks and benefits of surgery with your physiotherapist.
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In summary, when patients are coached to take an active role in their rehab, it will hopefully lead to improved outcomes and postpone the need for knee replacements.