It's my knees!
Our knees carry the whole weight of our bodies for all our lives, so it's hardly surprising they feel the strain sometimes. Osteoarthritis - often called 'wear and tear' arthritis - is the commonest cause of persistent joint pain in the UK, and the knees, along with hips, spine and hands, are the most common joints affected. The joint cartilage becomes worn and the two sides of the joint grind together. The result? Pain and stiffness (often worse in the mornings) and sometimes swelling.
Contrary to popular belief, your symptoms won't inevitably keep getting worse - symptoms often come and go and there are lots of ways to help yourself. Keeping your weight down and regular exercise are key. Walking with well-cushioned shoes and swimming are perfect, and it's quite safe to 'knock on the door of pain' - you may feel a bit achy after you exercise, especially if you're not very fit, but build up gradually and stop for a few days if the pain is bad.
To run or not to run?
Exercise itself isn't bad for your knees (apart from the risk of acute injuries like tears to the cartilage inside the knee in football or contact sport injuries). In fact, it's one of the cornerstones of treatment for osteoarthritis - it helps keeps the joints moving and strengthens the muscles around them. It also, of course, helps keep your weight down - and carrying excess weight is a major cause of knee problems. What's not so good is running without the right shoes. Proper shoes with good insoles act as 'shock absorbers', reducing the jarring on your knees, hips and spine every time you take a step.
Medicines - what works?
For short-term strains and aches, your pharmacist can give invaluable advice. Anti-inflammatory tablets like ibuprofen can be really effective at reducing inflammation as well as pain. In the long term, they can affect your kidneys or inflame the stomach lining, so your GP may recommend an alternative like a gel or cream form of anti-inflammatory. Paracetamol can be very effective, but if it's not controlling your pain, a combination with codeine may be recommended. However, codeine medications can also cause problems in the longer term, so do speak to your doctor if you've needed them for some time.
When should I worry?
See your doctor if:
- Your knee is swollen, hot and you can't move it at all (especially if you're also feverish or unwell) as it could be a warning symptom of a condition called septic arthritis
- Your knee locks or gives way after an injury (especially a twisting injury)
- Your knee is too painful to put weight on or you have severe pain even when you're resting
- Your knee looks deformed
- The pain and/or swelling extend to your calf - a deep vein thrombosis (DVT) of your calf.
Knee replacements - the lowdown
Knee replacement is a common procedure these days, with over 70,000 people a year having them in England and Wales alone. There are two main types of replacement, replacing either the whole joint or one side only. Partial knee replacement involves less time in hospital but is only worth doing if one side of your knee is much more worn than the other. Most replacement knees last 15 or 20 years if you look after them. It's usually offered if your knee pain is severe and affecting you at rest as well as preventing you from getting about. About 95% of people recover without complications, but you're likely to be offered medicine after surgery to cut the chance of developing DVT (a clot in your leg which can travel to your lungs).
Recovering from a knee replacement
You'll be encouraged to start walking as soon as possible with help from hospital staff- usually with a frame or crutches at first, but hopefully with sticks by a week after your operation. You'll probably be in hospital for a week or just over for a full knee replacement (occasionally less if you're otherwise fit), and your physiotherapist will help you with strengthening exercises you must do regularly. You should be driving in four to six weeks and back to work in six to 12 weeks - check with your medical team. Your new knee should last you for years, but sports that might injure it (like skiing) are best avoided.
With thanks to 'My Weekly' magazine where this article was originally published.