Q What is Knee Osteoarthritis?

The cartilage between prevents the bones from colliding with each other. However, as we age and inflammation occurs in the joints, the cartilage wears away. This puts strain on the bones, and they lose their original shape and become deformed into a bumpy and uneven shape, which is called osteoarthritis. An X-ray of the joint may show unusual bone shapes and a narrow gap between the bones.

What are the symptoms of Knee Osteoarthritis?

Typical symptoms include:

Difficulty or pain when sitting upright.
Pain when going down the stairs or standing up from sitting.
Pain, stinging, and throbbing when lying down or sleeping, if the inflammation is strong.
Pain when walking, in the case of severe bone deformity.

Pain variation in Knee Osteoarthritis:

Pain can increase with bad weather:

Many people find that their pain increases in line with weather variation, especially before it rains. This is to do with blood vessels. As shown in the figure below, osteoarthritis of the knee causes an increase in abnormal blood vessels in the painful area. When blood vessels increase, nerve fibers tend to increase with them, so where there is an increase in these blood vessels, there is also an increase in nerves, and the increased blood flow causes throbbing pain.

On rainy days, the atmospheric pressure drops. Since human blood vessels tend to dilate with a drop in air pressure, blood flow to abnormal blood vessels also increases, leading to increased pain. If your pain changes with the weather, it may be caused by blood vessels. We urge you to see a medical specialist.

Pain without severe deformity:

The deformity of the bone on x-ray examination does not always coincide with the intensity of the pain. In other words, some people have strong pain even though the x-rays don’t show much deformity, but some people have no pain even though the x-rays show the deformity.
In fact, the pain of osteoarthritis of the knee is not only caused by bone deformity. Bone deformity can cause pain when the deformity is quite severe, but it is not the cause of pain at the stage before it becomes severe. Then, what can cause of pain except the bone deformation?
One of the causes is inflammation. Inflammation around the knee joint can cause pain. It has also recently been discovered that many abnormal blood vessels can form around the joint, and they cause pain.

You can also check the article here for further information.

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Knee Osteoarthritis treatment

Treatment methods vary depending on the degree of deformity. If the condition is in its early stages, it may be possible to prevent from progressing. If you recognize any of the symptoms, it is recommended to visit a specialized medical institution.

Early treatment to prevent or minimize progression:

Weight is a contributing factor to the strain on the knee, which leads to the cartilage being worn out. However, weight is not only factor. In fact, it is known that a high-calorie diet can cause inflammation in the body (even if not overweight), and this inflammation can lead to increased pain and deformity. The human body is prone to inflammation when it takes in too many calories from carbohydrates and fats. And when inflammation occurs, a substance called "inflammatory cytokines" is released, damaging the body's tissues. When inflammation occurs in the knee, the cartilage in the knee is damaged by inflammatory cytokines and wears out. Therefore, it is important to avoid inflammation.

It is also important to promptly reduce inflammation if it has already occurred. Inflammation causes pain in the knee, so pain indicates inflammation is occurring. Treatment to reduce inflammation can improve pain and prevent further progression of deformity in the future.

Self-treatment to manage pain:

One simplified method that you can do by yourself to manage your discomfort with knee osteo arthritis is this simple 15-second acupressure.

There are "pressure points" around the knee. Often there is one or more small areas about the size of one finger. This is a point that hurts more than other places. If you feel pain on the inside of your knee, you can press inward; if you have pain on the outside, you can press outward; and if you press various places around your knee with your thumb, you should be able to discover the point. If you can find this painful point, keep pressing there for 15 seconds. It does not have to be so strong. You will feel pain when you start pressing, but if you keep pressing, you will notice that the pain goes away.

Surgical Treatment options:

Arthroscopic surgery:

A procedure in which four holes are drilled in the knee and a thin scope, called an arthroscope, is used to observe the inside of the knee joint to clean out synovial membrane, joint rats, and other potential sources of pain. In the early stages, some patients may be relieved of pain, but since the deformity of the joint remains the same, the pain may recur over time.

High tibial osteotomy:

This is a surgery to correct bowlegs by cutting a portion of the tibia (shin bone). It requires the implantation of an artificial bone and fixation with a metal plate, which increases the length of hospital stay. This surgery is often performed on patients who are relatively active.

Artificial knee joint replacement:

This is for patients with severe deformity. It is a surgery to replace the deformed joint with a metal implant joint. Patients with end-stage deformity are eligible for this surgery. However, a certain percentage of patients remain in pain even after the surgery.

If your doctor recommends surgery, ask him or her in detail about the progression of your knee deformity, which surgery is suitable for you, what your postoperative life will be like, and the probability that you may still have pain.

Non-Surgical treatment options:

Surgery for knee arthroplasty or osteotomy is a very heavy burden on the body and should certainly be chosen carefully. As a non-surgical option, "multidisciplinary treatment," which combines various therapies, is effective.

Multidisciplinary treatment means combining several "non-surgical methods" to relieve knee pain.

For example, as described on this site, catheterization to reduce the number of abnormal blood vessels around the knee (for more information, see this page　https://okuno-y-clinic.com/en/problem-blood-vessels/ ), adding embolic agent to strengthen the bones if there is bone damage, reviewing lifestyle to produce more serotonin, and/or losing weight by actively managing diet. This is a treatment to relieve pain without surgery as much as possible.

If you are interested in multidisciplinary treatment, please consult with a medical facility specializing in pain management.

Consultation

Knee Osteoarthritis is caused by wear on the knee and inflammation. Treatment for the condition varies from self-management or self-prevention through to surgery. Finding the right treatment depends on many factors such as the progression of the condition, as well as the patient’s lifestyle and age. If you are experiencing knee pain, it is important to see a healthcare professional who can help diagnose and treat your condition.