Knee Osteoarthritis

Overview

Knee osteoarthritis (OA) is the most common form of arthritis in the knee. Over time the smooth cartilage that cushions the joint becomes thinner and rougher, the bone underneath can change shape, and the joint lining may become irritated. The result is a knee that feels stiff, aches with activity and sometimes swells.

It mostly affects people over 50, but it can start earlier after a previous knee injury or surgery. OA is a long-term condition, so the aim of treatment is long-term management rather than reversal. The good news is that the amount of change seen on an X-ray does not predict how much pain you will have — many people with "worn" knees on imaging stay active and comfortable with the right approach.

Symptoms often come and go in flares. Stiffness in the morning or after sitting usually eases within half an hour, and pain tends to be worse on stairs, getting out of a chair or after a long walk.

Causes and risk factors

• Age — cartilage changes become more common from the 50s onward
• A previous knee injury, meniscus tear or ligament surgery
• Being overweight, which increases load through the joint
• Jobs or sports involving repeated kneeling, squatting or heavy lifting
• Family history of osteoarthritis
• Weak thigh (quadriceps) muscles, which reduce the knee's shock absorption
• Being female, particularly after the menopause

How we may be able to help

Your first visit is a full assessment. We look at how your knee moves, test the strength of the muscles around the hip and knee, check your walking pattern and ask how the pain affects your day. If imaging or a medical opinion is needed, we can arrange an online private GP consultation.

Evidence from NICE and international guidelines consistently supports exercise as the core treatment for knee OA, and this forms the backbone of our physiotherapy plan. We prescribe a graded programme to strengthen the thigh and hip muscles, improve movement and build confidence. Hands-on manual therapy may help reduce stiffness in the short term so that exercise feels easier.

Where swelling or pain is limiting progress, interferential therapy may be used as an adjunct after your assessment. If your foot posture or knee alignment appears to be adding to the load on one side of the joint, a 3D foot scan and custom orthotics may be suggested. Kinesiology taping can give some people extra support during walks or exercise.

What you can do at home

• Keep moving: short, regular walks are generally better than long rests
• Strengthen your thighs — sit-to-stand repetitions from a chair are a simple start
• If you are carrying extra weight, even modest weight loss can reduce knee load noticeably
• Use heat for stiffness and a wrapped ice pack for a swollen, achy knee after activity
• Choose cushioned, supportive footwear rather than flat or worn-out shoes
• Try lower-impact activities such as cycling, swimming or aqua-aerobics on flare days