Osteoarthritis and Other Common Causes of Knee Pain

This article is part of the Ultimate Guide to Knee Pain Relief.

As we move throughout the day, our knees can suffer from the impact and pressure taken on by walking, running, squatting and jumping. A painful knee can disrupt your daily activity and lifestyle.

Knee pain can arise from an injury or underlying condition. If your knee pain lasts for more than a few days, it should not be ignored. 

IBJI recently chatted with Dr. Gregory Fahrenbach, board certified orthopaedic surgeon. Dr. Fahrenbach discusses osteoarthritis and other common causes of knee pain. Learn about some of the most common reasons for knee pain and how they are typically treated. His responses—below—have been edited and condensed for space.

What is Osteoarthritis of the Knee?

Osteoarthritis is categorized as a non-inflammatory arthritis. Osteoarthritis is a breakdown (degeneration) of the joint surface cartilage and articular cartilage caused mostly from repeated microtrauma over a length of time. 

“Degeneration from osteoarthritis generally takes years to develop but sometimes it can have a more rapid and progressive nature over months,” says dr. Fahrenbach, “Most of the time the degeneration is not noticeable until it has a critical period when the joint no longer has a smooth motion and it becomes painful. This change in motion may not be noticeable early on but your knee knows. The pain can have a variety of origins, ligaments’ strain secondary to micro-malmotion or the onset of swelling as a reaction to the debris caused by the wear and tear.”

A patient may either have primary or secondary osteoarthritis. “Primary osteoarthritis is caused by a degenerative process of the joint. It is considered a wear and tear process. Whereas, secondary osteoarthritis results from a prior injury, such as a fracture. Both have a joint surface and articular cartilage degeneration origins,” says Dr. Fahrenbach.

How is Osteoarthritis treated?

The main goal of the treatment for osteoarthritis is to decrease pain and improve the activities of daily living. Everyone has specific goals. “The initial treatment may be over-the-counter medication or prescription medication with an exercise program or physical therapy. It may require draining the knee and injecting steroids. ‘Gel’ injections have some qualifications as to its benefits that should be discussed with the doctor. The OrthoHealth program to help lose weight and optimize metabolic health may also be recommended. 

Additionally, according to the American Academy of Orthopedic Surgeons (AAOS) there are ongoing efforts underway to develop surgical techniques to help restore articular cartilage by stimulating the growth of new cartilage.  Restoring articular cartilage can relieve pain, allow better function, and delay or prevent the onset of arthritis.  These techniques continue to advance the treatment of joint injuries, and doctors are learning more every day about cartilage and its healing response.  

Ultimately, if conservative treatments fail, a joint replacement may be recommended,” says Dr. Fahrenbach. 

Unfortunately, the joint surface does not heal when it is damaged or wears down. When the degeneration starts, Dr. Fahrenbach says it cannot be reversed. With the treatment methods listed above, the degeneration can often be slowed and made more tolerable.

How often do I need to see the doctor for Osteoarthritis?

Dr. Fahrenbach says, “After your initial treatment program has been planned, a return visit is often scheduled within four to six weeks for monitoring. If your symptoms improve, your follow-up appointments for monitoring will be spaced out longer. Repeat injections are spaced no sooner than four months for steroids and six months for ‘gel’ injections.”

While not everyone will develop osteoarthritis, you can still take precaution to try to minimize your chance of developing it by maintaining an ideal weight and staying active.

Any sudden pain and swelling of the knee joint without an injury needs to be assessed to determine if it is from osteoarthritis or from other inflammatory arthritides. Common inflammatory arthritides include; infection, gout, rheumatoid arthritis, psoriatic arthritis, other auto-immune diseases and other causes. In addition, red and painful swelling over the knee cap may be bursitis, another cause of knee pain.

Other Common Causes of Knee Pain

Other common causes of knee pain may be from injury or overuse strain. An acute injury may be painful with immediate or delayed swelling. Overuse pain may take a day or weeks to fully develop.

Your history of the mechanism of injury or strain will help to determine the problem. Expect an exam of the knee with X-rays and other diagnostic testing to reach a diagnosis. The treatment plan will vary as to your symptoms, presentation and expectations. Everyone is different and every knee pain is specific to you and your lifestyle.

Common Causes of Knee Pain Q&A with Dr. Fahrenbach

When should I see a doctor for my knee pain?

“In the absence of trauma/injury or swelling of the knee if the pain does not reside after a few days and your activity is affected then make an appointment to be seen. After a week if you have no improvement then you should be seen.”

Are there any home remedies you recommend to treat knee pain?

“It is difficult to recommend any home remedies to treat knee pain without knowing the cause. In general apply the R.I.C.E. principle; rest, ice, compression and elevation. Over-the-counter medication may also help with the pain.”

What are common treatments for overuse injury of the knee?

“The obvious first thing to do is avoid the activity that is causing the pain. Use the R.I.C.E. principle. Start a stretching program. Motion is good for your joints. Continued discomfort should not be ignored.”

What are some examples of an acute injury?

“Acute injury is associated with a definable event that causes discomfort. It may be a sports injury, a fall from any height (stair or ladder etc.), or a twisting event with near immediate discomfort or pain.

Acute onset of pain may be from injury but also may be insidious over a short period of time as is seen with inflammatory arthritis and osteoarthritis. When your symptoms have been ongoing for 6 weeks, it is considered chronic. Though chronic pain can have acute episodes necessitating a visit to the doctor.

No matter the cause of your knee pain, it’s important to remember to seek help from an orthopedic physician if the pain persists. IBJI’s knee physicians are ready to help assess, diagnose and treat your knee pain so you can get on the path to recovery.”

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Knee Care and Treatment at IBJI

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