KNEE PAIN &

osteoarthritis

A guide to causes, symptoms, and relief.

Osteoarthritis is the degradation, or “wear-and-tear” of articular cartilage within a joint. Articular cartilage is the protective layer between bones which allows for smooth, painless movement. The erosion of this protective layer causes pain, inflammation, and disability. Any joint can develop osteoarthritis, but it is most common in load bearing joints such as hips, knees, and ankles. Osteoarthritis is most common over the age of 50, but can occur at any age.

OSTEOARTHRITIS?

Did you know… 

Osteoarthritis is expected to be the 4th leading cause of disability in Canada by the end of 2021? Osteoarthritis affects approximately 4.6 million Canadians. 29% of those cases involve the knee joint.


What is 

Pain in the joint that increases with activity.
Swelling and/or warmth around the joint.
Stiffness in the affected joint.
Locking or clicking in the joint.

Diagnosis:

Osteoarthritis is typically diagnosed using a weight bearing x-ray image to determine if there is narrowing of the space between bones of the affected joint, indicating a loss of cartilage in that area.

Symptoms can include:

OSTEOARTHRITIS?

Osteoarthritis is typically considered to be an aging related condition, but there are several factors which may increase the risk of developing it. 

A “knock knee” or “bow legged” standing position creates a higher risk of developing Osteoarthritis in their knees. 

One side of the knee joint may develop Osteoarthritis sooner, or more severely than the other. 

Heredity/Poor lower limb alignment: 

As body weight increases, the forces travelling through the knee also increase. 

Carrying excess weight throughout your life increases the “wear and tear” on the knee which increases the risk of developing Osteoarthritis.

Increased Body Weight: 

Past Injury: 

An injury to the soft tissues in the knee can change the stability of the knee. Over time, these mechanical changes can lead to Osteoarthritis. 

What Causes

Joint replacement is currently the only end stage treatment for severe osteoarthritis of the knee, but age, activity level, and other health conditions may affect eligibility for surgery.

JOINT REPLACEMENT SURGERY

Partial or Total Joint Replacement Surgery removes the damaged joint and replaces it with an artificial joint.

FOR PAIN MANAGEMENT:

There are several options for conservative treatments which can help to improve quality of life prior to surgery or in some cases may be used as an alternative to surgical intervention. Different people may find some strategies more effective than others depending on the severity of their osteoarthritis, the severity of their pain, and the cause of their osteoarthritis. Talk to your doctor about which strategies may be best for you. Strategies may include: 

Research has shown a decrease in knee pain with the use of an offloading knee brace.

Medications:  

Bracing: 

Offloading braces change the alignment of your knee when you are standing to reduce the force travelling through the damaged part of the knee.

Foot Orthoses: 

Foot alignment can contribute to knee issues. Improving alignment from the ground up may result in a reduction in knee pain.

Weight Loss: 

Studies have shown that a decrease in body weight of 20% has clinically relevant results in terms of pain relief. 

Strengthening the muscles surrounding the arthritic joint can help to improve balance, increase stability of the joint, and reduce pain. 

Physiotherapy and Targeted Exercise:   

Programs such as GLA:D Canada (gladcanada.ca) provides targeted exercise programming for individuals with osteoarthritis.

Non weight bearing activities like cycling and swimming are good fitness alternatives to reduce strain on the knee

Lifestyle Modification:  

Walking aids such as a cane help to reduce the load put on the knees when walking.

Corticosteroid Injections: 

Reduce inflammation around the affected joint, allowing for improved mobility for the effective period of the drug. 

Viscosupplementation Injections: 

If applicable, your doctor may recommend prescription anti inflammatory or analgesic medications. 

Improve the lubrication of the joint and allow for smoother joint action. 

Over the counter oral and topical anti inflammatories (NSAIDs) and painkillers (analgesics) can be useful for short term pain relief. 

Treatment options

What does knee bracing cost?

The brace must be provided by a Certified Orthotist.

All Albertans are eligible for funding through the Alberta Aids to Daily Living (AADL) program, which is a branch of Alberta Health Services. This program provides funding for bracing, up to 100% coverage, provided that the following criteria is met:

If you are interested in, or want more information about knee bracing, schedule an appointment with a Certified Orthotist for a no-charge consultation. 

Must have a prescription from an orthopedic specialist OR have a prescription from a family doctor along with an x ray report confirming a diagnosis of Osteoarthritis. 

Patients must commit to wearing the brace full time (6 hrs/day) for a minimum of 6 months. Patients with surgery scheduled within 6 months will not be eligible. 



KNEE BRACE?

When you attend an assessment, a Certified Orthotist (CO.(c)) will assess your knee and determine if you are a good candidate for an offloading brace. Options for offloading knee bracing range from lightweight prefabricated braces to Custom made Carbon Fibre braces. Your Certified Orthotist will go over the best options with you based on your needs.

If you are a good candidate for custom bracing, a 3D scan of your leg will be taken to provide an accurate image of the shape of your limb. This model will be used to fabricate your custom made knee brace. 

If you are considering conservative pain management strategies for treatment of knee pain related to Osteoarthritis, you may be a good candidate for an unloading knee orthosis.  

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