What does arthritis pain in knee feel like

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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The knee joint can be thought of as primarily a hinge joint with the major motion of straightening and bending. It also has gliding and rotation components as well.

The knee is composed of the end of the thigh bone (femur), the top of the leg bone (tibia), and the kneecap (patella).

The ends of the bone are covered with a smooth, glistening layer called hyaline cartilage. This articular cartilage is very strong and resilient and allows the bones to glide smoothly.

The knee can be thought of as having 3 compartments - the medial, the lateral, and the patellofemoral. In addition, there are 2 pieces of fibrocartilage cartilages within the knee joint called the lateral and medial meniscus, which act as shock absorbers within the knee joint. There are also 2 ligaments within the knee, called the anterior cruciate ligament and the posterior cruciate ligament, which stabilize the knee.

Arthritis of the knee is a condition in which there is loss of the articular cartilage of the femur, tibia, or patella. This can be seen on x-ray as a loss of the space between the two ends of bone.

When osteoarthritis, the most common cause of cartilage loss develops, people with arthritis may feel their knee is stiff and their motion is limited. Sometimes people actually feel a catching or clicking within the knee.

Loading the knee joint with activities such as walking long distances, standing for long periods of time, or climbing stairs makes arthritis pain worse. When the arthritis gets more severe, the pain may occur even when sitting or lying down. Stiffness can worsen. The pain is usually felt in the inside part of the knee, but also may be felt in the front or side of the knee, depending on where the arthritis is most severe. As the cartilage is worn away preferentially on one side of the knee joint or the other, people may find their knee will become more knock-kneed or bow-legged.

Arthritis of the knee usually occurs in people as they enter their 40's, but may occur earlier depending on factors such as weight, activity level, and knee anatomy. Arthritis may be caused by a variety of factors besides cartilage degeneration. Examples include inflammatory disorders such as gout, psoriatic arthritis, or rheumatoid arthritis, infections, and trauma. People who have had prior injury to their knee, damaging the meniscus or cruciate ligament may also develop arthritis. The end result of all these processes is a loss of the cartilage of the knee joint, leading to bone rubbing on bone.

As mentioned earlier, the most common form of arthritis of the knee is osteoarthritis. In this disease, the cartilage in the joint gradually wears away. In rheumatoid arthritis, which can also affect the knees, the joint becomes inflamed and cartilage may be destroyed. Arthritis not only affects joints; it can also affect supporting structures such as muscles, tendons, and ligaments.

Someone who has arthritis of the knee may experience pain, swelling, and a decrease in knee motion. A common symptom is morning stiffness that lessens as the person moves around.

Sometimes the joint locks or clicks when the knee is bent and straightened, but these signs may occur in other knee disorders as well. The doctor may confirm the diagnosis by performing a physical examination and examining x rays, which typically show a loss of joint space. Blood tests may be helpful for diagnosing rheumatoid arthritis, but other tests may be needed too.

Analyzing fluid from the knee joint may be helpful in diagnosing some kinds of arthritis.

Imaging procedures such as MRI can detect osteoarthritis earlier than x-ray.

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