Knee osteoarthritis: what are your treatment options?

Knee osteoarthritis doesn’t mean you must stop moving

A diagnosis of knee osteoarthritis can sound frightening. People are sometimes told that the joint is “worn out” or that exercise will cause further damage.

Osteoarthritis involves changes within the whole joint, but symptoms don’t always match what appears on an X-ray. Some people have noticeable changes with relatively little pain, while others experience significant pain and restriction.

The condition doesn’t necessarily worsen continually, and there are several ways to manage its effects.

Common knee osteoarthritis symptoms

Symptoms may include:

• Pain during walking, stairs or prolonged standing

• Stiffness after rest

• Reduced confidence loading the leg

• Swelling or a feeling of fullness

• Grinding or clicking

• Reduced movement

• Difficulty exercising

• Pain affecting sleep

A physiotherapy assessment can also help determine whether the symptoms fit osteoarthritis or whether another knee problem may be contributing.

Why is exercise recommended?

Exercise is one of the most important treatments for osteoarthritis.

Strengthening the muscles around the knee and hip can improve the support available to the joint. General physical activity also supports cardiovascular health, confidence and the ability to manage everyday demands.

An appropriate programme may include:

• Quadriceps strengthening

• Hip and gluteal strengthening

• Calf and balance work

• Walking or cycling

• Gradual functional exercises

• Mobility work where movement is restricted

This shouldn’t mean being handed a difficult programme and told to push through severe pain.

The exercises should start at a manageable level and progress as your knee’s capacity improves. Some discomfort may be acceptable, but the response later that day and the following day should also be considered.

Managing flare-ups

Osteoarthritis symptoms can fluctuate. A more painful week doesn’t automatically mean that the joint has suddenly deteriorated.

During a flare, it may help to:

• Reduce—but not necessarily stop—aggravating activity

• Break longer tasks into smaller amounts

• Use heat or cold according to preference

• Continue comfortable movement

• Discuss medication with a pharmacist or GP

• Review whether activity increased too quickly

Once symptoms settle, activity can be gradually rebuilt.

Can physiotherapy help?

Physiotherapy may help by:

• Assessing strength, movement and function

• Designing a progressive exercise programme

• Advising on walking, stairs and daily activity

• Using hands-on treatment where appropriate

• Discussing pacing and flare-up management

• Helping you return to exercise

• Identifying when medical review is needed

Manual therapy may be useful as part of a wider plan, but it shouldn’t replace strengthening and physical activity.

What about injections?

Steroid injections may be considered for short-term relief when other treatments haven’t been sufficient, particularly when pain is preventing participation in rehabilitation. Their suitability and risks should be discussed with an appropriately qualified clinician.

Hyaluronic acid injections are available privately in some settings. Individual responses vary, and evidence is inconsistent. NICE currently advises against routinely offering intra-articular hyaluronan injections for osteoarthritis.

At Revive, an injection consultation should therefore include an honest discussion about the evidence, potential benefits, limitations, cost, alternatives and the rehabilitation still required.

No injection can reverse osteoarthritis, and suitability must be assessed individually.

When might surgery be considered?

Most people with osteoarthritis don’t immediately need surgery.

Referral may be considered when symptoms are significantly affecting quality of life and appropriate non-surgical treatment has not provided sufficient improvement.

The decision should be based on the impact on the person—not simply the appearance of an X-ray.

Seek medical advice urgently if:

• The joint becomes suddenly hot, red and severely swollen

• You’re unable to bear weight after an injury

• The knee is visibly deformed

• You have knee pain alongside fever or feeling significantly unwell

• The calf becomes suddenly swollen, painful or warm

Knee arthritis support near Worsley and Walkden

Revive Physio provides physiotherapy and individual treatment discussions for knee osteoarthritis from a clinic in Mosley Common.

An assessment can help you understand your current symptoms, identify an appropriate starting point for exercise and discuss the available options without pressure.

If knee pain is limiting walking, sleep or the activities you enjoy, book a physiotherapy assessment below.