What is knee osteoarthritis?
Knee osteoarthritis is wear and tear in the joint, here the knee. The smooth cartilage that cushions the bones thins over time, and the joint becomes stiff, achy and sometimes swollen. The glossary has a short entry on osteoarthritis.
It is very common. The World Health Organization (WHO) estimates that about 365 million people worldwide were living with knee osteoarthritis in 2019, and that about 73% of people with osteoarthritis are over 55 [1].
What does it feel like in everyday Ipoh life?
Most people notice it first in ordinary tasks. The pain comes on when you climb the stairs of a terrace house, stand up from a low seat, or squat on a squat toilet.
You may feel stiff for a while after getting out of bed, or after sitting through a long meal at a kopitiam. Walking on the morning route at Polo Ground or Gunung Lang may bring a deep ache, and the knee may click or feel as if it could give way.
If sitting on the floor for prayers, family meals or temple visits has become a struggle, that matters too. Tell your physiotherapist, because those movements decide the exercises we choose.
Who is it most likely to affect?
It is most likely in older adults, in people carrying extra weight, and in anyone with an earlier knee injury or surgery. It also affects people who have spent years on their feet, in work or sport.
Family may notice before the patient does. A parent who now avoids the stairs or takes the lift every time may be protecting a painful knee. Adult children can gently ask what is hard.
What does a physiotherapist check first?
We start by listening, then look at how the knee works as part of the whole leg. We ask about the pain, what eases it, what you want to get back to, and what you have already tried.
Then we check:
- how you stand, walk and climb stairs.
- how far the knee bends and straightens.
- strength in the thigh, hip and calf.
- balance, and how steady you feel on one leg.
- whether the hip, ankle or back is adding to the problem.
If anything points to a different cause, we say so and refer you on.
What helps a painful knee?
Exercise is the main treatment. A Cochrane review of 54 trials found that land-based exercise reduced knee pain and improved physical function straight after treatment, and the benefit was smaller when people were checked again some months later [2]. That is why we aim to build exercises into your normal week, not just the clinic hour.
WHO also lists weight management, education about the condition and, for severe joint damage, joint replacement as part of management [3].
In practice, a plan can include:
- strengthening for the thigh and hip.
- stair and sit-to-stand practice.
- advice on pacing walks and hikes such as Bukit Kledang.
- hands-on techniques to ease stiffness.
- guidance on a safer way to use the toilet and sit on the floor.
You can read how we approach this in our pages on knee pain and the squat toilet and knee pain.
What can I do this week?
Start with small changes that spare the knee without stopping movement.
- Walk short distances on flat ground, twice a day, rather than one long walk.
- Hold the stair rail and lead with the stronger leg going up.
- Use a raised seat or a firm cushion for low chairs.
- Do gentle sit-to-stand from a sturdy chair, a few times, three times a day.
- Warm the knee with a warm towel before exercise if it feels stiff.
Stop and ask for advice if an exercise makes the pain sharper for longer than a few hours.
When should I see a doctor first?
Go to a doctor or the emergency department if the knee becomes red, hot and very swollen, especially with a fever. Go too if it suddenly cannot bear weight after a fall, looks deformed, or the calf becomes swollen and painful.
See a doctor if the pain wakes you at night, or if you have unexplained weight loss. Hospitals in Ipoh such as Hospital Raja Permaisuri Bainun, Fatimah Hospital and Pantai Hospital Ipoh can see you for these.
How do home sessions in Ipoh work?
A physiotherapist comes to your house, assesses your knee where the pain happens, and teaches exercises on your own stairs and chair. Visits are available across Ipoh now, and our Canning Garden centre is opening soon.
Prices are quoted on WhatsApp after a short description. See how home physiotherapy works for the steps, and if surgery is already planned, knee replacement rehabilitation.
If both knees and a hip trouble you, hip osteoarthritis may also be relevant, and joint pain with extra weight covers that link.