In short
Knee osteoarthritis causes pain, stiffness and sometimes swelling, usually worse with activity. Exercise and, for people carrying extra weight, weight loss are the most effective treatments, and are recommended before anything else. Knee replacement is an option when symptoms are severe and other treatment hasn’t helped.
On this page
What is knee osteoarthritis?
Osteoarthritis affects the whole knee joint: the cartilage that covers the ends of the bones, the bone underneath, the joint lining and the muscles around it. It’s one of the most common causes of knee pain in middle-aged and older Australians.
Symptoms
- Pain, usually worse with walking, stairs, kneeling or getting up from a chair
- Stiffness, especially after rest, that eases within about 30 minutes
- Swelling at times
- Crunching or grinding
- A feeling the knee might give way
Sore joints slowing you down?
Talk it through with an Australian doctor online. No referral needed.
Risk factors
- Older age
- Previous knee injury, such as a ligament or meniscus tear
- Excess weight
- Family history
- Physically demanding work with repeated kneeling or squatting
Treatment
Exercise
A Cochrane review found that land-based exercise reduces knee pain and improves function, with benefits similar in size to those of commonly used pain medicines. Strengthening the thigh and hip muscles is particularly useful. Walking, cycling and water exercise also help. Programmes with at least 12 supervised sessions tend to work best.
Weight loss
For people carrying extra weight, losing weight reduces load through the knee. In a trial published in JAMA, overweight adults with knee OA who combined diet and exercise had less pain and better function than those who only exercised.
Other treatments
- Education and pacing
- Walking aids and knee braces for some people
- Medicines for pain flares, ideally alongside exercise. Talk to your GP or pharmacist about what’s safe for you.
- Injections may give short-term relief for some people
Surgery
Knee replacement is very effective for people with severe OA and significant ongoing symptoms. Arthroscopic “clean-out” surgery is not recommended for knee osteoarthritis, because trials have shown it doesn’t provide lasting benefit.
Do I need an X-ray?
Often not. Knee OA can usually be diagnosed from your age, symptoms and examination. An X-ray is useful if the diagnosis is unclear or surgery is being considered.
When to see a GP
See a GP if knee pain is affecting your walking, sleep or work, or lasts more than a few weeks. A hot, red, swollen knee with fever needs same-day care.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1(1):CD004376.
- Messier SP, Mihalko SL, Legault C, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. 2013;310(12):1263-73.
- Juhl C, Christensen R, Roos EM, et al. Impact of exercise type and dose on pain and disability in knee osteoarthritis: a systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheumatol. 2014;66(3):622-36.
- Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589.
- Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-1759.
- RACGP. Guideline for the management of knee and hip osteoarthritis.
- healthdirect. Knee pain.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.