Arthritis pain in knee

Arthritis pain in knee hurts and worse is very disabling.

The ends of the weight bearing bones of the knee, the femur and tibia, are lined with a shiny, hard, super slippery hyaline cartilage surface, not to be confused with the meniscus located inside the joint. Look at the end of a chicken drumstick to see what it looks like.

An injury to the knee can damage this weight bearing cartilage lining of the joint, and in more severe cases the underlying bone.

That could be a sporting injury, such as torn ligaments, a motor accident, or overuse, though obesity is one of the main causes; simply too much weight pressing on the cartilage.

A hole wears through the articular cartilage prematurely causing severe disability and pain; it often occurs around fifty.

This cartilage does not have the capacity to heal spontaneously resulting in the development of various orthopaedic techniques to induce the bone marrow to produce stem cells that can produce new cartilage.

Distraction of the knee joint for a time with an orthopaedic device which still enables you to walk has merit; unloading those cartilage ends of the bones does allow for regrowth. Even more effective is weight loss; in fact it's scientifically proved to be the most workable treatment.

So, what are the symptoms of arthritis in knee? When the injury is to both the cartilage and underlying bone, there is stiffness, swelling, pain and frequently an inability to bend the knee. The lady with the xrays below walked with a severe limp when she first arrived at our clinic. In her early fifties.

This page was last updated by Dr Barrie Lewis on 13th September, 2019.

Scan showing healthy knee cartilage.

Arthritis pain in knee

In the early stages of arthritis pain in the knee, when there is injury to the hyaline cartilage only, there is little to be seen on xrays which can't see the defect.

More severe degeneration of the cartilage can only be detected by a narrowing of the joint space. This is arthritis and knee pain in the making.

Real bone showing a hyaline cartilage defect.

See the raw bone under the cartilage?

X-ray showing narrowed joint space in the knee.

However, using a technique called arthroscopy, surgeons can look inside the knee and "see" the hole in the cartilage. A lesion of this size will certainly be causing symptoms of arthritis in knee.

Seriously damaged knee cartilage causing pain and disability.

Review study of 25,000 arthroscopies 

Widuchowski et al reported that fully two thirds of these patients had erosions of either the cartilage lining of the femur or tibia, or cartilage and bone lesions. These holes have little potential to heal according to the research, presenting a serious clinical challenge to your doctor or chiropractor. Permanent disability is a reality.

The single most effective, and most neglected treatment, is pure and simple, weight loss; except it's not easy. Patients it would seem would rather go through the pain, expense and danger of a total knee replacement, than lose 10 to 20 kg, but sometimes far more.

Having examined many of the victims of minibus accidents in South Africa, some months or years post trauma, I have come to the conclusion that a fractured tibia or femur very frequently results in arthritis pain in the knee.

What seems to commonly occur is that the fracture is obviously the first injury that has to be addressed, and is usually done quite adequately orthopaedically in most hospitals. However, once the plaster cast is removed, it appears to be the exception where other soft tissue injuries to the hip, knee or ankle are sought. When there's been enough force exerted to fracture a bone, there's inevitably associated ST injury; ligaments or menisci are damaged; untreated, arthritis is inevitable.

If you've had a fracture of the leg, always ask a competent chiropractor or physician to carefully examine the related joints once the break has healed. Otherwise you may well be faced with degenerative knee arthritis, or of the hip or ankle, in the future. Worn and painful limbs aren't fun, and the disability is even worse; much of it could be prevented with early treatment.

Worse, research now shows that how fast you can and do walk will directly affect how long you live, and whether you lose your marbles or not. Poorly managed arthritis pain in knee has a serious knock on effect on your whole outlook.


Whilst total removal of a damaged meniscus is not common today, it was common practice in the past. Damage to the meniscus, or total menisectomy, means that the cartilage of the femur presses directly on the cartilage of the tibia. It's not long before arthritis pain in knee is a reality as a hole wears in the cartilage.

Leg length inequality 

There is convincing radiological research that a short leg is one of the causes of both knee and hip arthritis. Oddly, it might be in either the short or the long leg. But certainly, if you have a short leg, whether caused by a fracture of the leg, a fallen arch in the foot, or simply a leg that grew more slowly that its mate, you are more prone to knee arthritis.

A simple insert in the shoe is the answer, but a professional should decide how thick it should be, and whether it should run the length of the shoe, or just under the heel.

Just a soft insert in the shoe would help.

Leg length inequality research confirming this is not just hot air.

Joint mice and arthritis pain in knee 

In the photograph above you can see small pieces of cartilage that could at any moment break off. These pieces of cartilage are not visible on X-ray but they float around in the synovial fluid in the joint, sometimes jamming between the condyles of the femur and the tibia, causing locking and pain.

Sometimes larger pieces, consisting in part of bone may break free, and are then visible within the knee joint. In the jargon, they are known as "joint mice," causing sometimes severe locking of the knee.

X-ray of knee with visible joint mice.

MICROFRACTURE and arthritis pain in knee 

Dr Richard Steadman developed a new technique some thirty years ago for the treatment of young athletes with weight-bearing cartilage lesions of the knee. Tiny fractures of the bone were induced allowing stem cells to seep through the fracture from the bone marrow to the site of damaged cartilage.

These stem cells have the ability to replace the damaged hyaline cartilage, but only with fibrocartilage which is less resilient than hyaline cartilage.

The technique is much less effective in patients older than 45, obese patients and in the case of a large cartilage lesion greater than one inch.

The stem cells are extremely susceptible to pressure in the early stage and it's vital the patient goes on crutches for a minimum of six weeks. Active, non weightbearing exercises of the knee begin immediately after the surgery, together with quad strengthening exercises.

This movement of the knee ensures that the vital nutrients and oxygen in the synovial fluid that feeds the newly forming cartilage are adequately replenished.

Most of the improvement in symptoms after microfracture occurs in the period from 6 to 12 months post surgery.

Arthritis can't be treated, right? You must learn to live with the pain, not so? That's absolutely untrue; arthritis can't be cured, that's so, but then neither can diabetes. Can raised blood sugar be successfully treated? Indeed, it can but these are in the main lifestyle disease; without ringing in changes to your way of life, what you eat and whether you exercise, both will cripple your life.

Add smoking and it's game over.

Chiropractic Help

So can arthritic joints, be it arthritis pain in knee, or neck, back, shoulder, foot... mostly with the correct chiropractic help, a change in diet, a vigorous exercise programme, the pain in these joints, and more important the disability can be reduced by fifty percent and more. Such is the case in this arthritis pain in knee casefile ...

Arthritis and obesity

"It is reported that hospital leaders in North Yorkshire said that patients with a body mass index (BMI) of 30 or above – as well as smokers – will be barred from most surgery for up to a year amid increasingly desperate measures to plug a funding black hole. The restrictions will apply to standard hip and knee operations."

-Daily Telegraph 2016.

There is compelling scientific evidence that the obese suffer far more from arthritis. In the case of arthritis pain in knee it's simply because of the cartilage wearing out as the lining of the femur presses down unerringly on that of the tibia. However, there's far worse to come. Adipose tissue releases toxic chemicals into the body that increase inflammation not only in the joints, but in all the organs.

Arthritis and obesity are inexorably linked.

"Illness is in part what the world has done to a victim,
    but in a larger part it is what the victim has done with his world."

Dr Karl Menninger

Broccoli osteoarthritis

There are indications that a substance in broccoli called sulphoranin has not only strong anti-malignancy properties but also those of reducing the inflammation of arthritis.

Read more on this complex subject at broccoli osteoarthritis

Make sure broccoli is on the table at least once a week. This chicken broccoli recipe combines the chicken bones and broccoli anti-arthritis properties. I make it into a delicious soup.

Compel yourself to acquire the taste for anti inflammatory chili if you have any painful, angry condition in the your body. Half a dozen jalapeno plants in amongst your flowers are a delight to the eye and a boon in the treatment of inflamed joints.

Adding to the complexity is the fact that adipose tissue itself begins to secrete inflammatory substances into the body causing generalised anger in organs and muscles, but also in joints such as the knee.

Some like it hot with jalapenos but more important is their anti-inflammatory properties in relieving arthritis pain.

Patello Femoral Pain Syndrome (PFPS)

Whilst arthritis pain IN the knee joint is clinically a challenge, under the kneecap (patella) it's very readily treated with chiropractic.

Interestingly, a magnesium deficiency is the cause of a condition called chondrocalcinosis that has a prediliction for depositing calcium in the cartilage under the kneecap. Patello Femoral Pain Syndrome ...

Dual antiinflammatory drugs 

There's a place for NSAIDs such as Brufin in the treatment of arthritis pain in knee, but do be aware of the dangers. Taking them for any length of time can make a serious hole in your stomach.

Taking dual antiinflammatory drugs such as aspirin + brufin is just asking for trouble.

You are seriously risking your life; rather think of using alternating ice and heat treatment as decribed here: cold hot therapy ...

Omega 3

Interesting research shows that the essential fatty acids known as omega 3 oils have a very similar mechanism in dealing with the pain and inflammation in joints as NSAIDs; without any of the side effects.

Omega 3 fatty acids are "essential". If we don't get them in the diet, we will die. They constitute 50% of the fat in the brain.

Anti inflammatory omega 3

Omega 3 fatty acids are found abundantly in:


What's clear is that nothing works all the time with arthritis pain in knee, and in fact most treatments are not very successful. Even total knee replacement is a relatively risky and oft not very successful procedure. Many patients tell me they wish they had never gone through with it.

Arthroscopy knee surgery too is not the great panacea it's often made out to be. Nor can I promise you that Chiropractic Help will adequately treat your arthritis knee pain either. Exercise, weight loss and omega 3 fatty acids are the only treatments that will always help, with no risk of aggravating the problem in your knee... for the rest, patient beware! Often the treatment may be worse than the disease.

Glucosamine Chondroitin sulphate

The theory behind these two natural compounds, glucosamine and chondroitin sulphate is good; they are the basic ingredients of cartilage, but the research that they are effective is weak, and often funded by the companies that manufacture them.

Either there are unknown microcompounds that come with them where they are found in nature, and missing from the manufactured product, or they are actually digested and broken down into the constituent amino acids in the stomach.

In any event, it would be better to make your own chicken bones bouillon where the research from Harvard Medical school is strong in the treatment of your arthritis pain in knee. 

The oleocanthal in olive pate is a strong natural anti inflammatory.

Acute knee trauma

Acute knee trauma is common in sporting countries; to prevent the onset of arthritis pain in knee is important to get your injury properly treated; consider chiropractic too depending on the diagnosis.

Interesting links

  1. Chiropractic Help
  2. Arthritis pain in knee

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

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