Symptoms of Arthritis in Knee

Symptoms of arthritis in knee include pain, swelling and stiffness; and a limp.

Advanced degenerative joint disease in the lower limb is one of the most difficult conditions to manage in any chiropractic or medical clinic. Taking drugs for an extended period is not recommended with a serious gastrointestinal bleed in every thousand cases resulting in one death in 10,000 people.

An x-ray showing the loss of joint space in the knee.

This page was last updated by Dr Barrie Lewis on 9th January, 2023.

If you take more than one tablet, say brufin and aspirin, then the rate of an abdominal hemorrhage rockets. Dual anti-inflammatory drugs should be avoided at all costs.

Rather increase those so called functional foods like olive oil and chilis that have the same benefit, but without the side-effects. 

Usually you will start to get warning signs from your stomach that troubles are coming; epigastric pain is the most common symptom. It may easily be confused with heartburn. If you are having discomfort discuss it with the pharmacist or your doctor.

The most serious sign is a black stool; stop taking that medication immediately. It is literally life-threatening.

Whilst a hip replacement, in the hands of a good surgeon, is a relatively safe and successful procedure, a total knee replacement is far more difficult. I've seen some terrible botch ups at the chiropractic coalface.

Likewise, I've seen no research on the successful chiropractic treatment for knee arthritis. For over thirty years I have declined to treat the condition seriously. Perhaps a few exercises or some alternating ice and heat; I even used ultrasound in the early days, until I realised that it was quite useless.

Symptoms of Arthritis in Knee

Symptoms of arthritis in knee make for a very disabling condition.

Latterly, after quite successful treatment of hip arthritis, we decided at the Chiropractor Hilton Streetview clinic to take on a difficult case. The symptoms of arthritis in knee are severe: pain, stiffness and reduced range of motion, sometimes loss of flexion, sometimes extension; swelling, clicking and cracking sounds. Add to that difficulty walking, particularly stairs, and night pain and you have a recipe for misery.

She had them all; would vigorous exercises for knee arthritis and a series of mobilisations of the knee help?

Arthritis pain in knee

Knee arthritis pain is exquisite. Sharp and extremely disabling. The stick and the wheelchair beckon... stairs become impossible and the lifestyle proscribed. But there is hope, without surgery; more about arthritis pain in knee.

Knee arthritis Case File

Case History @ Symptoms of arthritis in knee

A middle aged, consulted us with severe left knee pain. The pain had begun a dozen or so years earlier, growing progressively worse, especially the last few years.

At just over five foot tall and more than 200 pounds she had a body mass index of almost 40; above 30 is obese, over 35 is life threatening.

She had played plenty of sport as a young woman, but when she stopped her lifestyle became sedentary.

Previous treatment included six cortisone shots, an arthroscopy which included debridement and a microfracture procedure, 9 months before the first chiropractic consultation. After the operation she was unable to straighten her knee, and the pain became far worse.

She was taking anti-inflammatory drug medication nightly; otherwise she couldn't sleep. A glucosamine with chondroitin product and synvisc injections had brought minimal relief.

She was scheduled for a total knee replacement in two months, but decided to consult us in the interim.

On examination of this symptoms of arthritis in the knee there were many of the typical signs.

She was an obese woman, walking with an extreme limp, unable to straighten her left knee.

The pelvis was markedly low on the left, in part due to the bent knee, but also due to a leg length inequality with the expected sacroiliac joint fixation on the opposite side.

Both lower limbs, particularly the left, were swollen.

Flexion of the knee was almost normal, but there was severe loss of 25 degrees of extension. Any attempt to straighten the joint caused extreme pain. The bounce home test was strongly positive.

The tests for meniscus damage were normal. The AP drawer test for the cruciate ligments was normal, but both collateral ligament tests were very lax, but not painful.

Clarke's test for patello femoral pain syndrome was negative.

Noble's test for a ilio tibial band syndrome was positive; active trigger points were found down the tendon and in the tensor fascia latae muscle.

Examination of the lower back revealed a routine, uncomplicated L5 lumbar facet syndrome; it was nevertheless causing considerable discomfort.

Lower limb conditions, particularly if associated with a short leg, almost inevitably cause a significant knock-on effect in the low back.

X-rays @ Symptoms of arthritis in knee

X-rays show severe loss of the hyaline cartilage that lines the medial femoral and tibial condyles, with many fragmented pieces of cartilage (joint mice) floating in the synovial fluid. The tibial spines are severely sharpened.

There is almost certainly a hole in the cartilage as seen above in the stock arthroscopic photo, hence the narrowing of the joint. Bone on bone. (not hers, thus speculative just how serious it could be).

That joint mouse actually in retrospect is more likely an accessory bone called a fabella, or little bean.

Chiropractic treatment
Symptoms of arthritis in knee

Consult 1

The first consultation consists of a full history and examination of each patient, and she was no exception.

We gave her some gentle arthritis knee exercise do be done daily with each cup of tea. Frequently every day. They only take a minute or two.

Consult 2

A report of findings was given to Mrs X, and a short tour of What Chiropractic is.

There was no need to stress the seriousness of her case. She knew. Moreover, her dietician had spelled out that a BMI of 39 meant her whole life was at risk, not just a disabled knee. For three years she had limped from one doctor to another, unable to walk even the mall, unable to sleep without painkillers.

Nevertheless, I made it plain that I was not prepared to accept her case without a firm commitment to get the pounds off. At least 50. Because without that, she was wasting her time and money at our clinic.

Finally, she was ready to do what she knew had to be done; make some vital dietary changes. Our free weight loss programs are mandatory in the management of the symptoms of arthritis in knee in the long term if you want to escape a total joint replacement.

The first chiropractic treatment consisted of a gentle mobilisation of the knee joint, with axial traction, and use of electro-stimulation.

I referred Mrs X to our free weight loss programs and recommended fatty fish several times a week, plus omega-3 supplementation. Fish oil benefits are worth considering.

Consult 3

She felt a slight improvement in her knee pain. We introduced the first chiropractic treatment for her pelvis and lower back, and our lower back exercises programme.

We addressed for the first time the lateral thigh myofasciitis. Treatment was painful.

Consult 4

She felt a distinct improvement and for the first time in months was able to hobble around the mall, but suffered the next day. Her knee was still locked in flexion. Three pounds weight loss.

Her right foot was painful, which she had not mentioned earlier. We found fixations of the cuboid and medial cuneiform, and a general plantar myofascitis. Treatment for foot pain is central to chiropractic.

Consult 5 @ Symptoms of arthritis in knee

She is improving. She felt the sharp pain was 50 less, but was still unable to straighten her knee. She was off medication at night. Her lower back pain was much improved. She had lost 8 pounds. Some suboccipital headaches. Upper cervical adjustment.

Consult 6

Improving, same treatment. We are definitely getting increased movement in the knee, and extension is not so limited. She is walking better. 12 pounds weight loss

Consult 7

Setback. She stumbled on a step and came down hard on her left knee. McMurray's test was positive for the first time. 14 pounds.

Consult 8

Despite the setback, continued improvement. She was able to stand in church for a longer period, and she managed to do 16 lengths of backstroke at the pool. Her foot continued to burn when walking, but was much less swollen. No lower back pain. 18 pounds.

Consult 9 

Two weeks later. Her knee had locked over the weekend. Extension is reduced again. Discouraged. 22 pounds weight loss.

Consult 10

Much improved for two weeks but then sharp stabs in the knee again. No lower back pain. Foot improving. Almost full extension for the first time. Bounce home test negative. 28 pounds loss.

Consult 11

Her knee pain is much reduced. She can straighten her knee for the first time since the arthroscopy surgery, now one year previously. She can walk much further, is taking virtually no medication. She has now lost 36 pounds, and is taking an extended overseas holiday with family. She feels up to it.Some midthoracic and rib pain after much sewing. A thoracic spine exercise, and rib pain treatment ...

Two years later

Mrs P's knee is reasonable. She comes for a chiropractic help treatment every four weeks. It's good for about two weeks, and then gradually becomes more painful. She has minimal night pain, and takes only the occasional NSAID.

She can straighten the leg, but forced extension still hurts. She can bend the knee fully without pain.

She's lost 45 lbs, and really needs to lose another 15. Still that weight loss has overcome that crisis that obesity was in her life. Her BMI is around 30, still too high but no longer dangerously so.

Bread made with healthy flour and a salad lunch.

Three years later @ symptoms of arthritis in knee

Mrs P is still doing reasonably well in the circumstances. She was stuck with weight loss until she started the Banting diet. Now she has lost another four pounds in two weeks. I go along with many facets of it though oddly the recommendation is to increase the healthy fat in your diet; cold-water fish, olive oil and even butter is back.

The strict limiting of starches is to be recommended though I cannot support the black listing of fruit like apples and butternut squash. They do not have a high glycemic index like potato and white rice.

If you make your own low GI bread you can enjoy it with butter as long as you are having plenty of salads at the same meal; it takes only five minutes using an electric oven, plus five hours, of course.

She continues to have minimal lower back and foot pain, and has only the odd bad day or night. It can't be described as good either though; it is probably like she was ten years ago. Until she loses at least another ten pounds I cannot see much further improvement.

Here is a little update; after three weeks on the Banting diet she has lost another ten pounds. It is an unsustainable fad diet to my initial thinking, having to add so much fat and go without fruit and legumes, but in the short term it is working; actually I have changed my mind on the subject.

And now a review of this case file.

There come vital moments in all our lives; a tide in our affairs, to coin the Bard's phrase. Such was the defining moment when she first consulted us. She was faced with shallows and misery for the rest of her life, and I didn't need to point it out. She knew she had to take the flood tide.

The chiropractic knee arthritis treatment was, of course, important, but the vital decision was to lose weight, and a lot of it.

There is of course no certainly of the future. Research at the medical Dutch university at Utrecht has shown that cartilage can regrow if the knee is unloaded. She has done most of the hard work. Another 10 to 15 pounds and she has a good chance of escaping a total knee replacement, at least in the immediate future.

One of our fears of course is the general anaesthetic; the total joint replacement may be successful but if you lose your marbles...

Arthritis knee exercise

Baker's cyst

Not infrequently associated with symptoms of arthritis in knee is an outpouching of the capsule of the knee producing a golf-ball like cyst behind the knee; flexion becomes limited and painful.

This Baker's cyst in the knee does respond to conservative treatment but surgical intervention is sometimes necessary.

Anti inflammatory omega-3

One of the good things about chiropractic help for the symptoms of arthritis in knee is that it is totally safe. Provided it is done by a skilled and well-trained chiropractor, the chances of making the condition worse are zero.

And when the patient is on the verge of a total knee replacement, there is nothing to be lost; dietary changes to include anti-inflammatory omega 3 are a vitally important adjunct if you want something more than temporary relief. 

I have no difficulty with taking anti inflammatory drugs (NSAIDs) for a short trial period, but taken long term the risks of iatrogenic illness (doctor-caused disease) are relatively high.

However, taking dual anti-inflammatory drugs like brufin and aspirin together is extremely dangerous. Some pharmaceutical companies are totally unethical; read more about Pfizer Bextra fraud

If you are having to take medication long term, then what is vital is to dramatically increase the so called functional foods in your diet;
those that have been proven to promote wellness and prevent disease.

What does the research say about glucosamine chondroitin products?

Stuffed vine leaves using olive oil is rich in anti-inflammatory compounds.

Flax seeds

For example, foods containing significant amounts of the omega 3 fatty acids have a strongly anti inflammatory effect. Look to enjoying fatty fish several times a week and grinding flax seeds to go on your cereal every morning. Well, you can keep some in the fridge for a few days; every little bit helps with the management of the the very disabling symptoms of arthritis in knee.

The oleocanthal in extra virgin olive oil has been scientifically proved to block inflammatory chemicals released in arthritic joints in the same way as Cox 2 NSAIDs but without the nasty side effects in your gut.

Oddly the red hot capsaicin in chilis have a strongly anti inflammatory effect. Parboiling a jalapeno every day and enjoying it with your salad is easy; add plenty of hummus and perhaps avocado and you'll hardly notice the burning. Do not cut out the placenta and the seeds; that's where the potent effect of anti-inflammatory chili is to be found.

In short, negating the symptoms of arthritis in knee is about healthy eating and weight loss; otherwise severe disability and pain will be on the agenda sooner rather than later.

Here are many of the phytochemical foods rich in anti-oxidants.

The placenta of a chili is especially rich in anti-inflammatory capsaicin.

Homocysteine is a highly inflammatory break down product of protein metabolism; in normal circumstances the body immediately methiolates it to methionine, but this process is utterly dependent on adequate levels of three B vitamins, choline, folate and B12.

Read more about choline food sources and high folate levels.

A daily breakfast of eggs Florentine is the perfect foil to inflammation in the body. The egg is rich in choline and B12, the spinach in folate and the toast made from 100 percent whole flour in betaine.

  • What is betaine?

To find links to topics in bold use the site search function in the navigation bar on your left.

Eggs poached on spinach makes a splended banting breakfast.

Notice how pale these yolks are; recently we have stepped up to free range eggs.

Exercises for knee arthritis

There is strong evidence that exercise benefits knees, just like all arthritic joints. She has now bought a home with a swimming pool and is beginning to swim regularly.

Lax collateral ligaments

The purpose of ligaments is to give joints stability. When either they are stretched (as in whiplash, or sprained ankle), or if there is loss of joint space, the ligaments become lax. They lose some/ much of their capacity to stabilise the joint.

This gives rise to oft mentioned complaint that the knee feels as though it's about to "give". Instability. All that you can do in this instance is to strengthen the quadricpes muscle. Exercises for knee arthritis are a vital part of the chiropractic regimen.

Free weight loss programs

This is not idle rhetoric. Strong research shows that THE most effective treatment for the symptoms of arthritis in knee, assuming you are obese, is getting those unwanted pounds off. More effective that chiropractic. More effective that pills, more effective than surgery. Enter our free weight loss programs.

What's more it comes for free, and there are zero iatrogenic, doctor-caused effects.

I confess to being brutal in the practice. "Get it off, otherwise you are wasting your time and money here. Go and have the total knee replacement. Accept that pain and disability, and a very large hole in your retirement savings are going to be your lot."

I have seen folk grasp the nettle and lose dozens of pounds. It can be done once one realises the alternative is too ghastly to contemplate.

Significant weight loss is usually most safely and effectively done by a severe reduction in starches: potato, rice, bread, pasta, cakes, cookies and colas. Even though you are not a vegetarian, Vegen Weight loss is one good option. Pile on the salads, fruit and vegetables, minding to keep up your five colours a day. I aim for ten. Eat the sweet fruits in moderation; no need to avoid them, as they contain the cancer preventing phytochemicals.

I have adjusted the ketogenic meal plan which is really for diabetics; it's called the modified Banting diet.

Foods like these stuffed vine leaves are what enable to enjoy carbs without putting on weight.

Knee joint distraction

There is innovative research being done in the Netherlands with a temporary orthotic device that distracts the bones of the knee. What is interesting is that they have proved that the cartilage can and does regrow.

It is not without risks, the device have to be well secured to the femur and tibia, will screws into the bone.

But you are able to walk and move about.

What is interesting, however, is that the device is essentially unloading the knee, same as losing weight. Getting those pounds off is far cheaper and safer, without any possible iatrogenic illness (doctor-caused disease)

Conservative care @ Symptoms of arthritis in knee

Whatever your problem, try conservative care first. Can I guarantee that chiropractic, dietary change and weight loss will cure symptoms of arthritis in knee ? Of course not! But until you try, you'll never know. There is anecdotal evidence that glucosamine chondroitin sulphate may help. 

The bone marrow is full of fat. Never will I forget Mr S. His wife went in for a total knee replacement. The next day a fatty embolus from the tibia blocked an artery to her lung. She died.

Nor Mrs L who had a very successful knee replacement. Her walking was vastly improved, only she had no idea where she was walking. Anaesthetic Alzheimers ...

Now is the time to talk about that great known uncertainty; before you go for major surgery.


Useful links

Stones in my Clog ($2.99)

Did you find this page useful, interesting? Then you'll love my third book of Chiropractic anecdotes from Holland. Take a tour through the Dutch culture and find out more about better health at the Chiropractic Help coalface; nothing about symptoms of arthritis in knee in the book, though many patients; Holland is crazy about football and obesity abounds too.

The cover of Stones in my Clog by Dr Bernard Preston DC.

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