🦵 Men's Health

Osteoarthritis of the Knee

Understanding and managing the most common joint problem in Nigeria.

Osteoarthritis (OA) of the knee is the most common form of arthritis in Nigeria and one of the leading causes of disability in adults over 50. It is caused by gradual breakdown of the cartilage that cushions the joint. While there is no cure, effective management dramatically reduces pain and preserves function.

Signs and Symptoms

✓ Pain in or around the knee — worse with activity, better with rest

✓ Stiffness in the morning, lasting less than 30 minutes

✓ Crepitus — grinding, clicking, or crackling sounds with movement

✓ Swelling around the knee joint

✓ Decreased range of motion — difficulty fully straightening or bending the knee

✓ Pain when climbing stairs, rising from a chair, or walking on uneven ground

✓ The knee may "give way" occasionally

✓ Bony enlargement around the joint edges

✓ Pain that worsens with weather changes or prolonged activity

Risk Factors

Age over 50 — risk rises steeply with each decade
Overweight or obesity — every 5 kg of excess weight multiplies knee joint load significantly
Previous knee injury — torn meniscus, ligament injury, or fracture
Repetitive kneeling, squatting, or heavy lifting (occupational)
Female sex — post-menopausal women have significantly higher risk
Family history of osteoarthritis
Muscle weakness around the knee
Prolonged standing or walking on hard surfaces

When to Seek Help

SoonKnee pain significantly limiting daily activities, climbing stairs, or exercise — assessment, diagnosis, and a management plan can dramatically improve quality of life.

NowSudden severe pain with inability to bear weight after an injury — possible fracture or ligament rupture.

SoonHot, very swollen joint — could indicate infection or gout rather than OA, requiring different treatment.

RoutineMild knee pain in adults over 50 — early management (exercise, weight loss) slows progression and reduces future pain.

Tests & Diagnosis

🧪 X-ray of the Knee

The standard imaging — shows joint space narrowing, bony spurs (osteophytes), and subchondral sclerosis. Severity on X-ray does not always match pain severity.

🧪 MRI (if diagnosis uncertain)

Better assessment of cartilage, menisci, and ligaments — used when X-ray is inconclusive or another condition is suspected.

🧪 Blood Tests

To exclude rheumatoid arthritis (RF, anti-CCP antibody, ESR, CRP) and gout (uric acid) — which cause joint pain but require different treatments.

🧪 Joint Aspiration

If the knee is very swollen — removing and examining the fluid distinguishes infection, gout, and OA.

Treatment Options

Weight Loss — The Most Effective Non-Surgical Treatment

Every 5 kg of weight loss reduces knee pain and delays disease progression significantly. Combined with exercise, it is more effective than many medications.

Exercise — Not Rest

This is counter-intuitive but critical: rest worsens OA. Quadriceps strengthening exercises (straight leg raises, cycling, swimming) are the most evidence-based intervention for knee OA. Low-impact exercise is better than no exercise.

Physiotherapy

A physiotherapist develops a personalised exercise plan and can provide manual therapy, taping, and gait retraining.

Pain Management

Topical diclofenac gel (applied to the knee) is first-line — effective with fewer systemic side effects than oral NSAIDs. Oral NSAIDs (ibuprofen, naproxen) for moderate pain — use with food and for short periods. Paracetamol for mild pain. Avoid codeine-based analgesics long-term.

Intra-articular Injections

Corticosteroid injections into the joint provide 4–12 weeks of significant pain relief — useful during flares or before starting exercise. Hyaluronic acid injections benefit some patients.

Knee Replacement Surgery

For severe OA that has not responded to conservative management and significantly limits quality of life — total or partial knee replacement provides excellent outcomes in carefully selected patients.

Frequently Asked Questions

Is osteoarthritis the same as "rheumatism"?

"Rheumatism" is a colloquial term covering many joint conditions. Osteoarthritis (wear-and-tear) is the most common. Rheumatoid arthritis (autoimmune) is different and requires different treatment. Gout is another distinct condition. A proper diagnosis guides the right treatment.

Will exercise not damage my knee further?

No — this is a common and harmful misconception. Inactivity leads to muscle weakness, which worsens joint instability and pain. The right exercises, under physiotherapy guidance, slow OA progression and reduce pain. Swimming and cycling are ideal.

Can supplements like glucosamine and chondroitin help?

Some people report benefit. Evidence from large trials is mixed — neither glucosamine nor chondroitin has been proven to reverse cartilage loss. They are safe and may provide mild pain relief in some people but are not a first-line treatment.

At what point should I consider surgery?

Surgery (knee replacement) is considered when pain significantly impairs quality of life, conservative measures have been genuinely tried for 3–6 months without sufficient benefit, and the person is medically fit for surgery.

Does cold or rain make arthritis worse?

Many people notice worsening pain with weather changes. The mechanism is not fully understood — possibly related to atmospheric pressure changes affecting the joint. This is a real experience, even if not fully explained by imaging.