Does knee pain mean the cartilage has “worn out”?
Osteoarthritis of the knee is not only cartilage “wear and tear”. It involves chronic changes of the whole joint. Common symptoms include pain during movement, short morning stiffness, reduced range of motion, and difficulty going up or down stairs or standing up from a chair.
For people aged 45 or above with activity-related joint pain and morning stiffness lasting no more than 30 minutes, osteoarthritis can often be diagnosed based on symptoms and clinical examination. Routine imaging may not be necessary. Treatment should be guided by pain level and functional ability, rather than X-ray findings alone.
Should I avoid exercise if I have pain?
Not necessarily. Appropriate therapeutic exercise is one of the core treatments for knee osteoarthritis. Pain may increase slightly when exercise begins, but with suitable intensity, regular training can help improve muscle strength, joint function and quality of life.
Exercise may include walking, cycling, aquatic exercise, and strengthening exercises for the thigh and hip muscles.
For people who are overweight, gradual weight management can reduce knee loading and may improve pain and mobility. Weight management should combine a balanced diet, physical activity and sustainable lifestyle habits, instead of relying on rapid weight loss methods.
Is glucosamine effective?
Glucosamine is one of the components of cartilage, but research findings are inconsistent. Recent clinical guidelines generally do not regard it as a core treatment for knee osteoarthritis. Patients should not expect it to repair cartilage or bring significant improvement.
People considering glucosamine, especially those who are pregnant, breastfeeding, have diabetes, liver or kidney impairment, shellfish allergy, or are taking anticoagulants, should consult a doctor or pharmacist first. Some supplements may also contain sodium or potassium salts. People who need to restrict sodium or potassium should read product labels carefully.
When should I seek further assessment?
Please seek medical assessment if knee pain continues to worsen, the joint becomes suddenly red, swollen or hot, you cannot bear weight after an injury, or pain severely affects sleep and daily activities.
If exercise, weight management, medication and other non-surgical treatments do not improve severe symptoms, a doctor may consider referral for joint replacement assessment based on individual needs.
Sources:
Standardized Care for Diabetes, Hypertension and Lipid Disorders Programme. 葡萄糖胺治療退化性膝關節炎有效嗎？
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