Tiredness and pain in joints are common as we age. The knee is one joint that can cause a lot of pain.  

That is not surprising given knees shock-absorb a lot of pressure with every step, up to one-and-a-half times your body weight. That pressure – plus regular wear and tear, and weakening of muscles and ligaments – takes a toll. The knee shock-absorbers, which are pads of cartilage called menisci, start to deteriorate.  

Pain in the knee is often caused by osteoarthritis (the wearing away of knee cartilage). Articular cartilage protect the ends of the leg bones where they meet at the knee. If this cartilage is damaged, swelling, locking or giving way of the knee may result. You may be more prone to cartilage damage if you have a family history of osteoarthritis, are overweight, or have had knee injuries previously.

Another cause is wearing the hip joints, which can transfer nerve sensitivity and stress down the leg to an otherwise healthy knee joint. The same thing can happen because of foot joints transferring nerve sensitivity and instability upwards.

Expert medical advice is needed to determine the most suitable treatment.  

The good news for knee pain sufferers is that the once accepted ‘default’ treatment of surgery is being questioned. 

The Times newspaper quoted orthopedic surgeons saying there are no clinically relevant differences between early surgery and rehab with exercise. “A significant improvement in knee function could be achieved with exercise just as well as surgery.” 

The important thing is to let the knees recover and heal where necessary. Massaging and working the quadriceps at the front of the thigh can address the root of many knee injuries.

You can do this by sitting on a chair with your feet on the floor. Place both hands on one knee above the joint. Wrap your fingers around the back of the knee so your thumbs are at the front of the leg. 

Then grip the area above the kneecap with the thumbs and bend and straighten the knee eight to ten times. Do the same on the other knee. 

Here are some long-term solutions to help manage osteoarthritis of the knee: 

• Lose weight.  

• Control pain and inflammation. Aspirin, Advil, and Aleve and prescription-strength anti-inflammatory medicines are available over the counter.  

• Glucosamine and chondroitin are medications that may provide pain relief in osteoarthritis.  

• Reduce shock by using a walking aid (cane), wearing good shoes, choosing soft surfaces, and keeping the leg muscles conditioned for unexpected stresses.  

• Exercise daily to maintain range of motion, strength, and cardiovascular fitness.  

• Take precautions with daily activities to avoid stressing the knee.  

• Avoid activities in your fitness and recreational pursuits that cause high-impact loads to the knee, such as walking, jogging, hiking, and stair-stepper machines.  

• Substitute impact activities with low-impact activities such as stationary cycle, swimming, cross-country ski machine, rowing machine, or elliptical machine.  

• Follow a regular exercise program two to three times a week to stretch and strengthen the muscles around the knee.  

• Use a strap or brace to support the knee.  

• Foot orthotics to improve the way you walk  

• Try physiotherapy. 

Your doctor can talk to you and examine your knee. More information about knee surgery can be found here.  

Your doctor may order some tests, including:  

• Blood tests. 

• Imaging, such as an x-ray, ultrasound, or MRI scan. 

• Knee joint aspirate, where a small amount of fluid is taken from the knee using a needle.  

If the diagnosis is still unclear, arthroscopy may be necessary to look inside the knee and see if the joint surfaces are beginning to develop changes from wear and tear.  

Arthroscopy is a surgical procedure where a small fibre-optic television camera is inserted into the knee joint through a small incision. The surgeon can then move the camera inside the joint while watching the pictures on a TV screen. 

For further reading: Harvard Health, The Australian, Health Direct and Mass General