There are a number of underlying problems that cause one to have knee pain–a torn meniscus, a ligamentous injury, cartilage disruption, and osteoarthritis–to name a few. In today’s post, we’ll be focusing on ways of treating pain related to osteoarthritis as this is one of the most prevalent types of knee pathologies.
It’s estimated that nearly 32.5 million Americans suffer from osteoarthritis and as a Pain Management physician, it’s one of the most common problems that I treat. Unfortunately, it’s also an ailment that has hit home for me as my father, a long time construction laborer, is riddled with it throughout his body. Not only have I witnessed the pain that it can cause, but I’ve also seen how it can limit one’s function and prevent them from doing the things that they once loved.
Since I want all my patients and readers to be able to live their best life, let's look at what causes osteoarthritis and the strategies we can use for slowing its progression.
What is osteoarthritis?
Osteoarthritis is the most common arthritis world-wide. It typically occurs when our joints are exposed to excessive forces repetitively over time. This results in cartilage disruption causing this once adept shock-absorbing tissue to lose its elasticity making it stiff and susceptible to damage. As the disease progresses, cartilage degenerates, leaving the underlying bone susceptible to damage.
How can we prevent or slow the progression of osteoarthritis?
1) Weight Loss
In a study that has been cited nearly 600 times from the Journal of Arthritis and Rheumatology, Messier showed that for each pound of weight you take off, it results in a 4–fold reduction in knee joint forces per step. 
Now that is a serious return on your investment. Committing yourself to losing just 1 pound and you’ll see a 4–fold reduction in knee joint forces. Can you imagine the compressive forces you’d take off your joints if you lost 10 pounds?, 40 pounds? Given the average person takes roughly 3500 steps per day, that’s a whole lot of stress reduction for your joints. 
In my opinion, the patients that are most successful with getting weight off and keeping it off are those who approach their diet in an additive, as opposed to a subtractive fashion. What do I mean by this? Instead of restricting themselves to a certain number of calories or carbs per day, they replace calorie-dense, processed foods with unprocessed fruits, vegetables, and legumes. Essentially they are still able to eat reasonable portions of high quality foods that are low in calories and high in fiber, leaving them feeling satiated after each meal. Essentially, instead of eating less, eat more high-quality foods.
2) Build Strength and Endurance...Gently
As we said above, osteoarthritis typically develops as a result of excessive, repetitive forces applied to the joints over time. Therefore, if we are able to modify our activity in such a way, we may be able to slow its progression.
Let’s take a look at exercises that are good for the knees vs those that might be sub-optimal:
Strengthening the muscles around joints is a great strategy for reducing compressive forces within the joint. Strong muscles are able to take on more of the brunt of everyday life instead of your joints, resulting in a decreased risk of developing osteoarthritis.
3) Adhering to a Diet Rich in Anti-inflammatory Foods
In a randomized, double-blinded, cross-over trial participants were asked to drink a reconstituted drink containing 50g of frozen strawberries each day for 12 weeks. Afterwards, they were found to have decreased inflammatory markers and pain related to knee osteoarthritis. 
This is suggestive that the consumption of food containing poly-phenols, plant compounds with antioxidant-like properties, may help reduce the pain and inflammation associated with osteoarthritis. If strawberries aren’t your thing, a variety of other berries, turmeric, and different types of tea are also loaded with poly-phenols. Be berry nice to your joints!
4) Joint Preservation Strategies
In addition to weight-loss, developing joint preservation strategies is another way to reduce the compressive load and possibly the progression of osteoarthritis. Other joint preservation techniques include using an assistive device such as a cane or rollator when walking to help off-load the joints.
Although it’s not easy, there are actionable steps that each of us can take to focus on better joint health. The nice part is, many of the recommended steps mentioned above result in a variety of other health benefits as well. So, double down on caring for your joints–the future you will be grateful for it!
Messier, S. P., Gutekunst, D. J., Davis, C., & DeVita, P. (2005). Weight loss reduces knee‐joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis & Rheumatism, 52(7), 2026-2032.
Schell, J., Scofield, R. H., Barrett, J. R., Kurien, B. T., Betts, N., Lyons, T. J., ... & Basu, A. (2017). Strawberries improve pain and inflammation in obese adults with radiographic evidence of knee osteoarthritis. Nutrients, 9(9), 949.