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Knee Osteoarthritis

About Knee Osteoarthritis

Knee Osteoarthritis is one of the most common knee conditions. It is estimated that up to 4% of the world’s population is affected by it. Though it is more likely to happen to older adults, osteoarthritis can also affect young individuals.

What Causes Osteoarthritis?

Osteoarthritis occurs when the lubricating joint fluid that protects and cushions the bones is gradually reduced, losing its shock-absorbing properties. The bones begin to rub resulting in increased friction and surrounding bone oedema, causing joint pain, stiffness, and inability to move.

Knee osteoarthritis begins with knee pain and stiffness, but may also develop into joint deformities, impaired mobility or disability.

Some possible risk factors of Osteoarthritis are as follows:

  • Age
  • Sex
  • Weight
  • Prior Injury
  • Bone Deformity
  • Genetic and family history

Symptoms Of Osteoarthritis

Knee Pain and Swelling
Pain is a major symptom of Osteoarthritis; the pain is located towards the front of the knee. It may be localised to the inner knee or outer knee or just the entire knee itself. It may feel worse at the end of the day after walking or standing, and it may improve when you rest.
Joint stiffness and pain may affect the knee joints and impede your daily functions, this includes tasks such as walking, bending, going up or down the stairs, wearing trousers or getting out of the car.
Swelling and Tenderness
The word arthritis means active joint inflammation. This can result in swelling of the affected region, our doctors will also check for warmth, redness or soreness in the region.
Instability or Locking
Your knee feels as though it is giving out, occasionally, it may also lock in place. These are symptoms of joint instability of the knee and can be caused by osteoarthritis.

When Should I Seek Medical Attention?

You should seek medical help when:

  • Pain on the front, back or sides of the knee
  • Knee deformation
  • Difficulty walking and feeling as though the knee is giving out
  • Difficulty wearing trousers and getting out of the car
  • Unbalanced and restricted knee movements
  • Swelling in the affected area
  • Pain only with activities but not with rest

A Message About Knee Osteoarthritis

Knee arthritis is specifically directed to active inflammation of the knee. There are many other causes of knee inflammation like gout, rheumatoid, meniscal injuries and fractures. Very often, osteoarthritis has been implied to mean a degenerative knee condition. This is incorrect. One can get degeneration of the knee through wear and tear of the knee joint resulting in degenerative changes such as loss of cartilage and meniscal degeneration without active inflammation.

Intra-articular knee injections are a useful adjunct treatment of osteoarthritis. It will prolong the longevity of the integrity of the knee, stopping inflammation, and slowing down degeneration. There are various different injectate ranging from hyaluronic acid to platelet-rich plasma to steroids.

After treatment of the knee inflammation, the degenerative features may not have changed but the knee inflammatory pain would have been aborted and not present itself further. The knee can undergo further wear and tear, causing active bone swelling or joint inflammation, resulting in an on-off pain flare.

The knee can undergo degeneration painlessly. There is a need for intensive rehabilitation to train the surrounding muscles to provide active support for the “failing” knee. Once there is adequate strength in the thigh and calf to offload the loading pressures of the knee, it will slow down the degeneration and reduce the pain flares attacks.

Diagnosing Knee Osteoarthritis

Here at Singapore Paincare, our team of experienced primary care and specialist pain care doctors will conduct a thorough diagnosis. This includes a physical exam, questions about your symptoms and an evaluation of your medical history. An X-ray or MRI scan may be needed to evaluate or confirm the degree of arthritis. Blood tests and other laboratory tests may also help to determine the type of arthritis.

What Treatments Are Available for Osteoarthritis

With the increasing number of patients with knee osteoarthritis, treatment methods have become extensive and comprehensive. At Singapore Paincare, we strive to treat your pain with the least invasive option possible after accurately identifying the cause. Our approach to pain resolution focuses on the removal of pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments and cognitive and physical rehabilitative therapies, we help patients improve functions and prevent pain from recurring.

Non-Surgical Treatment for Osteoarthritis

Physical therapy
The therapy sessions by our specialists involve both aerobic and resistance training to reduce pain. However, the intensity and type of exercise may differ based on the conditions of the patient.
Pain killers such as Non-Steroidal Anti-Inflammatory drugs

Non-steroidal anti-inflammatory drugs may be prescribed to help relieve pain. This type of medication is most effective and targets the inflammatory pathway, stopping pain. It does not only act as a painkiller but it acts directly on the bone oedema. Occasionally, stronger painkillers (opioids) such as Tramadol or Oxycontin may be added to ease the pain.

Lubricant/Gel Injection
Hyaluronic acid injections may alleviate the pain by providing some cushioning to your knee. Alternatively, we also offer viscosupplement joint injections, it is used as a lubricant for the joint, and has varying durations of the outcome. Lastly, non-steroidal anti-inflammatory drugs and anaesthetics can also be injected around the knee ligaments for pain relief.
Our proprietary Myospan Gel injection incorporates identification of different pain generators apart from the local inflammation of the knee, together with intra-articular injection of the hyaluronic acid, to provide excellent long-lasting pain relief. We prognosticate the time interval needed for the next “top-up” of gel injection.
Knee brace
Knee braces may be used temporarily to limit the movement of the knee and provide support, this can effectively reduce pain or stimulation of the inflamed muscles.
Platelet-rich plasma (PRP)
Platelet injections are commonly used for pain caused by a torn meniscus as well as conditions such as osteoarthritis. The injection sites include the meniscus and surrounding ligaments.

Surgical Treatments for Osteoarthritis

Surgery is an option for intractable painful OA. This is only done after careful consideration to see if you are suitable for the procedure. Regardless, surgeries always come with associated risks, complications and downtime – it may not be suitable for everyone.

Knee replacement surgery
Knee surgery may be recommended if the feet have been bent into type 0, it is a symptom of advanced arthritis. Unless the joints are replaced, this kind of cartilage wear and tear is incurable. The joints are no longer gelatinous, and the friction of the bones is naturally painful, therefore, there may be no other options. The metal implant will also undergo wear and tear. It may last 8 – 12 years depending on the individual’s lifestyle, posture and use. The common practice is to delay knee replacement as long as possible so as to avoid having to repeat redoing another replacement on the original knee replacement – to ensure that only 1 knee replacement surgery is needed during the lifetime of the patient age 65 and above.

How Can I Prevent Knee Osteoarthritis?

Osteoarthritis cannot be fully prevented. However, you can help lessen daily stress on your joints by doing the following:

  • Keeping a healthy body weight
  • Monitoring and controlling your blood sugar
  • Staying active
  • Addressing pain immediately

Get Your Pain Resolved

Send your enquiries or consult our pain experts today.

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