When you live with osteoarthritis — the most common type of arthritis — knee pain and stiffness can seem difficult to avoid. Your knees and other joints may feel swollen, especially after being active, and the symptoms can worsen over time. More than just “wear and tear” on your joints, osteoarthritis is a joint disease.
Some of the factors that can make knee osteoarthritis worse won’t come as a surprise. If you’ve had a long career working at a job that requires you to stand for extended periods of time, bend a lot, or lift heavy objects, this can impact your cartilage, or the connective tissue in the joints between bones. When cartilage wears away, this causes swelling, pain, and trouble moving the knee joint. Athletes who sustained injuries, even long ago, can also be at risk for faster cartilage breakdown and osteoarthritis.
As osteoarthritis progresses, the knee and other bones may break down and develop what are called spurs, which are growths around the bone’s edges. Little pieces of bone or cartilage can also break off and float around in the knee joint, according to the Arthritis Foundation. In the later stage of osteoarthritis, the cartilage between the knee bones wears away completely, causing bone to rub against bone, which can lead to even more pain as well.
An important part of managing osteoarthritis knee pain is working with your doctor. Although there are medications and surgery available for osteoarthritis, the best treatment for you may be different than that of someone else with the condition.
To help control pain, also take an honest look at your daily habits, some of which may be triggering your joint pain. “People with osteoarthritis have a lot of control over behaviors that can help to reduce pain symptoms,” says Matt Garver, PhD, associate professor and chair of the school of nutrition, kinesiology, and psychological science at the University of Central Missouri in Warrensburg. Often a mix of different approaches is most helpful for osteoarthritis.
Is your lifestyle contributing to your osteoarthritis pain? Find out if these habits may be harming your knee joints.
Diet Plus Exercise May Aid Knee Osteoarthritis
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You Aren’t Exercising, Which Is Bad for Your Knees
It may seem counterintuitive to exercise if you have joint pain, but the Arthritis Foundation advises people to be active. “The knee joint loves motion,” says Brian Halpern, MD, a sports medicine physician with the Hospital for Special Surgery in New York City and author of The Knee Crisis Handbook. The challenge is to find the best types of activities for you. Dr. Halpern recommends bicycling, swimming, and elliptical trainers, as well as strengthening exercises that help muscles support the knee joint.
You’re Overdoing the Wrong Exercises, Putting More Stress on Your Knee Joints
Although everyone with osteoarthritis is different, Halpern says that exercises that tend to aggravate knee osteoarthritis are deep squats, lunges, and any movement that pounds on the joint. Additionally, some people with osteoarthritis are simply too active, says Wayne Johnson, MD, an orthopedic surgeon at Comanche County Memorial Hospital in Lawton, Oklahoma. For example, runners might need to cut back on running, while people who do other active things — like gardening, for example — should spread out their activities instead of trying to do it all in one day. Talk to your doctor about what types of exercise are safe for you, given the severity of your osteoarthritis and the amount of pain you experience.
You’re Not Losing Excess Weight, Which Could Stress Your Knee Joint
The more you weigh, the more stress is placed on the knee joint, which can trigger an increase in pain, according to the American Academy of Orthopaedic Surgeons (AAOS). What’s more, a study found that when overweight and obese adults lost weight over a two-year period, they significantly slowed down their rate of knee cartilage degeneration.
You’re Trying to Cope With Knee Osteoarthritis By Yourself
People with knee osteoarthritis often know that healthy lifestyle habits like exercise and weight control are recommended, but they aren’t doing them, Dr. Garver says. His research team found that meeting with others who have osteoarthritis and sharing similar challenges can help motivate people to change their habits and add an exercise routine into their life.
You’re Not Eating Your Fruits and Vegetables, Which Can Help You Lose Weight
People who eat more fruit, as well as those who are active and generally in good health, tend to have lower levels of osteoarthritis pain, according to the results of a study that surveyed 197 adults. Plus, eating healthier and being active can help reduce weight, which can also help reduce stress on the knee joint. “In general, eat more fresh fruits and vegetables and lean meats, and avoid processed foods if you need to lose weight,” says Dr. Johnson.
You’re Ignoring Depression, Which Can Worsen Pain
Depression, sleep problems, and osteoarthritis pain appear to be linked, according to a study published in Arthritis Care & Research that assessed sleep, pain, and depression symptoms in 288 adults over the course of a year. “The anxiety, stress, and worry that can go along with someone who’s depressed may minimize their ability to cope with osteoarthritis,” Johnson says. If you think you may be depressed, seek treatment immediately.
You’re Low on Vitamin-D, Which Is Important for Bone Health
Vitamin D is crucial for bone health, as well as helping regulate the immune system. A study involving 769 adults with knee or hip pain revealed that a moderate level of vitamin D deficiency is correlated with increased pain levels. However, other studies suggest that taking vitamin D supplements may not be the answer to this issue: An article published in the Orthopaedic Journal of Sports Medicine concluded that the effectiveness of vitamin D supplements for osteoarthritis was uncertain. It might be better to rely on other ways to get vitamin D besides taking supplements, such as eating foods specifically fortified with vitamin D like certain cereals, soy products, milk, and cheese; consuming fish; and even getting a bit of sunshine, which helps your body absorb vitamin D. Your doctor can test your vitamin D levels and make an appropriate recommendation.
- Osteoarthritis. Arthritis Foundation.
- Treatment Guidelines for Osteoarthritis. Arthritis Foundation.
- Gersing AS et al. Is Weight Loss Associated With Less Progression of Changes in Knee Articular Cartilage Among Obese and Overweight Patients as Assessed With MR Imaging Over 48 Months? Data From the Osteoarthritis Initiative. Radiology. August 2017.
- Arthritis of the Knee. American Academy of Orthopaedic Surgeons. February 2023.
- Focht BC et al. Group-Mediated Physical Activity Promotion and Mobility in Sedentary Patients With Knee Osteoarthritis: Results From the IMPACT-Pilot Trial. The Journal of Rheumatology. October 2014.
- Connelly AE et al. Modifiable Lifestyle Factors Are Associated With Lower Pain Levels in Adults With Knee Osteoarthritis. Pain Research and Management. September–October 2015.
- Parmelee PA et al. Sleep Disturbance in Osteoarthritis: Linkages With Pain, Disability, and Depressive Symptoms [PDF]. Arthritis Care & Research. March 2015.
- Laslett LL et al. Moderate Vitamin D Deficiency Is Associated With Changes in Knee and Hip Pain in Older Adults: A 5-Year Longitudinal Study. Annals of the Rheumatic Diseases. April 2014.
- Garfinkel RJ et al. Vitamin D and Its Effects on Articular Cartilage and Osteoarthritis. Orthopaedic Journal of Sports Medicine. June 2017.
David Alboukrek, MD
Medical Reviewer
David Alboukrek, MD, is board-certified in internal medicine and rheumatology. He is an affiliate clinical professor at Florida Atlantic University's Charles E. Schmidt College of Medicine, where he has been a preceptor for first and second year medical students, and participates in clinical activities such as elective rotations with the third and fourth year medical students and second and third year internal medicine residents. He is currently chairperson of the Medical Staff Excellence Committee (peer review) at Boca Raton Regional Hospital, where he previously served as chief of medicine from 2011 to 2013. He maintains privileges at Boca Raton Regional Hospital and Delray Medical Center.
Dr. Alboukrek was born in Mexico City and grew up in Guatemala, where he attended medical school. He went on to complete a family medicine residency program in Guatemala City before moving to the United States. He did a one-year fellowship in child psychiatry at the Children's Hospital in Philadelphia, followed by a residency in internal medicine at Berkshire Medical Center in Pittsfield, Massachusetts. He then completed a fellowship in rheumatology at the University of Texas Health Science Center in San Antonio, Texas. Before moving to Boca Raton in 1995, he was in practice with Berkshire Orthopedic Associates in Massachusetts.
Alboukrek has been a member of multiple medical societies in the USA and abroad. He is a fellow of the American College of Rheumatology. He is a member of the Florida Medical Association, Florida Society of Rheumatology, and the Palm Beach County Medical Society. He has had active roles in the Osteoporosis Diagnostic and Treatment Center of South Florida and the RASF–Clinical Research Center, and has provided care to indigent patients at the Whelton Virshup Creaky Joints Arthritis Clinic for many years.
When not at work he is most likely playing pickleball or ping pong somewhere.
Madeline R. Vann, MPH, LPC
Author
Madeline Vann, MPH, LPC, is a freelance health and medical writer located in Williamsburg, Virginia. She has been writing for over 15 years and can present complicated health topics at any reading level. Her writing has appeared in HealthDay, the Huffington Post, Costco Connection, the New Orleans Times-Picayune, the Huntsville Times, and numerous academic publications.
She received her bachelor's degree from Trinity University, and has a master of public health degree from Tulane University. Her areas of interest include diet, fitness, chronic and infectious diseases, oral health, biotechnology, cancer, positive psychology, caregiving, end-of-life issues, and the intersection between environmental health and individual health.
Outside of writing, Vann is a licensed professional counselor and specializes in treating military and first responders coping with grief, loss, trauma, and addiction/recovery. She is a trauma specialist at the Farley Center, where she provides workshops on trauma, grief, and distress tolerance coping skills. She regularly practices yoga, loves to cook, and can’t decide between a Mediterranean style diet and an Asian-fusion approach.