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Women and Joint Pain

October 17, 2017


There are three distinct risk factors that lead women to suffer from arthritis more than men: biology, genetics, and hormones.

Biology:  The hips.  Women are designed to have babies so they’re shaped differently than men.  The angle of their hips distributes their body weight across the knees less efficiently than in men.  Also their ligaments are more elastic so their knees are less stable.  More pressure and less stability makes a knee joint more likely to get hurt.

Genetics:  Women whose mothers had OA should not be surprised to find themselves suffering the same type of joint pain, in the same places, and around the same age.  It is common for OA to run in families.  Research shows the genetic links.

Hormones:  Estrogen protects cartilage.  As the estrogen decreases so does the protection.  There is an increased prevalence in the onset of OA during menopause.

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Menopause can be linked to the onset and progression of osteoarthritis.   (menopause and OA study)

Women suffer from osteoarthritis more than men, and it is more prevalent after menopause.  Women have more joints involved with OA, more symptoms, and more severe cases.  Studies suggest that the loss of estrogen during menopause increases OA risk factors.  When women’s estrogen levels decrease their joints suffer, specifically the hands and knees.

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Stage 4 – Severe

The pain is severe.  Walking anywhere hurts.  This is the most advanced stage of knee osteoarthritis.  There’s not much cartilage left, if any.  There’s very little fluid remaining in the knee.  The joint space has narrowed to the point where an x-ray will show bone-on-bone.  The legs may be bowed or pigeon-toed depending on what side of the knee is most impacted.  The remaining treatment options all involve surgery.   Joint replacement is common.


Stage 3 Knee Osteoarthritis – Moderate

Daily activities are starting to hurt.  The arthritis has your attention.  Walking, bending down, running, kneeling can all cause your knee to hurt.

The knee will probably be inflamed and swollen.  Damage to the cartilage is obvious.  The joint space is narrowing.   The cartilage is thinning and eroding.  The bones begin expanding, becoming thicker, responding to the changes in cartilage.  Lumps on the bone form.  All this drama impacts the tissue lining the joint.  This is where the fluid and inflammation come from.

Treatments get a bit more serious.  We move into NSAID’s, cortisone, physical therapy, and supplement injections.

Stage 2 – Mild

Stage 2 is where symptoms start to develop.  A knee may start to get achy if a person sits for a long time, walks too much, or spends the whole day on their feet.  Stiffness and joint pain are common complaints.

Bone lumps and thinning cartilage can be seen on X-rays or MRIs.  The joint space will remain normal and the bones are not rubbing or scraping against one another.

Exercise and weight loss are still the primary treatment options.  Arthritis knee braces are also recommended.  An arthritis knee brace can help stabilize and protect the knee joint.

Stages of Knee OA

It takes many years to develop osteoarthritis of the knee – one step at a time.  The degradation of the cartilage can be tough to treat because the damage is usually done by the time it’s diagnosed.  Symptoms might only be experienced once the damage is irreversible.

There are progressive stages of knee osteoarthritis:

Stage 0 – A normal, healthy knee

The knee joint shows no sign of OA, and can move freely and without pain.

Stage 1 – Minor

Bone spurs may start to appear.  The cartilage may show some sign of wear.  There is no sign of joint space narrowing.  Pain or discomfort is rarely felt at this stage.

Your doctor may recommend exercise and weight loss, possibly some supplements.


Mall Walkers

This is the final article in a three part series of posts about the benefits of exercise for a knee suffering from osteoarthritis.

Strengthening, stretching, and exercising an arthritic knee has many benefits.  One of everybody’s favorites is weight loss.  Exercise and a healthy diet can help you lose weight.  The more weight you lose the less stress you’ll put on your knee.  The effect of weight loss has an incremental effect.  Every pound you lose decreases the pressure on your knees by three pounds.  It’s a 3:1 ratio.  The less stress on your knees, the less they will hurt.  The less your knees hurt the more easily it will be to move around.   Get the picture?

Strong and limber muscles will also help you maintain your activities of daily living.  What do you like to do?  If your answer is sit on the couch and watch television then these posts were probably a waste of your time.  But if you like to walk, go places, work, participate in sports and recreational activities then get up and get moving.  The more you do so, the easier it’s going to get.

Standing calf stretch

Strengthening, stretching, and exercising the knee will help provide pain relief for knees suffering from osteoarthritis.  This is the second part of three posts on this subject.

Exercise can also help support healthy cartilage.  Healthy cartilage requires motion and some stress.  Nutrients and lubrication are delivered to cartilage whenever it is used.  Synovial fluid moves in and out of knee cartilage every time you take a step.  If you don’t move, neither does the synovial fluid.  Imagine the difference between drinking water from a crisp clear babbling brook or a stagnant pond.  What do you think will be better for you?

Cartilage is like a sponge.  Keeping the synovial fluid moving through it keeps the sponge moist and supple.  Think of the sponge that dries out on your sink.  It gets crumbly and starts to deteriorate.  The same is true with your knee cartilage.

Knee Exercises

Exercise and stretching can help prevent and relieve knee pain associated with osteoarthritis.  When done regularly stretches, low-impact aerobic exercise, and strengthening exercise can provide many benefits.

Increase Function and Range of Motion – Exercise and stretching will keep the muscles surrounding the knee joint limber.  The more you stretch the greater your knee’s range of motion.  The easier it is for your knee to move, the easier it will be to exercise.

Pain reduction – An unstable knee joint will do much better when supported by strong muscles.  The knee can be protected from repetitive impacts, like walking, by strengthening the muscles that surround the knee.  The hamstrings and quadriceps should be the primary focus.  Exercise also releases the body’s natural pain relievers, endorphins.


Knee Trauma

A knee injury can lead to post-traumatic knee arthritis.  A break in the tibia, fibula, or femur may damage the joint surface and lead to arthritis years after the injury. It depends on the severity of the injury.  Meniscal tears and ligament injuries can lead to an unstable knee joint, and additional wear on the cartilage, which can result in arthritis as the months and years pass.