How to Treat an Arthritic Knee
Knee arthritis is one of the most common joint complaints I see in clinic, particularly among adults over 40. Many people ignore their symptoms for months or even years, putting them down to “just old age” or thinking, “I probably just need to lose a bit of weight.” While those factors can certainly play a part, they are rarely the whole story — and delaying help can allow stiffness and pain to worsen unnecessarily.
The good news is that many cases of mild to moderate knee arthritis can be managed effectively without the need for surgical or orthopaedic intervention. Early, active management makes a real difference.
At The Waterside Practice, I believe the best outcomes come from a combination of skilled manual therapy and a structured, personalised exercise routine. When used together, these approaches can significantly reduce pain, improve mobility, and help you regain confidence in your knee.
Understanding Knee Arthritis
Knee arthritis occurs when the cartilage that cushions the joint begins to wear thin. The joint surfaces can become irritated, leading to inflammation, stiffness, and pain — especially with prolonged sitting, walking downstairs, or after exercise.
Arthritis in the knee can develop as part of the natural ageing process, but it’s not always simply “wear and tear.” In many cases, it’s linked to past injuries or repetitive strain. For example, tilers and floor layers who spend years kneeling on hard surfaces often place excess load through the joint, while a sports injury can trigger early degenerative change. I recall one patient who caught their foot in a small hole on a football pitch during an amateur match — the knee twisted awkwardly, and although it seemed to settle at the time, the effects of that injury became apparent years later as early osteoarthritis.
These stories highlight how arthritis is not just about getting older — it’s often the long-term result of how the joint has been used, loaded, or injured over time.
A Real-Life Example
Recently, I saw an 81-year-old gentleman with mild left knee arthritis who had begun to experience some locking and swelling behind the knee (known as popliteal swelling). What struck me was how well he had done to remain symptom-free for so many years. He has always been fit and active, regularly walking long distances, often with his children and grandchildren on family hikes. He’s maintained a healthy weight and good general fitness, which have undoubtedly helped protect his joints over time.
What triggered this recent flare wasn’t new damage, but a change in his movement pattern. A few months earlier, he’d had a minor operation on his right foot, which temporarily altered his gait and reduced his usual activity levels. This shift in load and period of rest likely led to an inflammatory response in an already arthritic joint. It’s a perfect example of how underlying changes in the knee can remain symptom-free for years, only to become noticeable when normal movement patterns are disrupted.
Aggravating Everyday Factors
In the treatment room, I often discuss with patients the everyday factors that can quietly aggravate knee arthritis. One common issue is foot biomechanics — how your foot lands and absorbs shock with each step.
For instance, those with pes planus (collapsed foot arches) often experience increased inward rotation of the knee, placing more stress on the medial (inner) side of the joint. Over time, this altered load can contribute to earlier cartilage wear and discomfort.
Even something as simple as shoe choice can make a big difference. Worn-out trainers, unsupportive flat shoes, or hard-soled work boots may all change how forces travel up through the leg. Reviewing your footwear and, where appropriate, using arch supports or switching to more cushioned shoes can be a simple but powerful step in managing symptoms day to day.
How Osteopathy Can Help an Arthritic Knee
Osteopathy takes a whole-body approach, recognising that knee pain often doesn’t exist in isolation. The way your hip moves, how your foot lands, and even your pelvic alignment can all influence how much stress the knee experiences.
At your appointment, a thorough case history and active assessment are carried out to identify the key factors contributing to why the joint is inflamed or irritated. Understanding these mechanical and lifestyle influences allows for a more targeted treatment plan.
Through gentle hands-on techniques, osteopathic treatment can:
Improve joint mobility by reducing stiffness in the surrounding muscles and tissues.
Enhance circulation and drainage, helping to ease inflammation and swelling.
Address compensations in the hips, pelvis, or feet that may be aggravating the knee.
Support better movement patterns so your knee can function more efficiently.
Treatment is then combined with guided rehabilitation, helping you build strength, stability, and movement confidence at a safe and steady pace.
Patients often report feeling lighter, more mobile, and more confident after osteopathic care. The aim isn’t just to relieve pain — it’s to restore balance and movement throughout the lower body so your knee has the best environment to heal and adapt.
The Importance of Rehabilitation Exercise
While hands-on treatment plays a vital role in reducing pain and stiffness, long-term success depends on building strength, stability, and flexibility around the joint. A consistent, well-structured exercise routine is key.
Here are a few simple examples of exercises commonly recommended for mild to moderate knee arthritis:
Quadriceps Strengthening (Static Quads)
Sit or lie with your leg straight. Tighten your thigh muscles, pressing the back of your knee gently into the bed or floor. Hold for 5 seconds, relax, and repeat 10–15 times per leg.Bridges
Lie on your back with knees bent and feet flat. Gently lift your hips off the ground, engaging your glutes and core. Hold for a few seconds, then slowly lower. Repeat 10–12 times.Heel Raises
Stand tall, holding a chair for balance. Slowly rise up onto your toes and lower back down. This strengthens the calves, which help stabilise the knee during walking.Mini Squats (Pain-Free Range)
With feet shoulder-width apart, gently bend your knees as if sitting back slightly into a chair, keeping heels grounded. Only go as far as comfortable. Repeat 10–15 times.Gentle Cycling or Walking
Low-impact movement helps maintain joint lubrication and muscle strength — movement really is medicine for arthritic joints.
Lifestyle, Nutrition, and Weight Management
Maintaining a healthy body weight and staying active both play a role in managing knee arthritis. Extra body weight can increase pressure through the joint, so even small, sustainable weight changes can make a noticeable difference to pain levels and function.
However, it’s essential to remember that movement and alignment are just as important as weight. Many slim, fit individuals experience arthritis due to past injury or joint mechanics, while others with a higher body weight manage their symptoms well through good mobility and muscle strength.
In addition to exercise, I often discuss diet and inflammation with patients. A diet high in processed sugar and refined carbohydrates can promote inflammation, whereas including more anti-inflammatory foods such as oily fish, colourful vegetables, and spices like turmeric and ginger can be beneficial. Some people choose to take these as supplements, but it’s important to note that they can interact with certain medications, particularly those used for heart conditions or blood thinning — so always check with your GP or pharmacist first.
The most important step is to stay active within your comfort level, eat well, and seek professional guidance early — rather than waiting for things to deteriorate.
When to Seek Further Advice
If you experience persistent swelling, locking, or instability, or if pain worsens despite conservative treatment, it’s wise to have a thorough assessment. In some cases, imaging or an orthopaedic opinion may be appropriate — but for many, ongoing osteopathic management and exercise are enough to maintain excellent function.
Final Thoughts
Managing an arthritic knee is about more than pain relief — it’s about restoring confidence, mobility, and independence. Osteopathy offers a safe and effective way to support your body’s natural movement, while targeted exercises strengthen and protect your joints for the long term.
If knee arthritis is limiting your daily activities, don’t wait until it gets worse. A tailored combination of manual therapy, lifestyle changes, and rehabilitation can make a significant difference.
📍 To book an appointment or learn more about how osteopathy can help with knee arthritis, visit our online booking page: https://thewatersidepractice.janeapp.co.uk or call us on 01487 209 084