Are women at a higher risk for chronic knee pain?
Knee pain is a common problem that interferes with daily activity. A recent study reported by the Center for Disease Control showed that the lifetime risk of knee osteoarthritis (OA) is 46 percent. Thus, the knee joint is the most common joint affected by osteoarthritis and the most common joint surgically replaced.
Women have a higher incidence of knee OA and undergo more knee replacements compared to men. Knee pain varies from minor aches and intermittent pain to severe debilitation.
Symptoms often include morning stiffness, pain behind the knee, dull aches at night, pain that limits walking, and weakness with stairs and getting out of a seated position. Knee pain is not normal and if you have knee pain there are treatments.
The anatomy of a woman’s knee
The knee anatomy of women differs from that of men. This difference has been shown to lead to an increase in kneecap pain as well as ligament injuries in female athletes. These differences may also account for increased problems women face with their knees compared to men.
As these differences are better understood, effective treatments can be targeted specific to women with knee pain. Treatments for knee pain can be broadly grouped into separate categories: activity modification, exercise and physical therapy, medication, knee injection and surgical treatments.
Activity modification and stretching
Activity modification typically is used to treat minor knee pain. Resting and icing a sore knee can be beneficial when the problem is simple minor overuse or a very minor strain or bruise. This allows the injury to heal the pain typically should subside in 12 to 24 hours; if it lasts longer the injury may be more significant.
Stretching is an activity that should be performed when the knee pain is improving and should be done when the knee can be “warmed up” with some mild activity. Stretching a “cold “ or sore muscle is not only painful but may worsen an injury.
Exercise is a treatment that has been shown to lessen knee pain by improving the strength and balance of the muscles that move the knee. A recent study called the Multicenter Knee Osteoarthritis Study (MOST) investigated the relationship between knee strength and symptomatic knee pain in 3000 men and women.
The study found that the women with the strongest thigh muscles had a lower incidence of knee pain, a finding that was not true with men. Physical therapy is used to lessen joint pain and improve strength and flexibility.
Once complete, a home therapy program is designed to maintain strength and flexibility. All exercise programs should be moderate and pain-free. At least one day of rest should exist between workouts.
Arthritis medication includes both over the counter and prescription drugs. There are medications that target pain and those that target the cause of the pain, inflammation. When the knee joint is irritated an inflammatory reaction occurs.
In severe cases, the knee may become extremely swollen. In mild cases, over the counter anti-inflammatories work well and in more severe cases, prescription drugs may be required. Pain medication should be used with caution, as this does not treat the cause, only the symptoms.
Knee injections can be very beneficial in that they treat the problem directly with little effect on the rest of your body. Injection therapy is either anti-inflammatory (a cortisone shot) or a viscosupplementation. Viscosupplementation is typically given in three to five injections one week apart. This treatment provides medication for the cartilage, a lubricant for the joint as well as an anti-inflammatory drug.
Lastly, surgical options range from arthroscopy to knee replacement. One of the more recent advances in knee replacement has been the development of a “women’s knee.” This development stems from differences in knee anatomy.
Simply put, a female knee is often narrower then a male knee. Newer designs of knee replacement components have addressed this. To date there have been no studies that show that the new design is better and that each case is individualized. Knee replacement surgery continues to be one of the most successful orthopedic procedures with beneficial outcome in over 90 percent of patients.
Treatment of knee pain can be complex and is patient specific. Thus, an understanding of the differences between men and women can be used to direct specific individualized treatment plans.