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Clinics in London and Bedford
Open Mon-Fri 9-5pm

Knee
Arthritis
Clinic

Non-surgical knee arthritis treatment for pain relief, improved mobility and cartilage enhancement

Have you been told by your doctor that your only options for symptom relief are painkillers, a steroid injection, or a knee replacement?

Are you worried about the growing amount of research showing the negative short and long term side effects of these knee arthritis treatment options?

We offer an alternative to knee replacement. A safer and more effective solution to reducing your symptoms of knee arthritis.

Knee Arthritis Consultation and Examinations

  • Full Medical History
  • Full Bio-Mechanical Scan & Analysis
  • Dynamic Orthopaedic Movement Tests
  • Digital Muscle Strength Testing

Knee Arthritis Treatment Program

  • Prolotherapy - Prolozone Therapy
  • Strength and Conditioning - Knee Arthritis Exercises

Prolozone Therapy

In recent years, an advanced form of Prolotherapy called Prolozone Therapy has built its reputation within the medical community for its clinically proven ability to treat knee arthritis and act as an alternative to knee replacement.

Research has proven it’s pain relieving, anti-inflammatory and regenerative benefits for individuals suffering from knee osteoarthritis and rheumatoid arthritis.

The natural treatment uses an activated form of medical oxygen (medical ozone) and specific nutrients to promote the regeneration and rebuilding of cartilage, alongside other structures within the knee that have suffered degeneration or become painful and weak.

The reason cartilage degenerates in someone with knee arthritis is because it is one of the only structures in the body that doesn’t have a blood supply.

When you cut your skin, it heals over and grows back because it has a good blood supply, unfortunately cartilage doesn’t have that luxury.

Oxygen is the main component within our blood that helps body tissue to heal and regenerate.

The concentrated form of medical oxygen (medical ozone) used within Prolozone has been shown in studies to stimulate stem cell production.

Stem cells are the primary cells the body uses to repair and regenerate damaged body tissue, including cartilage.

The stimulated stem cells are deposited in the form of mesenchymal progenitor cells called chondroblasts, which then convert into chondrocytes. These cells are the pre-curser building blocks of cartilage.

Prolozone injections have shown to not only reduce pain, inflammation and stimulate cartilage growth, but also to repair and strengthen the ligaments within the knee, which have been put under additional strain from the instability that arthritis causes within a knee joint.

This increase in cellular repair activity both strengthens and stabilises the joint as a whole, significantly reducing pain and stiffness in someone with knee arthritis.

Prolozone injections are naturally anti-bacterial, so deemed one of the safest injections on offer within medicine. Its impeccable safety record has been the reason why thousands of doctors and practitioners around the world are now adopting it as an effective, non-invasive alternative to knee replacement surgery.

Knee Arthritis Treatment - Patient Testimonials

What is Knee Arthritis?

With the knee joint being the largest joint in the body, it is also the most complex. Its functions are to allow the leg to bend, straighten and rotate, helping the ankles and hips to carry the weight of the body. This complexity is the reason why we have taken a multifaceted approach to our knee arthritis treatment program.

When a knee joint is affected by arthritis, it becomes damaged, painful, and stiff. This occurs due to the breakdown of cartilage and its inability to repair and regenerate as efficiently as other structures in the body, such as muscle and skin.

This inability to repair is a result of its lack of blood supply. As the cartilage wears down, the gap between the bones narrows, causing the bones to begin to rub and form bone spurs (osteophytes).

The knee joint has an inner layer called the synovium, which can thicken and result in excess fluid building up. This is the most common cause of swelling in an arthritic knee. Swelling creates pressure in the knee, which can also contribute to the pain already caused by the bones rubbing.

Arthritis of the knee joint causes it to become unstable. The supporting structures of the joint are then forced to work harder to stabilize it, leaving them susceptible to injury themselves. The supporting structures of the knee include muscles, tendons, ligaments, and the meniscus. Our knee arthritis treatment program helps to address problems in these supporting structures as well as the joint damage.

Knee Arthritis Symptoms

  • Pain
  • Inflammation & Swelling
  • Stiffness
  • Tenderness
  • Cracking & Popping
  • Buckling
  • Locking
  • Grinding
  • Weakness & Muscle Wasting
  • Instability

Pain with knee osteoarthritis

Knee pain comes in several different forms with knee osteoarthritis. Some people experience a dull ache, some sharp pain, and some a deep throb.

A dull ache is caused by either the pressure of the swelling or bruising of the bones as they have been rubbing against each other.

Sharp joint pain is experienced when two bone spurs collide against each other during certain movements.

A bony spur (osteophyte) develops when the bones attempt to repair themselves after they have started to wear down. Deep throbbing results from the build-up of swelling which leads to pressure within the knee joint.

Different types of arthritis will cause different types of pain.

A man sitting on a bench with knee arthritis symptoms

Inflammation and Swelling with knee arthritis

Another common knee osteoarthritis symptom is inflammation and swelling.

When the bones in the knee start to rub against each other, it can stimulate the immune system to send white blood cells to the area. Often the body can send more white blood cells than is needed, which causes the joint to swell up and knee pain as a result.

Movement can help to provide pain relief by flushing unnecessary inflammation out of an area of the body. So if a patient isn’t too mobile, then the pressure of the swelling can start to cause joint pain, stiffness, and heaviness. If severe enough, the swelling can cause compression of certain nerves around the knee.

A common time for swelling to build-up is at night when an individual isn’t moving. People suffering from knee injuries or knee arthritis will often say to us that they have to get up in the middle of the night to walk about to find pain relief.

The action of walking helps to gently flush inflammation out of the joint enough to take the pain down and allow someone to fall back to sleep again. Some people resort to taking non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, or acetaminophen (paracetamol) just before bed. The problem with these drugs is that they can have long term side effects.

Stiffness and poor range of motion

Stiffness can be caused by a range of different issues associated with knee arthritis:

  • Swelling: As previously described, the pressure from inflammation and swelling can restrict the range of motion in the knee joint.
  • Muscle tension: Alongside absorb shock, cartilage also plays a role in stabilizing the knee joint. When cartilage starts to break down, the knee becomes unstable, so the muscles around the joint are required to work harder to compensate. Over time, the muscles start to tighten up and cause stiffness.
  • Bone friction: Cartilage is a smooth elastic tissue that coats the ends of the bones and is designed to help knee joints articulate freely. Once worn down, the joint surfaces can’t glide against each other as smoothly, and as a result, become stiff during movement. The knee pain gets worse as an individual starts to develop bone spurs.

Tenderness with knee arthritis

Much of the tenderness associated with knee arthritis symptoms don’t necessarily come from the bones rubbing. It more comes from many of the soft tissue structures that attach into the knee.

These structures include muscles, tendons, ligaments, and bursa.

As described in the above section, when cartilage starts to break down, it causes the knee joint to become unstable. The attaching structures are then forced to work harder in an attempt to keep the knee stable during routine activities such as walking and climbing stairs.

Also, as the muscles start to tighten up, they aren’t able to perform their role of absorbing shock very well. The shock then gets deflected into tendons, ligaments, and bursa, which weren’t designed to absorb shock as well as muscles.

It leads to these structures becoming tender and weak.

A doctor examining a man with knee osteoarthritis

Cracking and popping with knee arthritis

Cracking and popping are often wrongly perceived to be coming from bones rubbing against each other. Knee arthritis symptoms that are associated with the bones rubbing are more sensations of grinding and grating.

Cracking and popping are caused by trapped nitrogen gas bubbles escaping from the joint. The gas bubbles build up during sedentary activities, which is why the noises are most commonly noticed during the first few movements of waking up in the morning, or after sitting for a prolonged period of time.

The more active a knee joint is in the day, the less it will crack and pop.

If an individual has a particularly large bony spur, then this can also cause a cracking sensation during certain movements as it rubs against the joint surface.

Buckling with knee osteoarthritis

As knee osteoarthritis progresses, the supporting structures of the knee start to become weak and are unable to stabilize the knee properly during painful movements.

This can result in the knee buckling or ‘giving way.’ It is most common during twisting movements or unexpected movements such as stepping off a curb that you didn’t realize was there.

Occasionally, floating pieces of cartilage in the knee can get trapped during walking activities or climbing stairs.

A woman holding her arthritis in the knee

Locking

The majority of locking sensations are caused by damage to the meniscus in the knee. Almost all knee arthritis symptoms are associated with damage to the meniscus.

It is a crescent-shaped form of cartilage that sits between each side of the joint. There are two menisci located within each knee, the medial and lateral.

A tear of this structure can cause a portion of it to get trapped within the joint, causing it to lock. The medial meniscus is most commonly affected.

Grinding and grating with knee arthritis

The sensation of grinding and grating is caused by the unsmooth bones in the joint rubbing against each other. It is also known as crepitus and most commonly felt under the kneecap during weight-bearing activities.

The kneecap is more affected than other parts of the knee joint due to muscle tension or previous injuries causing it to misalignment and track outside of the groove that it is supposed to sit it.

This eventually leads to friction and wearing of the cartilage on the underside of the kneecap.

Some individuals experience grinding and grating, but have no joint pain at all.

Weakness and muscle wasting

As knee arthritis symptoms start to get worse, an individual will find themselves becoming less and less mobile.

A decrease in physical activity causes the muscles around the joint to become weak, and unable to support the knee very well.

The vastus medialis oblique (VMO) muscle normally wastes much quicker than other muscles around the knee. It is located on the medial aspect of the knee and plays a large role in stabilizing the joint.

As the muscle wastes, the increased instability in the joint puts additional strain on ligaments and tendons, which then start to cause pain.

A diagram of knee muscles

Worsening symptoms with prolonged activity

If the knee osteoarthritis is bad enough, it can start to cause friction between the bones. This friction can start to cause bone bruising, which is characterized as a deep ache.

Prolonged weight-bearing activities such as walking can make this worse. The speed at which the pain comes on during walking is dictated by how severe the cartilage has worn down in the joint.

Instability

As discussed in previous sections, a sense of instability in the joint can be caused by several different issues associated with knee cartilage damage and knee osteoarthritis.

Muscle wastage and weakness: A combination of immobility and tension means that muscles aren’t able to contract as effectively as they normally would. The knee joint needs muscles to be able to contract properly to stabilize it during movement.

Ligament and tendon weakness: When cartilage becomes damaged or starts to wear down, ligaments and tendons have to work harder, and as a result become tired and weak.

Poor proprioception: Proprioception is the term used to describe how well musculoskeletal structures communicate with each other during coordinated movements.

To keep the proprioception of a joint in good working order, it needs to be moving on a regular basis.

If the pain caused by knee arthritis has stopped someone from moving the joint frequently, then they start to lose coordination and the knee starts to suffer from instability.

Another factor is that the blood supply to your nerves becomes less efficient as you age, which further affects your coordination.

Pain in neighboring joints

The limping postures that people adopt to avoid pain in the knee can often start to cause problems in neighboring structures such as the lower back, hip, shinbone, and ankle.

If you find yourself limping regularly, then it is wise to go and see an osteopath or chiropractor every 6 weeks to help correct any misalignments that may have developed.

A graphic of a man sitting down holding his leg pain

Muscle cramping with knee arthritis

With anyone suffering from knee arthritis, the muscles around the knee joint have to work harder and can end up causing cramps.

There are many reasons why they have to work harder. If an individual starts to limp when they walk, the muscles are forced to function at an angle that they weren’t designed too.

Also, once the knee becomes unstable from the damaged cartilage, the muscles are required to work harder to compensate.

Deformities

Deformities only tend to affect individuals with severe cartilage damage associated with knee osteoarthritis.

There are two types of deformities. The most common is a knock-knee deformity, clinically known as genu-valgum deformity. The least common is a bow-legged deformity, clinically known as genu-varum deformity.

These deformities can either be a cause of osteoarthritis or develop as a result of it. In the case of them developing as a result of osteoarthritis, it is normally at a more advanced stage of the condition which may indicate the need for a knee replacement. Physical therapy and prolozone injections will only be able to provide pain management when the deformity is at an advanced stage. Weight loss may also be able to provide some pain relief.

A knock-knee deformity occurs when the medial (inner) aspect of the knee has worn down.

A bow-legged deformity occurs when the lateral (outside) aspect of the knee has worn down. Bow-legged issues are less common due to the muscles on the outside of the thigh being stronger than the inner thigh muscles, enabling them to better support the outside of the joint.

More information about knee osteoarthritis can be found on different arthritis foundation websites.

How is knee arthritis diagnosed?

An x-ray scan is the most common scan to be used to identify osteoarthritis of the knee. If your practitioner needs to find out more information about the specific condition of the cartilage for some reason then an MRI scan can be performed.

What causes knee arthritis?

There are many factors involved that predispose an individual to knee osteoarthritis. Much of the population are under the false impression that genetics is the main factor. Research is now showing other factors have more of an influence such as nutrition, lifestyle, body alignment, and our environment. An effective knee arthritis treatment needs to take all of these factors into consideration.

Harvard University inspected the skeletons of 1,581 people who lived during the 19th century, and who were aged 50 or more, and compared them to those of 819 similar people who lived in the 20th century. After taking into account age and body mass index, cases of knee arthritis had doubled in the latter group, which suggests that something other than age and body weight had something to do with the increase.

The big difference between the two centuries has been the rise of chemicals in our environment, foods, and our cosmetics, which may well have more of an impact on the disease than the current culprits that medicine believes are responsible, the researchers say.

Conventional knee osteoarthritis treatment options

Many patients come to see us because they don’t want to go down the conventional route of treating their condition. Many of the conventional treatments that are offered have risks and long-term side effects associated with them. Either surgical or non-surgical treatment is normally offered by a conventional doctor depending on the type of arthritis that you have.

Over-the-counter pain relievers

  • Non-steroidal anti-inflammatory drugs – ibuprofen (Advil)
  • Acetaminophen or Tylenol – paracetamol
  • Naproxen (Aleve)

Knee Braces for knee arthritis

There are several types of knee braces available for knee arthritis pain. The type of knee brace you need will be dependant on the location of arthritis within the joint. They help to provide pain relief by stabilizing the joint during weight-bearing activities.

Viscosupplementation

Viscosupplementation is a procedure that involves the injection of hyaluronic acid into the knee joint. Hyaluronic acid is part of the synovial fluid. Its primary role is to help to lubricate the joint. It is a treatment that we can combine with Prolozone Therapy at the clinic if we feel it is suitable.

Platelet-Rich Plasma (PRP)

A form of injection therapy, platelet-rich plasma involves removing a small amount of blood which is then placed into a centrifuge. This process separates the red blood cells from the plasma. The plasma is rich in certain growth factors, which have shown a positive effect on knee cartilage in clinical trials.

Physical Therapy

A physical therapist will help to improve muscle strength, suppleness, and coordination. Physical therapy advice may also include lifestyle changes and recommendations on different types of regular exercise.

Supplementation

Alongside our treatment at the clinic, we advise patients on specific supplements that may be able to help, such as glucosamine and chondroitin. Glucosamine is a building block to cartilage cells and chondroitin helps them to maintain their elasticity. Topical creams that include capsaicin in them can sometimes offer pain relief. Supplements and topical creams tend to only help patients in the early stages of the condition.

Corticosteroid injections

This treatment involves the injection of anti-inflammatory medication. The problem is that the effect is only temporary and studies performed at Boston University identified a list of complications. These included accelerated knee osteoarthritis progression and rapid joint destruction.

Treatment for Rheumatoid Arthritis

Rheumatoid arthritis is classed as an auto-immune disease. A rheumatology clinic will often prescribe antirheumatic drugs in an attempt to reduce inflammation and limit joint damage. Unfortunately, the treatment has a long list of side-effects associated with it. Regular blood tests are taken to monitor the effectiveness of the treatment.

Knee surgery options for knee arthritis

Knee replacement surgery (Arthroplasty)

There are two types of joint replacements in the knee, a partial knee replacement and a total knee replacement. Statistics show that knee replacement surgery is considerably less successful than hip replacement surgery, and they only last an average of 9 years. This means sufferers of knee arthritis are desperate to find knee replacement alternatives.

Arthroscopy

Arthroscopy is a key-hole surgical procedure that involves small incisions being in order to fit instruments into the knee. These instruments shave away jagged pieces of bone and flush out floating pieces of cartilage.

Osteotomy

This procedure involves cutting bone to either shorten or lengthen it, resulting in a change to the alignment of the knee.

Due to the risk factors, surgery should only be considered for patients who are suffering from severe pain and where conservative treatments haven’t been able to help.

A safe alternative to knee surgery

Our clinic offers alternative therapies that have shown to be safer and more effective than conventional treatments. Your first appointment will involve taking down a comprehensive medical history and examination to help us formulate the most effective treatment plan for your knee osteoarthritis. The treatment combines both Prolozone Therapy and physical therapy techniques. The medical ozone component of Prolozone Therapy has been shown to stimulate stem cell production.

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