Living Well With Knee Arthritis: A Practical Guide

Understanding What Is Actually Happening in Your Knee

Osteoarthritis is not simply "wear and tear" — that description does not capture the complexity of the condition or the possibility of meaningful treatment. Osteoarthritis involves the progressive degradation of the cartilage that cushions the joint surfaces, leading to inflammation, pain, and eventually bone-on-bone contact.

The good news is that the process is not linear or inevitable. Many patients with severe arthritis on X-ray have mild symptoms; others with relatively mild changes have significant pain. The X-ray is only one part of the picture — your symptoms and function matter most.

The Single Most Important Thing You Can Do

Exercise. Not rest — exercise. This may seem counterintuitive when your knee hurts, but extensive evidence shows that strengthening the muscles around an arthritic knee — particularly the quadriceps — significantly reduces pain and improves function. The muscles act as shock absorbers, reducing the load transmitted through the damaged cartilage with every step.

A structured physiotherapy programme, tailored to your current fitness level and degree of arthritis, is the foundation of conservative management. Dr. Hargovind Singh recommends physiotherapy as the first-line treatment for all patients with knee arthritis who have not yet tried it.

Weight Management: The Maths Are Compelling

The knee experiences forces equivalent to 3–6 times body weight during normal walking. This means that every kilogram of body weight reduction removes 3–6 kilograms of force from the knee with every step. Even a 5–10% reduction in body weight produces measurable improvements in knee pain and function in overweight patients with arthritis.

Injections: What Works and What Does Not

Several injection options are available for knee arthritis:

• Corticosteroid injections: Rapidly reduce inflammation and pain, typically effective for 6–12 weeks. Best used for acute flares or before physiotherapy to allow exercise to begin.
• Hyaluronic acid (viscosupplement) injections: Improve joint lubrication. Some patients achieve significant relief lasting 6–12 months.
• PRP (Platelet-Rich Plasma): Uses your own blood platelets to stimulate tissue repair. Growing evidence base — Dr. Singh recommends this for appropriate patients.

Injections are supportive treatments, not cures. They work best when combined with physiotherapy and lifestyle modification.

When to Consider Surgery

Surgery — specifically knee replacement — is considered when conservative measures have been optimised and symptoms remain severe enough to significantly limit daily life. The threshold is personal: some patients are ready at a relatively early stage; others prefer to continue managing conservatively for longer.

Dr. Hargovind Singh's approach is never to push patients towards surgery — the decision must be right for you. What he does ensure is that when surgery is chosen, it is performed with the precision and technique that gives you the best possible long-term result.