Knee Osteoarthritis Explained: Symptoms, Causes and Non-Surgical Options

Knee osteoarthritis can make everyday movement feel more difficult than it used to. Walking, standing, using the stairs or getting up from a chair may bring pain or stiffness. Over time, this can affect your confidence and the activities you enjoy.

The good news is that there are several non-surgical ways to manage knee osteoarthritis. Understanding what is happening inside the joint is a useful first step towards finding the right support.

What is knee osteoarthritis?

Osteoarthritis is a condition that affects the whole joint, including the cartilage, bones, muscles, tendons and ligaments.

Cartilage is the smooth, tough tissue that helps the bones in your knee move comfortably against each other. With osteoarthritis, this cartilage can become thinner and less effective at cushioning the joint. Changes can also develop in the bone beneath the cartilage, while the surrounding tissues may become irritated or weaker.

Knee osteoarthritis can develop gradually. It may be associated with age, previous injury, family history, body weight, the demands placed on your joints or the way your legs and feet move. Often, there is no single cause.

Importantly, the amount of change seen on an X-ray does not always match the amount of pain someone feels. Your symptoms, movement and day-to-day experience all matter when deciding on treatment.

What does knee osteoarthritis feel like?

Symptoms can vary from person to person, but common experiences include:

• Pain during movement: You may notice discomfort when walking, climbing stairs, standing for a long time or getting in and out of a chair.
• Stiffness: Your knee may feel stiff after waking up or sitting still for a while.
• Swelling: The joint may look puffy or feel full, warm or tender.
• Reduced movement: Bending or straightening your knee may become more difficult.
• Clicking or creaking: Sounds from the knee are common and do not always mean that further damage is occurring.
• Weakness or instability: Some people feel that their knee may give way or cannot be fully trusted.
• Changes in walking: Pain can lead you to shorten your stride, avoid putting weight through one leg or move differently.

These symptoms can affect much more than your knee. You may stop going for walks, reduce your exercise, avoid social activities or plan your day around where you can sit and rest. Moving less may then lead to weaker muscles and greater stiffness, creating a cycle that can be difficult to break.

How is knee osteoarthritis diagnosed?

A healthcare professional will usually ask about your symptoms, how they affect your life and whether you have had any previous injuries. They may examine your knee, look at how it moves and assess your strength, balance and walking pattern.

An X-ray may be used if the diagnosis is uncertain or if another condition needs to be considered. However, scans are not always needed to identify osteoarthritis, particularly when the symptoms and examination are typical.

It is important to seek medical advice if your knee pain started after a serious injury, your knee is very swollen or hot, you cannot put weight through it, or it repeatedly locks or gives way.

Non-surgical options for knee osteoarthritis

Many people manage knee osteoarthritis without surgery. Your treatment plan should be tailored to your health, symptoms, goals and daily routine.

Exercise and physiotherapy

Regular, suitable exercise is one of the most important parts of managing osteoarthritis. Strengthening the muscles around your knee and hip can improve support and make movement easier. Flexibility, balance and low-impact aerobic exercise can also be helpful.

A physiotherapist can guide you towards exercises that suit your current ability. You do not need to exercise at a high intensity to make progress. Consistency is usually more useful than doing too much at once.

Weight management

If you are above your healthiest weight, losing weight can reduce the load placed through your knees. Even small, sustainable changes may support movement and general health. A healthcare professional can help you choose an approach that is realistic for you.

Pain relief

Depending on your circumstances, a GP or pharmacist may discuss options such as topical anti-inflammatory gels or other pain-relieving medicines. Some medicines are not suitable for everyone, particularly if you have other health conditions or take regular medication, so professional advice is important.

Injections and support aids

Some people may be offered a corticosteroid injection for short-term relief. Knee supports, walking aids, taping or orthotics may also be useful in selected cases.

These options are not right for everyone. A clinician can help you understand whether a particular support is suitable and how to use it safely.

Apos® as a non-surgical option

Apos® is a personalised, non-invasive medical device designed to support people with knee osteoarthritis. It is worn on the feet and adjusted according to your individual walking pattern.

The treatment works through two principles:

• Redistribution: calibrated elements beneath the footwear help shift pressure away from painful or overloaded areas.
• Re-education: the changed foot position encourages a different walking pattern, helping your body practise more comfortable movement.

Apos® is typically used at home for around one hour a day while you continue with your normal routine. It is intended to complement appropriate care, including exercise and clinical guidance, rather than replace every other part of an osteoarthritis management plan.

What does NICE say about Apos®?

NICE recommends AposHealth® as a cost-saving option for a specific group of adults with knee osteoarthritis. This includes people whose non-surgical standard care has not worked well enough, who meet referral criteria for knee replacement surgery and who do not want surgery.

NICE also recommends that relevant information is collected when AposHealth® is used, including quality of life, healthcare resource use and whether a person later has knee replacement surgery.

This is not a recommendation that Apos® is suitable for everyone with knee osteoarthritis. NHS availability and funding decisions are made locally, and suitability should be assessed by an appropriately trained healthcare professional.

Finding the right next step

Knee osteoarthritis can be managed in different ways, and your plan may change as your needs change. The most helpful approach is usually one that combines clear information, appropriate movement and support that fits your life.

If knee pain is limiting your walking, exercise, work or independence, speak with a GP, physiotherapist or musculoskeletal specialist. They can help identify the likely cause of your symptoms and explain which non-surgical options may be suitable.

You do not have to stop moving. With the right support, you can take a practical next step towards moving more comfortably and staying connected to the things you enjoy.