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Brief about gonarthrosis
Gonarthrosis is osteoarthritis of the knee joint and one of the most common causes of long-term knee pain in adults.
Common symptoms are pain with exertion, stiffness after rest (often less than 30 minutes), pain on stairs or when standing up, and clicking or the feeling that the knee is unstable.
The risk increases with increasing age, previous knee injuries, obesity, heredity, physical inactivity and prolonged high load on the knee joint.
The diagnosis is usually made based on symptoms and examination. X-rays are not always needed before treatment begins.
Seek care if knee pain lasts for weeks to months, if you experience recurrent swelling or clearly impaired function. Seek care more quickly if there is severe swelling, fever, locking or instability after injury.
The most important treatment is individualized exercise. If you are overweight, losing weight can reduce pain and improve function. Medication can be used as a complement, while surgery is usually only considered when basic treatment does not provide sufficient effect.
Self-care is an important part of treatment. Continue to be physically active, adjust the load, strengthen the muscles around the knee and review factors such as shoes, body weight, sleep and work situation to reduce discomfort and maintain function.
Gonarthrosis – the most common form of osteoarthritis in the knee joint
Gonarthrosis is osteoarthritis in the knee joint, i.e. a slowly developing joint disease where the entire joint is affected. It is not just about the cartilage “wearing out”, but about changes in several parts of the knee: cartilage, bone under the cartilage, joint capsule, ligaments and muscles around the joint. Knee osteoarthritis is one of the most common causes of long-term knee pain in adults and is treated primarily with information, individualized exercise and, if necessary, weight loss, not with surgery as the first step.
What symptoms does gonarthrosis cause?
Typical symptoms of gonarthrosis are pain when straining, stiffness after rest and reduced function in everyday life. Many describe that the knee feels stiff in the morning or after sitting still, but that the stiffness usually subsides within about 30 minutes. It is a pattern that speaks more for osteoarthritis than for inflammatory joint diseases.
The problems often occur in specific situations. It can hurt when you climb stairs, get up from a chair, walk long distances or carry heavy loads. Some people hear or feel a clicking or rasping sound in their knee, known as crepitation, while others mainly notice that their knee no longer feels reliable.
The pain does not always mean that the joint has rapidly deteriorated that particular day. Knee osteoarthritis often comes in periods, with better and worse weeks. Sleep, physical strain, stress, previous injury and muscle strength affect how much the knee feels.
Why do you get knee osteoarthritis?
The risk of knee osteoarthritis increases with age, but osteoarthritis is not just a matter of age. Heredity plays a role, as do previous knee injuries, obesity, physical inactivity and work or sports with high and repeated knee strain. Women are also affected more often than men.
Overweight is a particularly important risk factor for knee osteoarthritis. This increases the mechanical load on the knee joint, and fatty tissue contributes to low-grade inflammation in the body that can affect the joint biologically. Therefore, even moderate weight loss can provide significant symptom relief in people who are overweight and have gonarthrosis.
Previous injuries are another common explanation, especially in people who have been physically active. An old meniscus injury, cruciate ligament injury or fracture in connection with the knee can change the load pattern of the joint for many years. This means that gonarthrosis sometimes occurs earlier than expected.
How is the diagnosis made and when should you seek care?
The diagnosis of gonarthrosis is often made clinically, i.e. based on symptoms, medical history and examination. Typical symptoms are pain on exertion, stiffness lasting less than 30 minutes and gradual deterioration of function. X-rays or other forms of diagnostic imaging are not always required to initiate treatment if symptoms and examination findings clearly indicate knee osteoarthritis. If the diagnosis is uncertain, or if other injuries or conditions are suspected, X-rays or — in certain cases — MRI may be considered.
The examination assesses, among other things:
Mobility
Swelling
Tenderness
Leg alignment
Muscle strength
The doctor or physiotherapist also wants to understand how the problem affects real-life activities such as:
Walking to the bus
Working a full shift
Going for walks
Being able to exercise
It is often that function, rather than a single image on the X-ray, that determines the treatment plan.
Then you should seek care
You should seek care if the knee pain lasts for weeks to months, if you experience significant functional impairment or if the knee swelling occurs repeatedly. Seek medical attention more quickly if the knee suddenly becomes severely swollen, warm, locked, unstable after trauma or if you also have a fever, as this may indicate something other than osteoarthritis. These types of warning signs need to be assessed separately.
Treatment of gonarthrosis: what actually helps?
The most well-documented treatment for gonarthrosis is exercise through individually tailored training as a basic treatment, often in combination with patient education. The goal is not to “grind away” pain, but to improve muscle function, load tolerance, balance and confidence in the knee.
It doesn't have to start out advanced. For one person, it may involve training the thigh and gluteal muscles two to three times a week and replacing short, pain-controlled walks with regular cycling. For another, water-based training or osteoarthritis school may be easier to get started with. The crucial thing is that the exercise is adapted to the current situation and can be repeated over time.
If you are overweight, weight loss can significantly reduce symptoms. Studies and guidelines support that weight loss, especially in combination with exercise, improves pain and function in knee osteoarthritis. This is rarely about perfection, but about a sustainable change that can be lived with.
Medication can be a complement when the symptoms prevent activity. Topical NSAIDs, i.e. anti-inflammatory gel or cream on the skin over the knee, are recommended in several guidelines for knee osteoarthritis. In some cases, tablets with NSAIDs or cortisone injections into the joint are also used, but the choice must be weighed against side effects, comorbidities and how often the problems return.
However, arthroscopic surgery is not recommended as routine treatment for knee osteoarthritis or suspected degenerative meniscus damage in this patient group. Swedish guidelines emphasize that resources should instead be spent on measures that actually help, such as exercise and structured treatment. Knee replacement surgery only becomes relevant when the symptoms are severe and basic treatment is not enough.
A brief overview of what you can do yourself for knee osteoarthritis
Keep moving, but adjust the load. Resting too much can lead to reduced muscle strength and more discomfort.
Think "moderately but regularly". Shorter walks or training sessions several times a day can work better than putting too much strain on the knee at once.
Review factors that affect the knee, such as shoes, hip and thigh strength, sleep, body weight and work situation.
When doing physical work, small changes in working postures, breaks and aids can reduce the strain on the knee joint.
Follow your symptoms over time. A symptom diary together with health data, such as blood pressure, weight, waist circumference and other health markers, can give a better picture of which factors influence the discomfort.
Look at the big picture. Gonarthrosis is affected by the interaction between muscles, strain, recovery, metabolism and lifestyle. Understanding your own patterns can help preserve function over time.
