The Ultimate Guide to Knee Osteoarthritis: Where to start, what to expect, and more- The 5 BURNING questions

Knee Osteoarthritis is a form of inflammatory arthritis, not wear and tear. There are so many misconceptions out but we are going to make it simple for you. The hardest part about a knee osteoarthritis diagnosis is not knowing where to go next and constantly worrying about if what you are doing is the right thing for pain relief. You will be able to answer: what is knee osteoarthritis, where do I start after a knee osteoarthritis diagnosis, and how do I best help my knee joints! 

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“Per the x-ray we just did, it appears you have knee osteoarthritis.”

“The next thing you need to do is lose weight and start exercising but you won’t ever really be able to stop the progression.”

“I’ll see you back in 6 months.”

Does this sound familiar?! 

I hope it doesn’t, but unfortunately, this is what many people have to go through when getting a diagnosis of knee osteoarthritis. 

You go see your family doctor, rheumatologist, or other physician for your knee pain that has been gradually getting worse. Most often they will take an x-ray or even an MRI to rule out any major injuries or reasons for pain. 

They find some arthritic changes in your joint, loss of cartilage and loss of space in the joint itself which you’re told explains your pain. Osteoarthritis.

It can be both scary and overwhelming to hear that word. I’m sure you’ve heard or seen others struggling with this disease and it can be hard to imagine that now it is happening to you. 

The main mission of this ultimate guide is to give you hope. I want to answer your questions, give you the real information you need to know and  show you that your life isn’t over because you have knee osteoarthritis.

I have seen hundreds of people with knee osteoarthritis and have helped them truly understand the best ways to take care of their knees while still living an active, adventurous life.

You’ll learn stories of men and women who overcame knee osteoarthritis and are able to now do things like running, jumping, walking without a cane, and more. This could be possible for you to if you follow these next tips closely.

If you want a fast track to success like Staci below, the Arthritis Adventure Blueprint can get you on the exact path to pain relief, even with bone on bone knee arthritis! 

The keys to success with knee arthritis

Table of Contents

You will learn important steps you need to take in order to manage pain, prevent your knees from getting worse, and how to continue to lead an active life. Not only is it important to learn what these steps are but it is also important to implement them as well. Without action, your pain likely will continue to get worse and it could be a fast track to surgery. 

Make sure you save this post for later and share with your friends when you’re done reading because I promise you, this is your Ultimate Guide to Knee Osteoarthritis.

What is Knee Osteoarthritis?

I guarantee the first thing you will see when you type this question into Google is “deterioration of cartilage” or “degeneration of the joint from wear and tear” in almost every article on the first page. You may have even been told these things by medical professionals. 

The truth is, knee osteoarthritis is primarily driven by inflammation and there is emerging recent research out there looking at exactly that.

“The past decade has seen a gradual but fundamental shift in our understanding of the mechanisms underlying OA. We no longer view [osteoarthritis] as a prototypical degenerative disease resulting from normal bodily wear and tear, but rather as a multifactorial disorder in which low-grade, chronic inflammation has a central role”

Robinson et al. 2016

This is actually good news and I’ll explain why.

If osteoarthritis was a degenerative condition caused simply by “wear and tear” you would have no hope for pain relief and everyone that had knee osteoarthritis would end up needing surgery. Also, movement would continue to make the condition worse which is the opposite of what exactly is true. 

Knee osteoarthritis is caused by many different factors that can allow inflammation to become out of control. These factors, then contribute to the further irritation of your knee joints. 

There is a strong genetic component as well but if you are aware of what continues to irritate the joint, you can live with a tolerable level of knee arthritis and prevent it from getting worse. Even though many of us have a family history of the inherent susceptibility to more inflammatory cells, this also means your knee joint is “bad”. Instead, it is just, quite frankly, angry and we can use specific tactics to decrease the amplification of the anger!

Since osteoarthritis has a strong inflammatory background, if we can control the inflammation- we likely can control both the pain and the progression.

Where Do I Need to Start if I Have Been Diagnosed with Knee osteoarthritis?

From the previous section, we know that if we can control inflammation, we can lessen the irritation and our symptoms. In the video above, you will find some ideas to get you started on the path to reducing inflammation in your body. The FIRST step is understanding how you can most easily reduce inflammation from your life.

There are a few ways that are going to help decrease inflammation more significantly than others, so these should become your priorities. It is important to note that each person’s priorities are going to be different depending on how they live their lives. You essentially need to look at three categories and think about which one has the most room for improvement in your own life.

  1. Food: what you are eating, how much you are eating, and are you getting enough nutrients?
  2. Movement: what are you doing for exercise, how often, and how motivated you are when doing it.
  3. Emotion: are you constantly stressed, tired, frustrated, overworked, anxious or overwhelmed? Do you believe nothing can be done about your pain?

Each of these things can impact your levels of inflammation in your body.

If you find yourself eating out quite frequently, frequently binge on processed foods, or are not eating enough- these are all scenarios in which food should be a priority. Check out the best anti-inflammatory foods to get started with here.

If you find yourself avoiding exercise, getting <10 minutes per day of exercise, or if your only exercise is a monostructural movement such as walking, cycling, or running- exercise should be considered a priority. Learn more about how exercise can work wonders for osteoarthritis here.

If you find yourself constantly displaying the emotions above or if you are constantly living life on edge, your emotions could be increasing your inflammation levels.

This is one people commonly do not think about. Let’s look a little deeper into how emotions impact inflammation from Stacey Colino,  an award winning writer, specializing in health and psychology:

“Emotional inflammation refers to the psychological and emotional state of constantly being on edge, angst-ridden, hyper-reactive or hyper-vigilant, full of dread, or generally filled with a WTF!!! feeling about what’s happening in the world. But it does have physiological ripple effects because when you have cortisol coursing through your body 24/7, there’s an inflammatory cascade, where your blood flow and blood pressure increase, your muscles tense up, your heart rate and breathing rate shoot up, and so on.”

Stacey Colino

In order to start turning your emotions and working on a positive mindset, this article puts things into perspective

Choosing one of these three items can truly help you get on the right path to long term pain relief. If we try to focus on and change everything at once, we are setting ourselves up for failure. Remember, one step at a time. 

What should I expect with knee osteoarthritis?

When you receive the diagnosis, it can be scary because the future seems unknown to you. You’re not sure what you are going to be feeling and doing years from now. 

The hard part in answering this question is that everyone has different experiences. The severity and impact on your life is highly dependent on how you live your life and your mindset about your osteoarthritis. The path and symptoms if we take action may be completely different than those who didn’t know other options were available. 

Common symptoms of knee osteoarthritis are explained here.

You may experience all or just a few of the symptoms mentioned. Here are some other things, not explained in this article you should expect:

  • Discomfort with exercise and other movements like climbing stairs, especially when starting or with a new onset. This pain typically tends to stay around 0-4/10 and is totally normal.
  •  You may experience some swelling, especially after a lot of activity. The swelling should subside after a day or two.
  • You may notice short bouts of significant pain with a flare up. I have known people who had a flare up once a year and those that have them about 1-2 times per month. This is partially dependent on controlling inflammation, the weather outside (increased pain with changes in weather and cold weather). This pain typically lasts 24-72 hours usually followed by full recovery.
  • Appropriate control of inflammation can usually relieve pain up to 80-90%. There may be times where you experience increased pain but this increased pain is usually not significant. This is because most of the time we don’t see it as much of a threat with a positive mindset. 

I know exercise is good, what exercises are the best and which should I avoid?

This is a common question so you are not alone! The goal is to keep your knees happy without flaring them up. This is possible, contrary to popular belief! But the number one thing most people are lacking is…


Many times we are told by healthcare professionals, friends, neighbors, or family that all we can do with knee osteoarthritis is swim and walk. No jumping, no running, no high impact activities ever again. 

That is simply not the case for most people if you can master variety, your joints should be prepared to potentially handle these activities (again, it’s important to remember that everyone is different).

I recently was working with someone who finally returned to running for the first time in 5 years after dedicating herself to strengthening her body to prepare her joints for it! 

The key though, aside from variety is to strengthen not only your knees but other joints as well, particularly hips, ankles, and back/core. With these two principles you are so much more likely to succeed. 

You can add variety lots of different ways to help with your knee osteoarthritis. For example, adding in sideways and backwards movements before or after your walk can absolutely make a difference.

If walking is your primary form of exercise, watch this video below to learn exactly how to relieve knee osteoarthritis pain or prevent it from getting worse by adding a few simple things.

Here is a bonus article about how to hike with arthritic knees too! 

If you want to get started on the right foot with exercise, adding in exercises like side stepping, supported squats, and backwards kicks can be a great start.

The idea is to find exercises and exercise variations that don’t flare up pain. If you are new to exercise, try this video below to get started. If you love this, I have a 5 day arthritis-friendly workout challenge that you’ll also LOVE. 

Leran more about the 5 Day Challenge here!

What should I look for in my knee osteoarthritis x-ray?

To be quite frank, x-rays don’t really matter. Whenever I see a client for knee osteoarthritis, I usually do not even look at the x-ray. Findings on x-rays like loss of cartilage and loss of joint space don’t necessarily correlate with pain and there has been a lot of research on that. 

For example, one study found that “The prevalence of knee osteoarthritis features on MRI in otherwise healthy, asymptomatic, uninjured knees is high— up to 43% in adults aged ≥40 years.” This means that there are people walking around out there that would have changes on their MRI similar to those found in patients with knee arthritis but they don’t have pain. 

So the question is, why do some have pain and others don’t with the same “joint damage”. This is where inflammation, lifestyle factors like the foods we eat, and genetics comes in. The more inflammation you have, the more likely you are to have pain. 

Instead of focusing and tediously looking into your x-rays, instead you should look at why you are in pain compared to someone who may have an x-ray that looks similar to yours. The findings on your x-rays may show normal signs of aging and this may not be the reason you are in pain.

For example, one woman who I have been working with had an x-ray that showed a minor meniscus injury and beginnings of knee arthritis due to lessening of the cartilage and narrowing of the joint space. A surgeon wanted to schedule surgery almost immediately but instead she went the natural route and now guess what….she’s the one RUNNING again. 

X-rays are not what we should base our thinking on, even if it is “bone on bone” or the “worst we have ever seen” (trust me if I had a dime for every time I heard that a client was told their knee was the “worst they have ever seen and they have no idea how you are even walking”, I’d be on a beach somewhere living in the Virgin Islands.

What does my future look like?

It is possible for your pain to become tolerable and plateau. Knee osteoarthritis pain does not have to progress. You’re pain doesn’t have to get worse if you can find ways to outsmart it.

Mindset plays a huge role in this. If you sit back and think, “there is just nothing I can do about this knee osteoarthritis pain, it runs in my family” then you need to hear this.

All too often we succumb to our arthritis pain because we simply don’t know that there are options available to us for pain relief. We also continue to believe that the long list of things that we think we can’t do has to dictate our lives.

There are options for pain relief and possibilities are out there, even if you have knee osteoarthritis! Understanding your osteoarthritis, learning how to manage it, and having a positive mindset are absolutely the most important keys to success when finding relief.

If you would love to join a supportive community of people 50+ who have arthritis but are looking to remain active and healthy, come join us! 

What about stem cells for arthritis pain relief?

Stem cells for arthritis pain relief is a common option people find when searching for treatments that are available. Regenerative medicine and stem cell therapy can be an alternative to surgery with less risk as they accelerate your body’s own healing process in a noninvasive way. 

There are considerations to be made when it comes to considering if stem cell therapy is the right choice for you. A few of these considerations include: 

  • this procedure is not typically covered by insurance providers and can be pricey
  • you may need to go in for more than one procedure
  • similar to cortisone shots, results are not guaranteed
  • this option carries much less risk compared to other surgical procedures
  • there has been great success for select patients
  • leading an active, healthy lifestyle will maximize your results including exercise, weight loss, and proper nutrition

So what is stem cell therapy like? What can I expect?

You can expect short, non-invasive procedures like having blood drawn. Once the harvesting is done, the physician will often use an ultrasound or fluoroscopy to precisely target and inject the stem cells into the injured area. You may experience some pain and swelling right after the procedure. Depending on the severity of your condition and the procedure done, you may recover within as little as 1-2 days. More severe problems will require more significant procedures and longer recovery. Many patients experience results within a few weeks and continue to see the improvement until about four months.

Joe Albano, MD and regenerative medicine specialist in Cottonwood Heights, UT

For more information, check out a very informative interview I did with Dr. Albano to answer your questions regarding stem cell therapy, PRP injections and more!

Are you believing myths about knee osteoarthritis?

One of the biggest problems we find when asking people about their knee pain is that they are believing the wrong things! When we believe these myths to be true, that’s when we can find ourselves in trouble. They can actually be making our pain WORSE.

Here’s the deal: Understanding the truths about knee pain can set you free. There are 3 main myths we find almost everyone believes. Want to see if you have been believing the wrong things, inevitably making your pain worse? Download our free guide below! 

Disclaimer: This post is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Kuhn and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Move Well Age Well, LLC and Dr. Alyssa Kuhn, PT, DPT are not liable or responsible for any advice, course of treatment, diagnosis or any conclusions drawn, services or product you obtain through this video or site.

arthritis adventure blueprint

The Arthritis Adventure Blueprint

Dr. Alyssa Kuhn’s signature program to help you go from hopeless to hopeful with osteoarthritis. You will learn the secrets to arthritis pain relief that actually work- including exercise, diet, and other ways to control inflammation! Say goodbye to short term pain relief, it’s time to make it last.

Learn more!

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