More than 250 million people worldwide suffer from knee OA.

African-Americans, elderly females, and obese people are the populations at highest risk.


Primary OA is idiopathic and non-traumatic and secondary is related to trauma or a structural misalignment.

The knee

The knee consists of bony structures (femur, tibia and patella) as well as the cartilage (hyaline and meniscus) as well as ligaments, bursae, a capsule and synovium. The synovium is like a thin covering which secretes a viscous liquid called synovial fluid which provides nutrition to cartilage which has little blood supply.


The symptoms of arthritis are pain, weakness, inflexibility, swelling and clicking in the knee. As the disease progresses symptoms such as pain during and after exercise, muscular wasting and difficulty walking up and down stairs can ensue.

The pain of arthritis is usually not caused by cartilage, as it does not have much innervation, but rather by various other structures in the joint cavity such as the capsule, ligaments, synovial lining and tendons.


Inflammation has been postulated to be a possible cause for the breakdown in cartilage in the knee. With various inflammatory mediators entering the synovium and triggering enzymes which degrade the proteins and components of the cartilage.

Macrophages which are usually helpers in the body’s defence mechanism then proceed to have an impact on osteophyte formation.

Prevention using osteopathy

If inflammation is the leading cause of osteoarthritis then reducing inflammation is something osteopaths can advise on using their naturopathic expertise. Naturopathy is the use of natural therapeutic measures such as nutrition, supplements and healthy lifestyle changes to reduce exposure to environmental toxins.

Advice on ways of moving which could reduce the chance of weight bearing abnormally in the knee can also be given as a preventative measure, and as a way of slowing down the progression of already existing arthritis.

Techniques used in an osteopathic session can help prevent osteoarthritis by improving alignment, increasing flexibility, muscular tone and improving circulation around the whole body.

Treatment and management

Techniques used in an osteopathic session can help manage osteoarthritis by reducing what is known as a “sensitising soup” which is an area of the body full of inflammatory mediators that cause pain. Osteopaths can drain areas, reduce swelling and increase lymphatic flow, increase flexibility, stretch tissues and break down adhesions and improve circulation.


Research clearly shows that osteopathic manipulative therapy can not only decrease pain in patients diagnosed with osteoarthritis, but also prevent the disease from manifesting. Further research in this field in regards to curative methods are yet to be elucidated and perhaps grounds for further research.

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