India is facing a knee arthritis epidemic. In fact, the problem is so rampant that over 150 million Indians suffer from some kind of knee problems and 40 million need total knee replacement, according to various studies. Worse still, the prevalence of knee arthritis in India is said to be 15 times higher than in Western nations.
While the issue is associated with many lifestyle factors, in India, it is also related to genetic predisposition, increased life expectancy, and socio-cultural habits such as sitting cross-legged, squatting, long-standing hours of work, and frequent use of stairs.
Incidentally, the problem is more prevalent among women. In India, one in three women over 60 years suffers from arthritis. Even in their 20s and 30s, women are highly prone to arthritis, the reason being hormonal changes causing the cartilage in the joints to degenerate faster, and leading to osteoarthritis. Hormonal changes during pregnancy and menopause can also cause joint pain and stiffness among women. In the general populace, the most common knee problem is age-related degenerative arthritis, which involves degeneration (wear and tear) of cartilage affecting the joints.
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Lifestyle to blame
Most of the time, the reasons revolve around your lifestyle choices, lack of regular exercise and poor nutrition. “These are the three factors that mainly contribute to varying degrees of different types of knee problems,” says Dr Aashish Chaudhry, director and head of department of orthopaedics and joint replacement at Aakash Healthcare in Delhi.
For office-goers in particular, ergonomics plays a significant role in knee health. For instance, cramped office spaces, uncomfortable seating arrangements, and abnormal knee bending can exacerbate pain, especially if frequent stair climbing is involved. Footwear is another factor to consider. Wearing high heels without maintaining muscle tone can place excess pressure on the knees, making it a common cause of knee pain among office workers, Dr Chaudhry says.
Another common type of knee pain is anterior knee pain, which affects the front part of the knee joint. Typically, middle-aged and younger patients, both male and female, start complaining of pain when climbing up or down stairs, getting up from a chair, standing for long periods, or walking long distances. This is especially true for individuals in jobs like airport staff or those who must stand and walk for long hours. Conversely, those who sit continuously without engaging in physical activity may also experience this type of pain.
“While you might not think about it, sitting down all day can be very stressful, especially on your knees and back. If your job calls for hours of sitting in a particular position, then you will probably experience knee pain due to inactivity. The muscles and tendons can become stiff and painful. Sitting in the wrong position for a long period can also cause pain by putting pressure on knee caps,” says Dr Vinay S Joshi, consultant orthopaedic and joint replacement surgeon at Kokilaben Dhirubhai Ambani Hospital in Mumbai.
Anterior knee pain is mostly caused by chondromalacia, a condition characterised by the softening of the cartilage over time, which medical experts say is partly reversible. Other causes may include varying stages of arthritis, particularly in middle-aged and elderly individuals who struggle to carry out basic activities without pain. Additionally, muscle weakness, imbalance, and morbid obesity can contribute to knee pain, as many patients with such issues find it challenging to exercise, leading to muscle weakness. Excess weight places additional pressure on the knees, accelerating the onset of arthritis.
“Knee pain in office settings often stems from prolonged sitting, improper chair height, inadequate leg support, and lack of movement. Poor ergonomics — like chairs without proper support or workstations set too high or low — can cause unnatural knee positioning and strain on the joint. Over time, this strain can lead to muscle tightness, reduced circulation, and knee discomfort, especially when knees are bent for long hours without breaks,” explains Dr Ashwani Maichand, director, department of orthopaedics at CK Birla Hospital in Delhi.
Other rare causes of knee pain include inflammatory arthritis, infections of the knee and surrounding tissues, and previous injuries, such as trauma or fractures, which may later manifest as knee pain and stiffness. “Age-related wear and tear on the knee joint, including arthritis, is the cause of many knee issues. Other causes could be strain or injury that stresses the knee and can cause other knee issues,” says Dr Deepak Kumar Mishra, director and head of orthopaedics at Asian Hospital in Faridabad.
Dealing with it
Medical experts focus on prevention and treatment to take care of knee problems. Most of the time, lifestyle modifications, varying levels of exercise according to age and specific knee issues, and nutritional supplementation are key. This commonly includes appropriate doses of calcium, vitamin D, and B12, along with a high-protein diet for those without contraindications.
Once someone is diagnosed with a knee issue, treatment can involve lifestyle modifications, regular physiotherapy, and home exercises. In a few cases, medication and additional
physiotherapy support may be required to begin with.
Regular exercises for the muscles around the knee are essential, along with participation in physical activities like brisk walking, running, athletics, or yoga, which can improve muscle tone.
If these measures are ineffective, or if you are already experiencing knee pain of varying degrees, you can use ice packs for acute conditions and heat therapy for chronic issues lasting more than six weeks. Regular ice or heat therapies can provide relief.
Additionally, oil massages with gentle application can also help alleviate different types of knee problems.
“If you are prone to knee pain at work, make sure you ice it at night and keep it elevated in the evenings. Popping your leg up on a cushion while relaxing is very comforting for your tired knees,” advises Dr Joshi of Kokilaben Hospital. If your job is at the desk for a long time, make sure you take some time after work to get some physical activity to keep your muscles, ligaments and joints in healthy working order, he further says.
Medications, including anti-inflammatory drugs, muscle relaxants, and supplements of calcium, vitamin D, and vitamin B12, can significantly aid recovery from knee issues. For those suffering from knee arthritis, cartilage-regeneration medicines like glucosamine can also be beneficial in treatment, doctors say.
WARNING SIGNS
- Stiffness and swelling can be brought about by overuse, trauma, or injury
- If you hear popping or clicking sounds, it is time to see a doctor
- Lack of strength, sensation of weakness, or feeling unstable while standing
- Difficulty or pain while walking; if your knee hurts, do not brush it off
- In advanced stages of arthritis, you might complain of knee joint deformity, such as bowing of legs
- Difficulty in full knee extension or bending your knee
- Difficulty climbing stairs or sitting on the ground
TAKE CARE
- Use proper ergonomics like aligning furniture in the correct position and height
- Adjust your chair to keep knees at 90-degree angle with feet flat on the floor
- Take short breaks every hour to stand, stretch, or walk to relieve pressure on knees
- Ensure you are wearing proper footwear
- Increase your level of activity, engage in regular exercise to maintain tone of knee muscles
- Include back-strengthening exercises, as back strength can indirectly affect knee issues
- Make sure to get up and stretch every hour
- Keep your knee elevated in evenings, ice it at night if you are prone to knee pain
- Eat a healthy diet rich in fruits, veggies, protein, calcium, and vitamins
- Control your intake of sugar, sodium, refined carbs, and fried food
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