Q: My knee just started hurting three weeks ago out of the blue. Before that, I didn't have any pain. My doctor told me I have osteoarthritis. I thought osteoarthritis was a chronic problem. Can it happen all of a sudden? Is my doctor wrong about my diagnosis?
Osteoarthritis is indeed a chronic process. It is not a condition that just happens "all of a sudden." However, in certain situations the symptoms of osteoarthritis can occur suddenly. It is similar to cholesterol or high blood pressure causing a heart attack. High cholesterol and high blood pressure don't "feel bad." But high cholesterol and high blood pressure do lead to fatty plaque deposits in the arteries. One day, while running for a cab, the heart may need an increased amount of blood supply but the red blood cells can't get past the stiff, fatty plaques fast enough and so the heart is starved of oxygen. "All of a sudden" chest pain develops.
In a similar vein, joints tend to lose cartilage slowly over time. If a joint has lost enough cartilage, or if the cartilage has become eroded in a particular way, one day a person may move or twist in a seemingly benign way and develop a flare of pain that may seem to have come "all of a sudden, out of the blue."
Osteoarthritis could aptly be considered the silent killer of joints. Over time, without care, cartilage in joints degrades, which leads to the "wear-and-tear" of joints. In our sedentary society, our joints are suffering while we sit all day at work, commute on buses, trains, and in cars, and then sit on the couch at home. Joints require strong, flexible muscles surrounding them to take the pressure off. In addition, movement is necessary in order for joints to receive proper nourishment and have the waste products created within the joint removed.
When we are in our twenties, our joints can and generally do silently suffer a fair amount of abuse. As we age, our joints, arteries, and bodily systems have less "give" to them. The plain truth is that the sooner we start taking care of our bodies, including our joints, the longer they will last and support us as we go through our journey of life. By eating an anti-inflammatory diet and stretching and strengthening your muscles, you can go a long way toward keeping your joints healthy and strong so that you'll be dancing and playing with your grandchildren and great grandchildren, pain-free, well into your 80s and beyond.
Back to the question posed at the beginning of this blog: there are many causes of sudden knee pain. In general, knee osteoarthritis presents with a dull ache that gets slowly worse through the years. However, many people experience their osteoarthritis for the first time when they do something that is seemingly benign and develop a subsequent flare of pain. Of course, only your doctor, after a full medical history and physical examination, and possibly diagnostic imaging tests, can diagnose what is causing your individual pain.