How can we halt it? Anyone concerned by OA knee pain should first get a diagnosis to establish the state of the joint and, if it is OA, how much cartilage is left. When it comes to self-management, it won’t be possible to reverse, but there are steps that might prevent further deterioration and certainly control symptoms. “If you get it right, you might be able to get through all your active life with a little bit of pain but avoiding surgery,” says David Vaux, the head of therapies and exercise at Arthritis Action and author of Stronger. “If you get it wrong, and especially if you do too much, you potentially accelerate your journey towards a knee replacement.” So what might help?

The best supplements for knee pain

Turmeric

“Turmeric is a natural anti-inflammatory,” says Tibrewal. “I tell my patients to take it and for some, it really works.” Curcumin, one of its active components, has anti-inflammatory properties similar to that of non-steroidal anti-inflammatories and a BMJ review of studies of turmeric or curcumin on knee OA found that all recorded improvements in pain and function.

Glucosamine

“This plays a role in building cartilage and might delay it’s breakdown,” says Tibrewal. “Again, not everybody is going to feel a benefit, but some do.” While some research has found that glucosamine reduces OA knee pain, other studies showed little improvement.

Chondroitin

“This can nourish the joint and improve cartilage health,” Tibrewal explains. According to the charity Versus Arthritis, chondroitin has been tested in more than 20 randomised controlled trials and many have shown significant clinical benefits in pain reduction. Although, again, evidence is mixed.

Vitamin D

“Vitamin D supplements are important for general bone health,” notes Tibrewal. It may also have anti-inflammatory effects and help maintain the immune system.

Get the right footwear

“Your knee is affected by everything around it,” says Tibrewal. “The ankles, hips, back and spine all feed into it. It’s one whole chain and little imbalances anywhere can affect the knee. People who are flat-footed, or have an incorrect gait, for example will get good symptom relief by addressing that.”

A doctor, occupational therapist, physiotherapist or podiatrist can all give advice here. For those with advanced knee arthritis, Nice guidelines recommend Apos, a foot worn device which looks like a trainer and redistributes pressure in order to reduce pain. (It’s also available privately, often covered by medical insurance.) “Insoles can make a big difference,” says Tibrewal. “I also use a lot of knee bracing. For people who have a lot of wear in one part of the knee, special braces can push the leg straight and take away the pressure.”

Finding the correct footwear is essential. Shoes should have thick soles, enough toe room, and good arch support. “There should be enough cushioning to reduce the impact when you walk,” says Vaux.

Listen to your knees

“Exercise is so important to strengthen the joint but if you feel pain doing something, it’s a request for change,” says Vaux. “Either you did it for too long or it’s the wrong exercise for you. Anyone with OA needs to listen to their body and pace themselves far more than the person on the next treadmill or climbing the escalator in front of you who doesn’t have OA. It’s not fair but it’s important to understand that. Exercise, like medicine, requires the correct dose and for that, you need a diagnosis first, and then a schedule where you ‘train clever’, not hard, doing less exercises but precise ones. We need a little bit of impact for strong bodies, but prolonged impact is detrimental.”