What causes knee pain and stiffness in old people, and what can be done about it?

Knee pain and stiffness in older adults are common issues, often resulting from a combination of age-related changes, wear and tear, and underlying conditions. Here’s a breakdown of the causes and potential remedies:

Causes of Knee Pain and Stiffness in Older People

1. Osteoarthritis (OA):

The most frequent culprit. As people age, the cartilage in the knee joint wears down, leading to bone-on-bone contact, inflammation, and stiffness. This degenerative condition often worsens with time and use.

2. Rheumatoid Arthritis (RA):

An autoimmune disorder that can affect older adults, causing joint inflammation, pain, and stiffness. Unlike OA, RA often involves multiple joints and may flare up unpredictably.

3. Tendinitis or Bursitis:

Overuse or irritation of tendons (tendinitis) or bursae (small fluid-filled sacs that reduce friction) can lead to pain and limited movement, especially if repetitive activities or injuries are part of the person’s history.

4. Meniscus Tears:

The meniscus, a cartilage cushion in the knee, can tear or degenerate over time, causing pain, swelling, and stiffness. In older adults, even minor stress can exacerbate this due to reduced tissue resilience.

5. Loss of Muscle Strength and Flexibility:

Aging often brings sarcopenia (muscle loss), weakening the quadriceps and hamstrings that support the knee. Reduced flexibility in surrounding tissues can also stiffen the joint.

6. Obesity:

Extra body weight puts significant stress on the knees, accelerating cartilage breakdown and worsening pain or stiffness.

7. Previous Injuries:

Old fractures, ligament tears (e.g., ACL injuries), or dislocations can resurface as pain or instability years later, especially as joint integrity declines.

8. Gout or Pseudogout:

Crystal deposits in the joint (uric acid in gout, calcium pyrophosphate in pseudogout) can cause sudden, severe pain and stiffness, more common in older age due to metabolic changes.

Reduced Synovial Fluid:

9. With age, the production of synovial fluid (which lubricates joints) may decrease, leading to friction, stiffness, and discomfort.