Knee Osteoarthritis Could Affect 6.5 Million Americans by 2020

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November 28, 2014 | 111,038 views

Story at-a-glance

  • By 2020, nearly 6.5 million Americans between the ages of 35 and 84 are expected to be diagnosed with knee osteoarthritis
  • Osteoarthritis occurs about twice as often in women as in men, and wearing high-heeled shoes may be a primary reason
  • Exercises to help you lose weight and build your quadriceps muscles are especially helpful for preventing and relieving knee pain

By Dr. Mercola

By 2020, nearly 6.5 million Americans between the ages of 35 and 84 are expected to be diagnosed with knee osteoarthritis. More than half of the new cases will appear in people as young as 45 to 64 years, and by 2020 the average age of diagnosis is expected to fall from 72 to 55.1

Why are so many young people suffering from this painful degenerative joint disease, which has historically been associated with wear-and-tear and joint deterioration that occurs over a lifetime?

Rising rates of overweight and obesity likely play a role. Arthritis rates are more than twice as high in obese people as those who are normal weight, because the extra weight puts more pressure on your joints, as well as increases inflammation in your body.

This not only leads to osteoarthritis, it can also make joint pain from any cause exponentially worse. Another clue as to why knee osteoarthritis is on the rise? It occurs about twice as often in women as in men. This is partly due to anatomy – women tend to have wider hips, which adds stress to your knees.2 Another contributor, however, is women’s footwear, specifically high-heeled shoes.

High-Heel Shoes Increase Stress on Knee Joints Up to 90 Percent

It’s estimated that one in 10 women wear high heels at least three days a week, and up to one-third of women suffer from permanent problems as a result of prolonged wear.3 

High heels (generally described as a heel height of two inches or higher) shift your foot forward into an unnatural position with increased weight on your toes. Your body tilts forward, so you lean backwards and overarch your back to compensate. 

This posture changes the dynamics of human walking significantly and adds tremendous strain to your hips, lower back, and your knees. When researchers analyzed how walking on high heels changes muscle activity and walking stance, their results were quite concerning:4

The results indicate a large increase in bone-on-bone forces in the knee joint directly caused by the increased knee joint extensor moment during high-heeled walking, which may explain the observed higher incidence of osteoarthritis in the knee joint in women as compared with men.”

Additionally, according to research from the University of Southern California, wearing 3.75-inch heels may increase stress on your knee joints by up to 90 percent compared to wearing a half-inch heel!5

Separate research also concluded, “The altered forces at the knee caused by walking in high heels may predispose to degenerative changes in the joint.”6

Generally, the higher the heel the more stress it places on your knee joints, however, even shoes with moderately high heels (1.5 inch) “significantly increase knee torques” that may contribute to the development and progression of knee osteoarthritis.7

Furthermore, it doesn’t matter if the heel is a stiletto or a wedge… both wide-heeled and narrow-heeled shoes increase pressure on your knees in the places were degenerative joint changes often occur.8 So one of the easiest changes you can make to avoid knee pain is to wear appropriate footwear for all of your daily activities.

Opt for comfort over style, and if you do wear high-heeled shoes, reserve them for occasions that don’t involve extended periods of walking and standing. Ideally, bring them with you to a special event, put them on when you get there, and then change into your more comfortable shoes when you leave.

Movement and Exercise Are Essential for Preventing Knee Pain

Research from Northwestern University School of Medicine found that over 40 percent of men and 56 percent of women with knee osteoarthritis were inactive, which means they did not engage in even one 10-minute period of moderate-to-vigorous activity all week.9

This is unfortunate because the notion that exercise is detrimental to your joints is a misconception. There is no evidence to support this belief. Instead, the evidence points to exercise having a positive impact on joint tissues. It can also improve bone density and joint function, which can help prevent and alleviate osteoarthritis as you age.

And if you exercise sufficiently to lose weight, or maintain an ideal weight, you can in fact reduce your risk of developing joint pain due to osteoarthritis rather than increase your risk. As Harvard Health Publications stated:10

"Each pound you lose reduces knee pressure in every step you take. One study found that the risk of developing osteoarthritis dropped 50% with each 11-pound weight loss among younger obese women.11

If older men lost enough weight to shift from an obese classification to just overweight… the researchers estimated knee osteoarthritis would decrease by a fifth. For older women, that shift would cut knee osteoarthritis by a third."

Build Your Quads and Other Tips for Reducing Knee Pain with Exercise


Effective exercise such as taking 7,000-10,000 steps a day, high-intensity interval training (HIIT), weight training, stretching, and core work all have a place in improve the health of your joints. Such exercises help prevent and relieve joint pain through a number of mechanisms, including strengthening key supportive muscles and improving flexibility and range of motion.

This is important, as the pain of osteoarthritis has a tendency to lead to decreased activity, which in turn promotes muscle weakness, joint contractures, and loss of range of motion. This, in turn, can lead to more pain and loss of function, and even less activity. Exercise can help you to break free from this devastating cycle and prevent knee pain in the first place.

Specifically, building your quadriceps is especially important. People with knee osteoarthritis who have greater quadriceps strength report less knee pain and better physical function.12 If you've already developed osteoarthritis in your knees, you'll want to incorporate exercises that strengthen your quadriceps muscle at the front of your thigh. And, rather than running and other high-impact activities, you may be better off with non-weight-bearing exercises like swimming and cycling.

Strengthening and stretching the areas around, above, and below your knee is key to reducing most knee pain, which is the goal of the exercises demonstrated in the video above. I recommend a qualified physiotherapist to properly assist you with your exercises to avoid injury.

Eat Your Way to Healthier Knees?

Diet doesn’t usually come to mind when you think about knee pain… but it should. Eating a whole-foods-based diet, like the one described in my nutrition plan, will reduce inflammation in your body and may even be beneficial for cartilage. Broccoli, for instance, appears to be particularly useful for the prevention and treatment of osteoarthritis. As reported by BBC News:13

"Eating lots of broccoli may slow down and even prevent osteoarthritis, according to a team of researchers at the University of East Anglia who are starting human trials following on from successful lab studies.14 Tests on cells and mice showed that a broccoli compound, sulforaphane -- which humans can also get from Brussels sprouts and cabbage -- blocked a key destructive enzyme that damages cartilage."

According to lead researcher Ian Clark, the results are "very promising," as they've shown that sulforaphane works in each of the three laboratory models they've tried so far—in human and cow cartilage cells, tissue, and live mice. Sulforaphane, which is known for its anti-inflammatory and anti-cancer benefits, can also be found in other cruciferous vegetables, such as Brussels sprouts, cauliflower, and cabbage. Broccoli, however, is one of the richest sources of this potent compound, and broccoli sprouts appear to be one of the richest sources of all.

Before Surgery, Seriously Consider Ozone Therapy


I recently interviewed Dr. Robert Rowen for his work on ozone and treating Ebola in Africa. He is one of the leading ozone physicians in the US and has successfully treated many patients with ozone therapy as an alternative to surgical intervention. If the ozone treatment fails, there is no harm and one can always have surgery, but if you have surgery and it fails, the surgery may cause irreversible damage.

Natural Remedies for Growing Healthy Cartilage and Relieving Pain

For joint pain, many physicians commonly recommend anti-inflammatory drugs (non-steroidal anti-inflammatory drugs or NSAIDs) and analgesics (such as Tylenol) to their osteoarthritis patients. I don't recommend the chronic use of these drugs due to significant side effects, which may include kidney and/or liver damage. There are safer and more effective natural options for relieving joint pain. Although popular, I am also not much of a glucosamine and chondroitin fan because studies have failed to demonstrate their effectiveness. However, there are some very effective natural remedies that are truly backed up by science. The following are my favorites:

  • Vitamin D: Cartilage loss in your knees, one of the hallmarks of osteoarthritis, is associated with low levels of vitamin D. So if you're struggling with joint pain due to osteoarthritis, get your vitamin D level tested, then optimize it using appropriate sun exposure or a high-quality tanning bed. If neither of these options is available, you may want to consider oral vitamin D3 and vitamin K2 supplements.
  • Sun exposure is your best option, because your skin produces two types of sulfur in response to sun exposure: cholesterol sulfate and vitamin D3 sulfate. Sulfur plays a vital role in the structure and biological activity of both proteins and enzymes. If you don't have sufficient sulfur in your body, this deficiency can create a number of health problems, including negative impacts on your joints and connective tissue. Which brings us to the next item...

  • Sulfur/Epsom salt soaks/MSM: In addition to making sure you're getting ample amounts of sulfur-rich foods in your diet, such as organic and/or grass-fed/pastured beef and poultry, Dr. Stephanie Seneff, a senior scientist at MIT, recommends soaking your body in magnesium sulfate (Epsom salt) baths to counteract sulfur deficiency. She uses about 1/4 cup in a tub of water, twice a week.
  • It's particularly useful if you have joint problems or arthritis. Methylsulfonylmethane (known as MSM) is another alternative you might find helpful. MSM is an organic form of sulfur and a potent antioxidant naturally found in many plants. It is available in supplement form. For more on the benefits of MSM, I recommend listening to this interview.


  • Infrared laser: Infraredlaser treatment (also called K-Laser) is a relatively new type of therapy that speeds healing by increasing tissue oxygenation and allowing injured cells to absorb photons of light. This special type of laser has positive affects on muscles, ligaments and even bones, so it can be used to speed the healing of traumatic injuries, as well as chronic problems like arthritis of the knee.
  • Astaxanthin: An antioxidant that affects a wide range of inflammation mediators, but in a gentler, less concentrated manner and without the negative side effects of steroidal and NSAID drugs. Astaxanthin significantly reduces inflammation in many people—in one study, more than 80 percent of arthritis sufferers improved.15
  • Eggshell membrane: The eggshell membrane is the unique protective barrier between the egg white and the mineralized eggshell. The membrane contains elastin, a protein that supports cartilage health, and collagen, a fibrous protein that supports cartilage and connective tissue strength and elasticity. Eggshell membrane also contains transforming growth factor-B, a protein that helps with tissue rejuvenation, in addition to other amino acids and structural components that provide your joints with the building blocks they need to build cartilage.
  • Hyaluronic acid (HA): Hyaluronic acid is a key component of cartilage required for moving nutrients into and waste out of your cells. One of HA's most important biological functions is the retention of water. Unfortunately, as you age your body produces less and less HA. Oral HA supplementation may improve your joint cushioning in just two to four months.
  • Grounding, or walking barefoot on the earth, may also provide a certain measure of pain relief due to its potent antioxidant effect that combats inflammation.
  • Boswellia: Also known as boswellin or "Indian frankincense," I've found this Indian herb to be particularly useful in treating the pain and inflammation of osteoarthritis. With sustained use, boswellia may improve the blood flow to your joints, which may boost their strength and flexibility.
  • Turmeric/curcumin: A study in the Journal of Alternative and Complementary Medicine found that taking turmeric extracts each day for six weeks was just as effective as ibuprofen for relieving knee osteoarthritis pain.16 This is most likely related to the anti-inflammatory effects of curcumin—the pigment that gives turmeric its vibrant yellow color.
  • Animal-based omega-3 fats: Omega-3 fats are excellent for arthritis because they are well known for reducing inflammation. Look for a high-quality, animal-based source such as krill oil.

Read This if You’re Considering Knee Surgery

Arthroscopic knee surgery is one of the most common unnecessary surgeries performed today. It has been shown to be no better than placebo surgery, and physical therapy and exercise have repeatedly been shown to be just as effective as surgery, and perhaps even more so in some cases. So please, carefully weigh your options before consenting to this procedure. Time and time again, researchers have concluded that the real knee surgeries offered no better outcomes than the sham surgeries.17

[+]Sources and References [-]Sources and References

  • 1 American College of Rheumatology 2011 Press Release
  • 2 Huffington Post November 17, 2014
  • 3  American Osteopathic Association, The Real Harm in High Heels
  • 4 J Appl Biomech. 2012 Feb;28(1):20-8.
  • 5 Gait & Posture June 2012, Volume 36, Issue 2, Pages 271-275
  • 6 Lancet. 1998 May 9;351(9113):1399-401.
  • 7 Arch Phys Med Rehabil. 2005 May;86(5):871-5.
  • 8 Lancet. 2001 Apr 7;357(9262):1097-8.
  • 9 Arthritis Rheum. 2011 Nov;63(11):3372-82.
  • 10 Harvard Healthbeat January 25, 2014
  • 11 Ann Intern Med. 1992 Apr 1;116(7):535-9.
  • 12 Arthritis & Rheumatism January 2009, Vol. 60, No. 1, pp 189-198
  • 13 BBC News August 28, 2013
  • 14 Arthritis & Rheumatism 2013 Aug 27 [Epub ahead of print]
  • 15 Trends in Biotechnology. May 2003
  • 16 J Altern Complement Med. August 2009
  • 17 NEJM December 26, 2013