There is now thought to be an inflammatory process involved in what we call OA. It is not simply wear and tear. There are multiple factors such as genetic, occupational and environmental considerations. It is a process which affects joint surfaces, in particular the cartilage. This can be eroded leaving bare bony surfaces connecting in the joint. Sometimes x-rays reveal severe damage but few symptoms, at other times minimal changes but severe pain. There seems to be little that can change the course of events but there are encouraging indications that suitable activity, careful weight control and pain medication can bring relief and possibly slow down the process.
Night pain is a very common symptom causing sleep disturbances. See above for advice regarding restless legs. Sometimes using a pillow under the knees gives relief but care needs to be taken not to slow down the circulation to and from the lower legs. Lying on the side with a pillow between the knees is often a help.
It seems that paracetamol is the medication of choice but must be taken as prescribed and not used according to pain. Taking it on a regulated basis keeps the pain under control with minimal doses. Otherwise, waiting till there is pain means taking a bigger dose. There is conflicting advice about supplements and it is perhaps good to consult your GP or a body such as ResearchArthritis Uk
Flexion deformity may develop in which the knee becomes stiff in a bent position and unable to completely straighten. The muscles and ligaments shorten leading to a limp unless attention is given to stretching the knee completely straight several times a day. In such a case it may not be advisable to sleep with a cushion under the knee.
Hydrotherapy is ideal for such conditions as the warm water gives relief from pain making it easier to move. Most weight is taken off the legs with the buoyancy of the water and so more vigorous exercises can be done. Swimming regularly is beneficial.
A well balanced diet combined with plenty of movement is the best and often the most economical way to curb the worsening of the condition. It seems that broccoli has a good effect on the system. Use your discretion regarding diet and supplements as adequate research is sometimes lacking. However ArthritisResearch.UK has confirmed in their autumn journal that Omega-3 fish oil in guinea pigs does slow down the progression of the disease, possibly even preventing its development.
A pillow between legs is sometimes a great help. There are web sites with adapted pillows for purchase.