Is My Knee Pain Arthritis or a Torn Meniscus?

Knee osteoarthritis and knee meniscus tear are distinct conditions that cause pain and swelling in the knee joint. ¹ Hsu H, Siwiec RM. Knee Osteoarthritis. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507884/ ^{, 2} Bhan K. Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus. 2020;12(6):e8590. Published 2020 Jun 13. doi:10.7759/cureus.8590

Knee osteoarthritis affects the entire knee joint, while a meniscal tear is limited to the cartilaginous tissue that lines the joint surfaces of the knee. Both conditions affect about 10-16% of the population. ³ Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2020;29-30:100587. Published 2020 Nov 26. doi:10.1016/j.eclinm.2020.100587 ^{, 4} Luvsannyam E, Jain MS, Leitao AR, Maikawa N, Leitao AE. Meniscus Tear: Pathology, Incidence, and Management. Cureus. 2022;14(5):e25121. Published 2022 May 18. doi:10.7759/cureus.25121

Understanding the difference between knee osteoarthritis and meniscus tear

Differentiating between osteoarthritis and meniscus tear in the knee is often confusing due to their overlapping symptoms and signs. Here are the key differences between the two conditions.

Knee osteoarthritis 

Knee osteoarthritis is a complex condition involving the gradual degeneration of the articular cartilage that lines the knee joint and enables smooth movements at the knee. The degeneration of the articular cartilage leads to increased friction and inflammation of the knee joint. ¹ Hsu H, Siwiec RM. Knee Osteoarthritis. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507884/

Read more about Knee Osteoarthritis on Arthritis-health.com

Over time, osteoarthritis affects the entire joint and causes the degeneration of other structures, including the joint capsule, menisci, and tendons. 

Osteoarthritis occurs due to age-related wear and tear and is more common in females and individuals over 40 years of age. ⁵ Hame SL, Alexander RA. Knee osteoarthritis in women. Curr Rev Musculoskelet Med. 2013;6(2):182-187. doi:10.1007/s12178-013-9164-0 Osteoarthritis can also occur due to birth defects leading to the abnormal position of the bones in the knee joint or a chronic trauma that does not heal properly. 

Meniscal tear 

Meniscal tear is generally restricted to the meniscus tissue that lubricates and serves as a shock absorber at the knee joint. 

Meniscal tears causing knee pain are generally observed after an offending incident, such as: 

• Forceful twisting of the knee 
• A rapid change in the direction 
• A direct injury to the knee
• Lifting heavy weights

Around 80% of knee meniscal tears occur in men, and young athletes, especially those who play soccer, football, or basketball, are more likely to experience this injury. ² Bhan K. Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus. 2020;12(6):e8590. Published 2020 Jun 13. doi:10.7759/cureus.8590  Meniscal tears also arise from the gradual breakdown of the tissue due to normal wear and tear. 

See Causes of Meniscal Tears

Shared symptoms of knee osteoarthritis and meniscus tear

Knee osteoarthritis and torn meniscus tend to cause certain symptoms that are similar, which typically include:

• Pain in the knee joint that usually worsens with activity
• Swelling at the joint 
• Knee instability and weakness often result in the knee buckling during weight-bearing activities on the affected knee
• Knee stiffness and a decreased range of motion

These overlapping symptoms are often a source of confusion, leading people to incorrectly self-diagnose or delay treatments.

How to differentiate between knee osteoarthritis and meniscus tear

The key differences between knee osteoarthritis and a torn meniscus include the onset, sensation, and recurrence of pain. ¹ Hsu H, Siwiec RM. Knee Osteoarthritis. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507884/ ^{, 2} Bhan K. Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus. 2020;12(6):e8590. Published 2020 Jun 13. doi:10.7759/cureus.8590 ^{, 6} Raj MA, Bubnis MA. Knee Meniscal Tears. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431067/

The severity and location of the underlying condition also dictate the intensity of pain and other symptoms.

Read more about Symptoms of Meniscal Tears

Next steps: Managing knee osteoarthritis and meniscus tear

The next steps for addressing knee osteoarthritis and a knee meniscus tear involve a comprehensive approach to treatment. An orthopedic specialist helps diagnose and treat arthritis-related pain in the knee, and an orthopedic surgeon or physiatrist helps manage pain from a meniscal tear. 

For knee osteoarthritis, focusing on pain management, low-impact exercises to strengthen the surrounding muscles, and potentially exploring medications or injections under medical guidance are crucial.

Read more about Knee Osteoarthritis Treatment on Arthritis-health.com

In the case of symptomatic meniscus tear, surgical intervention is generally considered.

See Meniscal Tear Treatment Options

Consulting with a medical professional to create a tailored plan is essential for the best outcomes in both conditions.