My knees are stiff every morning and crack when I stand up. Is it arthritis?

What this pattern usually means

In osteoarthritis, the knee tends to stiffen after it has been still: first thing in the morning, after a long drive, or after sitting through a meeting or a family gathering. The stiffness typically loosens within 20 to 30 minutes of gentle movement. This short 'warm-up' stiffness is one of the features doctors look for.

Cracking or grinding (crepitus) comes from roughened joint surfaces or soft tissues moving over each other. On its own, painless cracking is very common, even in healthy knees, and is not a reason to worry. It matters more when it comes with pain, swelling or a gradual loss of bending.

When it may be something other than osteoarthritis

Morning stiffness that lasts well over an hour, affects several joints such as the hands and wrists, or comes with marked swelling and tiredness can suggest an inflammatory arthritis such as rheumatoid arthritis. That needs blood tests and often a rheumatologist.

A single sharp click with catching or locking may point to a meniscus problem, and cracking behind the kneecap on stairs can come from the joint between the kneecap and thigh bone. The history and examination usually separate these.

What you can do now

• Move before you load: a few minutes of gentle knee bending and straightening in bed or seated before you stand often eases the first steps
• Break up long sitting: stand and walk for a minute or two every half hour at work or in the car
• Strengthen the thigh and hip muscles with simple exercises such as straight leg raises and sit-to-stand from a firm chair
• Keep walking: regular, moderate walking helps the cartilage and muscles, and an air-conditioned mall or indoor track works well in the Doha summer
• Warmth helps many people, for example a warm shower in the morning

When to book a knee assessment

See a knee specialist if the stiffness is getting longer, the knee swells, you are losing the ability to fully straighten or bend it, or pain is starting to affect prayer, stairs or sleep. At Aman Hospital, Dr. Gelber examines the knee, reviews weight-bearing X-rays and explains what the findings mean and which measures are likely to help at your stage.