Treatment Goals: Manage Pain And Improve Function
Osteoarthritis treatment plans often include exercise, rest and joint care, pain relief, weight control, medicines, surgery, and complementary treatment approaches. Current treatments for osteoarthritis can relieve symptoms such as pain and disability, but there are no treatments that can cure the condition.
Although health care professionals can prescribe or recommend treatments to help you manage your arthritis, the real key to living well with the disease is you. Research shows that people with osteoarthritis who take part in their own care report less pain and make fewer doctor visits. They also enjoy a better quality of life.
Key Points To Remember
- The decision you and your doctor make depends on your age, health, and activity level, and on how much pain and disability you have.
- Most people have knee replacement only when they can no longer control arthritis pain with medicine and other treatments and when the pain really interferes with their lives.
- Rehabilitation after knee replacement requires daily exercises for several weeks.
- Most knee replacements last for at least 10 years. Some people need to have the knee replaced again.
- If you wait so long to have a knee replacement that you have already lost much of your strength, endurance, and ability to be active, then after the surgery you might have a harder time returning to your normal activities.
Torn Anterior Cruciate Ligament
You hear a pop and cant move after you suddenly change direction often while playing soccer, football, or basketball. You may have torn your ACL, which connects the femur and the tibia and prevents the tibia from moving too far forward. Your knee will hurt and swell and feel unstable.
You can tear or strain any of the tissues that hold your knee together: Ligaments connect bones to each other tendons connect muscle to bone. Irritated tendons from using them too much? Thats tendinitis.
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Physical Therapy Guide To Osteoarthritis Of The Knee
Osteoarthritis of the knee is the inflammation and wearing away of the cartilage on the bones that form the knee joint . The diagnosis of knee OA is based on 2 primary findings: radiographic evidence of changes in bone health , and an individualâs symptoms . Approximately 14 million people in the United States have symptomatic knee OA. Although more common in older adults, 2 million of the 14 million people with symptomatic knee OA were younger than 45 when diagnosed, and more than half were younger than 65. Physical therapists treat knee OA to reduce pain and improve range of motion.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
Knowing If You Have Arthritis Of The Knee
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I Have Knee Arthritis: Is Surgery My Only Option
According to the Centers for Disease Control and Prevention , arthritis affects 23% of all adults, making the condition one of the most common ailments affecting older Americans. If youre living with arthritis, you know how debilitating it can be.
To learn more about knee arthritis, we spoke with , MD, an orthopedic surgeon with Banner Health Clinic in Glendale, AZ, who sees many patients affected by the condition.
Arthritis of the knee falls into one of two general categories: inflammatory or degenerative, explained Dr. Rosen. Inflammatory arthritis is systemic, meaning it can affect your whole body and target organs within your body, one of which is your knee. Examples of inflammatory arthritis include rheumatoid arthritis, lupus and arthritis associated with psoriasis.
Degenerative arthritis is localized to primarily a specific joint and is a wear and tear phenomenon that we all experience as we age, said Dr. Rosen. If you have degenerative arthritis of the knee, things that can worsen your arthritis include smoking, obesity and trauma to the knee, like a damaged cartilage or ligament. Osteoarthritis is the most common type of degenerative arthritis.
Treating Spinal Osteoarthritis May Take A Combination Of Therapies
Talk with your doctor about your neck and/or back pain to make sure your diagnosis is accurate and current. Remember that certain types of back problems are degenerative, meaning they may change, improve, or worsen with time. Management of your spinal arthritis pain may involve more than 1 medication or therapy. You have choices, and your doctor can work with you to find the right drug or combination of medications and therapies to ease your spinal osteoarthritis symptoms.
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How Is Bone Spur Of Knee Diagnosed
Bone Spurs of Knee may be diagnosed by the following observations and tests:
- A complete physical examination with thorough evaluation of medical history
- X-ray of the knee: X-rays are noninvasive medical tests that use radiation to produce images of the bone
- Computerized tomography scan of the knee: A CT scan takes a series of X-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues with the body
- Magnetic resonance imaging scan of the knee: An MRI is a more detailed scan that uses radio waves and a magnetic field that generates thorough images of interior bones and soft tissues
- Electromyography : An EMG shows the electrical activity of the muscle during rest and muscle contraction. This test may be performed if the signs and symptoms indicate that there is muscle or nerve damage
- Nerve conduction velocity studies: Nerve conduction velocity shows the speed at which electrical signals move through the affected nerve. Slow nerve signal speed may indicate nerve damage
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
Coping With Low Mood And Sleep Problems
You might find that osteoarthritis of the knee makes you feel depressed or anxious. Speak to your doctor if youre feeling low as they may be able to recommend psychological therapies to help you, such as cognitive behavioural therapy and stress-relieving techniques.
If your sleep is disturbed because of osteoarthritis of the knee, this could make your pain feel worse. However, there are things you can do for yourself that might help, such as:
- Keep a sleep diary to work out if there are any patterns to your sleep problems
- Sleep at regular times to get your body into a routine
- Avoid phones and other screens in the bedroom to help you wind down before bed.
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What Is Moderate Physical Activity
Physical activity is considered moderate if you can easily have a conversation while doing it. Common types of moderate physical activity are walking, biking, and swimming, but youre not limited to these activities. If it gets your heart rate up, it counts:
- Yardwork, like raking or trimming shrubs
- Household chores, such as vacuuming
- Walking your dog
- Playing with your children or grandchildren
Is Knee Pain Due To Gout Or Something Else
Most people with gout in the knee experience intense pain during a gout attack. Swelling may also be noticeable during an active flare, as well as redness and warmth.
The pain may develop in the night and hurt continuously for up to two weeks before the flare subsides, with the most intense pain in the first 24 hours. But if gout is not treated, typically with medication to lower uric acid levels, gout flares will recur and over time and affect more joints, including the knee.
Doctors cant say for sure why gout flares occur more often at night but, according to a 2015 study, it might be because your body temperature goes down at night, which could make uric acid more likely to crystallize.
Although the pain of a gout attack is distinct, there may be other reasons for your knee pain you should be aware of.
Your knee pain could be caused by buildup of different kinds of crystals called calcium pyrophosphate . Doctors can examine fluid in your inflamed knee to determine if the crystals are uric acid or calcium pyrophosphate.
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What Does The Procedure Involve
You can usually receive a knee injection in your doctors office. The procedure only takes a few minutes.
Youll be seated during the procedure, and your doctor will position your knee. They may use ultrasound to help guide the needle to the best location.
Your doctor will:
- clean the skin on your knee and treat it with a local anesthetic
- insert the needle into your joint, which might cause some discomfort
- inject the medication into your joint
Though you may feel some discomfort, the procedure is rarely painful if your doctor has experience administering this type of injection.
In some cases, your healthcare provider may remove a small amount of joint fluid to reduce pressure.
Theyll insert a needle attached to a syringe into the knee joint. Then, theyll draw out the fluid into the syringe and remove the needle.
After removing the fluid, the doctor can use the same puncture site to inject the medication into the joint.
Finally, theyll place a small dressing over the injection site.
What Causes Osteoarthritis
Osteoarthritis is a complex disease and is still the focus of much research. Approximately 80% of adults aged 55 and over show evidence of OA on their X-rays, according to the Cleveland Clinic. Evidence is growing for the role of systemic factors, such as genetics, diet, hormones, and bone density as well as more acute factors like obesity, muscle weakness, and overuse of joints.
Scientists believe the cause of OA can also depend on which part of the body is involved. For example, OA in the hands or hips may be due to genetic factors. OA in the knees can be linked with being overweight or having past injuries. Overuse can also cause OA in joints, especially in the case of long-term occupations which require repetitive movements.
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Use Splints And Supports
Wearing splints can often help to ease the strain or pain in your joints. There are two types of hand and wrist splints.
- Working splints provide more flexible support to help reduce pain while youre working.
- Resting splints consist of a custom-made cradle with straps to hold it in place. These can help if you have pain at night which affects your sleep or if you need to rest your hands for a short time during the day.
Some people find that compression gloves are also helpful in reducing pain and swelling and are easier to wear. These can be worn day or night, when working or resting.
A hand therapist can explore the options with you.
Stock Your Pantry With Healthy Foods
One of the things Ive discovered that makes a huge difference in how I feel is what I eat, Michelle says. Avoiding sugar, gluten, and processed foods really reduces the amount of inflammation and flare-ups I have its really hard but its worth it. This is something she wishes shed started the day she got diagnosed, instead of taking years to figure it out. Now she says she tells others who are being tested for arthritis that step one should be to go home and clear all the crap out of your pantry and stock up on fruits and vegetables. Learning how to make a healthy smoothie that satisfies her sweet tooth while still giving her a healthy boost of fresh produce has been a gamechanger, she says.
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Use Ice And Heat Therapy
Ice is mother natures anti-inflammatory, says Darwin Chen, MD, an orthopedic surgeon specializing in joint replacement surgery of the hip and knee and an associate professor of orthopedics at the Icahn School of Medicine at Mount Sinai in New York City.
Ice can be good at the end of a long day if your knee becomes inflamed, he says, whereas heat is good for warming up your knee in preparation for an activity. Never apply ice directly to your skin always place a towel on your skin before applying the ice to your knee.
What Are The Treatments For Arthritic Knee Pain
After determining that your knee pain is, in fact, caused by arthritis, Dr. Williams and the caring staff at Interventional Orthopedics of Atlanta will recommend an appropriate treatment plan to help you as quickly and reliably as possible. Some of the most widely known and used treatments for arthritis and arthritic knee pain include:
- Knee injections
- Fluid drainage
- Weight loss
- Physical therapy
In addition to these methods, Dr. Williams is proud to offer the breakthrough Regenexx family of nonsurgical treatments, which are designed to use a patients own stem cells to treat common and degenerative conditions without the need for going under the knife. While there are certainly some cases in which surgery may be unavoidable, Regenexx treatment has proven to be highly beneficial for chronic pain relief caused by a large number of conditions.
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Injections Are Another Low
If other strategies dont provide enough relief, injection therapy is an option with low risk.
A corticosteroid injection involves delivering this anti-inflammatory drug directly to the knee. The benefits are typically short lived. But it varies from person to person. I tell my patients the pain relief can last anywhere from a week to a year, says Dr. Day. One cautionary note with corticosteroids is the potential to increase blood sugar, which is a concern for people with uncontrolled diabetes.
For a possibly longer lasting effect, an injection of hyaluronic acid can be tried. Hyaluronic acid is a substance that healthy joints have a lot of and arthritic knees dont, says Dr. Day. It takes longer to start working than a corticosteroid injection, but the effect often lasts six months to a year.
Currently, research is being done on the effectiveness of platelet-rich plasma , which is not yet covered by insurance. PRP involves drawing some blood, spinning it in a centrifuge, and injecting part of it into the knee.
If youre not able to get your symptoms under control with a combination of these measures, she says, it could be time to talk to your doctor about surgery.
This article originally appeared in Cleveland Clinic Arthritis Advisor.
Treating Arthritis Of The Knee
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How To Use Pain Medications Properly
There are two types of over-the-counter pain medications that can be used for osteoarthritis. Acetaminophen is a pain reliever but not an anti-inflammatory. It may help with mild knee pain.
NSAIDs can be more effective because they both relieve pain and reduce inflammation. However, they come with potential side effects and risks. NSAIDs can irritate the lining of the stomach, which may lead to an ulcer or other stomach problems. They also can impair kidney function. Some NSAIDs can increase blood pressure. And theyve been linked to an increased risk for heart disease.
Because of the risks, Dr. Day cautions against using NSAIDs regularly over long periods of time. Instead, she uses NSAIDs for her patients in two ways. First, people who have a flare-up of pain can take them regularly for three to five days and then stop. Second, they can be used over the long term, but only occasionally, maybe a couple of times a week as needed.
If youre taking NSAIDs several times a day for long periods of time, Dr. Day advises reducing their use by maximizing the other treatment strategies. She also suggests trying a topical NSAID, such as diclofenac , which has fewer potential side effects.
Opioid pain relievers are discouraged for long-term treatment of chronic knee pain. The milder narcotic tramadol might be appropriate for occasional use in some people, says Dr. Day.