How To Identify The Culprit And Which Drugs Injections And Habits Will Bring You The Most Relief
by Alison Gwinn, AARP, September 20, 2019
En español | Oh, my aching knees! If that’s your daily refrain, whether you’re walking the dog, climbing stairs or just sleeping, you’re not alone.
For many, the culprit behind that nagging soreness is osteoarthritis, which affects an estimated 31 million Americans quite often, in this particular joint according to the Arthritis Association.
But there are other common causes of knee pain, stemming from the fact that knees are our largest, most complex joints. Knee joints allow you to stand up straight, walk stairs and get up and down from sitting, says Daniel Saris, an orthopedic surgeon at the Mayo Clinic and professor of orthopedic surgery at the Mayo Medical School. But they are also the most difficult joint because they’re not stable. Hip joints and ankles are both pretty stable by themselves, but the knee is just three bones trying to be good friends, and they need muscles and ligaments for stability.”
Knee pain is not to be taken lightly. A Japanese study, published last year in the Journal of the American Geriatrics Society, found a link between the onset of knee pain in people 65 or older and depression. And a recent study from the University of North Carolina School of Medicine Thurston Arthritis Research Center and Harvard’s Brigham and Women’s Hospital found that knee pain in men and women over age 45 correlated with higher rates of death.
Watch Our Video About What Osteoarthritis Is
Osteoarthritis is a very common condition which can affect any joint in the body. Its most likely to affect the joints that bear most of our weight, such as the knees and feet. Joints that we use a lot in everyday life, such as the joints of the hand, are also commonly affected.
In a healthy joint, a coating of tough but smooth and slippery tissue, called cartilage, covers the surface of the bones and helps the bones to move freely against each other. When a joint develops osteoarthritis, part of the cartilage thins and the surface becomes rougher. This means the joint doesnt move as smoothly as it should.
When cartilage becomes worn or damaged, all the tissues within the joint become more active than normal as the body tries to repair the damage. The repair processes may change the structure of the joint, but will often allow the joint to work normally and without any pain and stiffness. Almost all of us will develop osteoarthritis in some of our joints as we get older, though we may not even be aware of it.
However, the repair processes dont always work so well and changes to the joint structure can sometimes cause or contribute to symptoms such as pain, swelling or difficulty in moving the joint normally.
For most joints, osteoarthritis is more common and more severe in women.
Whats The Difference Between Tendinitis And Bursitis
Overusing one part of your body like a baseball pitchers arm can lead to tendinitis or bursitis. Tendinitis is irritation of the tendon, a cord-like tissue that secures muscles to bones. Bursitis is inflammation of the bursa.
You may have both conditions at the same time or one or the other. Your healthcare provider can tell which one you have by the location of your pain or by viewing imaging tests.
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Risks Of The Procedure
As with any surgical procedure, complications can occur. Some possiblecomplications may include, but are not limited to, the following:
Blood clots in the legs or lungs
Loosening or wearing out of the prosthesis
Continued pain or stiffness
The replacement knee joint may become loose, be dislodged, or may not workthe way it was intended. The joint may have to be replaced again in thefuture.
Nerves or blood vessels in the area of surgery may be injured, resulting inweakness or numbness. The joint pain may not be relieved by surgery.
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your doctor prior to the procedure.
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What Is A Knee Replacement Surgery
Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure toresurface a knee damaged by arthritis. Metal and plastic parts are used tocap the ends of the bones that form the knee joint, along with the kneecap.This surgery may be considered for someone who has severe arthritis or asevere knee injury.
Various types of arthritis may affect the knee joint. Osteoarthritis, adegenerative joint disease that affects mostly middle-aged and olderadults, may cause the breakdown of joint cartilage and adjacent bone in theknees. Rheumatoid arthritis, which causes inflammation of the synovialmembrane and results in excessive synovial fluid, can lead to pain andstiffness. Traumatic arthritis, arthritis due to injury, may cause damageto the cartilage of the knee.
The goal of knee replacement surgery is to resurface the parts of the kneejoint that have been damaged and to relieve knee pain that cannot becontrolled by other treatments.
Reasons For The Procedure
Knee replacement surgery is a treatment for pain and disability in theknee. The most common condition that results in the need for kneereplacement surgery is osteoarthritis.
Osteoarthritis is characterized by the breakdown of joint cartilage.Damage to the cartilage and bones limits movement and may cause pain.People with severe degenerative joint disease may be unable to donormal activities that involve bending at the knee, such as walking orclimbing stairs, because they are painful. The knee may swell or”give-way” because the joint is not stable.
Other forms of arthritis, such as rheumatoid arthritis and arthritis thatresults from a knee injury, may also lead to degeneration of the kneejoint. In addition, fractures, torn cartilage, and/or torn ligaments maylead to irreversible damage to the knee joint.
If medical treatments are not satisfactory, knee replacement surgery may bean effective treatment. Some medical treatments for degenerative jointdisease may include, but are not limited to, the following:
Cortisone injections into the knee joint
There may be other reasons for your doctor to recommend a knee replacementsurgery.
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How Do You Spell Nee As Referring To Your Maiden Name
According to the Webster’s Collegiate English Dictionary, it’s spelled, “nee.”
CORRECTION: It is hard for me to believe that Webster’s could get this wrong for these reasons. The word is spelled née or né The accent can ONLY be omitted in limited circumstances. It is a respected dictionary. Unusually for an English word, its spelling is regulated . The online edition of the same company’s collegiate dictionary spells it correctly.
I am curious why the original requester didn’t just go to that dictionary link above.
Here’s more than anyone would ever want to know about the word.
née , né – Adjective.French.
It means “born” as in the name someone was born with. It is almost always used to introduce a woman’s original maiden surname following her married surname. In its basic meaning it is interchangeable with the English word born. For example: Hilary Clinton is equivalent to Hilary Clinton except for the following consideration:
The sole purpose of its original introduction into English usage was to convey class , suggesting that the lady might be descended from the originally French-speaking nobility in England, the land-owner class of Norman descent. That’s why it retains French rules for grammar and spelling.
The acute accent on the first ‘e’ is not optional . The second ‘e’ is the feminine form and is only for use with a female name. In all other cases it is spelled né. Examples:
What Can I Do At Home For Pain Relief
Self-care measures at home can often help relieve pain until youre fully recovered. You can:
- Elevate the injured area.
- Ice the area if sudden injury caused the pain.
- Apply heat to ongoing pain.
- Use a splint, sling or brace to keep the injured area from moving.
- Take over-the-counter medications to relieve pain and swelling, such as ibuprofen or naproxen.
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How Is Bursitis Diagnosed
Your healthcare provider will ask you questions about the pain and do a physical exam. The results may be enough for a diagnosis. If you have another bursitis flare-up or signs of infection, your provider may recommend:
- X-rays to rule out other conditions.
- Ultrasound or MRI imaging tests to detect swollen bursae.
- A blood test to look for infection.
- A sample of fluid from the bursa, if infected.
How Do I Prepare For Knee Arthroscopy
Your doctor or surgeon will advise you how to prepare for your surgery. Be sure to tell them about any prescriptions, over-the-counter medications, or supplements that youre currently taking. You may need to stop taking certain medicines, such as aspirin or ibuprofen, for weeks or days before the procedure.
You must also refrain from eating or drinking for six to 12 hours before the surgery. In some cases, your doctor may prescribe you a pain medication for any discomfort you experience after the surgery. You should fill this prescription ahead of time so that you have it ready after the procedure.
Your doctor will give you an anesthetic before your knee arthroscopy. This may be:
If youre awake, you may be able to watch the procedure on a monitor.
The surgeon will begin by making a few small incisions, or cuts, in your knee. Sterile salt water, or saline, will then pump in to expand your knee. This makes it easier for the surgeon to see inside the joint. The arthroscope enters one of the cuts and the surgeon will look around in your joint using the attached camera. The surgeon can see the images produced by the camera on the monitor in the operating room.
When the surgeon locates the problem in your knee, they may then insert small tools into the incisions to correct the issue. After the surgery, the surgeon drains the saline from your joint and closes your cuts with stitches.
There are also risks specific to a knee arthroscopy, such as:
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What Other Treatment Options Are Available
Your healthcare provider may recommend advanced treatment options such as:
- Antibiotics if you have an infection.
- Physical therapy to increase range of motion.
- Occupational therapy to learn how to move in ways that dont stress the area.
- Injection of a corticosteroid medication to quickly decrease inflammation and pain.
- Surgery to repair the bursa, if other treatments dont work after six months to a year.
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What Happens During The Procedure
Your doctor will perform arthroscopic surgery in a hospital or outpatient operating room. The type of anesthesia youâll receive depends on the joint and what your surgeon suspects is the problem. It may be general anesthesia , or your doctor will give it to you through your spine. They might also numb the area they are doing the surgery on.
Your doctor will insert special pencil-thin instruments through a small cut the size of a buttonhole. The arthroscope tool they use has a camera lens and a light. It allows them to see inside the joint. The camera projects an image of the joint onto a screen. The surgeon will fill the joint with sterile fluid to widen it so itâs easier to see.
Theyâll look inside the joint, diagnose the problem, and decide what type of surgery you need, if any. If you do need surgery, your surgeon will insert special tools through other small incisions called portals. Theyâll use them to cut, shave, grasp, and anchor stitches into bone.
If your surgeon decides you need traditional, âopenâ surgery to fix the problem, they may do it at the same time as your arthroscopic surgery.
Afterward, theyâll remove the arthroscope and any attachments. Theyâll close the wound with special tape or stitches.
What Does A Meniscus Tear Feel Like
Symptoms of a meniscus tear include:
- Pain in the knee
- A popping sensation during the injury
- Difficulty bending and straightening the leg
- A tendency for your knee to get “stuck” or lock up
At first, the pain may not be bad. You might even play through the injury. But once the inflammation sets in, your knee will probably hurt quite a bit.
To diagnose a meniscus tear, your doctor will give you a thorough exam. They will want to hear details about how you got your injury. X-rays may be necessary, to rule out broken bones and other problems. You may also need an MRI scan, which allows a more detailed evaluation of knee cartilage.
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How Can You Prevent Bursitis
Because most cases of bursitis are from overuse, the best treatment is prevention. Its important to avoid or change activities that cause the problem. To prevent bursitis:
- Learn proper posture or technique for sports or work activities.
- Avoid sitting or kneeling too long. These positions put a lot of pressure on joints.
- Maintain a healthy weight to reduce pressure on joints.
- Use cushions and pads when you kneel or put weight on your elbows.
- Ease into new exercises or activities to avoid injury.
- Take breaks if youre doing a repetitive task.
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Pronounce the word knee . By typing or pasting a word or text in the text box, then clicking on the ‘Speak’ button, you are able to hear the correct pronunciation in British English . You can also choose a male voice or a female voice as well as the language: United States English, United Kingdom English or Australian English. So, you can hear the different pronunciations.
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Complementary Medicine For Osteoarthritis
In many cases, theres little research evidence to show that supplements and herbal remedies can improve arthritis or its symptoms, but many people feel they do benefit from them.
Below are a few of the supplements often used by people with osteoarthritis.
Glucosamine is found naturally in the body in structures such as ligaments, tendons and cartilage. Supplements are usually produced from crab, lobster or prawn shells, although shellfish-free types are available. Theres some research to suggest it may have some benefit in painful osteoarthritis, especially of the knee.
Most trials have used a dose of 500 mg three times a day, and the evidence seems to suggest glucosamine sulphate may be more effective than glucosamine hydrochloride. It doesnt help the pain straight away so youll need to take it for a couple of months. If it hasnt helped after two months, then its unlikely that it will.
Chondroitin exists naturally in our bodies and its thought that it helps give cartilage elasticity. The research evidence is limited to animal studies that suggest it might help to slow the breakdown of cartilage.
Dont expect to see any improvement for at least two months. And if your cartilage is badly damaged, its unlikely that youll benefit from chondroitin.
There are a number of different treatments available and they can generally be used alongside prescribed or over-the-counter medicines.
Other Pain Relief Treatments
Transcutaneous electrical nerve stimulation
A TENS machine sends electrical pulses to your nerve endings through pads placed on your skin. It produces a tingling sensation and is thought to relieve pain by altering pain signals sent to the brain. The research evidence on the effectiveness of TENS is mixed, but some people do find it helpful. A physiotherapist will be able to advise on the types of TENS machine available and how to use them. Or they may be able to loan you one to try before you buy.
Hyaluronic acid injections
Hyaluronic acid, or hyaluronan, is a lubricant and shock absorber thats found naturally in the fluid in your joints. Injections of hyaluronic acid have sometimes been used as a treatment for osteoarthritis of the knee. The treatment isnt currently available on the NHS because research evidence on its long-term effectiveness is mixed. The treatment is, however, available privately.
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Patient Discussion About Knee
Q. Can knee pain at childhood be connected to osteoarthritis? My mother is suffering from osteoarthritis . She is 72 years old and the OA is a major problem in her life. My son is 10 years old. He has a relapsing knee pain. His pain occurs mostly at day time but can wake him from sleep. The pain is in both legs. Is my son in a risk group for OA?
Q. how to treat knee pain nothing
Q. I have a reccurent ache just below my knee. what can it be? I am a 18 years old healthy guy. I never go to my physician, because i never need him, but in the past 4 month i recognized a strange pain just under my knee. The area is tender to palpation and the pain excruciate during walking and running.What can it be? What can I do to prevent it?P.S.I play collage basketball and this pain ruins my games…
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