Injections For Knee Pain
Valaik says theres good science behind cortisone shots and other injections, such as hyaluronic acid injections, that lubricate the inner workings of the knee and help relieve arthritis pain.
According to Valaik, there is less evidence supporting the benefits of other injectable substances, including platelet-rich plasma and concentrated bone marrow or stem cells, but further studies will reveal more about their efficacy in treating knee arthritis.
Injections can provide temporary relief typically a few months which can help you stay on your feet and postpone surgery, he says.
Knee Replacement Alternatives To Consider
Crunching sounds as you climb stairs, chronic aching and swelling: Knee osteoarthritis is a real pain. If youre suffering with it, you may be considering surgery.
Getting a knee replacement is one approach, but you may not need surgery, at least not right away. And some patients cannot undergo knee replacement surgery for various reasons. Other people with knee pain are too young for a knee replacement the artificial knee is only likely to last 15 or 20 years, after which the person may need revision surgery.
There are several things you can try first, on your own or with a professionals help, that can help with knee pain and even delay the need for replacement, says Daniel Valaik, M.D., orthopaedic hip and knee specialist at Suburban Hospital in Bethesda, Maryland.
Arthritis doesnt go away, he explains. Of the thousands and thousands of patients Ive treated, Ive never seen anyones X-rays improve in terms of arthritis, unfortunately. But there are things you can do to lessen pain and stay more active.
How To Reduce Swelling After Knee Surgery
This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.There are 10 references cited in this article, which can be found at the bottom of the page. This article has been viewed 32,352 times.
Swelling may be moderate to severe in the first few days after knee replacement surgery, but it will gradually subside as you recover. Still, you might experience some mild to moderate swelling in the weeks and months following your recovery. Luckily, there are several strategies you can try to reduce swelling, such as following your doctors instructions after surgery and trying out exercises meant to reduce swelling. If you experience an increase in swelling, tell your doctor right away.
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Signs You Have Scar Tissue In Your Knee
Sometimes scar tissue takes years after an injury to show signs of build-up. When scar tissue or adhesions build up in the joints, tendons, and soft tissue, you may experience aches and pains, as well as a loss of stability and a full range of motion.
Aches and pains in the knee from scar tissue may be felt during normal daily activities like walking or squatting. Other cases of knee pain from scar tissue may arise from more strenuous activities like working out or running.
If you’re experiencing pain, stiffness, or a diminished range of motion in your knee joint, then you most likely have scar tissue in or around your knee. Other signs of scar tissue in the knee may include an inability to straighten your leg, walking with a limp, an inability to bend your leg, swelling in the joint, or a grating sound or sensation when moving the knee joint.
Where Will I Feel Knee Replacement Pain
As mentioned above, knee replacement pain can come in many different forms depending on the cause. Knee pain is to be expected due to the surgical procedure itself, with swelling, bruising, and the introduction of prosthetic parts.
Beyond that, it is possible to feel pain in parts of the body other than your knee. This is known as referred pain.
Your hips, lower back, groin area, and calves may initially hurt due to the change in your stance and the way you walk. Of course, it is also typical to feel sore due to extended amounts of time in bed during your recovery.
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How To Fix Knee Pain
This article was medically reviewed by Troy A. Miles, MD. Dr. Miles is an Orthopedic Surgeon specializing in Adult Joint Reconstruction in California. He received his MD from the Albert Einstein College of Medicine in 2010, followed by a residency at the Oregon Health & Science University and fellowship at the University of California, Davis. He is a Diplomat of the American Board of Orthopaedic Surgery and is a member of the American Association of Hip and Knee Surgeons, American Orthopaedic Association, American Association of Orthopaedic Surgery, and the North Pacific Orthopaedic Society.There are 11 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 96% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 48,833 times.
Preparation For Total Knee Replacement Surgery
Patients undergoing total knee replacement surgery usually will undergo a pre-operative surgical risk assessment. When necessary, further evaluation will be performed by an internal medicine physician who specializes in pre-operative evaluation and risk-factor modification. Some patients will also be evaluated by an anesthesiologist in advance of the surgery.
Routine blood tests are performed on all pre-operative patients. Chest X-rays and electrocardiograms are obtained in patients who meet certain age and health criteria as well.
Surgeons will often spend time with the patient in advance of the surgery, making certain that all the patient’s questions and concerns, as well as those of the family, are answered.
Costs
The surgeon’s office should provide a reasonable estimate of:
- the surgeon’s fee
- the degree to which these should be covered by the patient’s insurance.
Total Knee Replacement Surgical Team
The total knee requires an experienced orthopedic surgeon and the resources of a large medical center. Some patients have complex medical needs and around surgery often require immediate access to multiple medical and surgical specialties and in-house medical, physical therapy, and social support services.
Finding an experienced surgeon to perform your total knee replacement
Some questions to consider asking your knee surgeon:
- Are you board certified in orthopedic surgery?
- Have you done a fellowship in joint replacement surgery?
- How many knee replacements do you do each year?
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What Are Some Types Of Knee Surgery
The most common knee surgeries involve arthroscopy â a surgical technique used to repair many different types of knee problems â or knee replacement.
Arthroscopic surgery
Arthroscopy is a type of keyhole surgery used to diagnose and treat a wide range of knee problems. A keyhole surgery is one in which long, thin instruments are inserted into the patientâs body through small incisions.
For arthroscopic knee surgery, the surgeon inserts a probe with a small camera, called an arthroscope, into the knee joint. The scope displays pictures on a video monitor to help guide the surgeonâs work. Surgical instruments are inserted into the joint through a second incision.
The American Academy of Orthopaedic Surgeons describes the following as the most common arthroscopic procedures for the knee:
- Removal or repair of a torn meniscus â a type of cartilage in your knee that cushions and stabilizes the joint
- Reconstruction of a torn anterior cruciate ligament , which is a ligament that helps stabilize the knee joint
- Removal of inflamed synovial tissue
- Trimming of damaged articular cartilage
- Removal of loose fragments of bone or cartilage
- Treatment of patella problems
- Treatment of knee sepsis
Knee replacement
In a knee replacement operation, the surgeon removes damaged parts of the knee joint and replaces them with new parts made of materials such as metal, ceramic, or plastic. Contrary to the name of the procedure, the surgeon does not replace the entire knee joint.
What Is An Anterior Cruciate Ligament And Why Is An Anterior Cruciate Ligament Surgery Done
Anatomically, the knee joint is held together by two pairs of ligaments on each side of the knee called the collateral ligaments and two ligaments inside the knee which are known as posterior cruciate ligament or PCL and Anterior Cruciate Ligament .1 These ligaments hold the bones of the knee together and control movement of the knee.
The anterior cruciate ligament being in front of the knee bears the maximum force and thus more often than not gets strained or torn. This causes severe pain and inability to fluidly move the knee. Milder cases of ACL strains may be treated nonoperatively but in case of a major tear of the Anterior Cruciate Ligament , surgery is required. People who opt for surgical treatment of an ACL injury are those who are young, healthy, have no medical comorbidities, and want to return back to normal activities of daily living at the earliest possible time. Athletes and other sportsmen usually go under the knife for an Anterior Cruciate Ligament injury.
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Building A Strategy For Your Post
Every patientwill respond to medications and pain relief techniques differently. Whendetermining your total hip or total knee replacement pain management protocol,your doctor will consider your unique needs. A combined pain managementapproach is usually the best route. Prescription medications may be used in theshort-term immediately after surgery with a transition to non-narcotic painmeds and alternative pain management techniques.
Immediately After The Operation
Doctors have made big advances in pain management after total knee replacement over the last 10 to 15 years due to advancements in using regional nerve blocks, spinal blocks, and other methods of pain control.
During knee surgery, your healthcare team might either use a general anesthetic, where you will be fully asleep, or a localized anesthetic, where youre numb from the waist down but still awake.
After the surgery anesthesia wears off, your healthcare team can provide pain medication either orally or through an intravenous tube.
These medications may include a strong opiate or opioid such as morphine, fentanyl, or oxycodone, and are intended only for short-term use. Its important to note that larger doses over time can lead to physical dependence and addiction. Follow your doctors instructions to avoid adverse effects.
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Expected Range Of Motion
After knee replacement surgery, it is important to work with a physical therapist to achieve the maximal range of motion. Typically, the range of motion will progress quickly during the first three months and can continue to increase for up to two years following surgery.
Normal motion after knee replacement is defined as the ability to get within 5 degrees of a straight knee and the ability to bend the knee back to 90 degrees. Most knee replacements have movement ranging from 0 degrees to 110 degrees or more.
The optimal motion of the replaced knee can be achieved with a combination of stretches, exercises, and gradual resumption of normal activities. Some surgeons will recommend the use of a machine to bend the knee, called a CPM, .
Muscle Strengthening For Healthy Knees
Weak muscles surrounding the knee joint can perpetuate and overstress the knee. Strength training the muscles in the leg, especially the quadriceps and hamstrings is crucial in maintaining healthy knees where scar tissue is present.
Make sure to warm your leg muscles up before performing any strength trainingyou can do some jumping jacks, or go for a light jog. Once you begin to sweat or breath more heavily, you’re plenty warm. After you’ve warmed your muscles up, proceed with a light stretch.
There are many different types of exercises that help build your leg muscles for optimal knee support. Always start with light weights, and increase weight gradually over time. A basic muscle strengthening program might include the following exercises:
- Leg press
- Calf raises
- Hip abductions
It is best to perform these exercises two to three times per week. You can do them in sets of three with ten to fifteen repetitions each set. Make sure to get plenty of rest in between workout sessions for optimal muscle recovery.
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What To Do If You Have Painful Joints After Tka
Total Knee Arthroplasty , also known as total knee replacement, is an orthopedic surgical procedure performed on the knee. TKA is a treatment option for those with a worn-out knee joint, one of the most common causes of which is the wear and tear associated with arthritis. When a TKA is performed, the defective cartilage is removed between the joint, the ends of the bones that meet at the joint are reshaped and fitted with metal implants, and a plastic piece called a spacer is put in between the metal implants so the bones can move smoothly without touching each other.
There is significant rehabilitation required after a TKA, and it can take a few months before patients are able to get full functionality of their knees. While it is normal to feel significant pain after a TKA procedure, some people feel joint pain that is not associated with the healing process after a TKA. Here are some reasons why a patient may feel joint pain after a TKA.
Pain Medications After Surgery
- Opioids: Opioids like codeine are prescription medications that temporarily change the way your brain perceives pain. For post-surgery hip or knee pain, prescription medication is usually a temporary pain relief technique. Opioids can help you feel better throughout the day but come with a risk of addiction.
- Synthetic Opioids: Tramadol is a commonreplacement for codeine and other opioids, though it is still a narcotic. Tramadol is a synthetic opioid that affects how you perceive pain, but also influences your mood. Tramadol is regularly used in combination with non-steroidal anti-inflammatory drugs.
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Similar Conditions That Affect The Knee
Meniscus tear
Sometimes patients with knee pain don’t have arthritis at all. Each knee has two rings of cartilage called “menisci” . The menisci work similarly to shock absorbers in a car.
Menisci may be torn acutely in a fall or as the result of other trauma or they may develop degenerative tears from wear-and-tear over many years. Patients with meniscus tears experience pain along the inside or outside of the knee. Sometimes the pain is worse with deep squatting or twisting. Popping and locking of the knee are also occasional symptoms of meniscus tears.
Since some of these symptoms may be present with arthritis and the treatment of arthritis is different from that of meniscus tears, it is important to make the correct diagnosis. A good orthopedic surgeon can distinguish the two conditions by taking a thorough history, performing a careful physical examination, and by obtaining imaging tests. X-rays and Magnetic Resonance Imaging scans may be helpful in distinguishing these two conditions.
Knee Joint Infections
Also called infectious arthritis or septic arthritis, a joint infection is a severe problem that requires emergent medical attention. If not treated promptly knee infections can cause rapid destruction of the joint. In the worst cases they can become life-threatening.Symptoms of a knee joint infection include:
- severe pain
- fevers and
Again, a joint infection is a serious condition that requires immediate medical attention.
Why Did I Get Sciatica After My Knee Replacement
You likely have Sciatica after your knee replacement because you arent moving around as much, your circulation is a little limited and you have swelling. Our bodies are made to move, this allows our muscles, nerves, ligaments and tendons to move, too. It allows everything to stretch and glide and not get stuck. Movement also improves your circulation. If youre moving less because you just had surgery then your blood is still circulating, just slower, so it means that different parts of your body arent getting the same amount of new blood to them. New blood to the area brings nutrients to help heal and takes away toxins and inflammation. If you have swelling in any part of your leg it means that those areas have more pressure on them. There is only so much room under your skin for all the muscles, tendons, ligaments, nerves, arteries and veins. So, if swelling is taking up some of that space it just means that there will be more pressure on everything, which also means pressure on the Sciatic nerve. Pressure on the Sciatic nerve then sends the Sciatica symptoms.
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Lose Weight To Lessen Stress On Your Knees
Number one on Valaiks list of ways to reduce knee pain and delay knee replacement: reaching and maintaining a healthy weight.
Extra weight puts pressure on the knees and increases stress on the joint, increasing pain and making it hard to exercise, Valaik explains. Research compiled by the Johns Hopkins Arthritis Center confirms that carrying extra pounds raises your risk of developing knee arthritis and speeds up the destruction of cartilage that cushions the joint.
I know its not easy, he says, but losing weight really helps, whether youre dealing with arthritis in one or both knees. If you are overweight or obese, consulting with a nutritionist or a bariatric specialist may be the right place to start.
Opioid Benefits And Risks
- The medicine works quickly.
- You will feel less pain.
- You will be able to be active to speed your recovery. For every day you stay in bed, you need 3 days to regain your strength.
- You will be able to sleep or rest better.
Potential risks are:
- Taking an opioid can lead to addiction.
- On average, more than 130 people die each day in the U.S. from an overdose of opioids, according to the Centers for Disease Control and Prevention.
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