These Problems Are Getting Worse Despite Years Of Medications
When we see a patient in our clinic with knee swelling, we ask, what have you been taking for this?
Typically the first line of treatment will include the use of anti-inflammatory drugs. The list includes many familiar names, medications you may already be on as well.
- Most common : aspirin, ibuprofen , naproxen
- Prescriptions: celecoxib, diclofenac indomethacin, oxaprozin , piroxicam
Ice To Treat A Swollen Knee Joint At Home
Ice is one of the most recurrent and effective anti-inflammatory treatments for use on any joint, such as the knee, especially when the inflammation has been caused by a trauma or stroke.
To do this, you will need ice covered with a clean cloth to avoid direct contact of ice on your skin because excessive cold can provoke burns. You can also use ice packs manufactured specifically for this purpose.
Top 10 Ways To Reduce Knee Arthritis Pain
Knee arthritis pain is a common problem.
Approximately 11% of people over the age of 64 have arthritis.
Osteoarthritis of the knee is when there is wear and tear of the bones and cartilage of the knee.
In knee arthritis, the cartilage that lines the knee joint thins, while the bone underneath thickens. This produces bony spurs known as osteophytes, which makes the joint surface all bumpy rather than being nice and smooth and flat. This often results in knee pain and stiffness
Here are the top 10 things you can do to reduce arthritis knee pain and improve how the knee moves.
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Does It Run In Families
You cant pass reactive arthritis on to your children. However, they can inherit the HLA-B27 gene, which could slightly increase their chance of getting the condition. This doesnt mean that by having this gene theyll definitely get reactive arthritis. However, the condition tends to be more common in people with HLA-B27.
Around 1 in every 10 people in the UK carry this gene.
The first signs of reactive arthritis are often:
- painful and swollen joints, usually in the ankles or knees
- sausage-like swelling of fingers or toes
- puffy, sore, red eyes, often with a mucus discharge known as conjunctivitis
- extreme, unexplained tiredness, known as fatigue
You may notice that your knees, ankles or toes suddenly become swollen, stiff and painful to move. Or the swelling may appear gradually over a few days.
Reactive arthritis can also affect other joints, such as your fingers, wrists, elbows and the joints at the base of your spine, known as the sacroiliac joints . It can also cause inflammation in the tendons around your joints, such as the Achilles tendon which runs down the back of your ankle.
You may find your whole finger or toe swells up if both the tendons and joints become affected at the same time. This is often called sausage digit or dactylitis .
Selective Nsaids Vs Otc Nsaids
- Do not block the production of a stomach-protecting compound called prostaglandin. Because of this, these drugs do not have the same adverse gastrointestinal side effects.
- Do not impact your bloods ability to clot, which makes them more appealing for individuals with bleeding disorders.
Both of these are a concern with OTC NSAIDs.
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What About Glucosamine And Chondroitin
Glucosamine and chondroitin are components of healthy cartilage. Both are produced naturally in the body. They are also available in supplement form.
Researchers have long studied the effects of glucosamine and chondroitin supplements on arthritis. Many studies have found mixed resultssome have shown pain relief and function improvements compared to a placebo, while others showed no benefit from using these supplements.
Because of the lack of confirmatory evidence on the effectiveness of glucosamine and chondroitin supplements, the 2019 ACR/Arthritis guidelines recommend that people with knee OA not use these supplements.
There has been little or no research on the effects of glucosamine and chondroitin supplements in people with knee arthritis related to RA.
Most supplements are generally safe to use. Talk to your healthcare provider about whether it is safe for you to start a supplement with your current knee arthritis treatment plan.
While supplements have few severe side effects attached to them, it is still possible to experience these. Supplements can also interact with prescription drugs, can make other treatments less effective, and affect other health conditions you may have.
Supplements For Those With Mild Pain
The evidence for glucosamine and chondroitin is mixed, but they are safe. So it might be worth trying. However, people with a shellfish allergy may not be able to tolerate them. Any effect wont kick in right away. Dr. Day recommends trying it for six to eight weeks. If you notice improvement, great if not, then stop it, she says.
Turmeric has anti-inflammatory properties, and there is some evidence for its usefulness for painful knee arthritis. You can add turmeric to your food or take it as a supplement. It can thin blood, so people who take a blood thinning medication should not use turmeric.
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How Do I Massage My Knee To Reduce Swelling
There are many techniques that can be used to reduce the swelling of the knee. The most common are
- Deep strokes
- Lymphatic drainage
Massage can be used to help kickstart the healing process. It enhances circulation around the affected area.
Effleurage is a great way to begin reducing the swelling of the knees. It involves applying gentle pressure to the area using flattened hands and fingers.
The soft and gentle pressure is used throughout effleurage means that even the most tender areas can be treated.
It gently pushes the excess fluids in the swollen area towards the glands where they can be evacuated to different areas. This includes the armpit, groin, and behind the knee.
Deep strokes can also help to effectively reduce swelling. Like effleurage, it is also performed using flattened hands and fingers.
The pressure is a lot firmer than in the effleurage so that it gets deeper within the muscle fibers. It is used on swelling that has occurred for a long time and is no longer tender to the touch.
Firm pressure is used during deep strokes to allow the therapist to get deeper into the muscles to push and remove the excess fluid and waste products away from the swollen area.
It can create friction between the skin and the fingers, helping to stimulate the blood and lymph flow.
Lymphatic drainage is also very effective to minimise knee swelling. It involves applying pressure to the area in upwards movements in the direction of the glands.
Research: Patients Do Not Know How Bad Their Inflammation Is Or How Destructive It Is To Their Knees
This is really something that is hard to imagine. The patient does not know how bad swelling is for their knee. Knee osteoarthritis and the eventual development of bone on bone knees do not usually happen overnight. We say usually because there is the phenomenon of rapidly accelerated knee osteoarthritis where a patient can go from stage 1 to stage 4 osteoarthritis in a matter of months or a few years. So even in this rapid stage, bone on bone does not occur overnight. As this is a gradual progression it is easy to stay with the same management routine day after day, month after month, year after year of painkillers, anti-inflammatories, and knee braces. You know all the while your knees are getting worse but you need to work or be a caregiver or do the things you need to do so you manage your knees on a daily as needed basis. On a daily basis, unless there is an acute event, it is difficult to see how your knees are moving forward to a degenerative disease requiring knee replacement.
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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.
Risk Factors For A Swollen Knee
- Being overweight or obese your knees are weight-bearing so any excess weight puts more strain on them, which can damage your knee joint over time obesity also increases the risk of osteoarthritis, which is a common cause of a swollen knees
- Playing certain sports if you take part in sports that involve pivoting, rotating or twisting your knees, youre at greater risk of knee injuries, which cause swelling
- Your age your risk increases as you get older
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How Can A Physical Therapist Help
Once you have received a diagnosis of knee OA, your physical therapist will design an individualized treatment program specific to the exact nature of your condition and your goals. Your treatment program may include:
Range-of-motion exercises. Abnormal motion of the knee joint can lead to a worsening of OA symptoms when there is additional stress on the joint. Your physical therapist will assess your kneeÃ¢s range of motion compared with expected normal motion and the motion of the knee on your uninvolved leg. Your range-of-motion exercises will focus on improving your ability to bend and straighten your knee, as well as improve your flexibility to allow for increased motion.
Muscle strengthening. Strengthening the muscles around your knee will be an essential part of your rehabilitation program. Individuals with knee OA who adhere to strengthening programs have been shown to have less pain and an improved overall quality of life. There are several factors that influence the health of a joint: the quality of the cartilage that lines the bones, the tissue within and around the joints, and the associated muscles. Due to the wear and tear on cartilage associated with knee OA, maintaining strength in the muscles near the joint is crucial to preserve joint health. For example, as the muscles along the front and back of your thigh cross the knee joint, they help control the motion and forces that are applied to the bones.
Does The Patient Require Medication
When nonpharmacological intervention proves unsatisfactory, multiple guidelines recommend acetaminophen as a first-line agent for mild to moderate arthritis. Because of reports of gastrointestinal adverse events, elevated hepatic enzymes and overdose, the OARSI guideline recommends conservative dosing and treatment duration of acetaminophen. Although the OARSI guideline does not give exact parameters on this recommendation, the AAOS guideline indicates it may be prudent to restrict the over-the-counter dose of acetaminophen to 3000 mg per day and reserve the 4000 mg per day dose for prescriptions.
Second-line agents include oral and topical non-steroidal anti-inflammatory drugs , selective cyclooxygenase-2 inhibitors and topical capsaicin. Use of oral and topical NSAIDs received a strong recommendation in the AAOS guideline.
For patients with osteoarthritis localized to one or both knees, the OARSI guideline recommends the use of local medications, including topical NSAIDs and corticosteroid injections . This was especially emphasized in patients with coexisting medical comorbidities, which are very common in this patient population. Each medication carries unique safety and adverse-effect profiles, and therapies should be specific to each patients individual risk factors and medical comorbidities.
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Injuries That Could Lead To Knee Swelling
When your knee joint is damaged, it can cause excess joint fluid to build up. The following are common injuries that cause fluid buildup within the knee joint:
- Torn ligament
- Overuse of the knee joint
- Broken bones
Serious knee injuries can cause haemarthrosisblood within a jointwhich can lead to significant swelling, warmth, stiffness, and bruising.
How To Use Tubigrip Correctly
Get The Right Length: The key with using tubigrip to reduce knee swelling is to have a long enough piece. When using tubigrip for swollen knee treatment it should run at least from mid-thigh to mid-calf height and preferably from just below your hip to just above your ankle. It should also be worn double thickness.
So often I have seen people with a really small piece of tubigrip that only just covers the knee, and only a single layer. That is not going to do anything. The tubigrip needs to be long enough that the excess fluid is pushed away from the knee joint and back into general circulation, otherwise the fluid will just keep trying to get back into the knee. And wearing only a single layer will not provide enough compression to make much of a difference.
Choose The Right Size Tubigrip: Tubigrip is available in a range of sizes and it is important to get the right size for your knee too tight and it will quickly be very uncomfortable, too loose and it wont be effective. Check out our Tubigrip Size Guide to find the right one for you.
How Long Should You Wear Tubigrip: Tubigrip can be used for however long your knee swelling remains its effectiveness doesnt decreased with time. But you MUST take it off at night.
Top Tips: Check out the Tubigrip Compression Guide to find out everything you need to know about using tubigrip effectively for swollen knee treatment e.g. how to put tubigrip on, how to stop it rolling down and when not to wear tubigrip.
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Topical Nsaids And Capsaicin 1
Topical NSAIDs include patches, creams, gels, and ointments and work in the same way as orally taken NSAIDs, but are proposed to have a more favorable safety profile due to the low blood serum concentrations achieved with topical formulations. Topically applied medications reduce pain and inflammation by blocking the production of enzymes that produce inflammatory chemicals that ultimately result in pain and swelling. The pain-relieving property of capsaicin is found in many topical preparations and is known to relieve muscle, joint, and nerve pain. Capsaicin works by desensitizing nerves and blocking pain messages from being relayed to the brain. Topical treatments have been shown to be effective for knee arthritis pain as an adjunctive or alternative treatment therapy. While gastrointestinal side effects are less likely than they are with oral NSAIDs, local reactions such as itching, burning, and rashes are more frequent. Its important to work with your healthcare professional to ensure youre using the right solution, strength and application method of the topical treatment.
How Can I Prevent Knee Arthritis
There are things you can do to reduce the risk of developing osteoarthritis in your knees. The less stress you put on your joints, the less likely they are to wear out prematurely. Try to:
- Maintain a healthy weight
- Rest if joint pain starts to bother you
- Start new activities slowly and safely until you know how your body will react
When to seek treatment for your arthritis
Arthritis doesnt have to spell the end of an active life. If you are experiencing worrisome symptoms or persistent pain, the renowned arthritis specialists at Summit Orthopedics can help. We work with you to confirm a diagnosis and develop an appropriate conservative treatment plan. If nonsurgical treatments fail to support your lifestyle goals, fellowship-trained orthopedic surgeons will consult with you and discuss appropriate surgical options. Summit is home to innovative joint replacement options. Our Vadnais Heights Surgery Center is one of a select few nationally to receive The Joint Commissions Advanced Certification for Total Hip and Total Knee Replacement.
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The Most Important Piece Of The Puzzle
If youre overweight or obese, the most effective treatment is weight loss. This isnt surprising. Every extra pound of weight adds two to four pounds of excess pressure on your knees.
Losing weight is probably the most difficult part of the treatment puzzle, but its also the most important, says Dr. Day.
A weight loss program should include both diet and exercise. Some people have difficulty exercising to lose weight because their knees hurt. But any type of exercise can help, even strengthening the upper body.
How To Care For A Swollen Knee
When does a swollen knee require medical care, and when can it be treated at home? Mild to moderate knee swelling and knee effusionsometimes called water on the kneecan usually be treated at home. Medical attention is recommended if the knee is persistently swollen or accompanied by severe pain or other serious symptoms.
Read on to learn when to contact a doctor, how to treat a swollen knee at home, and how doctors can remove fluid from a knee using a process called aspiration.
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