Fda Approves New Treatment For Chronic Knee Pain
What we’re changing is the wiring of the knee so we’re taking away the pain signal and interrupting it,” Dr. Amin Sandeep, a pain specialist at Rush University Medical Center in Chicago who performs the procedure, told NBC News.
One 2016 study compared Coolief to popular cortisone injections, with patients reporting greater, longer-lasting pain relief with the new treatment than injections. Coolief reduces pain for about to 6 to 12 months, depending on how fast the nerves in the knee regenerate.
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Osteoarthritis can affect any joint when the cartilage wears off over time, often striking big joints like the knee, causing pain, swelling and stiffness. According to the American Academy of Orthopedic Surgeons, nearly 10 million Americans had osteoarthritis of the knee in 2010.
The three current recommended approaches for knee arthritis pain are physical therapy, non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen, or the opioid painkiller tramadol.
But those didn’t help Felicia McCloden, a 65-year-old grandmother from outside of Chicago. The excruciating pain in her right knee made simple tasks like grocery shopping impossible.
I had inflammation, swelling, and my knee was like the size of a golf ball, McCloden told NBC News. “The arthritis was so bad that I could barely step down without severe pain.
“I thought I was going to limp for the rest of my life,” she said.
How Vitamin C Reduces Knee Pain
Vitamin C is essential for collagen synthesis and for the metabolism of joint cartilage. Vitamin C is also a powerful antioxidant, especially in joint fluid.
Poor intakes of vitamin C can lead to reduced collagen formation and slow joint healing. In contrast, good intakes of vitamin C can reduce cartilage loss and disease progression in osteoarthritis, while its antioxidant action reduces joint inflammation.
Vitamin C stimulates bone-building cells to improve bone mineral density and support the overlying joint cartilage. Vitamin C may even help to prevent damage, cartilage loss and the development of osteoarthritis.
How Supplements Reduce Knee Pain
Nutritional supplements can improve painful knees in a number of ways, by:
- Providing building blocks for the repair of cartilage, ligaments and tendons
- Stimulating the repair of damaged tissues and the production of cushioning synovial fluid
- Regulating the enzymes involved in breaking down or building new cartilage
- Reducing inflammation
- Reducing pain through analgesic effects.
Some supplements, especially plant extracts, contain a wide variety of compounds that each work in different ways to provide more benefits than any single prescribed painkiller ever could.
In fact, supplements are set to play an increasing role in treating painful knees as the long-term use of paracetamol is no longer recommended. Paracetamol is not as safe as previously thought and is linked with an increased risk of heart attack and stroke. This follows similar findings that long-term use of non-steroidal anti-inflammatory drugs such as ibuprofen can also increase the risk of heart attack and stroke.
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Simple Home Exercises And Stretches Can Help Ease Some Common Types Of Knee Pain
If youve got sore knees, exercise might seem like the hardest thing you can do but its also one of the best.
“Exercise is one of the most important things you can do for knee pain,” says Dr. Lauren Elson, an instructor in physical medicine and rehabilitation at Harvard Medical School.
The right combination of strengthening and stretching exercises can relieve pain by helping to improve the way the joint moves and functions.
“The knee is often an innocent bystander between the hip and the foot. Knee pain is often caused by problems occurring above or below,” says Dr. Elson.
For example, weak hip muscles may cause more strain on the knee, intensifying your pain. Strengthening the muscles around the hip joint can help relieve it, says Dr. Elson.
In addition, knee pain is sometimes caused or aggravated by tight muscles around the knee, a problem that is often successfully addressed by stretching. If the muscles arent flexible, the knee joint sometimes wont move properly, says Dr. Elson.
Torn Acl Symptoms And Signs
With an acute injury, the patient often describes that they heard a loud pop and then developed intense pain in the knee. The pain makes walking or weight-bearing very difficult. The knee joint will begin to swell within a few hours because of bleeding within the joint, making it difficult to straighten the knee.
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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.
One Knee To Chest Stretches
For this one, lie on your back with your legs straight out in front. Then bring one knee up to your chest, grasping the back of your thigh. Pull the knee toward your chest so that you can feel your buttock muscle stretching. Hold this move for 15-30 seconds, then return the knee to the original position. Each side should be done about three times to benefit from this type of sacroiliac joint stretches.
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What To Expect At Your Office Visit
Your provider will perform a physical exam, and look at your knees, hips, legs, and other joints.
Your provider may do the following tests:
- MRI of the knee if a ligament or meniscus tear could be the cause
- CT scan of the knee
- Joint fluid culture
Your provider may inject a steroid into your knee to reduce pain and inflammation.
You may need to learn stretching and strengthening exercises. You also may need to see a podiatrist to be fitted for orthotics.
In some cases, you may need surgery.
Maintain A Healthy Weight
Every time you stand and walk, your weight puts stress on your joints, especially your knees. If youre overweight or obese, youre much more likely to damage the cartilage between your joints, resulting in joint pain.
For every excess pound you carry, you put about four extra pounds of pressure on your knee joints. If youre only 10 pounds overweight, youre putting 40 pounds of additional pressure on your knees but if youre 50 pounds overweight, thats 200 extra pounds of pressure.
When you think about how much you walk around every day, its easy to see why your knee joints are wearing out if youre overweight. Losing weight can be a significant factor in knee joint preservation.
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Complementary Medicines Or Alternative Therapies
Complementary and alternative treatments are widely used by people with musculoskeletal conditions, including osteoarthritis of the knee.
Transcutaneous electrical nerve stimulation A TENS machine is a small battery powered device with leads that connect to sticky pads on your body. It delivers very small electrical currents to your skin that stimulate nerves to relieve pain. Some people find it helpful in relieving pain while others do not. The quality of evidence showing it helps with knee OA is very low. If youre thinking of using a TENs machine speak with your doctor to see if its a suitable option for you. You can often hire one from your physiotherapist, local pharmacy or local hospital.
ElectrotherapyElectrotherapy treatments are thought to minimise inflammation, promote cell growth and modify pain. While some trials have shown short-term benefits with electrotherapy, the evidence for its use in knee OA is low to very low. For this reason its not generally recommended.
AcupunctureThe use of traditional , laser and/or electro acupuncture for knee OA is not supported by current clinical evidence. While some improvements in knee pain and function have been identified in low-quality studies, the benefits are considered so small that theyre not clinically relevant. Also to see any benefits from treatment, its likely that you will need multiple sessions of acupuncture which could become quite costly.
You Sit For Long Periods Of Time
If your knee hurts, you might want to stay off of it. But resting too much makes your muscles weaken and often makes knee pain worse. Find a way to get moving without hurting your knee. Some good exercises for people with knee pain include walking, swimming, and water aerobics.
Exercise strengthens the muscles around your knee and helps support the joint. At Coastal Empire Orthopedics, we can help you find the best exercise to keep you moving, even with knee pain.
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What If Pain Doesnt Subside
In most cases, knee pain will improve with home remedies. If it doesnt after several weeks, see a doctor. Several in-office treatments may be considered, Dr. Kissin says, including steroid injections or physical therapy.
Surgery may be an option if all other non-surgical treatments dont work. Its good to have a well-balanced approach for patients and see what we can offer without resorting to surgery, Dr. Kissin says. But the best treatment for knee pain is prevention, which should center around weight control and exercise, he adds.
Its important to do at least two hours of exercise a week and maintain this as we get older, he says. Diet alone isnt enough. We need to maintain our body, or it wont be there for us.
Comprehensive Knee Osteoarthritis Program Results In 28 Patients
Results Patient case results do align with the expected success rate of 90% stated for Wei Musculoskeletal Institute musculoskeletal treatments. It is important to note that cases showing no response have complicated factors such as ulcerative colitis in one patient and issues with multiple organ systems and infections such as parasites in the second patient. Both patients are undergoing more complex herbal protocols to address these underlying health issues and improve their response to the program. However, many patients who expressed that their pain level was at 0 also presented with other confounding conditions. In patients who saw less than a 50% pain improvement , there were more indications that patients were very active during their program as well as had some compliance issues. The average age of patients who had less than a 50% improvement were 65 compared to 64.7 for those who saw a 50% or greater improvement. The average time for patients to see the improvement they described was about 14 visits for those seeing 50% or greater improvement as opposed to 13 visits for those seeing less than 50% improvement.
Table 1 Average pain level after 1 month utilizing Osteoarthritis program*
|Stayed the same||7%|
Data on pain level of patients who have successfully completed 1 month of a comprehensive Knee Osteoarthritis program utilizing Wei Musculoskeletal Institute herbal treatment solutions and additional modalities.
* DISCLAIMER:Individual results may vary.
Losing Weight Can Improve Knee Pain
“Your weight plays a major role in knee pain,” says Bush-Joseph. “If you walked around all day with a backpack that had a 10-pound weight in it, you would feel how achy your back, hips and knees are at the end of the day. That shows you the impact extra weight can have on your joints.”
With each step people take, two to four times their body weight is transmitted through the knee joint, according to Bush-Joseph. Thus, the more you weigh, the harder the impact is on your knee joint.
However, people who are overweight and have arthritic knee pain can lessen the impact and ultimately, relieve knee pain by losing weight. In fact, people with arthritic knees lose about 20 percent of their pain with every 10 pounds of weight loss.
“If you are 20 pounds overweight and you have arthritic knee pain, almost half of your pain will go away by losing 20 pounds,” says Bush-Joseph. Of course, losing 20 pounds isn’t easy. But, if people are able to lose even 10 pounds and add in some stretching and flexibility training, they’ll experience significantly less pain, according to Bush-Joseph.
Glucosamine And Chondroitin For Knee Pain
Glucosamine and chondroitin are produced naturally in the body as building blocks needed to make cartilage, tendons, ligaments and synovial fluid. Their production declines with age, and it is often in short supply, especially when active joint repair is needed.
Glucosamine and chondroitin regulate the levels of at least 31 different proteins in cartilage cells which are involved in cartilage health, antioxidant stress responses, and the synthesis of new proteins such as collagen. Glucosamine and chondroitin act as biological signals to switch on the repair of damaged joint tissues, and suppress the inflammation and breakdown of cartilage that is a feature of osteoarthritis.
As you get older, your cartilage cells secrete less and less glucosamine and chondroitin. As a result, cartilage becomes more brittle and prone to the degenerative changes seen in ageing joints.
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Stand Up Straight To Feel Better
“When you slouch you are leaning forward and walking bent over at the waist and that posture will lead to knee pain,” says Bush-Joseph. “You want your head centered over your shoulders and your shoulders centered over your abdomen and pelvis. The more your body is off-center, the more you have to compensate for that with muscle activity. Those muscles eventually fatigue, causing strain on your joints.”
Having strong core muscles in your abdomen and lower back helps promote good posture and, ultimately, lessens the pressure on your knees. Exercises such as planks, back extensions, yoga and Pilates can help strengthen the core.
Heres how to do these exercises:
- Planks: Lie face down with your toes pointed to the floor. Put your forearms on the floor with your elbows at 90-degree angles. Tighten your abdominal and gluteal muscles and lift your body off the floor. Keep your back straight and hold for 15 to 45 seconds.
- Back extensions: Lie face down with elbows bent and hands on the floor. Keeping your hips on the floor, lift your head and shoulders up with your arms. Hold for 5 to 10 seconds and repeat five to 10 times.
Can Knee Pain Come Back After Treatment
Frequently, knee pain will occur for a short period of time and then resolve. Sometimes it can return a few weeks or months later. For chronic knee pain, it is important to get it evaluated to avoid further damage to cartilage, bones, or ligaments. Prognosis depends on the underlying causes of the pain.
With modern surgical techniques, it’s possible to relieve many of the knee pain syndromes and return to an active lifestyle.
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Facts You Should Know About Knee Pain
- Knee pain is a common problem with many causes, from acute injuries to complications of medical conditions.
- Knee pain can be localized to a specific area of the knee or be diffuse throughout the knee.
- Knee pain is often accompanied by physical restriction.
- A thorough physical examination will usually establish the diagnosis of knee pain.
- The treatment of knee pain depends on the underlying cause.
- The prognosis of knee pain, even severe knee pain, is usually good although it might require surgery or other interventions.
When To Contact A Medical Professional
- You cannot bear weight on your knee.
- You have severe pain, even when not bearing weight.
- Your knee buckles, clicks, or locks.
- Your knee is deformed or misshapen.
- You cannot flex your knee or have trouble straightening it all the way out.
- You have a fever, redness or warmth around the knee, or a lot of swelling.
- You have pain, swelling, numbness, tingling, or bluish discoloration in the calf below the sore knee.
- You still have pain after 3 days of home treatment.
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What Is Knee Pain
Pain is a common knee problem that can originate in any of the bony structures compromising the knee joint , the kneecap , or the ligaments, tendons, and cartilage of the knee. Knee pain can be aggravated by physical activity, as well as obesity, affected by the surrounding muscles and their movements, and be triggered by other problems . Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe.
Pt Treatment For Knee Pain
After a focused examination has been completed, your physical therapist can work with you to initiate the correct treatment. It is very important for you to be active and engaged in the program. Often, exercises to help strengthen and improve the mobility of the knee will be prescribed. You may be required to perform exercises at home as well as part of a home exercise program.
Exercise should be your main tool for treating your knee pain. Exercises to help your knee pain may include:
- Quad sets and straight leg raises
- Short arc quads
- Exercises to strengthen your hips
- Lower extremity stretches
- Balance exercises
Your PT will tell you how often to perform your exercises at home, and he or she should monitor your progress when you visit the PT clinic. He or she may also perform other treatments while you are in the PT clinic. These may include:
- Application of heat or ice
- Soft tissue massages or knee joint mobilization
Keep in mind that passive treatments like ultrasound or estim have not been proven to be the most effective treatment for knee pain. They may feel good, but your focus with PT should be on restoring functional mobility. You should discuss the overall goal of each treatment so you have an understanding of what to expect.
If knee pain persists for more than two to three weeks or occurs as the result of major trauma, a visit to a physician or healthcare provider is recommended.
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