Knee pain may start at any age group. It can occur in young patients like 20-25 years due to sports injury or may occur after 50-60 years due to arthritis. There are many other causes as well which if found at right time can be cured.
Let’s discuss some causes, precautions, special diet and various non-surgical options of knee pain
Causes –
Osteoarthritis
As we age, wear and tear start in the knee joint. The articular cartilage inside the joint when undergo wear and tear, fluid between the joints gets reduced. When joint space is reduced then we feel pain. Slowly the space continues to get reduced without treatment and bones start rubbing against each other.
Torn ligament – There are various ligaments in the knee. It can occur from accident from 2-wheeler, sports injury ( especially twisting and turning injuries). Symptoms could be severe pain, instability, swelling and hematoma.
Rheumatoid arthritis – It is a disorder of body’s immune system and hence affects multiple joints. It starts with joint in bilateral hands and can spread to other bigger joints including knees. It is important to differentiate between Rheumatoid arthritis and osteoarthritis as both have different causes and hence different treatment.
Gouty arthritis – In this body makes too much uric acid from the food you eat. There are intermittent episodes of severe pain, swelling and redness of the joint. It can last for few days.
Iliotibial band syndrome. Iliotibial band supports the knee from lateral side. If it gets inflamed, pain in superolateral side of the knee. It happens after prolonged walking without warm up.
Patellar Chondromalacia – There is erosion in the cartilage of back of the knee cap and , there is decreased water content in the cartilage along with inflammation. It occurs in young patients, pain in front of the knee and pain gets worse with climbing stairs both up and down.
Patellar tendonitis – Inflammation and pain located inferior to the knee cap area.
Baker’s cyst – It presents as swelling in the back of knee, along with stiffness. It is diagnosed with ultrasound and fluid can be aspirated with the same.
Risk factors – Vit D deficiency, Overweight/Obesity ( 1 kg of weight puts pressure of 4-5 times) , lot of exertion early erosion, thinning of articular cartilage, genetic
Diagnosis
Blood test – Some blood test like ESR, CRP and uric acid which tells us about X ray – It tells us about the joint space, osteophytes and alignment. MRI – It tells us the ligament injuries, and severity of the injury. It also tells us about the grading of the disease. Dexa Scan – It tells us about the bone strength.Treatment options ( बचाव और उपचार)
Medications
- Calcium and Vitamin D supplements. They help by strengthening the bones. Strong bones are able to carry body weight better and hence avoid wear and tear
- Topical analgesics like gels and spray which decreases the pain.
- Anti-inflammatory medications which can be used for short period of time or in acute phase of severe knee pain.
- In case of Rheumatoid arthritis, there are medications which are called disease modifying agents, which delays the disease progression.
Physiotherapy- It focuses on decreasing the inflammation by various instruments Exercises taught are to strengthen quadriceps muscle and hamstrings which are supporting muscles for the knee.
Diet which can help at knee pain
- Milk and milk products are good source of vitamin D which can be taken.
- To sit in the sun from half an hour daily is a good source of vitamin D
- Good protein diet especially for vegetarian include paneer, nuts, pulses, soya should be included in our diet routine.
- Food to increase our immunity include vitamin C rich products.
- Turmeric. It has both anti-inflammatory and antibiotic properties. It can be added in vegetables, can be boiled in milk (only a pinch though)
- Cinnamon, which can be taken after boiling in water. The daily quantity should in limit only.
- Fenugreek (Methi) increases the bone strength.
Caution while using these products is, first do not expect too much results from taking these. It can only decrease the pain by approx. 5- 10% only. Since dose can not be regulated, so suggestion is to take it in small quantity only. For example, lemon juice is good but should be taken as 1-2 glass only. If taken in large quantities, it will increase acidity level of the body. Same as excessive quantity of cinnamon can cause liver injury.
Dietary remedies could be taken as an adjuvant therapy along with other treatment.
Nonsurgical treatment for knee pain
These are PRP therapy and Radiofrequency ablation, which are done by pain physician for knee pain.
PRP Therapy ( Platelet rich plasma)
As in Osteoarthritis, there is thinning of articular cartilage, platelets when injected in form of PRP helps in regeneration. There is a separate blog explaining the PRP therapy and it take provide complete information for it.
RFA ( Radiofrequency Ablation)
In RFA treatment, we use special kind of needle. In this treatment, the nerves which are responsible for pain are ablated with heat therapy through RFA machine. By doing this, the pain signals do not reach the brain, and patient feels pain relief. This therapy helps for 1-2 years. Success depends on factors like body weight , bone strength etc. This procedure can be done with only day care admission. Advantages of this procedure is , it can be done without cuts and stitches, no anesthesia is needed, doesn’t require any long-term bed rest.
This treatment of followed along with weight loss, muscle strengthening exercises can help you avoid the surgery. This is a common complaint when trying to loss weight that “ we can’t even walk with knee pain, how do we lose weight”. Along with proper diet and pain relief from above treatment, you can start your walking exercises again.
Precautions
- Precautions, which mean doing something which prevents the progress of arthritis
- Avoid using stairs, especially getting down, as it puts pressure on the knees and hence contribute to wear and tear
- Squatting -avoid sitting on the floor, use a chair while sitting.
- Using Indian toilet also needs squatting, so avoid that as well.
- Avoid sedentary life style and junk food intake. Instead, we need to opt for Using active life style. We can adopt for active life styles by opting for doing household chores. This increases our muscle strength and keep out weight in check.
- Muscle strengthening and stretching exercises – Making regular exercises, even for 15- 20 min, a part of life style keeps us muscles toned up and out body in healthy shape.
Knee Supports
- The knee cap/ knee support if individualized will benefit more than the regular knee caps.
- Knee cap should be like which can off load your body’s weight and reduce stress on the knee.
- These are custom made and are very helpful in early arthritis.
- It may look bulky but its easy to wear.
- Patients who have used this share the pain relief they get immediately after wearing this.
- Expensive but worth your money as it will stay until you knee gets strengthened and may help you avoid medications.
- Exercises which will strengthen your adductor muscle. Muscle strengthening reduces the load on the knees.
FOR KNEE EXERCISES AND TO KNOW MORE ABOUT NONSURGICAL TREATMENT OF KNEE PAIN, FOLLOW THE LINK
