|Posted by Dr Jayant Arora on November 7, 2011 at 11:40 PM|
Knee arthritis--Staying fit and active
Dr Jayant Arora, Consultant Orthopedic Surgeon, Columbia Asia Hospital, Gurgaon discusses various ways by which patients suffering from knee arthritis can remain active and enjoy their life with easy simple steps.
You enjoy your morning walk, but you find yourself wincing from knee pain. If this gets any worse, you fear that you may need to drastically reduce your activity level!
In older adults, a common source of knee pain is osteoarthritis, often referred to as wear-and-tear arthritis. Osteoarthritis involves gradual damage or wearing away of the smooth cartilage that covers the joint. Osteoarthritis pain can be felt deep inside the joint or on the side of the knee. Arthritis can also occur under the knee cap (patella). This usually causes pain around or under the kneecap and may cause you to stop your exercise routine or avoid activities that you once enjoyed. Pain from knee arthritis is often worse when you first start moving in the morning or briefly after a period of inactivity. It may also be worse when going up or down a step — or may increase with overuse. Additional signs and symptoms may include stiffness of the joint, a feeling that the joint is unstable, swelling, or a feeling of clicking, grinding or locking within the joint.
Don’t let your knee let you down.
Consult your doctor if you have severe knee pain or persistent knee pain that’s bothering you or interfering with your day-to-day life. There are many potential causes of knee pain other than osteoarthritis explains Dr Jayant Arora. Diagnosis requires a detailed physical examination and possible X-rays or other imaging tests and blood tests.
Addressing osteoarthritis of the knee often starts with:
Strengthening — This is the cornerstone of knee joint therapy. Strengthening the muscles around your knee and hip helps support the joint. This can help make the joint more stable and give the muscles a greater role in absorbing stresses exerted on the joint. Strengthening of the front thigh (quadriceps) muscles appears to be of particular important in preventing the loss of cartilage in those with arthritis of the patella.
Weight loss — Being overweight puts extra strain on knee joints. Losing weight can make it easier to walk and climb stairs.
Low-impact exercise routine — Physical fitness is an important part of managing knee arthritis. Regular aerobic exercise can improve pain and function and help you gain strength and maintain a healthy weight. Your doctor may recommend low-impact activities such as swimming, cycling or walking, which put less strain on your knees than do higher impact activities. You may not be able to do everything you once did, but a well planned exercise routine along with other pain-relieving techniques can greatly improve your ability to be active with less pain and limitation.
Relieving pain flare-ups — If your knee arthritis flares up, try periodically icing your knee with a cloth-wrapped cold pack. Total knee rest may be fine for up to a day, but it’s usually best to keep the joint— and your body — moving in the least aggravating way you can.
Medications —Pain medications, such as Paracetamol, Ibuprofen or other similar anti-inflamatory medications can help ease arthritis pain. Talk to your doctor if you feel the need to take pain medication often. Regular or daily use can cause serious side effects for some. The prescription gel containing diclofenac , a topical anti-inflammatory drug that can be rubbed directly on the skin around the knee. Topical anti-inflammatory drugs appear to cause fewer side effects than do oral drugs of a similar class, such as ibuprofen or naproxen.
Joint Supplements - Glucosamine sulfate and chondroitin are commonly used. These supplements may provide at least some pain relief in moderately advanced knee arthritis in some people. Studies are conflicting about the effectiveness of these drugs. If you decide to take these supplements, consider trying them for a 12-week trial period. If it seems to be helping by then, you may want to keep taking it. If it’s not, you can stop taking the supplements.
Knee Supports — Various types of knee braces can help compress the joint and reduce swelling or realign the joint to lighten pressure in certain areas. Bracing can be fairly effective at reducing pain, providing a feeling of “support,” and for some people, improving walking ability.
Footwear modifications —A shoe with a soft, cushioned heel can help absorb some of the impact of walking. Your doctor may recommend placing a wedge in your shoe heel to take pressure off the areas of your knee that are involved with arthritis.
When your symptoms do not get well controlled with above measures, additional options may include:
Knee injections — One type of injection uses an anti-inflammatory corticosteroid. This may provide pain relief for up to a few months. Typically, injections are limited to no more than three a year. A second type known as viscosupplementation, involves injecting into the joint a thick, natural fluid (hyaluronic acid) that may help lubricate the joint and possibly reduce inflammation. It doesn’t offer immediate pain relief, but improvement in pain and function that may last up to a year.
Joint Preservation Techniques - These techniques are indicated especially in younger patients with cartilage damage. Various procedures can be done to regenerate the cartilage and to delay progression of the knee arthritis. These procedures include cartilage transplantation (OATS and ACI), Microfracture technique, High tibial osteotomy. Stem cells taken from the pelvic bone have also shown good prospects in cartilage healing in certain patients.
Joint replacement surgery —
This is an important option of last resort for advanced osteoarthritis. Extensive joint damage typically requires a total knee replacement. However, you may be a candidate for a partial knee joint replacement if only certain parts of the joint are damaged. This is usually a less extensive procedure than is total knee replacement and often results in a quicker recovery.