Actions You Can Take to Help Your Chronic Knee Pain or Arthritis!

osteoarthritis of the knee
osteoarthritis of the knee | Source

My Husband's Knee Pain.

My husband has always been very active. He is a that person who fixes everything himself and usually excels at most things he attempts to undertake unfortunately his life has almost come to a halt in recent months after years of knee problems.

Knee pain is exceptionally difficult as it limits your activities and causes tremendous emotional stress..He has a form of osteoarthritis which is caused by wear and tear on a joint and the aging process. My husband has been living with severe osteoarthritis for over 9 years. When we had full health insurance plans he was always to busy to stop and do anything about his slowly deteriorating knees. Walking has become almost unbearable for him yet he continues to work out at our cross fit gym. He loves to do wood working and water ski but all this is slowly coming to an end as the pain is now almost unbearable.



Acting on the Pain

Now being semi retired he has decided he is ready to act on the knee pain. He did undergo arthroscopy on the worst knee about 6 years ago with a wonderful outcome. This surgery was especially needed because of a knee injury from playing basketball.

We are self insured at the present time so anything he does from this point on will cost us quite a bit of out of pocket money. The orthopedic surgeon says he is a perfect candidate for total knee replacement.

We opted for Cortisone injections in both knees and this week we begin Hylagan injections which will help to increase the lubrication where his cartilage tissue has been destroyed. He will receive two injections, one in each knee for the next three weeks. We won't discuss the price as I may become nauseous.!!!!

Causes of knee Pain


The most common cause of knee pain is degenerative osteoarthritis of the knee. Some people have a predisposition to the disorder others may have been caused by either repetitive knee use in your occupation or sporting injuries.

As we age we tend to loose the cartilage in our knee that cushions our movement. After time some people are left with bone rubbing against bone. and bone spurs

Women tend to be more prone to this although it is not known why.

Certain diseases can increase a persons chances of having knee problems such as gout or hypo hypothyroidism.

Diagnosis

An orthopedic doctor can diagnose osteoarthritis of the knee with X-ray or Magnetic resonance imaging. Both of these tests will show the physician loss of cartilage and or bone spurs. From here he can send you to a more specialized clinic or physician, begin physical therapy or medical/surgical treatment.

Arthroscopic knee surgery is another form of diagnosis and also lends some healing as the surgeon can clean up the area and smooth up any bone spurs or broken bone fragments.

What Osteoarthritis looks like

This is a normal knee and an arthritic knee x-ray
This is a normal knee and an arthritic knee x-ray | Source

Minimal Treatments

Besides what we have already done for my husband's knee pain we have also used acupuncture. Ice, heat, lidocaine patches, exercises, especially cycling, rowing, swimming and rest. It is important not to do too much rest because your joints become stiff from inactivity.

In severe cases you may benefit from physical therapy especially to help strengthen your hamstring and calve muscles as they can take on more of the work when you walk.

Weight loss is always helpful if you are overweight.

NSAIDS are helpful for all kinds of osteoarthritis. There are many prescription strength ones that cal be taken with Tylenol . Caution should be used with Tylenol as it can cause liver damage. over the counter NSAIDS include, aspirin, Advil or Ibuprofen and Aleve.or Naproxen the generic of these. Always try to take NSAIDS with food to avoid possible stomach upset and intestinal bleeding disorders.

Antidepressants are sometimes needed due to the anxiety and loss of normal lifestyle.

Studies have been done and are continuing on chondroitin supplements as a way to assist the body in the increased production of cartilage for the

Topical Treatment

Capsacian cream can be found in drug stores. It works blocking the pain relaying substance P to the brain . Other local treatments include counter irritants that trick the body by their cooling and/or heating sensation rather than the pain. These include eucalyptus oil, camphor and menthol.

NSAID creams cross the skin barrier to relieve pain directly to the joint. These include Voltaren and Pensaid creams

Salycilates

Aspercreme and BenGay help to reduce inflammation.

Ice packs and heat can also aid in reducing pain and inflammation

Studies are being done on Sam E as a possible pain reliever.

New Research

A promising new drug, Actonel is a biophosphonate drug that actually inhibits chemicals that can cause the breakdown of the bone tissue. The studies are very promising according to Dr.Eric Matteson at the Mayo Clinic at least in delaying the need for surgery intervention.

Arthroscopic Surgery

My husband had arthroscopic surgery about 7 years ago with wonderful results. This helped him because of an injury suffered while playing basketball with lots of torn bone fragments.The doctor makes two small incisions under general anesthesia and with one inserts a camera and with the other he can remove torn bones and smooth areas that may be causing pain. Most people have good results with this but often this is only buying time if you have more serious forms of knee pain and osteoarthritis of the knee. This is also a good diagnostic tool prior to more serious knee surgery.

Polar Ice Large Knee Wrap

Have you had to decide to have a knee replacement

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Surgical Intervention

In my husband's case we will most likely have his knees totally replaced at some point in the not too distant future.

Surgery has progressed to the level that a patient can have arthroscopy, partial knee replacement or total knee replacement. In his case we have already done the arthroscopy so the next best step for him according to his doctors is a total knee replacement of both knees.

To under this kind of surgery you have to be 100% engaged and ready. He will be in more pain than ever on the first post op days and the physical therapy will seem slow at first but hopefully the outcome will be totally worth it.

Total knee replacement
Total knee replacement | Source

Minimally Invasive Surgery.

New minimally invasive techniques have progressed to the point the an incision of 3 to 5 inches is made through the quadriceps muscle rather than having to go through the tendon. The Damaged parts are removed from the thigh and beneath the knee on the tibia both a metal and plastic pieces are implanted and used according to the patients condition and doctors desires.

Patients are on antibiotics before, during and after surgery.

Total Knee Replacement

Total knee replacement requires and 8 to 12 inch incision and the upper part of the tibia and lower part of the femur are prepared for placement for the artificial knee. . The prosthesis is both metal and plastic and is stabilized with bone cement. The Patella or out part of the knee is often reinserted if it is in good condition. Sometimes a patient may go into surgery prepared to have either a partial or total knee replacement depending on the amount of damage seen by the surgeon once he gets into the affected site.

Spinal anesthesia with some medication to relax you is usually safer than general anesthesia.

Surgery generally lasts between 3.5 hours and the patient is taken to recovery.

The patient is out of bed by the evening of surgery to help prevent the development of blood clots and usually is discharged within 3 days post operatively. Sometimes patients go on the rehab or have rehab done at home.

Usually one knee is done at a time because of the pain factor. It has been found that 95% of knee replacement surgery patients say they would definitely have it done again if necessary.

The infection rate is less than 1% for knee replacement surgery in the us.

First day post op knee replacement

Health grades the Knee pain Diary Recommendations to prevent surgery

Nine things to do to help with osteoarthitis of the knee by Stella Ross


  1. Glucosomine . Try for 2 months if no results found this can be discontinued
  2. Nsaids or tylenol for pain and inflammation
  3. Daily morning knee stretch
  4. Cycling up to 30 minutes a day. "motion is lotion"
  5. Ice for 20 minutes post exercise or when in pain
  6. HA injections every 6 months
  7. Anti-inflammatory diet or arthritis diet , more fish , broccoli, increase omega 3 fatty acids
  8. Maintenance

Stretches for the knee to help with pain
Stretches for the knee to help with pain | Source

Our Future

My husband received his first HA injection on Tuesday 5 days ago.We won't know if it works for at least another 3 weeks. When and where he will have surgery is an unknown at this time. Artificial knees genially last about 10 to 15 years and he is in his 50's so we want to hold off as long as possible. Thank you for reading my hub.

References. Saint Francis Hospital System Greenville SC

Medicine net.com

Web MD

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