Osteoarthritis of the knee – the most common cause of knee pain – is a “wear-and-tear” condition that usually does not get better, notes orthopedic surgeon Dino Nicol E. DeJesus, D.O., who specializes in joint replacement at Cooper’s Bone and Joint Institute.
Sometimes called degenerative arthritis, osteoarthritis of the knee occurs when the cartilage in the knee deteriorates with use and age. Osteoarthritis typically develops gradually and tends to cause varying degrees of stiffness and pain. It also can lead to swelling and a decreased range of motion in the knee joints.
“Because injuries and structural problems can also be a cause of knee pain, it’s important to be evaluated by a physician to diagnose arthritis of the knee,” Dr. DeJesus said. “But for my patients with arthritic knee symptoms, before I recommend surgical intervention, I first recommend that they try what I call my ‘Top Ten List’ to help patients reduce their pain and increase their mobility,” Dr. DeJesus said.
Dr. DeJesus’ “Top Ten List” for patients with arthritic knee pain:
1. Over-the-counter medications: Tylenol and over-the-counter anti-inflammatories are my first line of treatment. Consult with your family physician for dosage recommendations.
2. Topical analgesics/ Hot and cold therapy: Bengay, Capsaicin, mineral ice products. Cold therapy should be used for 10-15 minutes at a time, three times per day. Remember to place a light towel between your skin and the ice to decrease potential for cold burn.
3. NSAIDs, COX-2 inhibitors: When Tylenol and over-the-counter anti-inflammatories are ineffective. Your family physician or medical specialist should provide the recommended dosage.
4. Weight loss if overweight: Any weight-loss will help decrease the stress in your knees as well as improve your overall health and mobility.
5. Exercise: Low-impact exercise is important for keeping the joints mobile, the surrounding muscles strong and supportive, and the blood flow consistent.
6. Activity modification: Avoidance of activities that may aggravate or injure your knee.
7. Assistive devices: Canes, walkers or crutches are used to unload the affected joint and transfer the stresses to the uninvolved extremity. Remember to have a qualified individual measure and train you on the proper use of this equipment.
8. Physical therapy: A rehabilitation regimen focused on strengthening and stretching muscles around the knee is vital for re-education of the musculature, as well as keeping the joints mobile, the surrounding muscles strong and supportive, and the blood flow consistent.
9. Viscosupplementation: Numerous brands of these injections now exist, and patients may have different responses to each brand. The theory behind these series of injections is that the fluid injected acts as a “lubricant,” which helps reduce pain and increase mobility. Patients with mild to moderate arthritis respond well to this treatment.
10. Cortisone injection: A cortisone injection may be beneficial when there is an acute flare-up as it provides medication in the knee joint. Relief from these injections are variable (weeks to months) and is dependent on the severity of symptoms and arthritis. As the arthritis progresses, a cortisone injection may only provide short-term relief.