About Knee Pain and Arthritis

The most frequent cause of debilitating knee pain is arthritis. It is estimated that 70 million people in the United States have some form of arthritis-that's one in every seven people or one in every three families. Of more than 100 types of arthritis, osteoarthritis, rheumatoid arthritis, and trauma-related arthritis are the most common causes of joint damage. Osteoarthritis is a disease which involves the wearing away of the normal smooth joint surfaces. This results in bone-on-bone contact, producing pain and stiffness.

Rheumatoid arthritis is a systemic disease because it may attack any or all joints in the body. Unlike osteoarthritis, rheumatoid arthritis causes destruction of the joint by severe inflammation. The body's immune system attacks and destroys the synovial lining covering the joint capsule, the protective cartilage and the joint surface, causing pain, swelling, joint damage and loss of mobility. Trauma-related arthritis results from damage to the joint from a previous injury. It is the third most common form of arthritis. It also results in joint damage, pain and loss of mobility.

When debilitating pain and stiffness in your knee limit your daily activities, you may need knee resurfacing or total knee replacement. More than one million people in the United States annually undergo knee and knee replacement surgery to relieve pain and stiffness and restore mobility. When conservative methods of treatment (pain medications, physical therapy etc.) fail to provide adequate relief, knee replacement surgery may be a good option for you. Knee replacement surgery helps relieve pain and allow patients to perform activities that may have been limited due to knee pain.

Osteoarthritis (OA) Treatment Options

Treatments for OA focus on ways to manage pain and improve function. Some examples include: exercise and weight control, physical therapy, medicines, surgery, and nontraditional approaches. Most successful treatments involve a combination of methods tailored to patient's needs, lifestyle, and health.

Millions of OA sufferers are dissatisfied with their current treatments, according to the results of a recent national survey released by NCOA. The survey, conducted by Harris Interactive, found that 43% of OA sufferers have stopped using their arthritis prescription medications in the last year. At the same time, there has been a small but noticeable increase in those patients aged 50-65 who are pursuing alternative therapies such as relaxation techniques, weight loss, physical therapy, herbs/natural remedies and nutritional supplements.

Exercise, Rest and Joint Care

Research shows that exercise is one of the best treatments for osteoarthritis. Exercise can improve mood and outlook, decrease pain, increase flexibility, improve heart and blood flow, help maintain weight, and promote general physical fitness. Exercise is inexpensive and, if done correctly, has few negative side effects. At the same time, treatment must include regularly scheduled rest. OA sufferers must learn to recognize the body's signals, and know when to stop or slow down, to prevent pain caused by overexertion.

Weight Control

Osteoarthritis patients who are overweight or obese are advised to lose weight. A healthy diet can facilitate weight loss, resulting in reduced stress on weight-bearing joints and limiting further injury.

Non-Drug Pain Relief

People with OA may find non-drug ways to help relieve pain. Warm towels, hot packs, or a warm bath or shower apply moist heat to the joint, which can help relieve pain and stiffness. In some cases, cold packs can relieve pain or numb the affected area. Water therapy in a heated pool or whirlpool also may relieve pain and stiffness. For OA in the knee, patients may wear insoles or cushioned shoes to redistribute weight and reduce joint stress.

Medicine

Patients must use medicines carefully and tell their doctors about any changes that occur. Medicines commonly used in treating OA include acetaminophen, NSAID's (nonsteroidal anti-inflammatory drugs), topical pain-relieving creams, rubs and sprays applied directly to the skin, mild narcotic pain killers, corticosteroids, and hyaluronic acid. Many medicines used to treat OA have side effects.

Surgery

When OA occurs, small pieces of cartilage may wear away from the joint surfaces and float around inside the joint. This joint debris may cause inflammation and pain. In certain cases of arthritis, arthroscopy may be necessary to remove the debris, clean up the joint, and provide pain relief.

Osteotomy is a procedure in which the bone is cut, either above or below the affected joint, and re-aligned to a better position. An osteotomy is often used for younger people where the limb is not straight and the cartilage wear is confined to one part of the joint. Unfortunately, the success of this operation decreases as the degree of arthritis and deformity increases.

Total Joint Replacement (TJR) can help relieve pain and increase patient mobility by resurfacing the damaged joint with ceramic, metal and/or plastic implants. For those with severe OA who are no longer achieving pain relief from over-the-counter drugs, prescription medications or other non¬surgical, TJR is an alternative treatment for OA. TJR can help people suffering with severe OA to resume routine movements of everyday life, such as climbing stairs, tying shoes and getting up from a chair. It can also allow them to resume work and the activities they love. For those patients with isolated arthritis to one part of the knee, partial or unicompartmental knee replacement is a better option because it is less invasive and bone preserving.