About The Knee Pain
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Knee joint is very complex joint. Many pain generator present in knee. Besides main reason is age related Osteoarthritis there may be Meniscal tear, Ligament injuries and Tendinitis.

Investigation For Knee Pain

X-RAY :
For age related osteoarthritis we are doing ” x-ray both knee in standing position –  AP & LATERAL “

MRI OF KNEE JOINT :
For other pathology like Meniscal tear, Ligament injuries ( ACL OR PCL ) and Tendinitis we may required  MRI of knee joint.

BLOOD TEST :
Routine Blood investigation is always required before any interventional procedures.

Common Causes of Knee Pain
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Osteoarthritis
Arthritis is a chronic condition that causes joint inflammation. Symptoms include redness, warmth, swelling, tenderness and pain. Up to 40 percent of the population may have knee osteoarthritis. This is age related loss of cartilage of knee joint.

Osteoarthritis usually occurs in old age person but it may found in young or middle aged patients who have had a knee infection or injury and those who are overweight.

Rheumatoid arthritis
Rheumatoid arthritis can affect joints on both sides of the body and cause knee pain. In rheumatoid arthritis, your body’s cells attack your own tissues.  Over time, rheumatoid arthritis can cause cartilage loss, swelling in the synovium, and excess fluid in the knee. In later stages.

Bursitis
Bursitis is the inflammation of any of the fluid-filled sacs (bursae) protecting the body’s joints. This is usually caused by repetitive motions or by a stress such as kneeling.

Tendonitis 
The tendons – rope-like tissues connecting muscles to bone at the knee and other joints – can become painfully inflamed by repetitive and strenuous movement. Tendonitis is a common in sports injury, caused by overuse of the same parts of the body. Patellar tendinitis, or “jumper’s knee,” is an inflammation or irritation of the tendon between the knee cap and the shin bone.

Patellofemoral pain syndrome (PFPS)
Knee pain or discomfort while walking up and down stairs, jumping or squatting may be symptoms of patellofemoral pain syndrome. This common knee problem is felt toward the front of the knee. It can cause a grinding sensation when bending or straightening your leg, and can cause the knee to occasionally buckle. Sometimes called “Runner’s knee Pain” patellofemoral pain syndrome may be caused by overuse, injury, excess weight or when the cartilage in the knee cap is worn significantly.

Injuries 
Knee injuries can be the result of sports, falls or trauma. They typically involve the ligaments that hold two of the bones of the knee – the femur and tibia – together eg-ACL, PCL & Meniscal injuries

How is Knee Pain detected?
A careful medical history which includes

  • A description of knee pain (aching, tenderness, burning or swelling)
  • Where the pain is located and when it occurs?
  • When did the pain start(and if it is the result of an injury or accident )?
  • Anything that makes the pain worse or better
Knee Pain Treatment

Conservative care
Many types of knee pain can be relieved and/ or resolved with conservative treatments such as:

Rest
When the knee is injured or is inflamed, as in bursitis, tendonitis or arthritis, it’s important to rest the joint and avoid overuse.

Ice/heat
Applying ice or cold packs to the knee can reduce inflammation and swelling, especially after an injury. Once swelling is gone, heat may be used to help relax and loosen tissues.

pain relievers medicine

Over the counter pain killer medicine is easily available to relieve the pain of knee joint for temporary and short term purpose. As this all medicine have lots of side effects and over a long period of time  this are causes damage the cartilage of knee joint, kidney and stomach like organs

Weight loss
Lose weight to reduce pressure on the knees.

Physiotherapy 

Basically people understanding that physiotherapy is treatment for any types of knee pain. Its not always true. Physiotherapy is good for prevention of arthritis not treatment of knee pain.

Physiotherapy exercise can help to improve the muscle strength and reduce the load on Knee joint and helping prevention of more damage to knee.

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PRP THERAPY ( stem cell like treatment )
PRP therapy involves injecting platelets from the patient’s own blood to rebuild a damaged tendon or cartilage. It has been successful in not only relieving the pain, but also in jumpstarting the healing process. The patient’s blood is drawn and placed in a centrifuge for 15 minutes to separate out the platelets. The platelet-rich plasma is then injected into the damaged portion of the tendon or cartilage.

RADIOFREQUENCY NERVE BLOCK :

  • Genicular nerve is giving sense to the knee joint. By blocking the nerve patient can feel pain relief for long time if we can do it with RadioFrequency machine. Cosman (USA).
  • This types of treatment is useful for aged patient having severe arthritis knee pain and not able to go for surgery due to some high risk disease.

Procedures in Knee Joint

  • Prolo-ozone Therapy
  • Visco-supplementation
  • Intra-articular analgesic
  • Genicular nerve block / Radio frequency ablation
Total Knee Replacement Surgery : 
It is advisable to any patient who are not willing for above treatment or not benefited by above mention treatment. 
As it is done by Joint Replacement surgeon we are not doing surgery in our pain clinic