MY KNEES HURT by Dr. Gregory Sarkisian

Many of us experience knee pain throughout our adult life. This pain is often activity dependent. The more active we are, the more apt we are to experience pain in our knee joints. This knee pain is commonly due to the accumulated mileage we have put on our knees throughout our life. This can lead to wear and tear of the knee joint. Other times, knee pain may be related to a remote knee injury or prior knee surgery. In some instances, a painful knee can be due to a recent acute injury. Whatever the cause, knee pain can become debilitating.

There are home remedies we can try before seeing a physician. These can offer great relief and afford us the ability to be more productive. If your knee pain is due to activity, you may have to modify your lifestyle to accommodate your knee discomfort. Certain exercises like jogging or aerobics may need to be changed to lower impact activities such as swimming, biking or walking. If you are used to participating in aggressive sports such as basketball or volleyball, you may need to cut back on your level of activity to decrease the discomfort in your knee. Changing to low impact activities reduces the stress on the joint which in turn can lessen knee pain. The mnemonic “RICE” often is a helpful way to deal with some injuries involving the knee. The “R” stands for rest, “I” for icing or cold compresses, “C” for compression such as a gentle Ace wrap, and “E” for elevation. Also, taking over the counter anti-inflammatory medications such as Advil or Aleve can be helpful to decrease knee inflammation from injury and/or arthritis. In some individuals, these medications can irritate the stomach and cause other medical problems, so please be careful when taking them.

Certainly, there are instances when seeking medical attention may be indicated. One indication may be persistent swelling in the knee joint or a sensation of the knee locking. Another may be the inability to fully bend or straighten the knee. And yet another may be a feeling of instability when the knee is shifting while doing certain activities. These may be signs of possible internal damage to the knee involving a ligament or cartilage. Such an injury may require arthroscopic intervention. Arthroscopy is a simple procedure which is done in the hospital as an outpatient. It consists of two small puncture holes (portals) on the knee into the knee joint. Instruments, including a small camera, are inserted through the portals into the joint. Cartilage and/or ligament damage can be corrected using this technique.

If the knee pain is secondary to advanced arthritis, there are conservative treatment options available. Some are holistic measures which can help arthritic knees which consist of glucosamine and chondroitin sulfate products, MSM, shark cartilage, and now a relatively newer preparation which is called hyaluronic acid. All these are basically vitamins for the knee joint to help the body produce and maintain healthy cartilage in the joints. These have very low side effects. Although they do not help all people, they can offer relief for many folks looking for over the counter options.

If arthritic symptoms become severe and home remedies and over the counter medications do not offer relief, there are other non-surgical options your orthopaedic surgeon can offer. Bracing can take the pressure off the arthritic joint offering relief and allowing you to be more active. Also, gel injections into the knee joint (visco supplementation) is a method introducing a lubricant and nutritional supplements to the knee which may offer arthritic pain relief for up to a year. Certainly, cortisone injections offer relief, but should be used judiciously.

Finally, if all else fails and arthritic symptoms are severely affecting all activities of daily living, even causing pain at rest, consider total joint replacement. There are many new options today in joint replacement surgery with minimally invasive techniques. These offer much smaller incisions, a much shorter stay in the hospital (oftentimes 2 or 3 days) and a much quicker recovery.

So if your knees are aching, I invite you to try the above conservative treatments. See if they offer relief. If your symptoms persist or worsen, call your doctor. Pain free knees could be on the horizon.

Dr. Gregory Sarkisian is a Board Certified Orthopaedic Surgeon. He is a partner at Precision Orthopaedic Specialties, Inc. and is Chief of Orthopaedic Surgery at UH Geauga Medical Center.

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