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Articles > Knee still hurts? There's hope!

Knee still hurts? There's hope!

Claudia M. Caruana

Provided by HealthMonitor

If you have osteoarthritis (OA) pain in your knee'including symptoms that oral painkillers
aren't relieving'don't despair. Today there are more choices than ever, and sometimes
switching to a new treatment, or even combining a few, can take you from "Doc, I've still
got pain" to "This is just what I needed!" Read on for a closer look at several options for knee
OA, and don't be shy about asking your healthcare provider if one of them may be right for you.

1 Physical therapy
What it is: Physical therapy (PT) is done by a licensed professional who can help you develop an exercise program to improve joint function, increase muscle strength and boost your fitness level. Therapists also give pain-relieving treatments like massage and electrical stimulation.
Why it works: According to Victor Ibrahim, MD, a physiatrist at National Rehabilitation Hospital, Washington, DC, physical therapy can greatly improve knee pain. "By simply mobilizing a joint's specific patterns, a therapist can improve circulation and take stress off the joint," he says. "Strengthening and conditioning the muscles around the joint can also
provide sustained relief. Posture training and movement corrections can help with pain prevention as well.'
Best used for: Nearly everyone can benefit from PT (often given once or twice a week for six to 12 sessions). Dr. Ibrahim says PT can delay the need for a knee replacement and allow for a quicker recovery if you do need surgery.
What to consider: Physical therapists can play a critical role in helping people deal with joint pain, Dr. Ibrahim says. "Even when other pain-relieving options are helpful, PT can enhance your treatment and help you gain better flexibility, muscle strength and range of movement."

2 Knee braces and strapping
What it is: For some painful knee conditions, custom-fitted braces and straps can be worn during certain activities (like long periods of walking or standing) and also at night to keep the joint immobile while you sleep.
Why it works: These devices keep the joint in place and help the kneecap track correctly as you move or while you are resting, says Joseph Purita, MD, an orthopedic surgeon in Boca Raton, FL. By taking pressure off damaged areas, braces and straps can help relieve pain and restore function.
Best used for: Moderate OA pain.
What to consider: Dr. Purita says knee braces must be fit meticulously by your healthcare provider to make sure the brace or strap is not too tight, which could impair healthy blood circulation. Ask how long you'll need to wear the brace or strap, and wear it only for the amount of time prescribed. Also, not everyone with knee OA can wear a brace, since body weight (whether too much or too little) will affect how snugly it fits.

3 Topical pain relievers
What it is: Over-the-counter (OTC) creams, gels or sprays can soothe achy joints. Your healthcare provider can also prescribe a gel that contains a nonsteroidal anti-inflammatory drug (NSAID).
Why it works: OTC rubs
generally create a warming effect on contact; plus, some ingredients, such as capsaicin, are counterirritants that disrupt nerve pain signals. Topical NSAIDs work by blocking inflammatory chemicals like prostaglandins.
Best used for: Mild to moderate OA pain; NSAID gels can also relieve inflammation.
What to consider: If you often take oral NSAIDs, these topical preparations may be a good alternative, says Joseph Markson, MD, a rheumatologist in New York City. Plus, NSAIDs rubbed into the skin are absorbed mainly near the application site, which may lower the risk of side effects'such as stomach bleeding or increased blood pressure'caused by oral NSAIDs. Ask your doctor how long and how often topical pain relievers are safe to use.

4 A knee injection
What it is: Doctors have injected steroid hormones into painful, swollen joints to relieve pain and inflammation for many years, says Tanya J. Hagen, MD, an assistant professor of medicine and orthopedics at the University of Pittsburgh. Another type of injection, hyaluronic acid, acts as a gel-like lubricant, she says.
Why it works: "Steroids reduce or eliminate inflammation and pain and can improve movement," explains Dr. Hagen. Hyaluronic acid works like a shock absorber in the joint, helping it to move more smoothly and reduce pain.
Best used for: Both types of injections are used for moderate
to severe knee pain.
What to consider: Steroid injections relieve pain quickly and can make it easier to start exercise or PT. How quickly hyaluronic acid works depends on your body's response, but studies show more than half of people respond within four weeks. Be sure to tell your healthcare provider if you have any allergies before having this
type of injection.

A knee replacement
When you've exhausted all your treatment options and you're still in pain, it may be time to consider knee replacement surgery. Consult the following checklist, and take
it along to your doctor visit to discuss the next step in your pain-management plan.
" My current treatment options
ease my pain.
Never Often Always

" My knee pain prevents me
from falling and/or staying
asleep at night.
Never Often Always

" I don't take stairs to avoid pain.
Never Often Always

" My knee pain prevents me from doing activities I once enjoyed (hiking, riding a bike, etc.).
Never Often Always

" My knee pain makes everyday activities difficult (getting up from a chair, getting in the shower, etc.).
Never Often Always

" Simply walking around causes
me significant pain.
Never Often Always

Allergy Knee Pain Osteoarthritis Knee Replacement Arthralgia Arthralgia, Knee Joint Aches Joint Enlargement Joint Pain Joint Swelling Knee Pain Loss of Strength Pain Pain, Joint Stress Swelling of the Joints Swollen Joints Joint Pain Qutenza Fatigue Exercise More Physical Therapy Inflammation Upset Stomach Swelling

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