Novel treatment for Osteoarthritis of Knee

Osteoarthritis of Knee

Overview of OA knee:

OA is known as degenerative disease and commonly referred as wear and tear, in which the natural cushioning between joints-cartilage wears away. Due to this, the bones of the joints rub closely against one another resulting in pain,swelling,stiffness,decreased ability to move and sometimes leading to formation of bone spurs.

Who gets OA knee ?

Several factors increase the risk of developing significant arthritis at an older age.

  1. Above 45 years old
  2. Gender usually women are more likely to be affected
  3. Overweight
  4. Heredity
  5. Repetitive stress injuries
  6. Affected by any other disease, such as rheumatoid arthritis, gout.

What are the symptoms ?

The severity of symptoms varies from person to person with some feeling mild discomfort which come and go and others suffering continuous debilitating pain which makes them difficult to do daily activities.

Imagine waking up in the morning and falling back down on the bed as soon as you stand because your knees cannot immediately support your weight due to pain and swelling resulting in joint stiffness and tenderness in the joint area followed by a grating sensation known as crepitus which occurs while moving the affected joint. Further, this pain is aggravated by muscle weakness, decreased range of motion, poor alignment of knee, hip and ankle.

How can OA knee be treated ?

There are various treatment options available, but it depends on number of factors needed to your body. These includes your medical history, level of pain, and impact of OA on your daily life. in most cases, treatment includes a combination of therapies, as well as healthy lifestyle modifications.

Healthy habits:

  1. Diet is one important measure considered in OA patients in which balance diet food such as rich in vitamins, omega 3 fatty acids and antioxidants are essential.
  2. Consuming water is essential step towards reducing arthritis pain and helping your body to respond well to exercise.
  3. Many times, the first line of treatment is exercise and weight reduction to decrease the pain and improve the joint mobility.
  4. People with arthritis wearing a wrong footwear can exacerbate the problem that already exist and contribute in long term damage to joints, muscles, ligaments and tendons. Right shoes can minimize pain and maximize the ability to do daily activities.

Various treatment approach:

Many treatment regimes include combination of exercise and assistive device or surgery along with medications.

  1. Medications: painkillers, paracetamol, NSAIDS are prescribed but long-term results have side effects.
  2. Intra-articular injections are also prescribed such as hyaluronic acid which acts like lubricant and shock absorber and for this right selection of patient is important and not beneficial for all.
  3. A proper physical therapy regime has depicted a benefit over long period of time in conjunction with tailored home exercise program to reduce the symptoms. The major goals of the intervention are to decrease pain, improve function and prevent disability thereby enhancing the quality of life.

There is various physiotherapy treatment program associated in managing the symptoms such as:

  • Improving flexibility and joint motion
  • Focusing on the muscles by enhancing the strength as well as building a strong core muscle function which further helps in improving the balance.
  • Manual therapy technique such as mobilization and manipulation help to decrease the pain and improve function.
  • Therapeutic modalities and dry needling for pain relief.
  • Taping technique to unload the pain sensitive areas.
  • Guiding the use of proper assistive device such as braces, canes etc.

And other than these treatments, there’s a highly effective treatmentcalled ESWT (Extracorporeal Shock Wave Therapy) which we use in our setup.In this high energy sound waves are introduced to the painful areas of the body therefore the therapy eliminates the pain and thereby restoring full mobility and improving quality of life.

In severe cases, surgery would be the option for instances knee arthroscopy, partial or total knee replacement.

OA knee prevention:

  1. Keep a healthy body weight
  2. Control your blood sugar
  3. Prevent injury to your joints
  4. Pay attention to pain
  5. Active Exercises play an important role as they cause a release of endorphins thereby triggering a positive feeling to the body as well as energizing a person’s life.

Recent study: physical therapy versus glucocorticoid injection for osteoarthritis of knee.

This study had 156 patients suffering from OA knee.They were randomized into two groups one with physical therapy and other for injection group. In the physical therapy group exercise include stretches, knee extension, squats etc. the other group had initial injection and follow ups at 4th and 9th month. WOMAC score were used for assessment. Conclusion: the physical therapy group that less pain and functional disability at 1 year than patients who received intra-articular glucocorticoid injection.

Dr.Roshini Menon (PT)