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Knee Arthritis Treatment
in Chennai
One of the commonest arthritis involving millions of people all over the world . This is not a disease but a physiological condition which every knee has to go through. Aging leads to degenerative changes in the cartilage and wear and tear happens but not all patients will have all the symptoms The most common joint to get involved is knee joint filled by hip joint and shoulder joint but all other joints of the body can get affected Osteoarthritis is a progressive disorder of wear and tear which is continuous Previous years there were not much treatment available but now it’s possible to arrest the progression of the disease
Symptoms:
Osteoarthritis is a slowly progressive disorder worsening over time It progresses from stage 1 to stage 4 and so does the signs and symptoms of the
disease
Symptoms include
- Pain : usually the pain is mild on climbing stairs or walking on irregular surface , but as the disease progresses the pain increases in intensity and later on pain at rest may also be present . Severe cases pain at night is common and patient has disturbed sleep
- Stiffness of the joints– stiffness of the joint occurs eventually and mostly noticed while getting up from sitting position . Early morning stiffness is common .
- Tenderness– tenderness is pain on pressing a particular point joint like tenderness is present. Depending on the damage of cartilage on medial or lateral side tenderness may be present accordingly
- Decreased range of motion – when the pain and stiffness becomes severe , range of motion decreases
Crepitus or grating sound from the joint
This happens when two bony structures come in contact with each other .
- Swelling – in acute condition, swelling of the joint can be seen
Risk factors:
- Family history – arthritis run in families , those whose parents or siblings suffer from arthritis Are prone for this
- Age – usually occurs in old age , but may occur in young age in rare cases also
- Gender – female gender is said to have more chances of developing this arthritis
Previous joint injury
Obesity – increased weight of the patient will put more strain to the joint and hence more prone for osteoarthritis
Diagnosis
Physical examination of the joint – tenderness , swelling , crepitus , restricted joint movements
Laboratory tests
Blood test , Urine tests, joint fluid examination is done to rule out other types of arthritis
Joint fluid analysis- repeated collection of fluid on the joint will require joint fluid analysis to rule out other causes of arthritis and joint pain like septic arthritis or tuberculosis of the joint
X-rays – X-rays will show the loss of cartilage and loss of joint space , bony spurs, osteophytes , irregularities of the bones and will help in garding the stage of osteoarthritis
CT Scan – taken from different angles and in different cross sections of internal structures
Though it is not required in majority of the cases
Ultrasound of the joint – this is the gold standard technique of identifying the joint, damaged cartilage , calculate the thickness of cartilage , abnormal bony spurs and ostophytes , presence of fluid of any , abnormalities of ligaments and muscles
Treatment
As it is a progressive disease , it requires a comprehensive approach towards
management
Each individual will respond differently to different types of treatment
Medications
Over the counter medicines – pain milers are available frequently , may help in
reducing the pain initially but may not help in reducing the infammation in the joint . Acelofeanc , paracetamol , tramadol are few medicines taken frequently
These medicines may help in pain relief initially but later on the side effects will predominate and regular intake is not recommended.
Counter-irritants – creams and ointments May give some relief by counter irritating the joints
This is also not a permanent treatment and gives initial treatment
Physical therapy
Specific physical excercises for the joint to strengthen the muscles around the joint is of prime importance . This will increase the flexibility of the joint and will decrease the stiffness is the joint .
The excercises should be specific for each individual based on body type , age , regular activities .
Occupational therapy – occupational therapy to alter your daily activities and task so as to perform it properly without stressing on the joint more .
Surgical interventions
Joint replacements was done very frequently until few years back . The original
damaged joint is removed and a metallic joint is put into the body . If Complications occur to replacement therapy then it is difficult to treat it again
Non surgical interventions
Viscosuplementations – it is done to provide a jelly fluid in the joint which will prevent the friction between two bones. Injection of hayluronic acid is given whose composition is similar to the composition of the fluid inside the joint . Usually this will work between 3montns to one year
This can be repeated again once the pain starts
Cortisone injection – cortisone is a medication injected in the joint to decrease the pain by decreasing the inflammation. It’s a temporary method of decreasing pain
Non surgical treatment
Radiofrequency ablation of the joint can be done under fluoroscopic and ultrasound
guidance . It will decrease the pain signals from the joint to be carried to the brain . It
is done using Radiofrequency machine and after identifying the target nerves ,
Radiofrequency waves are given to dampen the pain signals
This is a permanent treatment, done as day care procedure without any
complications
The results are similar to the replacement surgery
How to take care of your joint
Excercises to be done as advised by a physical therapist
Avoid taking pain killers
Weight reduction
Heat and cold therapies in severe pain
Braces may help in case where excessive movements is required
TENS therapy – resistant cases this therapy may help but for short term only