No magic bullet to knee health, staying active crucial

Tribune News Service

amritsar, December 28

In this fast-paced world, juggling between personal and professional life can be painstaking, leaving little to no room for self-care. While the onset of lifestyle diseases at an early age is a major concern, knee pain is also becoming a growing concern among people.

Typically osteoarthritis affects knees, hips, neck, lower back and hands – including the base of the thumb – and numbers of people with the condition are expected to rise.

Dr Shubhang Aggarwal, Director and Orthopedic & Robotic Joint Replacement Surgeon, NHS Hospital, Jalandhar, explains all about knee pain, its causes, symptoms and remedies.

Is all knee pain arthritis?

In the elderly, knee pain is commonly Osteoarthritis but in the young, especially women, it is mostly chondromalacia which means softening of the cartilage but not flaking off. Other causes may be torn ligaments/meniscii, mostly due to injury.

Is arthritis hereditary?

Some are clearly inherited, but most are not. Commonly, arthritis of the spine (ankylosing spondylitis) and gouty arthritis are inherited, but osteoarthritis and rheumatoid arthritis show a weak tendency to be inherited. Gout also usually skips a generation, so a grandson may be affected but not the son.

Are physically active people more prone to knee pain?

Some occupations predispose to arthritis, in particular osteoarthritis. Footballers develop arthritis of knees & ankles due to repeated injuries to these parts received while playing. There is no evidence that someone who is physically active but not exposed to injury, is any more prone to develop arthritis than an individual who does not exercise.

Does climate affects pain?

Living in a cold damp climate may make you feel your arthritis more than living in a hot, dry one. Change of weather, such as a rise in humidity and a fall in barometric pressure may also make the joints worse temporarily. Climate does not otherwise have an effect on the arthritis and it will not make its course any worse in the long term.

Why medical treatment only help some people?

This is usually because among the people who improve are those with different sorts of arthritis, some of which get better without treatment. Moreover, certain chronic types of arthritis may vary in their severity from time to time and appear to be cured. In pregnancy and jaundice, arthritis may spontaneously improve for months together.

What is ESR?

ESR stands for erythrocyte sedimentation rate. It measures amount of inflammation in the body when arthritis is present. A high ESR means a high amount of inflammation. ESR is useful as a guide to the doctor for checking activity of arthritis and monitoring progress.

Steroid injections yes or no?

Steroids are generally to be avoided except in rheumatoid flare-ups. The most common type – Osteoarthritis does not need any steroids at all.

How do I manage pain?

“Don’t let arthritis beat you, take control” But how? Treatment of severe pain due to arthritis needs a combination of strategies. We must understand that reason for pain is survival/ safety. Arthritis medication is only one part of the total plan that will help you reduce your pain, improve joint function and daily-living activities.

Arthritis no excuse to workout

Arthritis could be the perfect excuse, not to exercise. But research shows quite the opposite. Cartilage depends on joint movement to absorb nutrients and remove waste. Movement is actually giving it nutrition.Exercises reduces joint pain and stiffness, builds strong muscle increasing flexibility and endurance. It helps you sleep better, controls weight, decreases depression and gives you more self-esteem.

Joint Replacement Surgery?

If your arthritis is at a stage where it needs surgery to give you relief or the side effects of pain killers is predicted, then you undergo a total or half joint replacement surgery. Initially, we recommend that you continue with a conservative treatment strategy as a trial. Most people come to the hospital at such a stage, especially in Osteoarthritis, that doing lesser procedure like half a knee replacement can only give relief for a very short duration. Total knee replacement is the procedure of choice.

To eliminate surprises and give you confidence, find out about the surgery, the facility, the training and experience of the surgeon. Speak to other operated patients of the same surgeon. Ask about expected benefits and potential risks, especially in the long run. Learn what you are to do, both before and after surgery, to maximise those benefits and reduce any risks.

The single most important benefit of surgery is freedom from pain. Then, the greatly improved movement. People who have lived with an excruciatingly painful joint for years suddenly find themselves able to sleep without medication, participate in sports and get back to ‘normal’ life.

With technological advancement in medical science, total hip and knee replacements are now routine. With the new robotic technology and high quality implants, most people are up and walking on a new hip or knee within a few hours of surgery.