Not all patients suffering from knee pain require a surgical solution. Arthritis is a progressive disease that can be managed in its early stages through non-surgical, or conservative, treatment methods.
Patients with osteoarthritis (wear and tear arthritis) usually develop a deformity in their leg as the arthritis worsens. Commonly, the leg may become more varus (bow legged) or valgus (knock kneed) as the arthritis worsens.
Improved bracing technology has led to braces which can “unload” the arthritic side of the knee. Thus, for a person in varus or valgus, the brace applies a force counter to this deformity. This decreases the contact pressures on the affected side of the knee and can alleviate various amounts of patient's pain.
In Dr. Cunningham's experience, these unloader braces work best for patients with a relatively thin or muscular leg. If there is a lot of fatty tissue in the thigh, these braces do not tend to stay in place and are less effective. Moreover, if someone has arthritis equally throughout all parts of their knee (and not primarily on the inside or outside of the knee), then these braces are not helpful.
Vail Summit Orthopaedics offers custom knee brace fittings for its patients. We utilize multiple brace companies such as Donjoy and Breg depending on which brace is best for your needs. We would check with your insurance carrier ahead of time, but most insurances cover this service.
Osteoarthritis of the knee results in the breakdown of articular cartilage. There is an increased concentration of degradative enzymes in the knee. The normally viscous joint fluid becomes less viscous and is less able to lubricate joint surfaces.
Viscosupplementation, such as Synvisc One can help at least temporarily restore this viscosity to the knee. It is thought to lubricate the arthritic joint surfaces and stimulate one’s own remaining cartilage to produce more hyaluronic acid, which is one of the main constituents of cartilage, thus making the cartilage surface a healthier one. It decreases inflammation in the knee, which causes pain and swelling.
Dr. Cunningham has many patients with arthritis who come in every 9–12 months for their viscosupplementation injection. With it, they can have 6–9 months of relief and feel 60% better on average. The injection is done by first numbing the knee with a tiny needle so that there is minimal pain involved. Given that the injection is placed into the knee and provides good relief, this may obviate the need to take any oral medications.
As the arthritis in the knee worsens, patients may find that Synvisc is no longer effective. In rare circumstances, patients can have a reaction to the synvisc injection where they experience increased swelling and tightness. This is remedied by removing the fluid from the knee and placing a steroid injection into the knee to decrease the inflammation.
Other factors that decrease Arthritis Pain:
- Weight loss
- Eating raw fruits, raw vegetables, and unrefined whole grains and eating less processed food and animal products which cause inflammation
- Smoking cessation
- Physical Therapy and Low impact exercise
- OTC medications (acetaminophen and non-steroidal anti-inflammatories)
- Glucosamine and Chondroitin Sulfate (efficacy data from studies are mixed)