Osteoarthritis Knee By Dr Anmol Arora ( Sr Homoeopathic Physician )

Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative, or wear and tear, arthritis. OA commonly affects the knee joint. In the past, people were led to believe that nothing could be done for their problem. Now doctors have many ways to treat knee OA so patients have less pain, better movement, and enhanced quality of life.
This guide will help you understand
•    how OA develops
•    how OA of the knee causes problems
•    how doctors treat the condition



How does knee OA develop?
OA of the knee can be caused by a knee injury earlier in life. It can also come from years of repeated strain on the knee. Fractures of the joint surfaces, ligament tears, and meniscal injuries can all cause abnormal movement and alignment, leading to wear and tear on the joint surfaces. Not all cases of knee OA are related to a prior injury, however. Scientists believe genetics makes some people prone to developing degenerative arthritis. Obesity is linked to knee OA. Losing only 10 pounds can reduce the risk of future knee OA by 50 percent.
Scientists believe that problems in the subchondral bone may trigger changes in the articular cartilage. Normally, the articular cartilage protects the subchondral bone. But some medical conditions can make the subchondral bone too hard or too soft, changing how the cartilage normally cushions and absorbs shock in the joint.

What does knee OA feel like?
Knee OA develops slowly over several years. The symptoms are mainly pain, swelling, and stiffening of the knee. Pain is usually worse after activity, such as walking. Early in the course of the disease, you may notice that your knee does fairly well while walking, then after sitting for several minutes your knee becomes stiff and painful. As the condition progresses, pain can interfere with simple daily activities. In the late stages, the pain can be continuous and even affect sleep patterns.

How do doctors identify OA?
The diagnosis of OA can usually be made on the basis of the initial history and examination.
X-rays can help in the diagnosis and may be the only special test required in the majority of cases. X-rays can also help doctors rule out other problems, since knee pain from OA may be confused with other common causes of knee pain, such as a torn meniscus or kneecap problems. In some cases of early OA, X-rays may not show the expected changes.



These are plain film images of a right knee with narrowing of the medial compartment and a widening of the lateral compartment. There are also a number of osteophytes and a large subchondral cyst where the bones have been rubbing on each other

Magnetic resonance imaging (MRI) may be ordered to look at the knee more closely. An MRI scan is a special radiological test that uses magnetic waves to create pictures that look like slices of the knee. The MRI scan shows the bones, ligaments, articular cartilage, and menisci. The MRI scan is painless and requires no needles or dye.
If the diagnosis is still unclear, arthroscopy may be necessary to actually look inside the knee and see if the joint surfaces are beginning to show wear and tear. Arthroscopy is a surgical procedure in which a small fiber-optic TV camera is inserted into the knee joint through a very small incision, about one-quarter of an inch long. The surgeon can move the camera around inside the joint while watching the pictures on a TV screen. The structures inside the joint can be poked and pulled with small surgical instruments to see if there is any damage.

What can be done for the condition?

Homoeopathic approach:

Osteoarthritis is a degenerative disease. The cartilage that is destroyed cannot regenerate again. Homoeopathy helps in the management of pain and swelling. It also helps the patient in coping up with the pain. The patient must also try to reduce his weight and control food habits. Certain exercises which strengthen the muscles around the knee must also be performed. Homeopathic medicines which are prescribed commonly in these cases are:
Arnica: Sore lame feeling, as if beaten.
Rhus Tox: Pains especially in the rainy season
Ledum Pal: Severe pains of gout and rheumatism
Angustura Vera: Specific for Knee pains.
Bryonia: Pains which come on slightest motion but better by hard pressure.
Belladonna: Severe throbbing pains and swelling
Osteoarthritis Nosode: Again a specific drug given to start treatment

These are just a few drugs. There are more than a hundred drugs useful in these cases.
Homoeopathic drugs are highly individualistic and must not be taken without proper consultation.
Homoeopathic drugs are safe and non-habit forming.
Homoeopathic medicines are very individualistic and should be administered under the supervision of a good homeopath

Physical Therapy



Physical therapy plays a critical role in the nonoperative treatment of knee OA. A primary goal is to help you learn how to control symptoms and maximize the health of your knee. You will learn ways to calm pain and symptoms, which might include the use of rest, heat, or topical rubs.

Physical therapists teach their patients how to protect the arthritic knee joint. This starts with tips on choosing activities that minimize impact and twisting forces on the knee. People who modify their activities can actually slow down the effects of knee OA. For instance, people who normally jog might decide to walk, bike, or swim to reduce impact on their knee joint. Sports that require jumping and quick starts and stops may need to be altered or discontinued to protect the knee joint.

Shock-absorbing insoles placed in your shoes can also reduce impact and protect the joint. In advanced cases of knee OA or when the knee is especially painful, a cane or walker may be recommended to ease joint pressure when walking. People who walk regularly are encouraged to choose a soft walking surface, such as a cinder or grass track.
A new type of knee brace, called a knee unloading brace, can help when OA is affecting one side of the knee joint. For example, a bowlegged posture changes the way the knee joint lines up. The inside (medial) part of the knee joint gets pressed together. The cartilage suffers more damage, and greater pain and problems occur. The unloading brace pushes against the outer (lateral) surface of the knee, causing the medial side of the joint to open up. In this way, the brace shares the pressure and unloads the arthritic medial side of the joint. A knee unloading brace can help relieve pain and allow people to do more of their usual activities.

For mild cases of knee OA, you may be given a heel wedge to wear in your shoe. By tilting the heel, the wedge alters the way the knee lines up, which works like the unloading brace mentioned above to take pressure off the arthritic part of the knee.
Range-of-motion and stretching exercises will be used to improve knee motion. You will be shown strengthening exercises for the hip and knee to help steady the knee and give additional joint protection from shock and stress. People with knee OA who have strong leg muscles have fewer symptoms and prolong the life of their knee joint. Your therapist will also suggest tips for getting your tasks done with less strain on the joint.

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