All Posts tagged Knee Osteoarthritis

Knee Osteoarthritis

2007-2009. For men and women, the prevalence of age-adjusted arthritis increased significantly with increasing BMI (P <.001 for trend). The age-adjusted prevalence of OA among people who were obese (25.2% for men and 33.8% for women) was nearly double that of people who are underweight/normal weight (13.8% for men and 18.9% for women). Source: CDC. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation— United States, 2007-2009. MMWR. 2010;59(39):1261-1265.

Treatment options for OA

In patients with knee OA, my approach tends include shoe inserts. These  are good adjuncts to supplements, laser, Deep Muscle Stimulation (DMS), injectables, taping, and exercise therapy. I recommend swimming, recumbent bicycles, rowing machines and elliptical trainers. I teacgh my clients a lot of low load, easy to do stretches and strenghtening exercises. Weight loss is really important here. 

On laser therapy for treating patients with knee OA:  It depends on the patient and the severity of his or her OA. For example, if the patient is older and has a severely arthritic knee, a total knee replacement will probably be necessary. If a patient has OA and joint effusion, I might recommend laser, aspiration and corticosteroid injection.

If I have a patient with symptoms of OA who may have incurred an injury such as an ACL tear, I will use warm laser and DMS. 

If you have undergone an arthroscopic procedure, but not yet fully out of pain, I will use laser. 

I often use glucosamine and chondroitin sulfate with high dose omega 3’s.

I like topical menthol products such as BioFreeze. These have evidence of efficacy.

There are dangers of using cortisone, which has been administered for years as an injection in the joints. If any of my patients ask for cortisone because it worked when administered to them 10 years ago, I would educate them on safer long-term options. The most common recommendation I have for most of my patients is to eat less carbs and exercise more. I love the anti-inflammatory diet coupled with UltraInflamX by Metyagenics and high dose omega 3 fish oils. Through weight reduction and a low-impact exercise program, many patients will achieve dramatic improvements in their arthritis pain.

My goal for patients is to decrease pain and inflammation, maintain or improve function and retard disease progression if possible. In this regard, preventing damage to subchondral bone, cartilage, joint space narrowing and osteophyte formation is the goal. 

The contraindications for NSAIDs include gastrointestinal (GI) bleeding or adverse effects to the kidneys or liver. Some patients worry about taking a glucosamine product because they have diabetes, but I inform them no data support this concern. 

I might recommend UltraInflamX by Metagenics alot. I like garlic, ginseng and gingko — but these affect bleeding time. If used in conjunction with NSAIDs, the risk of GI problems increases.

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Knee osteoarthritis

Ideal treatment for joint pain should include Pycnogenol, a pine bark extract with anti- inflammatory effects. Pycnogenol has been shown to help knee osteoarthritis,  conditions that need enhanced blood flow,  symptoms of menopause, and diabetics manage blood sugar levels. 

Dr. Tucker recommends combining  Pycnogenol  (150 mg of Pycnogenol daily), glucosamine and chondroitin sulphate ( 1500 mg daily), with omega-3s( 2-3 grams daily) to reduce inflammation related to knee OA.

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Laser therapy

The Effect of Low-Level Laser in Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Trial
Béla Hegedűs, László Viharos, Mihály Gervain, Márta Gálfi. Photomedicine and Laser Surgery. August 2009, 27(4): 577-584. doi:10.1089/pho.2008.2297.
Published in Volume: 27 Issue 4: August 20, 2009 Online Ahead of Print: June 16, 2009

Introduction: Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as a biomodulatory effect on microcirculation. This study was designed to examine the pain-relieving effect of LLLT and possible microcirculatory changes measured by thermography in patients with knee osteoarthritis (KOA).
Materials and Methods: Patients with mild or moderate KOA were randomized to receive either LLLT or placebo LLLT. Treatments were delivered twice a week over a period of 4wk with a diode laser (wavelength 830nm, continuous wave, power 50mW) in skin contact at a dose of 6J/point. The placebo control group was treated with an ineffective probe (power 0.5mW) of the same appearance. Before examinations and immediately, 2wk, and 2 mo after completing the therapy, thermography was performed (bilateral comparative thermograph by AGA infrared camera); joint flexion, circumference, and pressure sensitivity were measured; and the visual analogue scale was recorded.
Results: In the group treated with active LLLT, a significant improvement was found in pain (before treatment [BT]: 5.75; 2 mo after treatment : 1.18); circumference (BT: 40.45; AT: 39.86); pressure sensitivity (BT: 2.33; AT: 0.77); and flexion (BT: 105.83; AT: 122.94). In the placebo group, changes in joint flexion and pain were not significant. Thermographic measurements showed at least a 0.5°C increase in temperature—and thus an improvement in circulation compared to the initial values. In the placebo group, these changes did not occur.
Conclusion: Our results show that LLLT reduces pain in KOA and improves microcirculation in the irradiated area.

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