Nonsurgical Treatment for Knee Pain

Regenerative Medicine

Stem Cell Therapy for Knee Pain

Mesenchymal Stem Cells (MSCs) are remarkable cells located in many tissues of your body. One of the most important characteristics of stem cells is that they are unspecialized cells with the ability to mature and differentiate into multiple types of tissue including bone, tendon, ligament, cartilage, muscle and meniscus. In addition, these stem cells can self-renew, producing more stem cells. They can even prevent other cells from dying due to lack of oxygen and they can produce anti-inflammatory proteins.

When stem cells are injected into an arthritic knee, they attach to the areas of damaged tissue inside the knee. The stem cells are able to sense the microenvironment of the knee and determine what kind of cells to grow and what molecules are needed to enhance tissue healing. The stimulated stem cells begin to grow new cells and also act as your body’s own natural drug store producing and releasing the right combination of growth factors and proteins to stimulate healing and new growth of knee cartilage, tendon and other injured tissues. Learn more about how Stem Cell Therapy works to relieve knee pain.

Stem Cell Therapy

Platelet Rich Plasma (PRP) Therapy for Knee Pain

Plasma is the clear portion of the blood in which all the other blood components such as platelets, red blood cells and white blood cells travel. Platelets are part of the blood that circulate around the body ready to help stop the bleeding should you have a cut, broken bone or injury that bleeds internally. Besides containing clotting factors, the platelets release growth factors and proteins that help start the healing process of arthritis knees. PRP contains a concentrated amount of platelets that release potent quantities of these growth factors and proteins to stimulate a robust healing response.

Many famous athletes — PGA’s Tiger Woods, NBA’s Kobe Bryant and Steph Curry, MLB’s Alex Rodriguez, tennis star Rafael Nadal, and several others — have received PRP for various problems such as sprained knees and chronic tendon injuries. This treatment technique is relatively new in the field of sports medicine, but has been gaining popularity quickly. Learn more about how Platelet Rich Plasma (PRP) Therapy can relieve knee pain.

PRP Treatment

Knee injections

Your physician may prescribe oral medications for the relief of arthritis pain or joint pain. This can include pills with Aspirin, ibuprofen and naproxen which can relieve pain and reduce inflammation.

If oral medications fail to provide relief, your orthopedic surgeon may recommend an injection of medication into the joint. An injections can offer quick, effective pain relief. However, joint injections with either cortisone, steroids or other medication have limits because over time excessive use can damage the joint.

Knee orthotics and braces

In some cases, knee pain can be alleviated by something as simple as using a foot orthotic or knee brace. Foot orthotics are orthopedic devices like insoles or supports that are usually custom fit to control the foot and correct imbalances. An orthotic foot support can raise the arch of the foot and realign the bones of the foot to prevent excess motion when you bear weight. Foot problems can sometimes cause ankle, knee, hip, and back problems.

If you are an avid runner, and you are suffering from knee problems, you may want to explore an orthotic foot device. The device could position your foot in such a way that knee pain could be alleviated.

Many times, improper foot mechanics leads to improper running or other physical motion, and this can damage the knee. If you are suffering from arthritis, or you are overweight, the foot orthotic could help by repositioning your foot and counteracting stress on your knee to allow greater comfort and mobility for greater lengths of time. Orthotics come in rigid, semi-rigid, and soft materials. The rigid materials are generally prescribed when entire control and support is needed. The semi-rigid materials offer support, but they also allow for shock absorption.

Knee braces can be used to help an existing knee injury, or to protect the knee from future injury. Before these devices are used, you should consult with a physician. If worn improperly, the brace could do damage, and wearing it for a long period of time would not allow the muscles around your knee to grow stronger.

]A study from the Surgical Clinic of the Ullevaal Hospital at the University of Oslo in Norway found that patients in their study using a knee brace after anterior cruciate ligament (ACL) reconstruction had increased thigh atrophy after wearing the brace for three months.

Said another way, using a brace is like using a crutch. While it can help you become active after an injury, depending upon it excessively doesn’t encourage the supporting muscles to strengthen. And in a sense, you become dependent upon that crutch, so when it isn’t there, you can have problems.

With that said, a subliminal function of a knee brace is that it can act like a string around your finger—to remind you to be careful during activity, and not be overly aggressive with the knee joint.

Hyaluronic Acid for a degenerative knee joint

Hyaluronic acid injection is used to treat osteoarthritis. Hyaluronic acid is similar to the natural synovial fluid found in the joints. It works by acting like a lubricant and shock absorber in the joints and helps the joints to work properly.

During the procedure, the orthopedic specialist injects hyaluronic acid directly into your knee joint. The injection is repeated for up to 3 to 5 weeks. While the FDA has approved this treatment only for osteoarthritis of the knee, some use it for other arthritic joints as well as they report that it acts like lubricant in the joint.

Hyaluronic acid injections do not seem to work for all people. Those who are older or have advanced arthritis, may be less likely to find relief from these injections. Generally speaking, Hyaluronic Acid is often a last resort before more invasive knee surgery.

There can be some swelling in the knee area as a side effect of the injection. One study in 2016 in the journal Systematic Reviews found the possibility of serious side effects outweighed the benefits.

Micro-particle injection

Another non-surgical treatment option that is being explored is the use of tiny pellets that might treat arthritic knee pain, delaying the need for knee replacement surgery.

A small study by the Society of Interventional Radiology found that inserting micro-particles into small blood vessels around the knee reduced pain and improved function. The tiny micro-particles — spheres about a tenth of a millimeter in size — are made from a synthetic gel-like material. The micro-particles are inserted using a catheter run through a pinhole-sized incision, in a procedure that lasts between 45 and 90 minutes. While the research is preliminary, they have noted some patients experienced relief of symptoms from the procedure.

Knee therapists & customized exercises

For someone suffering knee pain the mere thought of exercise can be painful. For most knee problems specific exercises help rehabilitate injured tissues, strengthen weak muscles, and improve flexibility and range of motion.

A therapist who is specialized in knees can help an athlete rehab a partially torn ligament to avoid surgery. A knee therapist can also customize exercises that simulate the activity you hope to return to (e.g. golf, tennis, running) to strengthen the knee joint and lessen risk of injury. Same can be said for rehabilitating the knee after a surgical procedure to regain normal range of motion.

What are the best home remedies for knee pain?

There are several things you can do for relief of simple knee pain that doesn’t relate to trauma, fracture or a chronic arthritis syndrome.

Anti-Inflammatories

Non-Steroidal Anti-Inflammatory medication, or NSAID’s, such as ibuprofen can help reduce swelling and inflammation. The problem with using any drug, including ibuprofen, is that it also masks the pain of a knee injury and can damage internal organs (e.g. liver, ulcers) over extended use.

Drugs can also encourage the person to continue to abuse the knee and worsen the injury to it. For knee pain that lasts longer than a few days, the person really needs to seek out an orthopedic surgeon so they can determine the cause of your knee pain symptoms. There are many new NON-surgical treatment options now that can relieve the pain symptoms without relying on drugs that mask the symptom and may have dangerous side effects on a liver or other internal organs.

If you are a weekend warrior and have caused some knee pain with too much activity, you can try the following as a home remedy for knee pain:

Rest, Ice, Compression, Elevation = RICE

This is an easy to remember four-step formula for treating a knee injury that is incurred from activity.

• Rest, means to keep the knee away from any stressful activity, preferably immobile initially.

• Ice means to apply ice to the knee to control swelling and inflammation. Wrap ice in a towel so that it does not agitate the skin.

• Compression will help prevent hemorrhaging or internal bleeding.

• Elevation. Elevate the leg above the heart to reduce internal bleeding.

Other home remedies for knee pain:

Other home remedies for knee pain to delay joint replacement surgery can include:

  1. knee braces to restrict painful range of motion
  2. exercise and stretching
  3. weight loss to reduce pressure on the knee joint
  4. over-the-counter anti-inflammatory medication
  5. steroid injections into the joint
  6. hot packs and cold packs
  7. regenerative medicine procedures such as stem cell replacement
  8. alternative therapies, such as acupuncture and yoga

Weight loss to reduce knee pain symptoms

According to the US Government, 56% of Americans are overweight. This is bad news for our knees. Scientifically speaking, our knees form and develop in mass and strength in proportion to the amount of weight our body was designed to hold. So, if you are a small woman, your knees are meant to hold a smaller amount of weight than if you are a six-foot tall man. Although the body is very adaptable and can learn to hold different weights, a point can be reached where the body is simply not comfortable supporting the excess weight.

Body Mass Index is the number you come up with when you divide how much you weigh in kilograms by how tall you are in centimeters squared. The number you come up with is your BMI. A BMI between 18.5 and 25 is considered in the normal range. A BMI above 25 is considered overweight and a BMI of 30 or more is classified as obese. To find your BMI, there are several calculators on the Internet including the BMI recommendations from the Surgeon General.

Diet

Losing weight can provide instant relief for the knees. Although we are constantly inundated with new diet fads, remember that logically, the way to lose weight is to consume fewer calories than we burn and the way to maintain weight is to burn approximately the same number of calories that we burn.

Although in reality, this method can be harder to follow than it is to understand, once we build healthy habits, this lifestyle will become easier and easier to maintain. Some diets help you to do this. Others are shams. Be cautious. Anything that seems to good to be true, probably is.

If you have arthritis, there are pain aggravators that should be avoided. For instance, paprika, pepper, tobacco, cayenne, eggplant, large amounts of potatoes and tomatoes can irritate your arthritis because these foods have alkaloids that prevent the repair of collagen and cartilage. Aspartame (found in diet sodas and artificial sweeteners) can also worsen arthritis since in causes inflammation in the joints when regularly consumed.

In study after study, it seems almost innumerable health benefits can be accumulated from eating a diet rich in fiber and complex carbohydrates found in vegetables, whole wheat and fruits. Once again, knees also benefit from this diet.

Exercise

It is also important to incorporate exercise into your routine if you have knee pain. Although it may seem like a Catch-22 (you cannot exercise because your knee hurts, and your knee hurts more because you cannot exercise) strengthening the leg muscles can be crucial in alleviating knee pain.

The more support the muscles can offer, the less stress and therefore less pain. Please refer to our online exercise library, which will show you several knee strengthening exercises. Also, if your knee hurts and you want to start up an exercise routine, why not try a stationary bike or swimming? While running or stair climbing can be taxing to the knees, the stationary bike and swimming are both excellent cardiovascular activities that only minimally put pressure on the knees.

Glucosamine and Chondroitin Sulfate

Nearly 40 million Americans, or one in seven people, have arthritis. For many, the arthritis causes pain in the knees and joints. Early on, glucosamine and chondroitin sulfate were recommended as a non-surgical treatment option for knee pain.

But today, the American Association or Orthopedic Surgeons (AAOS) strongly advises against taking them in the form of dietary supplements for treating osteoarthritis of the knee

According to the AAOS, people who use these supplements hope they are going to get pain relief from osteoarthritis, and perhaps even some repair of the cartilage. Both glucosamine and chondroitin sulfate have been used in Europe for several years, with few reported side effects. Both supplements also have some anti-inflammatory effect.

But there is no study proving that either glucosamine and chondroitin, taken singly or in combination, will slow the degenerative process or improve the cartilage in arthritic joints. All studies done to date have been short and focused on pain relief. A long-term study is just beginning, sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Center for Complementary and Alternative Medicine.

Lastly, according to the AAOS, glucosamine and chondroitin sulfate are not tested or analyzed by the Food and Drug Administration before they are sold to consumers, which means there is little regulation that the consumer is even getting what they pay for. A recent study by ConsumerLab.com revealed that about half of the glucosamine and chondroitin supplements tested did not contain the amount advertised.

Similarly, according to Cochrane Report, a respected medical research journal, a Cochrane meta-analysis in 2007 found that the “symptomatic benefit of chondroitin was minimal or nonexistent. Use of chondroitin in routine clinical practice should therefore be discouraged.” A second Cochrane review in 2016 again found that many of the studies that touted the benefits of the chondroitin were low quality or flawed.

For more information or to schedule an appointment, call:

817-335-4316

or…

Request an Appointment