Knee pain? Here’s some options

By Dr. Armin Harandl

More people than ever are opting for joint replacement

If you’re one of the growing numbers of Americans suffering from constant knee pain, you know it can hurt your quality of life – and take away activities you love. That’s why more people than ever are opting for knee replacements.

In fact, more than 700,000 knee replacements are performed each year, and the rate of total knee replacement from 2000 through 2010 grew 86 percent for men and 99 percent for women, according to the Centers for Disease Control and Prevention (CDC).

Knee pain and back pain account for among the top 10 visit types overall for people seeking care based on CDC statistics.

With an aging population wanting to remain active, and with obesity on the rise, it is estimated that knee replacement cases will exceed 3 million a year by 2030.

“These numbers are not surprising, given that 9 out of 10 knee replacement patients report a significant improvement in their pain following surgery,” said Dr. Armin Harandi, an orthopedic surgeon at UVA Orthopedics, a department of Novant Health UVA Health System Culpeper Medical Center. Here’s a look at causes and options when it comes to knee pain.

1. What are the causes of knee pain?

“In general, the most common causes of musculoskeletal knee pain include osteoarthritis, bursitis/tendonitis, overuse injuries and trauma/acute injuries,” Harandi said.

“In assessing patients for knee pain, it is important to start with an accurate history to help narrow a diagnosis for a broad symptom such as knee pain,” Harandi said. Among the issues a provider will assess:

  • Is the pain chronic, or did it come on suddenly?
  • Is there swelling?
  • Does the patient have a history of previous injury or surgery?
  • Are there other symptoms present?

Providers will also examine patients to determine a specific pain location in the knee as well as areas above or below the joint. “Atypical or ‘red flag’ signs noted may indicate consideration of less common causes such as fractures, infections, tumors and rheumatologic processes,” Harandi said.

2. Who is most vulnerable to knee pain?

“Patients 50 years old and older are susceptible to pain caused by musculoskeletal issues, particularly osteoarthritis,” Harandi said. “It is even more frequent in people older than age 65.”

Osteoarthritis has been diagnosed in 23 percent of Americans, and arthritis is the leading cause for disability in America, according to the CDC. “Knees are a significant contributor to this number,” Harandi said.

That is not to say that younger people are not vulnerable to knee pain as well. “Knee replacement surgery is based on a patient’s pain and disability, not age,” he added.

3. Nonsurgical treatment options

In some cases, treatment may simply require resting the leg, elevating it, and applying ice packs and compression. Anti-inflammatory medicines are usually sufficient to help with the pain.

“Strengthening and stretching exercises or physical therapy may be recommended as well,” Harandi said. “Sometimes a brace may be necessary short-term. If the pain is related to chronic osteoarthritis, there are some joint injections that may be of benefit.”

Weight loss is another area that Harandi may recommend. “There are many studies with clear evidence of osteoarthritis in knees being linked with obesity,” he said. “Moreover, there are studies showing improvement of joint pain and quality of life with weight loss.”

Obesity is a growing concern related to knee pain in children. “One-third of all American children are overweight or obese, and this is continuing to increase,” Harandi said. “Over the years, this becomes a major contributor to joint pain and osteoarthritis.”

These are normally the first line of treatments unless the pain is caused by an injury or trauma.

4. When surgery becomes necessary

When basic measures don’t work, patients may need to see an orthopedic surgeon,” Harandi said.

When surgery is required, “Patients can expect get to back to enjoying their same activity level prior to surgery — but without the pain,” said Harandi. “Most patients can stand up and walk the day of surgery, and experience significant improvement in their pain after surgery.”

“With minimally invasive surgical techniques, pain control and early rehabilitation, we see patients recover from surgery faster than before.” Harandi said. “Even when knee replacement patients live alone, the vast majority of patients recover just as well, and may experience fewer complications, if they go home directly from the hospital. Outpatient rehabilitation is also less costly than spending days or weeks in a rehab facility.”

If you suffer from knee pain, plan to attend a free lecture on Common causes of knee pain and treatments presented by Dr. Armin Harandi, a physician at UVA Orthopedics, a department of Novant Health UVA Health System Culpeper Medical Center. The lecture will be held Wednesday, Feb. 7 at 6:30 p.m. in the Board Room at Culpeper Medical Center, 501 Sunset Lane. To schedule an appointment with Dr. Harandi, call 540-321-3120.

You can also talk to your primary care provider about knee pain you’re experiencing. He or she may refer you to a specialist for care. If you don’t have a primary care provider, find one at NovantHealthUVA.org.

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