Image via WikipediaPain in knees may have several causes, many are of academic interest. For practical purposes;- Trauma in all ages.
- Osteoarthrosis (OA) in mid and old age,
- Rheumatoid arthritis in mid ages,
- Rheumatic arthritis in children and adolescents,
- Other blood diseases like Sickle cell disease or Hemophilia, and
- Gout;
Osteoarthrosis (OA) is mostly seen;
- In both the sexes, perhaps male are a little more likely to get it.
- Single most important predisposing factor is obesity and weight gain.
- Stress and strain to knees due such nature of work or sports activity.
- Age related wear and tear.
- Osteoporotic females after menopause.
- Typical history of starting pain, relief after some walk; in late cases pain either in rest or walk; and age of patient.
- Restricted movement in late cases.
- Digital x-rays examination of knees.
- MRI (Magnetic Resonance Imagining), usually not required; but a good tool.
- Absence of positive markers for more aggressive inflammatory collagen diseases like;
- Much raised ESR (Erythrocyte Sedimentation Rate)
- RF(Rheumatoid Factor).
- CRP(C - reactive protein), but may sometimes seen to be raised in OA.
- ASO (Anti-Streptolysin-O) titer.
- LE Cell Phenomenon. Or
- ADSDNA ( Antibody against Double Stranded DNA)
Treatment of OA is a cumbersome task. Still some conservative approaches give good result and surgery can be avoided.
- Weight reduction if overweight.
- Avoiding more strenuous work/sports activity those put pressure on knees.
- Physiotherapy, especially swimming, easy walking; and lifting some weight kept on the foot from a hanging leg supported at knees; like sitting on a table top and hanging the legs freely from the edge of table.
- Apart from these measures, medicinal treatment like;
- Simple analgesics like paracetamol.
- Vitamin D and calcium supplementation.
- Methylcobalamin or Vitamin B 12.
- Prescription of Diacerein and pregabalin.
- Application of diclofenac on the joint after moist heat application.
- Interventions like;
- Arthroscopy and removal of free floating bodies in the joint space if any.
- Injection of steroids like Triamcenolone into the joint space which gives quick results but effect lasts short requiring more session, which may eventually have adverse effect on the joint.
- Injection of Hyaluronidase may be of help in early disease.
However, conservative treatment with good physiotherapy will go a long way in coping with Osteoarthrosis (OA).
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