Shockwave Therapy for Knee Pain

Knee pain is a common condition that can occur for a variety of reasons and causes. This informative article will talk about knee pain, and knee pain treatment.

It will go over the anatomy of the knee and some of the causes for knee pain. Knee pain exercises will show how to improve strength and stability of the knee. Knee pain treatment options will be discussed, including, conservative and surgical options.

What is knee pain?

Knee pain is any type of pain that is located at the knee joint. This type of pain can occur at the front, sides and even the back of the knee. In order to understand knee pain and knee pain treatment, we will first go over some basic anatomy.

The knee complex

Front view of knee complex

As can be seen, the front of the knee joint includes the knee cap (patella), quad muscle, knee tendon, and knee joint. Pain located on the front of the knee usually involves the quad muscle, knee cap and tendon.

Sometimes, tendon issues can arise and cause pain where the tendon insert on the bone. With knee arthritis, pain is normally located on the joint line more close the middle of the body.

Sometimes, the quad muscle can get tight and this tightness can be felt above the knee cap. This image allows you to see all the different types of pain areas that can occur in the knee.

Side view of knee complex

As can be seen above, there are very strong ligaments on the side of the knee. These ligaments oppose forces that cause the knee to twist. Usually, these ligament are injured with twisting sprains or falling in awkward positions. As well, the meniscus can be seen here. The meniscus is a joint cartilage that acts the the joints shock absorber. Meniscus is also very important for lubricating the joint.

The ACL and PCL can also be seen from this view. The ACL and PCL ligaments are very strong ligaments located inside the knee joint. These are important for stabilizing the knee especially when the muscle gets fatigues or has a very sudden impact or change of direction. Typically, trauma is the main cause for injury of the ACL and PCL ligament.

Back view of knee complex

The back of the knee is also a complicated structure. This is where you will find the hamstring muscles that are able to bend the knee. In addition, the calf muscle with cross the knee joint. When fluid collects in the knee joint, it can push in the back of the knee. This occurs with bakers cysts.

Common pain conditions in the knee joint?

We know that knee pain is common. The question is, what can cause knee pain? Lets go over some common conditions in the knee joint! And review some common symptoms, functional restrictions, diagnosis, and treatment options.

Knee osteoarthritis

Knee OA is a relatively common conditon that involves a breakdown of the knee joint. This can include swelling, pain in the muscles and knee joint, and decrease function. There is currently no cure for OA. There are many treatment options that can ease symptoms and reduce worsening.

Knee Pain Treatment options for OA

Pain killers can help with pain and stiffness.

  • They do not affect the joint or the repair of the joint. Painkillers are best when in pain or when you are likely to be doing more physical activity.

Combined painkillers

  • May have paracetamol and a codeine drugs. May be helpful for more severe pain, but not always. More research is indicating to perform exercise to improve pain.

NSAIDS

  • Meds like naproxen may be recommended if inflammation is contributing to the pain. Please note, NSAIDs have shown increased risk of a heart attack ,stroke, and bowel issues, especially in prolonged use.

Creams and gels

  • Can be applied directly onto painful joints and muscles. They are well tolerated by most patients. Can help with pain, but do nota dress underlying problems contributing to the pain.

Transcutaneous electrical nerve stimulation (TENS)

  • Often seen in physio clinics. It can can be used for pain relief, but not for everyone. The relief is temporary and normally lasts between 30-45 minutes after use.

Heat and cold therapy

  • Applying heat or warmth is a good way to help with pain. The type of therapy applied may relate to the patient preference and acuteness of the symptoms. Never apply hot or cold directly onto the skin and no longer the 30 minutes in duration.

Physical therapy

  • Physical therapy is effective for improving muscle strength around the knee and hip joint. This can improve function and improve pain relief.
  • Movement can increase joint lubrication and help remove stiffness and pain.
  • Strength exercises are a gold standard for knee OA in early, mid and even late conditions.

Opioids

  • These are getting prescribed less and less. They may help for severe pain in the short term. They are highly addictive and difficult to wean off. Stronger painkillers are more likely to have side-effects. Ask your doctor for advice on safe combinations withe medications.

Cortizone injections

  • These are often given into the knee joint and can start working within a day. Maintenance is normally required and effectiveness can vary between patients.

Hyaluronic acid injections

  • These may help to lubricate your knee joint and are sometimes given when steroid injections don’t work. You may be given a single injection or a course of several injections that are completed at specific times. Limited evidence of effectiveness is reported with ease injections and controversial.

Shockwave Therapy

  • This treatment is effective in mild to moderate OA. It can be used on the muscle that often tightens with OA. Shockwave can also help reduce swelling.
  • Not all patients will respond and it must be combined with hip and knee strengthening exercises.

Knee replacement

  • May be recommended if you have severe pain with mobility issues that are getting worse. An operation can give pain relief in cases where other treatments haven’t helped enough.
  • Certain activities will be restricted for a lifetime.
  • Replacements are reported to last around 15+/- years.

Chronic Knee Tendinopathy

Chronic tendinopathy is a common disorder. It can affect those who compete at all levels and even sedentary individuals. Chronic patellar conditions, or ‘patellar tendinosis’ or “jumper’s knee”, are in elite athletes. Such as, volleyball (over 40%) and basketball (over 30%).
Microtrauma to the tendon can occur with this condition. Especially when the tendon is under repetive forces such as running and jumping.

Treatment options for chronic knee tendinosis

hand over heart

NSAIDS

  • Meds like naproxen may be recommended if inflammation is contributing to the pain.

Creams and gels

  • Can be applied directly onto painful joints and muscles. They are well tolerated by most patients. Can help with pain, but again, they do not address underlying problems contributing to the pain.

Heat and cold therapy

  • Applying heat or warmth is a good way to help with pain. It can help temporary reduce pain but will not cure this condition.

Physical therapy

  • Physical therapy is effective for improving muscle strength around the knee. Typically, eccentric exercises are used and have shown very good results.

PRP injections

  • PRP treated patients demonstrated significant improvements in reduce pain at  6 months an at 12 months.

Shockwave Therapy

  • This treatment is effective but there is some evidence that suggests PRP is more effective than shockwave for knee tendinosis.

Stem Cell Therapy

  • No good evidence for this treatment at this time.

Knee pain treatment considerations

man and doctor getting consult

There are a variety of reasons why a knee may be painful. Today we discussed two reasons, OA and knee tendinopathy. A re-occurring theme is that exercise is the most important part of recovery. If you are intersted in more information about your painful knee give as a call by clicking this link http://regenerateshockwavetherapy.com/contact-us/