Do You Have A Dull Achy Pain In Your Knee?
Knee Osteoarthritis And How Can Affect You
If you have osteoarthritis of the knee, the cartilage over your knee joint bones gets scraped and worn down. This leaves the bones in your knees with little or no cushioning and as the cartilage becomes very thin it can result in friction, damage, inflammation. Even small bone fragments that float into the joint cavity and cause more aggravation. Osteoarthritis of the knee usually develops slowly over the years.
Osteoarthritis affects approximately 12% of the United States population (approximately 21 million adults; it is the most common type of knee arthritis. It is a progressive musculoskeletal, degenerative disease that wears away the articular cartilage and underlying bone in your knee joint, triggering chemical reactions within the knee joint that cause destruction. It can be very painful, weakening and eventually deforming.
A study published by the Louisiana State University Health Sciences Center reviewed radiographic evidence and estimated that osteoarthritis of the knee affects 25% - 30% of people between 45 - 64 years of age, 60% of people older than 65 years of age, and 80% of people older than 75 years of age.
What are the symptoms Knee Osteoarthritis?
The symptoms of knee osteoarthris can differ widely from person to person, ranging from very debilitating and occuring suddenly - to mild development gradually over time. Some that is suffering from knee osteoarthritis may experience few symptoms - even with obvious degeneration in their knee joint as shown on an X-ray. It is not unusual for someone with knee osteoarthritis to go pain-free for months or even years between episodes of greater pain symptoms.
Knee osteoarthritis symptoms don't generally affect other areas of your body. They are generally localized to one area; however they can affect people in different ways. Some people will only have a problem with 1 knee, others will have it with both knees, some experience gradual pain with little change over the years, others experience vast changes over the years. Often the cartilage on the inside of your knee, wears out faster than on the outside of your knee.
Early Knee Osteoarthritis Symptoms
When you have early osteoarthritis in your knee you generally will experience the following symptoms:
Constant or Recurring Pain or Tenderness - Pain and tenderness in your knee joint can be ongoing and feel like a dull tooth ache pain, or it can be a sharp, throbbing pain with sudden movements. Often you will feel pain and tenderness along the sides of your knees, over your knee joint line (where tibia and femur meet) and in front of your knee.
Pain is often worse in the morning or evening, or when you move your leg from a bent to straight position (or vice versa), or when you participate in a prolonged walking or standing activity (non-movement). Changes in weather or different seasons of the year can make a difference to the sensitivity you feel in your osteoarthritic knees (however, knee pain can be experienced in all weather environments). As the atmospheric pressure falls, the nerves in your knee are sensitive and react to pressure changes.
Stiffness will often be experienced in your knee joint, which will limit your range of motion so that you are not able to bend or straighten your knee all the way; making it difficult to climb stairs, or get in and out of chairs or bathtubs. This can result from periods of inactivity (morning stiffness, sitting or standing for long periods of time), or after vigorous movement in athletic or work pursuits. It generally lasts up to 30 minutes however it can persist for longer periods of time. It will often be difficult to use or move your knee joint normally during this time.
This makes your knee feel very stiff. As a result, your joint cavity produces extra fluid in the joint which is comprised of destructive proteins and enzymes that cause the cartilage and bones to deteriorate further. This causes your knee to swell up (known as "water on the knee"). The surrounding knee bones react by growing thicker. The bone at the edge of your knee joint eventually grows outward and develops into bony spurs (osteophytes), which affects your femur, tibia and patella.
Your knee joint tries to repair itself by creating these bony spurs however they generally just make your knee more painful and difficult to move; leaving thin parts on some areas of the knee and thick parts on other areas. Your joint capsule and ligaments then slowly thicken and shrink, and your leg muscles weaken (atrophy), which in turn creates instability in your knee joint (it gives way when you walk or put weight on it).
Swelling in your knee joint can occur either immediately if your blood vessels are disrupted because of a traumatic event, or within 12 hours after your joint tissues become inflamed. Swelling over time is a result of synovial fluid filling the joint cavity, as your body tries to protect itself (this is often called "water on the knee"). Warmth and redness that sometimes accompany swelling are normally not associated with osteoarthritis.
Progressive Knee Osteoarthritis Symptoms
As your knee osteoarthritis progresses, you may start to develop the following knee symptoms:
Deformity and joint enlargement will eventually result as your cartilage degenerates and bones become damaged. Bone spurs, cysts or overgrowths can develop as a result of ongoing knee symptoms due to your osteoarthritis. These are often tender when your skin is rubbed over them; and can result in irritation of other tissues and swelling. They can make it difficult to move your bones and can change the shape of your joint which force the bones out of their normal position and lead to deformity - knock-kneed/bowed-legged appearance.
Grinding, Popping or Locking - Knee joint grinding, clicking, popping or locking when you try to bend or straighten your knee can result from arthritis, as well as other knee injuries. This can range from being annoying to downright painful and can last a few seconds or be persistent for a few weeks. Joint locking often occurs after long periods of inactivity, when the meniscus fragment does not work its way out of being lodged between your bones. You will often feel a click or snap when it eventually unlocks. Sometimes you may have to manually move or manipulate your knee to get relief. You may experience your knees giving way because your thigh muscles have weakened, you've damaged ligaments or you have a Popliteal or Baker's Cyst (soft lump at the back of your knees leading into your calf).
Difficulties Performing Activities - Functional limitation as a result of osteoarthritis is very common in daily activities, work and/or recreational pursuits. This makes it very difficult to stoop, bend, kneel, stand more than 2 hours, walk 1 mile, push a heavy object, climb a flight of stairs, lift or carry 10 pounds, sit more than 2 hours, reach above your head and/or grasp small objects (as noted in the figure below).
Depression and anxiety will often be experienced as the osteoarthritis symptoms progress and you start to feel like a hostage in your own body. These often leave you feeling fatigued, irritable, restless, hopeless, and guilty. Your pain and inability to participate in everyday activities may make it more difficult for you to concentrate and make decisions, and your interest in the people and things around may start to decrease. Overall your self-esteem and self-image really decline. However, it is possible to treat your osteoarthritis symptoms, you can start to feel more like your old self and begin to return to the activities you enjoy.
Unfortunately, there is no cure for osteoarthritis but symptoms can be controlled and, for most, you can find relief from the pain.
What Causes Osteoarthritis In The Knee?
Arthritis is your knee's biggest enemy, and it can result over time from injury or disease. Osteoarthritis in the knee is the most common type, and there are a number of causes that influence your risk of developing it. These can be broken down into 2 types: primary osteoarthritis and secondary osteoarthritis.
Primary Osteoarthritis of the Knee
This is a slow, progressive arthritis condition that usually begins after 40 years of age. It mainly affects weight-bearing joints (like knees and hips) as a result of excessive loads placed on normal joint tissues, or reasonable loads applied on inferior joint tissues. The exact cause is not determined however it is believed to be affected by:
- Family history and/or genetics - The occurance of osteoarthritis in several members of the same family suggests there is a genetic link in type of arthritis
- Obesity - Excess weight on the knee joint increases the stress load that the cartilage in the knees must withstand. This can cause damage and inflammation in the joint to occur. According to the 2002 National Health Interview Survey, obese adults are up to 4 times more likely to develop knee osteoarthritis than normal weight adults; approximately 66% of adults with arthritis are overweight.
- Aging - As the water in cartilage increases with age it changes the protein makeup making the cartilage more prone to damage, irritation and inflammation.
- Wear and tear - As your knee joint experiences wear and tear there is a release of destructive enzymes which break down the cartilage to the point where the bones of the knee joint rub together and develop sclerosis (a hardening of tissue) as well as tiny fractures, cysts and bone spurs.
- Gender - Males are at greatest risk of experiencing the affects of Osteoarthritis before the age of 45, however, by the age of 55, the number of women sufferers surpasses men.
- Lack of activity - Without exercise or activity, muscles weaken and you begin to lack the proper muscle support. This can cause excess load on the knees and hips or your weight may be distributed unevenly within your knee joint causing damage to occur.
Secondary Osteoarthritis of the Knee - This type of arthritis often appears before 40 years of age. It is the result of a clearly defined cause, such as:
- Acute trauma from a knee injury, loose joints, or joint surgery (bone injury or fracture, ligament, tendon, meniscus or synovial tissue damage), especially if it never healed properly. Osteochondritis dissecans results in fragments of loose cartilage in the joint, and often leads to osteoarthritis.
- Repetitive stress movements or strains that result in excessive bending, excessive walking, or overuse of your knee joint at work or play.
- Blood disorders or joint infections (such as gout or septic arthritis).
- Metabolic imbalances resulting from increased levels of uric acid, calcium deposits, or ongoing use of medications.
- Hormone disturbances as a result of diabetes or growth hormone disorders that affect cartilage wear. Menopause often increases the progression of osteoarthritis of the knee.
- Poor bone alignment or posture (your joints don't line up properly) can result in Chondromalacia patellae (Patella femoral syndrome and Runner's knee), which involves degeneration of the cartilage on the back of the knee cap. Women are more prone to this condition as they tend to have wider hips than men, which creates a wider angle at their knee. This can affect tracking of their knee cap and cause imbalanced weight on their joint, which can pose problems with instability, dislocation or pain (like a tire that is out of alignment, the treads will wear out on one side of the tire). You can often look at your shoe treads to see if one side of your heel is worn out more than the other to determine if you have alignment issues.
Progression of Osteoarthritis can be classified into 5 stages of severity:
- Grade 0 - Normal, no loss of cartilage or damage
- Grade 1 - Chondromalacia involves early onset of osteoarthritis; softening of cartilage, joint surface stress, and fluid filling the joint cavity. As the condition progresses your knee gets inflamed and swollen, but there is no major joint surface damage at this point.
- Grade 2 - Fissuring, tearing or cracking of joint cartilage; this damage often goes unnoticed.
- Grade 3 - Fibrillation indicates later onset of osteoarthritis; very torn and worn appearance, damaged cartilage covering bone (bone is still in tact). Your damaged joint surface breaks into loose pieces which release enzymes that aid in destructing your joint surface. Up until now minor surgery can help your cartilage to heal.
- Grade 4 - Exposure and damage of underlying bone; healing without surgery is low.
Diagnosing Osteoarthritis in the Knee
As mentioned previously, the most common form of arthritis in the knee is osteoarthritis; however you can be diagnosed with more than 1 form of arthritis at a time. Medical professionals (such as an orthopedic surgeon or physician) will be able to assess and test whether you have knee arthritis, and then will determine what type you have through a variety of processes.
To help your doctor achieve a proper diagnosis, he/she will begin with a medical history about you, your current condition and symptoms. They will inquire about the intensity of your present pain, the duration of your symptoms and the limitations you are experiencing. Details about what instigated the problem, when it started, and whether or not you have ever had treatments for this or a similar condition in the past, are very helpful in assessing your injury.
A physical examination will be performed to determine if you have any signs of knee arthritis or other knee injuries. Your doctor will visually assess and palpate (feel) the bones and soft tissue in and around both of your knees to evaluate symmetry and recognize differences. This will identify any abnormalities, such as mild or severe inflammation, fluid, bone deformity, and weakened muscles. He/she will press on the injured side of your knee joint to test for point tenderness and help determine the main location of your injury. He/she may ask you to complete a series of knee and leg movements such as moving your knee from a bent to straight position (or vice versa), or rotating your knee to see what motions cause pain, weakness, instability and/or grinding, catching, popping or locking. These sounds or restrictions will often indicate a soft tissue tear and/or arthritis in your knee.
Common Knee Osteoarthritis Diagnostic Tests
A medical professional will sometimes recommend diagnostic testing to obtain more detailed information, and assess the amount and/or type of damage done to your knee. There are a variety of different tests available to help them analyze the situation; however these will be dependent on the degree of your injury.
X-rays will provide a two-dimensional image of the overall structure of your knee. It is helpful in identifying loss of joint space, arthritis, abnormal bone shapes such as bone spurs or bone cysts, fractures, and degeneration (wear and tear) on the joint.
X-rays can be helpful to exclude any other possible causes of your knee pain and assist the doctor in determining if surgery should be considered for your specific situation.
MRIs (magnetic resonance imaging) will provide more detailed information and will help to evaluate the soft tissues in and around your knee joint (muscles, tendons, ligaments, menisci, other connective tissues).
It can identify ligament and meniscal damage, and help to determine the extent of your injury, the displacement and degree of your tear, fluid on your knee, a discoid meniscus and/or other associated conditions.
Joint aspiration (arthrocentesis) involves withdrawing and analyzing fluid from your knee via needle and syringe. This will help to determine if there is inflammation and the cause of your joint swelling, for instance gout or some kind of infection. Arthrocentesis can be performed in your doctor's office.
Blood tests cannot diagnose osteoarthritis, but may be ordered to rule our other causes of knee pain, like rheumtoid arthritis.
Arthroscopy is used to visualize and repair damage to the knee. A small incision is made in the knee and an arthroscope with a camera is inserted to look inside the the knee joint and assess any damage.
Further diagnostic tests such as CT or CAT scans (computerized tomography) or diagnostic ultrasound can be used to determine the degree and location of your injury if required.
When a flareup occurs or when it is irritated by overuse or re-injury, you experience swelling and inflammation in your knee. Using ice packs to treat your knee helps reduce pain, swelling, and tissue damage.
Application of cold works by slowing nerve and tissue function in the knee. This is important because once blood vessels are damaged, they can no longer carry oxygenated blood to the meniscus and tissues begin to break-down.
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Scar Tissue & ReInjury
Resting an injured knee is important for the bodys natural healing process and this takes time. Not resting an injury can increase risks of a long term injury (chronic). To repair damaged tissue, the bodies quickest way to heal is to create scar tissue and adhesions - this is good in the short term, but in the long term will be problematic.
The growth of scar tissue and adhesions can lie in any direction. Ultimately what causes stiffening in the tendon and muscle, entrapping a nerve, restricting movement, less elasticity, poor circulation, and flexibility.
Unfortunately, scar tissue may plague you for weeks, months and maybe even years, depending on your level of activity and the amount of conservative treatments you have done during your rehabilitation. Scar tissue is a major problem, especially when it comes to re-injury of your tendon or muscles. When dealing with scar tissue it is always important to:
- listen well to your physician and if conservative treatments are recommended and remember to stick to your (daily) treatment plan using these therapies
- frequent use of a cold compress (or bag of frozen peas) will help reduce swelling quickly. Much of the pain you feel will be from the swelling, and you will be surprised how fast the pain drops off once the swelling is down.
- T•Shellz Wrap® is a safe, medical device that is, in our view the most effective home conservative treatment tool to help reduce scar tissue and increase blood flow to soft tissue in the knee (thereby accelerating the body's own healing process).
- when applied before stretching, the T•Shellz Wrap® will help flush the area with fresh blood. This will help improve your range of motion and prevent re-injury.
T•Shellz Wrap® Circulation Boost
When you stop moving your knee because it hurts the amount of blood that flows naturally to your knee joint is reduced, limiting your body's natural ability to heal itself.
Once inflammation and swelling have been reduced in your knee, nourishing and strengthening soft tissue in your knee joint is the goal. A Knee T•Shellz Wrap® boosts blood flow to the treatment area, bringing necessary oxygen and nutrients to soft tissue in your knee. This boost in blood flow speeds up the body's natural repair process for faster healing and improved tissue health in the knee.
In addition, the fresh blood flow whisks away dead tissue and toxins (including lactic acid, commonly found in trigger points) that have built up from the injury leaving the area clean and better prepared for healing. Our Knee T•Shellz Wrap® provides effective, non-invasive, non-addictive pain relief with no side effects. Improved blood flow also helps reduce the risk of atrophy in your muscles. When you stop moving your leg and knee due to pain, your muscles and other tissue can become weaker and dead tissue and toxins in the area can cause further tissue deterioration - this can lead to atrophy (muscle weakness and/or deterioration) in your quadriceps, hamstrings and other leg muscles. The Knee T•Shellz Wrap® is an amazing tool that can be used to help combat this problem.
Keeping your knee as healthy and strong as possible throughout the healing process will allow you to get back to your regular activities faster. The Knee T•Shellz Wrap®, available exclusively from MendMeShop®, provides effective, non-invasive, non-addictive pain relief and enhanced blood flow with no side effects.
Circulatory Boost (via use of the Knee T•Shellz Wrap®) compliments your body's natural healing process by promoting blood flow while you give your knee the rest it needs. Energy emitted from the Energy Pad stimulates blood flow to your knee, more than your body would ever be able to generate on it's own, giving your body the boost it needs to continue the reconditioning process. This enhanced blood flow helps speed tissue repair, whisk away toxins and dead tissue, and rejuvenates soft tissue for improved elasticity. Circulatory Boost enhances your body's own healing process by simply increasing the amount of blood that flows to your leg and knee to improve the health of your tissue by delivering an abundance of nutrients to the area.
The benefits of Circulatory Boost do not end once your knee pain stops! A T•Shellz Wrap® treatment before activity is an easy way to warm up the knee tissues and prepare them for use. Then, end your day with another treatment to prevent tightness from setting in overnight.
During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your knee area until your pain and inflammation settle. With these therapies you will notice great improvement within a few weeks, with many patients seeing some improvement quickly. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results. If you start using your knee before it has a chance to heal properly (even though it may feel better), you can end up doing a lot more damage than good!
It may seem hard to believe, but our T•Shellz Wraps® and other home therapy products will assist you in recovering from your injury faster and reduce the chance of degenerative conditions by maximizing blood flow where it is needed most, reduce swelling and inflammation induced pain.
Should You Seek Medical Attention?
This is up to your discretion; however any continued discomfort in your knee should be investigated. If you experience any of the symptoms for more than 2 weeks, or you find the symptoms interfere with daily living (can't complete normal task) and you've tried the initial conservative treatments. It is recommended that you seek professional medical attention when you experience:
- Increased or constant instability or inflammation of the knee (swelling, pain, heat or redness) that lasts longer than 3-4 days.
- Locking, catching or buckling of your knee on a regular basis, or very limited range of motion (can't fully extend, bend or rotate your knee or lower leg).
- Constant clicking, popping or grinding sounds in your knee.
- Unable to participate in activities or work due to the pain or limited range of motion.
- Knee looks deformed or you have significant bruising around that area.
- A traumatic accident may have broken or dislocated a bone.
- Any other unusual symptoms.
Taking measures to protect your knees and maintain healthy joints is something everyone can do to prevent knee pain. Should knee injury or disease become a part of your life, understanding your condition is the first step in determining the appropriate treatment.
Get an accurate diagnosis from your physician and discuss your options. Proper treatment will allow you to resume your activities faster and safer.
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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!