Symptoms of Arthritis in Knee

Keywords; symptoms of arthritis in knee.

Advanced degenerative joint disease in the lower limb is one of the most difficult conditions to manage in any chiropractic or medical clinic. Taking drugs for an extended period is not recommended with a serious gastrointestinal bleed in every thousand cases resulting in one death in 10,000 people.

If you take more than one tablet, say brufin and aspirin, then the rate of an abdominal hemorrhage rockets. Dual antiinflammatory drugs should be avoided at all costs. Rather increase those so called functional foods like olive oil and chilis that have the same benefit, but without the side effects. 

Usually you will start to get warning signs from your stomach that troubles are coming; epigastric pain is the most common symptom. It may easily be confused with heartburn. If you are having discomfort discuss it with the pharmacist or your doctor.

The most serious sign is a black stool; stop taking that medication immediately. It's literally life threatening.

Whilst total hip replacement, in the hands of a good surgeon, is a relatively safe and successful procedure, total knee replacement is far more difficult. I've seen some terrible botch ups at the chiropractic coalface.

Likewise, I've seen no research on the successful chiropractic treatment for knee arthritis. For over thirty years I have declined to treat the condition seriously. Perhaps a few exercises for knee arthritis or some alternating ice and heat; I even used ultrasound in the early days, until I realised that was quite useless.

Symptoms of Arthritis in Knee

Latterly, after quite successful treatment of hip arthritis, we decided at the Chiropractor Hilton Streetview clinic to take on a difficult case. The symptoms of arthritis in knee are severe: pain, stiffness and reduced range of motion, sometimes loss of flexion, sometimes extension; swelling, clicking and cracking sounds. Add to that difficulty walking, particularly stairs, and night pain and you have a recipe for misery.

She had them all; would vigorous exercises for knee arthritis and a series of mobilisations of the knee help?

Arthritis pain in knee

Knee arthritis pain is exquisite. Sharp and extremely disabling. The stick and the wheelchair beckon... stairs become impossible and the lifestyle proscribed. But there is hope, without surgery. More about arthritis pain in knee

Knee arthritis Case File

 Case History @ Symptoms of arthritis in knee

A middle aged, consulted us with severe left knee pain. The pain had begun a dozen or so years earlier, growing progressively worse, especially the last few years.

At just over five foot tall and more than 200 pounds she had a body mass index of almost 40; above 30 is obese, over 35 is life threatening.

She had played plenty of sport as a young woman, but when she stopped her lifestyle became sedentary.

Previous treatment included six cortisone shots, an arthroscopy which included debridement and a microfracture procedure, 9 months before the first chiropractic consultation. After the operation she was unable to straighten her knee, and the pain became far worse.

She was taking anti inflammatory drug medication nightly; otherwise she couldn't sleep. A glucosamine chondroitin product and synvisc injections had brought minimal relief.

She was scheduled for a total knee replacement in two months' time, but decided to consult us in the interim.

On examination of this symptoms of arthritis in knee there were many of the typical signs.

An obese woman, she walked with an extreme limp, unable to straighten her left knee. The pelvis was markedly low on the left, in part due to the bent knee, but also due to a leg length inequality with the expected sacroiliac joint fixation on the opposite side. Both lower limbs, particularly the left, were swollen.

Flexion of the knee was almost normal, but there was severe loss of 25 degrees of extension. Any attempt to straighten the joint caused extreme pain. The bounce home test was strongly positive.

The tests for meniscus damage were normal. The AP drawer test for the cruciate ligments was normal, but both collateral ligament tests were very lax, but non painful.

Clarke's test for patello femoral pain syndrome was negative.

Noble's test for a ilio tibial band syndrome was positive; active trigger points were found down the tendon and in the tensor fascia latae muscle.

Examination of the lower back revealed a routine, uncomplicated L5 lumbar facet syndrome; it was nevertheless causing considerable discomfort.

Lower limb conditions, particularly if associated with a short leg, almost inevitably cause a significant knock effect in the low back.

X-rays @ Symptoms of arthritis in knee

X-rays show severe loss of the hyaline cartilage that lines the medial femoral and tibial condyles, with many fragmented pieces of cartilage (joint mice) floating in the synovial fluid. The tibial spines are severely sharpened.

There is almost certainly a hole in the cartilage as seen above in the stock arthroscopic photo, hence the narrowing of the joint. Bone on bone. (not hers, thus speculative just how serious it could be).

Chiropractic treatment
Symptoms of arthritis in knee

Consult 1

The first consultation consists of a full history and examination of each patient, and she was no exception.

We gave her some gentle arthritis knee exercise do be done daily with each cup of tea. Frequently every day. They only take a minute or two. Knee arthritis and exercise ...

Consult 2

A report of findings was given to Mrs X, and a short tour of What is Chiropractic ...

There was no need to stress the seriousness of her case. She knew. Moreover, her dietician had spelled out that a BMI of 39 meant her whole life was at risk, not just a disabled knee. For three years she had limped from one doctor to another, unable to walk even the mall, unable to sleep without painkillers.

Nevertheless, I made it plain that I was not prepared to accept her case without a firm commitment to get the pounds off. At least 50. Because without that, she was wasting her time and money in our clinic.

Free weight loss programs

Finally, she was ready to do what she knew had to be done. Make some vital dietary changes. More about that later.

The first chiropractic treatment consisted of a gentle mobilisation of the knee joint, with axial traction, and use of electro stimulation.

I referred Mrs X to our free weight loss programs and recommended fatty fish several times a week, plus omega 3 supplementation. Fish oil health benefits ...

Consult 3

She felt a slight improvement in her knee pain. We introduced the first chiropractic treatment for her pelvis and lower back, and our lower back exercises programme.

We addressed for the first time the lateral thigh myofasciitis. Treatment was painful.

Consult 4

She felt a distinct improvement and for the first time in months was able to hobble around the mall, but suffered the next day. Her knee was still locked in flexion. Three pounds weight loss.

Her right foot was painful, which she had not mentioned earlier. We found fixations of the cuboid and medial cuneiform, and a general plantar myofascitis. Treatment for foot pain ...

Consult 5 @ Symptoms of arthritis in knee

Improving. She felt the sharp pain was 50% less, but was still unable to straighten her knee. She was off medication at night. Her lower back pain was much improved. She had lost 8 pounds. Some suboccipital headaches. Upper cervical adjustment.

Consult 6

Improving, same treatment. We are definitely getting increased movement in the knee, and extension is not so limited. She is walking better. 12 pounds weight loss

Consult 7

Setback. She stumbled on a step and came down hard on her left knee. McMurray's test was positive for the first time. 14 pounds.

Consult 8

Despite the setback, continued improvement. She was able to stand in church for a longer period, and she managed to do 16 lengths of backstroke at the pool. Her foot continued to burn when walking, but was much less swollen. No lower back pain. 18 pounds.

Consult 9 

Two weeks later. Her knee had locked over the weekend. Extension is reduced again. Discouraged. 22 pounds weight loss.

Consult 10

Much improved for two weeks but then sharp stabs in the knee again. No lower back pain. Foot improving. Almost full extension for the first time. Bounce home test negative. 28 pounds loss.

Consult 11

Her knee pain is much reduced. She can straighten her knee for the first time since the arthroscopy surgery, now one year previously. She can walk much further, is taking virtually no medication. She has now lost 36 pounds, and is taking an extended overseas holiday with family. She feels up to it.Some midthoracic and rib pain after much sewing. A thoracic spine exercise, and rib pain treatment ...

Two years later

Mrs P's knee is reasonable. She comes for a chiropractic help treatment every four weeks. It's good for about two weeks, and then gradually becomes more painful. She has minimal night pain, and takes only the occasional NSAID.

She can straighten the leg, but forced extension still hurts. She can bend the knee fully without pain.

She's lost 45 lbs, and really needs to lose another 15. Still that weight loss has overcome that crisis that obesity was in her life. Her BMI is around 30, still too high but no longer dangerously so.

Three years later @ symptoms of arthritis in knee

Mrs P is still doing reasonably well in the circumstances. She was stuck with weight loss until she started the Banting diet. Now she's lost another four pounds in two weeks. I go along with many facets of it though oddly the recommendation is to increase the healthy fat in your diet; fatty fish, olive oil and even butter is back.

The strict limiting of starches is to be recommended though I cannot support the black listing of fruit like apples and butternut squash. They do not have a high glycemic index like potato and white rice.

If you make your own low GI bread you can enjoy it with butter as long as you are having plenty of salads at the same meal; it takes only five minutes using a breadmaker appliance, plus five hours, of course.

She continues to have minimal lower back and foot pain, and has only the odd bad day or night. It can't be described as good either though; it's probably like she was ten years ago. Until she loses at least another ten pounds I can't see much further improvement.

Here's a little update; after three weeks on the Banting diet she's lost another ten pounds. It is an unsustainable fad diet to my thinking, having to add so much fat and go without fruit and legumes, but in the short term it's working.

And now a review of this case file.

There come vital moments in all our lives; a tide in our affairs, to coin the Bard's phrase. Such was the defining moment when she first consulted us. She was faced with shallows and misery for the rest of her life, and I didn't need to point it out. She knew she had to take the flood tide.

The chiropractic knee arthritis treatment was, of course, important, but the vital decision was to lose weight, and a lot of it.

There is of course no certainly of the future. Research at the medical Dutch university at Utrecht has shown that cartilage can regrow if the knee is unloaded. She has done most of the hard work. Another 10 to 15 pounds and she has a good chance of escaping a total knee replacement, at least in the immediate future.

Arthritis knee exercise

Anti inflammatory omega 3

And anti inflammatory drugs

One of the good things about chiropractic help for knee arthritis symptoms is that it is TOTALLY safe. Provided done by a skilled and well trained chiropractor, the chances of making the condition worse are zero. And when the patient is on the verge of a total knee replacement, there is nothing to be lost.

I have no difficulty with taking anti inflammatory drugs (NSAIDs) for a short trial period, but taken long term the risks of iatrogenic illness (doctor-caused disease) are relatively high.

However, taking dual antiinflammatory drugs like brufin and aspirin together is extremely dangerous.

If you are having to take medication long term, then what is vital is to dramatically increase the so called functional foods in your diet;
those that have been proven to have health promoting and disease preventing functions.

What does the research say about glucosamine chondroitin products?

Grinding flax seeds @ symptoms of arthritis in knee

For example, foods containing significant amounts of the omega 3 fatty acids have a strongly anti inflammatory effect. Look to enjoying fatty fish several times a week and grinding flax seeds to go on your cereal every morning. Well, you can keep some in the fridge for a few days.

The oleocanthal in extra virgin olive oil has been scientifically proved to block inflammatory chemicals released in arthritic joints in the same way as Cox 2 NSAIDs but without the nasty side effects in your gut.

Oddly the red hot capsaicin in chilis have a strongly anti inflammatory effect. Parboiling a jalapeno every day and enjoying it with your salad is easy; add plenty of hummus and perhaps avocado and you'll hardly notice the burning. Don't cut out the placenta and the seeds; that's where the potent effect of anti inflammatory chili is to be found.

In short, negating the symptoms of arthritis in knee is about healthy eating and weight loss; otherwise severe disability and pain will be on the agenda sooner rather than later.

Exercises for knee arthritis

There is strong evidence that exercise benefits knees, just like all arthritic joints. She has now bought a home with a swimming pool and is beginning to swim regularly.

Lax collateral ligaments

The purpose of ligaments is to give joints stability. When either they are stretched (as in whiplash, or sprained ankle), or if there is loss of joint space, the ligaments become lax. They lose some/ much of their capacity to stabilise the joint.

This gives rise to oft mentioned complaint that the knee feels as though it's about to "give". Instability. All that you can do in this instance is to strengthen the quadricpes muscle. Exercises for knee arthritis are a vital part of the chiropractic regimen.

Weight loss @ Symptoms of arthritis in knee

This is not idle rhetoric. Strong research shows that THE most effective treatment for the symptoms of arthritis in knee (assuming you are obese) is weight loss. More effective that chiropractic. More effective that pills, more effective than surgery.

What's more it comes for free, and there are zero iatrogenic, doctor-caused effects.

I confess to being brutal in the practice. "Get it off, otherwise you are wasting your time and money here. Go and have the total knee replacement. Accept that pain and disability, and a very large hole in your retirement savings are going to be your lot."

I have seen folk grasp the nettle and lose dozens of pounds. It can be done once one realises the alternative is too ghastly to contemplate.

Significant weight loss is usually most safely and effectively done by a severe reduction in starches: potato, rice, bread, pasta, cakes, cookies and colas. Even though you are not a vegetarian, Vegen Weight loss is one good option. Pile on the salads, fruit and vegetables, minding to keep up your five colours a day. I aim for ten. Eat the sweet fruits in moderation; no need to avoid them, they contain the cancer preventing phytochemicals.  Phytochemicals foods ...

Knee joint distraction @ symptoms of arthritis in knee

There is innovative research being done in the Netherlands with a temporary orthotic device that distracts the bones of the knee. What is interesting is that they have proved that the cartilage can and does regrow.

It is not without risks, the device have to be well secured to the femur and tibia, will screws into the bone.

But you are able to walk and move about. Knee joint distraction ...

What is interesting, however, is that the device is essentially unloading the knee, same as losing weight. Getting those pounds off is far cheaper and safer, without any possible iatrogenic illness (doctor-caused disease)

Conservative care @ Symptoms of arthritis in knee

Whatever your problem, try conservative care first. Can I guarantee that chiropractic, dietary change and weight loss will cure symptoms of arthritis in knee ? Of course not! But until you try, you'll never know.

The bone marrow is full of fat. Never will I forget Mr S. His wife went in for a total knee replacement. The next day a fatty embolus from the tibia blocked an artery to her lung. She died.

Nor Mrs L who had a very successful knee replacement. Her walking was vastly improved, only she had no idea where she was walking. Anaesthetic Alzheimers ...


Useful links @ Symptoms of arthritis in knee

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

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Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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