Join forces to take care of joint pain

The prognosis for people with knee osteoarthritis isn't as bleak as it may seem in the wake of a finding that arthroscopic surgery, once hailed as promising, may not be the best option.

That study, released in a recent issue of the New England Journal of Medicine, suggested that people who underwent the surgery didn't fare any better in the long run than their counterparts who received physical therapy.

Multiple treatments

During the surgery, small incisions are made, through which a camera and surgical instruments are inserted. Physicians can then repair or remove cartilage, or flush the knee to remove debris — or both.

The trick is to find one or more treatments that can ease the pain of worn cartilage.

“I give my patients a list of 17 options. At the very bottom is arthroscopy. It works for a while but it's not going to cure it.

"What I've found is that nothing works for everybody and everything works for somebody,'' says Dr Ronald Grelsamer, a knee surgeon in Mount Sinai School of Medicine in New York.

Temporary respite

Oral non-steroidal anti-inflammatories can reduce inflammation and pain, as can cortisone injections.

Hyaluronic acid injections can replace some of the viscous synovial fluids that lubricate the joints but that sometimes decrease with age.

Acupuncture and massage may also alleviate pain. But as people get older and knees become more worn, the remedy could be a total knee replacement.

But much can be said for consistent exercise, which can also tamp down pain and improve mobility, according to health experts.

A good first line of defence is shedding weight. Even a little makes a huge difference, because walking and running can put extra force — equivalent to several times one's body weight — on the knees with every step.

“Even with 5 to 10 pounds, people can expect a significant improvement,'' he says.

Water workouts

Physical therapist at Good Samaritan Hospital in Los Angeles, Laura Bennett, says walking, swimming and water workouts are great for some with arthritic knees.

“Being in the water takes some body weight off the knees and hips. Joints have an easier time moving and the water gives muscles some resistance.'' Many prescribe exercises and stretches to correct disparities and weaknesses.