Treatment of Transcutaneous Electrical Nerve Stimu
Epidural And Spinal Anesthesia Techniques
Cancer Pain Management
Diagnostic Cardiac Procedures
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Over weight is one of the largest risk factors for knee pain. The knee supports much of the body’s weight, and too much weight taxes the joint and increases the likelihood of pain. Anterior knee pain, which develops at the front and center, is one of the more common types of knee pain associated with carrying extra weight. Inactivity or muscle weakness, both associated with being overweight, can exacerbate the condition.Obesity stresses the structure of the knee, including the patella—the medical term for the kneecap.
2. Muscle weakness
The knee connects the thighbone—also known as the femur—to the shinbone—also known as the tibia. Having strong quadriceps muscles helps to stabilize the knee joint and keep it healthy.And improving muscular fitness can be one of the best ways how to prevent knee pain, even if you’re older. However, strong quadriceps and hamstring muscles can help insulate the knee from stress.
3. Inactivity/lack of mobility
A cause of muscle weakness and obesity—inactivity—is also another factor for knee pain. People who are inactive are less strong, less flexible, and more sedentary. When the time comes to move and exercise, there is a greater risk of injury. Inactivity has also been found to make knee pain from arthritis worse. Being sedentary results in muscle deterioration that weakens the knee and increases pain
4. Not resting after injury
Injured people who don’t rest their knees for a long enough period of time increase their risk of re-injury. Although recovery periods can last anywhere from several weeks to several months, taking the time to allow the body to adequately repair and heal is critical for allowing the knee to regain its strength.Resting is particularly difficult for athletes and other active people, but spending some quality time on the couch will go a long way to keeping the knees healthy and protecting against future injury.
Smoking increases the risk of a host of health problems, and knee pain can be added to the list. Quitting smoking is one of the best ways how to prevent knee pain when you get older. smoking increased the risk for both cartilage loss and knee pain in men who had developed osteoarthritis in the knee. Because smoking affected the amount of cartilage the men had in their knees, it increased the amount of pain they experienced.
Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain.
Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.
Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:
Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.
Patient Controlled Analgesia (PCA): This method is also known as ‘Pain Pump’. An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.
Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.
Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.
Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.
Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.
The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.