Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

Hot and Cold therapy is one of the most popular home remedies for any kind of joint pain or muscle sprain. In some cases applying heat therapy and cold therapy alternatively, can help relieve the pain while for others only one form of therapy is necessary. To understand what to use when, one should first understand the effect of heat and cooling on the body.

Applying a heat pack or immersing the affected limb in hot water improves blood circulation and makes the muscles more flexible. Thus, it can help relax a muscle and fasten the healing of damaged tissues. On the other hand, cold therapy or cryotherapy reduces blood flow to the affected site. This helps relieve inflammation and pain caused by it. It can also make the area feel numb by reducing nerve activity temporarily.

Types of Heat Therapy
Heat therapy can be categorized as dry heat and moist heat. Dry heat involves using saunas or dry heating packs to relieve pain. This is also known as conducted heat therapy. As the name suggests, moist heat involves the use of steamed towels, hot baths and moist heating packs. This is also known as convection heat therapy. Moist heat is usually considered more effective than dry heat.

Types of Cold Therapy
Cold therapy may be applied to a part of the body or to the entire body. This includes ice packs, coolant sprays, ice baths, ice massages and whole body, cold therapy chambers.

How to use heat and cold therapy?
The sooner heat and cold therapy is given to a person, the faster they will recover from their pains. Heat therapy can be given to a person for extended periods of time but when giving cold therapy, a person should not be exposed to a cold pack or ice bath for more than 10-15 minutes. Care should also be taken no to apply ice or a frozen pack directly on the skin as it can damage the skin and nerves.

When not to use Heat Therapy?
If the injury site is swollen or bruised, cold therapy is better than heat therapy. Heat therapy should also not be applied to an open wound. People suffering from conditions such as diabetes, dermatitis, deep vein thrombosis, vascular diseases and multiple sclerosis should also avoid heat therapy as these conditions can increase the risk of burns and other such complications. Pregnant women should also consult a doctor before using a hot tub or sauna.

When not to use Cold Therapy?
Cold therapy is avoidable for treating stiff joints and muscles. People suffering from poor circulation and sensory disorders should also avoid using cold therapy without a doctor s supervision. 

Hot & Cold Therapy - How It Can Treat Pain?

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.

Multimodal Pain Relief After Total Knee Replacement

Stress is sometimes good for you. When you stretch yourself beyond your capacity, your body accepts challenge and increase the capacity to cope up with challenge. To a certain extent, it is good for body. But when the stress crosses the limits, it starts hurting you. That's the bad stress for you. Moderate stress for too long a time also is bad for you. Most of the hormonal diseases like diabetes, thyroid etc. Occur because of long standing underlying moderate stress. 

Stress can be physical or mental. Physical stress is due to long and continuous physical activities like walking, jogging, travelling, cycling. Mental stress is mainly because of financial tension or relationship distress. Both types of stress cause similar damages to body. Stress is the main underlying cause behind diseases like high blood pressure, heart disease, thyroid, diabetes, kidney disease, peptic ulcer, bleeding disorders, cancer, recurrent infections etc. 

Finding out the reason of stress and removal of cause of stress should be the main line of treatment of such diseases.

Stress - Good and Bad

Care for shoulder pain and related problems

Shoulder problems usually happen because of internal problems or external trauma. People who are into any form of manual labour, pick up a lot of heavy things regularly or play sports experience shoulder pain at some point of time or other. Shoulder pain can be detected by physical examination, mri, x-ray, ultrasound and medical history.

The most common types of shoulder problems are arthritis, fracture, dislocation, frozen shoulder, rotator cuff tear, and rotator cuff disease. Cures for the different shoulder pains are different. Follow these simple ways to help you manage the pain.

1. Rest the hurtful shoulder: you need to take ample rest. Using the arm which is affected is not a good idea and needs to be avoided. If your job involves manual labour, it is advised that you stay at home to rest.

2. Ice pack healing: applying ice pack on the wound is also advised around 3-4 times in a day. This varies as per the kind of shoulder pain, so doctor's advice must be followed.

3. Be consistent with exercise: depending upon the source of pain, physiotherapist will advise certain sets of shoulder exercises. It is very important that they should be performed diligently for fast recovery.

4. Support it well: wearing a sling is extremely important and should not be taken lightly at any point of time. A good support will ensure there is no mislocation and faster recovery.

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Shoulder Pain Care - 4 things you must not ignore!

4 exercises to strengthen your knees

Knee pains and pains in the joints are not restricted to a certain age group anymore. Younger people of today face this problem too. To stay active all your life and escape the severe aches associated with weakening of muscles, joint pains or arthritis, you must start now. The only way to keep your knees fine and working is to exercise. 
4 moves that help you strengthen your knees.
1. Leg lifts (inner thigh) - lie on any one side, lay your head on the arm of the side below you. Make sure this hand is straight above your head, touching the ground. Keep your legs straight, one above the other. Lift the leg on top a few inches above, hold for few seconds and bring it back. Do this for 10 times and then with the other leg, on the other side. This exercise strengthens your inner thighs, eventually strengthening the knees.
2. Hip raises: lie flat on your back, your shoulders touching the ground. Bend your legs comfortable, your feet resting firmly on the ground. Raise your hips and thighs so that from your head to feet, you form an angle. Wait in this position for about 10 seconds, lower your hip until it touches the ground. Repeat for ten counts.
3. Lunges: stand straight. Take a step ahead with your right leg. Left leg remains in its place. With your back straight, bend your knees so that both are at 90 degrees. Go back to standing position; take your right leg back to where it was. Do the same step with your left leg. Repeat both sides ten times.
4. Bent leg extensions: this is pretty easy and all that you need to do it sit on a chair comfortably, with your back straight first. Your feet firmly flat on the ground in front of you, lift the right leg straight extending to the front. Make sure your thighs stay on the chair. Bring your leg back to the original position, firmly planted on the ground. Do the same with your left leg. Repeat 10 times on both sides.
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The Only 4 Moves That Strengthen Your KNEES

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