Knee pain is something that can affect anyone - irrespective of their age. While sometimes it may be of minor importance - and can easily be handled by self-care, often, lingering pain is a manifestation of some other serious underlying problem, such as arthritis. In this case, it is imperative that you consult a doctor and take appropriate measures to combat it.

Causes :

Arthritis: The chief cause of lingering knee pain, arthritis itself can be of a number of types:
 Osteoarthritis, which is a result of deterioration of cartilages due to wear and tear
 Rheumatoid Arthritis, an inflammatory chronic disorder
 Septic Arthritis, causing pain, swelling and redness.
 Gout caused due to the development of uric acid crystals in the joints
Fractures: These are caused by the breaking up of the kneecap due to falls or collisions.
ACL Injuries: Caused due to the tearing of the anterior cruciate ligament (that connects the femur and the shinbone). Especially common in sportspersons such as footballers or basketball players.
Meniscus tears: The meniscus or the rubber-like cartilage (that acts as a shock absorber) can be torn by sudden jerks or excess pressure.

Symptoms:The major symptoms of knee pain include weakness, redness, instability, stiffness or the inability to properly straighten or move the leg. Often, a deformity is also visible, such as a bone sticking out of the leg - in which case it is advisable to consult a doctor immediately.

Possible risks :Factors which include the odds of being inflicted by knee pain and cause serious complications include :
Being overweight: This exponentially increases the stress or pressure that is applied on the knee joints - even in doing mundane tasks like walking up and down stairs.
Excessive physical activity: Some activities, such as sports apply excess stress on the knees as compared to other tasks.
Loss of muscle flexibility: Tightness or weakness in muscles causes increasing number of problems in the knees.

All About Knee Pain

Runner s knee is a very common problem with athletes. It is definitely not something one needs to worry about. In fact, with certain exercises, it can be prevented and if you do develop a runner s knee, it can be treated with some exercises as well. There are special sports medical practitioners who prescribe not only regular physiotherapy, but also specific exercises to deal with specific sports injuries. To fight with runner s knee pain, there are a few exercises. 

But the four most important ones are described in detail below.

Quads: For performing proper quads, all you need is a back wall for additional support. You need to hold yourself against the wall and keep your legs apart from each other. The legs should be folded in the knees. In this position, you have to move up till the knee position with a minimum of one minute hold time in the knee position. You can repeat this exercise 10 times at a stretch before moving on to the next exercise.
Hamstring: This is a fairly easier exercise than the previous one. You have to stand straight with your legs apart. Bend downwards from your hips. Relax your neck and back. Ease your head downwards as well. Keep your hands behind. Join both your hands and give it a stretch. If you think that this position is straining your neck or back a little too much, then you can simply stretch your hands without joining them.
Calves: Calves is a standard exercise that is prescribed by medical practitioners and physiotherapists for easing out the pain caused by runner s knee. You have to stand with your hand against the wall. Put your left leg forward and bend it at the knees. Stand on your right heel. Hold yourself in this position for 20 to 30 seconds before changing the legs and doing the same.
Lateral: Lateral is also one of the easiest and common forms of exercises. You have to stand with your legs directly below your hips. Then stretch your right leg apart. Without bending your knees, try to touch the toes of your right leg with the fingers of your left hand. Hold this position for 20 to 30 seconds before changing the position and performing the lateral with your left leg.
Thus, these are some of the very fundamental exercises that one should follow in order to get quick relief from the pains of a runner s knee. These exercises are very easy and help in reducing pain.

Runner's Knee - 4 Most Important Exercises for it

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

Joint pain is considered to be one of the first few signs of aging. According to the science of Ayurveda, joint pain is triggered mainly by an accumulation of toxins in the body. These toxins can create an imbalance in the doshas which in turn can cause pain and inflammation on the joints. Along with joint pain, a person is likely to experience a loss of flexibility, weakness, tenderness and enlargement of the joints.

Unlike some popular forms of medication that focus on relieving the pain, Ayurveda addresses the root cause of the issue. Panchkarma aims at cleansing the body of toxins and clearing blockages in the body s digestive and circulatory system. This helps the vatta dosha flow easily through the body and reduces pain associated with arthritis etc. Panchkarma can be defined as a collection of five ayurvedic techniques. These are:

Vasti or Medicated Enema: Vasti aims at removing toxins and waste products from the body through the colon. In doing this, it cleanses the digestive channels and improves circulation of air or the vatta dosha in the body. With better circulation, joint pain is effectively reduced. An enema also nourishes the body and gives it the strength to rebuild tissues while boosting the immune system.
Abhyanga or Full Body Massage: This technique helps I the removal of toxins from deep tissues within the body. It pacifies the vatta and nourishes the body while simultaneously reducing stress and enabling better quality sleep. A full body massage also helps calm the body both physically and mentally.
Potli or Poultice Massage: As the name suggests, a potli involves massaging the body with medicated herbs tied together in a tiny bundle that has been warmed with medicated oils. This potli is then used to massage the entire body. This technique helps relax the muscles of the body and soothes the aggravated vatta dosha. It is very effective when it comes to providing relief from joint pains caused by arthritis, spondylitis, muscle cramps etc.
Pizhichil or Rich Oil Massage: A rich oil massage involves subjecting the body to streams of lukewarm oil that has medicinal properties while simultaneously softly massaging the body. This type of massage helps relieve tension and stress and is a very effective remedy against joint pains. It is highly recommended in the case of rheumatic diseases.
Svedana or Steam Bath: A steam bath helps cleanse the body both physically and mentally by aiding in the removal of toxins through sweat and calming the mind. It also helps soften the muscles and tissues and dilates the channels in the body.

Joint Pain - How Panchkarma Therapies Can Help You?

5 Ways to Stop Muscle Cramps

Muscle cramps are feared and loathed by all of us alike – they hurt, they slow us down and they just give us a helpless feeling! The most common cause of these cramps is premature fatigue which affects the reflex control of muscles. Here are 5 ways guaranteed to beat these troublesome muscle cramps:

1. Take rest
The most easy and sure-shot way to kill a muscle cramp is to take rest. Just rest your body, be at one place and the cramp will not last more than 3-4 minutes. Moving around will only cause the pain to be aggravated and eventually affect other areas as well.

2. Consume solutions rich in salt
Whenever you encounter a troublesome cramp, the first instinct is to reach for water. However, studies have shown that salt solutions are far more effective in countering cramps as compared to plain water. You can have pickle juice and similar drinks which have a high salt concentration.

3. Be physically active
The most common reason for muscle cramps is over-straining of the body. If you are planning to indulge in an extremely intensive physical activity, make sure to train well in advance. Also, keep the duration and intensity of the training at a similar level to that of the actual activity.

4. Keep your body hydrated
Dehydration is the root of a number of troublesome conditions, muscle cramps being one of them. Make sure to always carry a water bottle with you and drink a minimum of 7-8 glasses of water on a daily basis.

5. Indulge in light passive muscle stretching
When faced with a muscle cramp, in addition to resting, try and gently stretch the affected muscle. This continuous and light passive stretching lets the brain know that it can relax the muscle and help it return to normal.




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5 Winning Ways to Stop those Nasty Muscle Cramps

Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions. 

Knee Pain - How Physiotherapy Can Heal Knee Pain?

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