The knee is the largest joint in the human body and is a complex structure formed of bone, muscle and cartilage. Development of pain in the knees can be caused by numerous factors such as aging, injuries, diseases, dietary deficiencies, etc.

Arthritis is the most common cause of knee pain and usually affects the elderly and aged. It occurs due to an inflammation of the joint and causes pain, swelling, redness and inflexibility of the knees.

What are the factors that determine treatment method?

Diagnosis for knee pain varies from patient to patient as each case is different and must be approached differently. Some of the factors that determine the treatment method are as follows:

- Cause of the problem
- Nature and intensity of pain
- Age of the patient
- Medical history of the patient
- Diet and lifestyle of the patient

There are a number of different types of arthritis which can affect the knees in different ways and, consequently, require different types of treatment methods.

What are the various treatment methods for knee pain?

1. Conventional Remedies - These are used in case of conditions that are not too severe or chronic. It includes keeping on bed rest, using an ice pack, taking a painkiller and anti-inflammatory medicines, wearing knee braces, etc.

2. Physical Therapy - There are many stretching and strengthening exercise routines that help alleviate knee pain and treat the condition. Recovery is achieved by making the muscles around the knees stronger and increasing stability and flexibility.

3. Injections to the Knees - A number of anti-inflammatory substances and supplements, as well as lubricants, can be injected into the knee joint which helps reduce pain and makes the joint more supple.

4. Stem Cell Therapy - This involves drawing platelets from the patient's blood and injecting it into the knee joint for repairing damage caused to ligaments, tendons or cartilage.

5. Surgery - Surgical procedures for treating knee pain include partial or complete knee replacements.



What kind of treatment does your knee pain require?

Knee is a hinge joint where the lower leg bone tibia meets the thigh bone femur. During osteoarthritis, cartilage or ligament defects and degenerative arthritis, knee replacement surgery is recommended world-wide to get relief from extreme pain. Knee replacement surgery, also known as knee arthroscopy, is a surgical procedure, in which the affected knee joint is replaced with synthetic material. The most likely candidates for total knee replacement are the patients with severe destruction of the knee joint coupled with progressive pain and impaired function.

Modern technological advances have made computer assisted knee replacement surgery extremely popular around the globe. In this surgery, the surgeon is assisted by a computer to remove the optimum amount and angle of the bone, which otherwise is done by inspecting manually. This is an excellent example of surgery through small incision and it eliminates the chances of human error. A perfect alignment and balance is achieved and hence longevity is also increased to 20 - 30 years. Knee replacement surgery is also specific to gender as the anatomy of male and female patients is different.

There are many types of knee replacements, most common being the total knee replacement or Total Knee Arthroplasty. In addition, there is partial knee replacement, bilateral knee replacement, revision knee replacement and knee arthroscopy.

In knee replacement surgery, the worn out surfaces of joints of knee are replaced with artificial implant of plastic and metal. The lower end of the femur bone is removed and replaced with a metal shell. The upper end of the lower leg bone (tibia) is also removed and replaced with a channelled plastic implant with a metal stem. A plastic ball is also added under the kneecap depending on its condition. These artificial components are commonly referred as prosthesis. The design of these highly flexible implants replicate knee, with the rotating knee replacement implants assist in backward and forward swing of the legs.

Patients whose knee joints have been damaged by either trauma or progressive arthritis should consider total knee replacement surgery. Post-surgical hospital stay after knee joint replacement is usually three to five days. The surgery has a very high success rate and shows dramatic improvement after a month. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is reduced significantly when the new gliding surface is constructed during surgery. Initially, patient will walk with the help of a walking aid until the knee is able to support full body weight. After six weeks, patient can walk comfortably with minimal assistance. Patients with artificial joints are prescribed to take antibiotics during the course of any elective invasive procedures including dental work. Physiotherapy is an essential part of rehabilitation and it will increase the muscle strength and patient can enjoy most activities, except running and jumping.

Knee Replacement

If you are suffering from gout, you should try undergoing a homeopathic treatment. Gout is a type of arthritis and is considered to be the most painful type. It is featured by the inflammation of joints accompanied by great pain. The pain and inflammation occur because of the deposition of urate crystals in a joint. The accumulation occurs when there is excessive uric acid present in the blood.

Here are some effective homeopathic remedies for the treatment of gout:

Colchicum: This medicine is the primary homeopathic medicine for treating gout because of its effectiveness. It is mostly used in chronic cases of gout. Usually, a patient experiences extreme pain in the big toe, which is too intense to be touched. The toe and other parts which get affected become swollen, red and hot. The pain worsens in the evening and at night. Patients who require this medicine should keep away from warm weather conditions. This medicine is also used in case of increased weakness and internal cold.
Ledum Pal: This effective medicine is used in cases where the pain travels in an upwards direction from below. The pain is likely to start at the feet and gradually move upwards, affecting the knees and legs. The pain also shoots through limbs. Small joints are commonly affected. There is a sensation of decreased warmth in the joints and in the body. The patient will find it difficult to tolerate any kind of external warmth. The pain improves by cold applications. The ankle balls or big toe may be swollen.
Benzoic acid: This homeopathic medicine is used for treating gout where offensive urine is experienced. The urine becomes very offensive with a very strong odor, which can be detected from a distance. The odor is usually repulsive and the color of the urine is brown. Extreme pain is experienced in the big toe and the knees are swollen.
Antim Crudum: This is an efficient homeopathic medicine used for treating gout. It is used when a patient experiences gastric symptoms along with joint pain and inflammation. The patient may develop an increased craving for food and hence, several problems occur due to over eating. Pain is experienced in the heels and fingers.
Sabina: This homeopathic medicine is important for treating gout in women, when the patient already suffers from another female disorder. Uterine symptoms are experienced along with the basic symptoms of gout. Shooting pain is experienced in the toes and heels. The joints get swollen and look red and shiny.
Homeopathy offers a completely natural treatment for different types of gout and goes beyond just curing the symptoms. You need to consult your doctor before starting a homeopathic treatment for gout.

5 Homeopathic Remedies for Treating Gout Pain

Arthritis, which is quite a common ailment among people aged above 40, is painful regardless where it affects a person, be it the hands or the toes. However, the Ayurvedic field of medicine has come up with historic ways of treating the issue. Over the course of time, these methods have proved to be quite effective, and especially popular as they have no side effects. A person only needs to spend a little time to get to know how to go about using Ayurveda to cure the arthritic aches and pains, which plague daily life!


One of the best things about Ayurveda is the fact that the solutions are generally made using ingredients that are very easy to source. For example, there is a solution for arthritis, which involves mixing a cup of mustard oil with about 10 grams of camphor and then heating the combination. This oil mixture then needs to be massaged on the affected areas. Now, isn t that simple?


The common potato, long considered to be a vegetable of the masses, also finds its use in Ayurveda when it comes to treating arthritis. If you soak a few unpeeled slices of potato in a glass of water overnight and drink this water the following morning, you are sure to find an improvement in your condition quite soon. 


Additionally, there are a few other food items that are recommended in the Ayurvedic treatment. These include bitter gourd, which is not only low in calorie content, but also very high on vitamins and ginger which improves metabolism. Consuming garlic and buttermilk is also considered advantageous. 


Moreover, you may also need to make some changes to the lifestyle habits, which have been deeply ingrained. For instance, sleeping as per a regular schedule and not going to sleep very late at night has a positive impact.


As you have probably be discerned, when it comes to health, the devil is in the eating! If a person who has arthritis makes an effort to conform to a good and healthy diet, which does not contain fried or sugary food, or even those which have spices in excess, he or she will not only find the pain symptoms of arthritis reducing, but also gain a general sense of health.


As long as a person has the patience to follow the way of treating arthritis set out by Ayurveda, the benefits will truly be bountiful!

Arthritis - How Ayurveda Can Help Treat it?

There is a distinct relationship between sleeping disorders and your emotional health, both influence each other. Insomnia is a common sleeping disorder, which is generally caused due to stress and tension. Depression and anxiety also account for insomnia. It has been proven by research that people who experience sleeplessness or cases of insomnia are at a higher risk of depression and similar psychiatric disorders.

Insomnia is an important factor which causes depression and many people affected by it commit suicide. Researchers have found dysfunctional activity in the area of the brain where emotions are processed and regulated, among people with insomnia. Their study explains the mechanism by which insomnia affects and influences emotions in people, which leads to depression and other disorders.


The ways in which insomnia affects your emotions

    There is a clear difference in the brain activities of people with insomnia when compared with normal people who get good sleep. There is usually a great difference between the activities of the amygdala, which are neurons in the temporal lobe of the brain. The amygdala is very important in regulation and processing of emotions.
    Insomnia disrupts the ability of the brain to process negative emotions.
    Neural change and problems with regulating emotions are also caused because of insomnia.
    Insomnia disables the ability of judging or sensing any kind of emotion by looking at the face of a person. It is difficult to judge emotions such as anger and sadness in people suffering from insomnia. This impairment occurs more in women.
    Insomnia and similar sleeping disorders affect our inhibition and disrupt our impulse control mechanism. An insomniac person is likely to develop increased impulsiveness to negative stimulus.
    People suffering from insomnia develop a perception towards negative stuff and perceive most things in a negative way, rather than looking at the bright side which a normal person tends to do. People affected by insomnia are characterized by a negative mood and are pessimists in nature.
    A sleep deprived or insomniac patient shows greater activity around the limbic area of the brain. This is the area where major emotional regulation and processing are undertaken.
    A person suffering from insomnia develops a cranky personality. The patient is in an irritable mood and is triggered by the slightest and pettiest of circumstances. An insomniac patient is also characterized by swinging moods, high temper and general fatigue, which result due to lack of sleep.

Insomnia is a sleeping disorder which directly affects a person's emotions and the processing and regulation of emotions. There is a direct and important link between insomnia and emotional disorders.

How Insomnia Influences Your Emotions

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

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