Management of Knee pain due to osteoarthritis with Chiropractic care
Knee pain is perhaps one of the most mobile joints of the body that forms an integral component of axial skeleton. Any injury or disease process that affects knee joint can directly interfere with the quality of life. Osteoarthritis is perhaps the most common cause of knee pain that eventually affects physical, psychological and social aspects of the individual’s life. Currently, over 26 million individuals suffer from osteoarthritis of one or more joints (1)
According to statistics reported in the peer reviewed New England Journal of Medicine (2), investigators suggested that approximately 80% general population have osteoarthritic bone changes by 65 years of age (on radiological examinations that may or may not be symptomatic). The most common presentation of knee osteoarthritis is pain, swelling, redness, altered range of motion, disability and other similar issues.
Pathophysiology of knee pain in the setting of osteoarthritis:
- Damage or destruction of articular cartilage
- Reduction in the secretion of synovial fluid (that offers lubrication to the gliding surfaces of the adjoining bones)
- Formation of bony spurs due to constant friction of hard bony surfaces striking with each other in the joint motion.
Chiropractic care for osteoarthritis management:
According to a latest research study published in the Journal of the Canadian Chiropractic Association (3), investigators concluded that a short-term (only 2 –week) protocol of manual therapy can be effectively used for the management of knee pain in 43 patients with chronic history of knee pain due to osteoarthritis. Investigators also suggested that:
- Manual chiropractic therapy was effective and safe (the age range of study participants was 47 to 70 years)
- The response to therapy was excellent since most patients reported improvement in range of motion and degree of physical independence with just 3 therapy sessions performed over a period of 2 weeks.
Osteoarthritis is a progressive disorder of the joints, resulting in their degeneration and pain in bones and bone junctions. There are many treatments available depending on whether the disease is chronic or acute. Also under consideration are other underlying disorders that can possibly aggravate or predispose the patient to other disorders associated with osteoarthritis.
Research published in Complementary and Alternative Medicine (4) suggested that so far there is no cure for osteoarthritis and other degenerative bone conditions in individuals; however, use of complementary and holistic care can play a significant role in the management of pain, discomfort and progression of knee joint destruction in obese or over-weight patients. Report also suggested that the popularity of complementary medicine is on the rise for the management of knee osteoarthritis. Another report by Draughty (5) suggested that the current rate is 14.6% (in United States and Canada) but growing at a rate of approximately 2.7 to 3.5% each year.
What other interventions or holistic protocols may help?
1. Acupuncture: this is a Chinese technique, involving the use of extremely thin needles on specific pressure points to stimulate the body. These stimulations can reduce pain sensations, increase sensitivity and relax the body muscles. Acupuncture has proven helpful in managing pain in patients undergoing chronic pain such as osteoarthritis.
2. Stress reduction: pain is sometimes triggered by emotions that trigger muscle tension, such as in case of tension and anxiety. A person who experiences pain only if the muscles are stretched or taut, may benefit from certain relaxation techniques. The aim of these breathing and physical exercises is mainly to keep the person calm and in control of his emotions. This ultimately helps in managing pain.
3. Assisting devices: when it comes to osteoarthritis of major components of axial skeleton (such as back and knee), certain methods such as using knee braces or back support can help in maintaining appropriate posture and balance by supporting connective tissue framework. Knee brace also helps in preventing knee joint bones from gliding or pressing the cartilage.
4. TENS: Transcutaneous Electric Nerve Stimulation devise, makes use of electrical stimulations to reduce nerve sensitivity around the area where pain is felt more often. This device makes use of simple to carry electrode and patches attached via wires, which can be carried to work and give quick and easy relief. Also important is the advantage of having very less side effects.
5. Herbal remedies: herbal remedies make use of drugs of natural origin to target muscle tightness, reducing pain and maintaining stress levels or any other condition that may aggravate the condition of osteoarthritis. Many preparations such as teas, decoctions and bath salts are effective in chronic osteoarthritis and are commercially available.
- Cooper, C., & Litwic, A. (2013). Epidemiology of osteoarthritis. Medicographia, 35, 145-151.
- Pollard, H., Ward, G., Hoskins, W., & Hardy, K. (2008). The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of the Canadian Chiropractic Association, 52(4), 229.
- Bradley, J. D., Brandt, K. D., Katz, B. P., Kalasinski, L. A., & Ryan, S. I. (1991). Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. New England Journal of Medicine, 325(2), 87-91.
- Lapane, K. L., Yang, S., Jawahar, R., McAlindon, T., & Eaton, C. B. (2013). CAM use among overweight and obese persons with radiographic knee osteoarthritis. BMC complementary and alternative medicine, 13(1), 241.
- Dougherty, P. E., Hawk, C., Weiner, D. K., Gleberzon, B., Andrew, K., & Killinger, L. (2012). The role of chiropractic care in older adults. Chiropr Man Therap, 20(1), 3.
