Non-surgical and Non-pharmacological Treatment of Knee Pain

Golding, David; Lee, Paul Yf

doi:10.4172/2167-7921.1000225

Cited by 4 publications

(5 citation statements)

References 50 publications

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“…Many studies have suggested that NPIs have a potential to alleviate the symptoms especially pain. 10 This is the first line of therapy in hospitals. But obtaining a favourable impact of NPIs depends on combination of many factors.…”

Section: Discussionmentioning

confidence: 99%

Need to Adopt a Patient Centered Approach for Obtaining Favourable Results of NonPharmacological Interventions among Knee Osteoarthritis Patients in Out Patient Department Settings

Sharma¹,

Pgimer²

2018

IJoHEMI

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Knee osteoarthritis (KOA) is one of the common causes of disability. Long-term effects of early to moderate KOA can be managed through non-surgical interventions. But due to overcrowding in Orthopaedic OPDs, doctors don't have enough time for explaining non pharmacological interventions (NPIs) in detail to KOA patients. Hence, desired impact of NPIs is not evident among KOA patients. This study elaborates the degree of patient centered approach adopted during doctor patient interactions in the Orthopedics OPD of a tertiary care hospital of India. The study was conducted in 2012-2015. Eligible KOA patients (N=123) were divided into two groups for the RCT. The patients aged 40-65 years of either gender without significant deformity or co-morbidities needing surgery (e.g. meniscus tears etc) were enrolled. An intervention room was established in Physical and Rehabilitation Medicine (PRM) department of the hospital. Doctors of Orthopaedics and PRM departments were requested to send grade 1, 2, 3 KOA patients as per Kellgren Lawrence scale to intervention room after initial work up. A referral system was established for this. Interviews of the diagnosed patients (N=31) suffering from mild and moderate KOA were conducted. Textual analysis was done for qualitative data. Patients are unable to comprehend 'capsule form' of advice provided in OPDs. This results in non-adherence. For better outcomes physicians must talk to patients. They need to understand the patient's underlying concerns, against their cultural background, and life history. Hence, patient centred approach is needed for obtaining the desired impact of NPIs in KOA patients reporting to Orthopaedics OPD in Indian hospitals.

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Section: Discussionmentioning

confidence: 99%

Need to Adopt a Patient Centered Approach for Obtaining Favourable Results of NonPharmacological Interventions among Knee Osteoarthritis Patients in Out Patient Department Settings

Sharma¹,

Pgimer²

2018

IJoHEMI

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“…This is still significant and clinicians should encourage overweight patients with knee OA to lose weight regardless of many other health benefits such as cardiovascular disease, diabetes, etc. Atukorala et al, also demonstrated dose-dependence between weight loss and a reduction in knee pain and symptoms during an 18-week program, indicating this is an important and valid lifestyle intervention to treat knee pain 32 .…”

Section: Goals Of Treatmentmentioning

confidence: 95%

“…The first neuromuscular exercise program developed for use in patients with OA was published in 2010 29 . A recent Cochrane review identified 32 trials investigating a variety of land-based therapeutic exercise programs. Results of a meta-analysis showed mean treatment benefits for both knee pain and physical function.…”

Section: Goals Of Treatmentmentioning

confidence: 99%

Untitled

2019

IJPSR

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Osteoarthritis is accepted as the most growing, frequent, debilitating and heterogeneous condition that worsens the quality of life globally in the elderly, affecting an estimated 10% of men and 18% of women over 60 years of age with a rise in both prevalence and incidence. At present, there is no definite cure for osteoarthritis and no effective treatments which arrest or slow its progression; however multiple numbers of treatments ranging from newly approved oral medications, topical agents, intra-articular injections to surgery exist, but these treatments are sometimes disappointing and may have a detrimental effect on health. Hence, traditional plants appear to be efficacious and safe with the anti-osteoarthritic effect that aid for greater relief of symptoms and/or disability along with highlighting various phytochemical with scientifically proven, and validated. In this present review study, an effort is made to treat OA by focusing on the clinical, scientific and mechanistic rationale for targeting inflammatory signaling pathways in OA by use of traditional plants. INTRODUCTION:Osteoarthritis (OA) is a longterm, chronic, progressive, musculoskeletal, degenerative, a rheumatic disorder characterized by deterioration of articular cartilage 1 , hypertrophy of bone at the margins 2, 3 leading to Arthralgia, Edema and Ankylosis 4 . It is the most common and destined to become 3 more prominent 5 multifactorial diseases causing disability in the elderly age group all over the world. For the last decades, OA was considered as wear and tear disease 4 (sometimes the condition is called as arthrosis or osteoarthrosis) 7 accompanied by subchondral bone sclerosis; other intrinsic changes such as increased pressure or overload on weightbearing joints (hips), joint effusion, crepitus, and deformities 6 .

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“…Physical therapies, bracing and lifestyle management are among many of the physical options available [8]. Oral pharmacological strategies such as simple analgesia, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids (CS) and dietary supplements such as glucosamine are all routinely used in an attempt to control pain [9].…”

Section: Introductionmentioning

confidence: 99%

Intra-articular Injections for Management of Knee Osteoarthritis

Golding¹,

Brock²,

Whiting³

et al. 2017

J Arthritis

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Knee pain is an increasingly common presentation to general practitioners worldwide which is thought to be related to the obesity epidemic, an ageing population and increasingly sedentary lifestyles in more developed nations. Degenerative osteoarthritis (OA) accounts for the majority of presentations in older age groups and this has traditionally been treated with analgesia, lifestyle modifications and adjuncts such as physiotherapy, braces and insoles. All these therapies aim to delay the need of total knee replacement (TKR), which is often the end-point for severe knee OA. However, TKR is associated with poor levels of patient satisfaction, low functional outcomes and has recently been shown to have low levels of cost-effectiveness except in patients with severe disabling OA. Increasingly doctors are turning to intra-articular injections which can provide temporary pain relief such as corticosteroids, hyaluronic acid and platelet rich plasma. This article aims to review the current options for intraarticular injections, comment on their efficacy and suggest areas for future development.

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Non-surgical and Non-pharmacological Treatment of Knee Pain

Cited by 4 publications

References 50 publications

Need to Adopt a Patient Centered Approach for Obtaining Favourable Results of NonPharmacological Interventions among Knee Osteoarthritis Patients in Out Patient Department Settings

Need to Adopt a Patient Centered Approach for Obtaining Favourable Results of NonPharmacological Interventions among Knee Osteoarthritis Patients in Out Patient Department Settings

Untitled

Intra-articular Injections for Management of Knee Osteoarthritis

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