Knee Doctor: 6 Good Reasons to See an Orthopedist for Knee Pain

Knee Doctor: 6 Good Reasons to See an Orthopedist for Knee Pain

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What 6 Reasons are there to See an Orthopedist for Knee Pain?

So, you have a knee problem. Should you see a knee doctor? Let’s take a look at when you really need to do more than the basic DIY methods discussed in the article 26 DIY Knee Health Secrets.

  • You injured your knee, and after a few days, it’s not better. This is called acute pain
  • You have pain, and it not only doesn’t go away, but it just hurts too much. This is called chronic pain
  • When walking or moving around, your knee ‘gives out,’ so that you fall, or can’t put weight on it
  • There is persistent swelling
  • You experience so much stiffness that your range of motion is limited. You can’t fully bend or straighten your knee
  • Your knee joint is deformed, overextended

A recent study says that 40 million people experience knee pain for one reason or another.

Acute vs. Chronic Pain

acute knee pain

Acute pain is associated with some event, like an injury, such as a sprain or an impact, when the knee hits the ground hard or something hits it. Hopefully, the pain will resolve itself naturally through the RICE method. However, in some cases, as we see in professional sports or car accidents, the injury can be very painful, thus requiring medical attention.

Chronic pain is pain that develops over time and just doesn’t seem to go away. It can be bearable; however, if it persists and really starts interfering with your daily life, then it may be time to take a look at professional help. If you rate your knee pain on a scale of 1-3, where 1 is noticeable but not too much, that is probably ok, and you may well be able to get by treating it yourself.

Pain levels of 2 is when the pain is annoying but not out of control. You still may be able to take care of it yourself.

However, if your pain level is 3 or higher–and you’ll know when you feel it–it’s probably time to see some sort of professional, whether an orthopedic doctor, physical therapist or even acupuncturist, massage therapist, at a minimum.

Acute and chronic pain are different clinical entities. Acute pain is provoked by a specific disease or injury, serves a useful biologic purpose, is associated with skeletal muscle spasm and sympathetic nervous system activation, and is self-limited. Chronic pain, in contrast, may be considered a disease state.

A Knee Doctor Understands Different Types of Knee Injuries

Your ability to move is based on bones, ligaments, tendons, and muscles and how they all work together.

Obviously, bones hold up our bodies, and since there are joints between the bones, we can move. Ligaments are like the ‘strings’ between our bones. Tendons connect our muscles to our bones. If any one of those is damaged, you are going to experience some symptoms, either pain, lack of flexibility, swelling, stiffness.

One other important component of your knee is the cartilage and meniscus. These are semi-soft tissues that act as shock absorbers when running or jumping.

Put this all together, and these are the types of injuries that can occur:

  • Sprains. These occur when a ligament is either overstretched or actually torn. You will feel pain, lack of full-motion, weakness so you can’t support your weight
  • Strains. Your tendons are stretched too far, resulting in pain on the sides of your knee. Your knee will not move freely.
  • Cartilage. Your knee may lock, lack full mobility, or feel weak or experience tenderness when you put pressure on it.
  • Bursitis. A Bursa helps to lubricate your knee so it can move easily. When they are inflamed, you’ll feel pain, swelling, and stiffness.
  • Broken bones and dislocations. If your knee bends backward or is clearly out of joint, you’ll know it. Likewise, broken bones are extremely painful.

For more details on these issues, go here:

The knee itself is a joint, but surrounding the joint are muscles, tendons, and ligaments, all of which can be damaged from impact or trauma, resulting in injury. When a knee injury is the result of stretched or torn ligaments, it is also called a sprain.

There are four ligaments in the knee area connecting the femur to the tibia.

The knee is one of the most common body parts to be injured. Types of common knee injuries include sprains, strains, bursitis, dislocations, fractures, meniscus tears, and overuse injuries.

Knee injuries are generally caused by twisting or bending force applied to the knee, or a direct blow, such as from sports, falls, or accidents.

What About Chronic Knee Pain?

4 x more searches for Chronic Knee pain since 2009!

Take a look at the 4 fold increase in people search for the term ‘chronic knee pain’ in the last 10 years. Clearly, this is a growing issue, probably due to both increase in sports, as well as an aging population. The fact is, as people get older, things wear out, and knees are no exception.

What are the Causes of Chronic Knee Pain?

Healthline, an authoritative website on all things health-related, gives a good overview of the causes of chronic knee pain. It cites a whopping 11 reasons for chronic, knee pain. However, topping the list are:

  • Knee Osteoarthritis
  • Tendinitis
  • Bursitis
  • Chondromalacia
  • Gout
  • Baker’s Cyst
  • Rheumatoid Arthritis
  • Dislocation
  • Meniscus tear
  • Ligament tears
  • Bone tumors

You can read the details at their article.

Chronic knee pain is long-term pain, swelling, or sensitivity in one or both knees. The cause of your knee problems and pain can determine the symptoms you experience. Many conditions can cause or contribute to the knee pain you are experiencing as well

However, for our purposes, the point is, at what point does a mild discomfort, turn to a dull ongoing ache, or to serious pain? If you have ongoing pain that continues over time, two things to do. First, look carefully at what you are doing. If you exercise, don’t push through the pain. Heroism is not good for knees!

Second, one of the main causes of knee pain is weight. If your BMI, or Body Mass Index is over 24, it’d be a good idea to look into some weight loss program. That is because all that weight focused on your knee is one of the main causes of chronic knee pain.

Third, when you reach the point where the pain really is hindering your life, see a professional of some kind. A physical therapist may also have some good suggestions and treatments.

An orthopedic doctor, though, may well recommend an MRI, which can give a definitive answer to what is actually going on with your knee. At that point, you’ll have a better idea of how to proceed. The main thing is, if your knee hurts constantly, don’t let it go untreated and unexamined by a professional.

When Should You See an

Again, if you are experiencing significant swelling, redness, tenderness, or warmth around the joint, significant pain, or a fever, you need to make an appointment with your doctor. This is also true if there was any kind of forceful impact that resulted in the pain.

What Kind of Doctor Should You See for Knee Pain?

The majority of the time, you will find that your knee pain can be assessed by your primary care doctor. However, if the knee pain is going to require knee replacement surgery or further evaluation is needed, then you will need to make an appointment with an orthopedic surgeon. If you have gout, arthritis, or any inflammatory joint problems, you will need to consult with a rheumatologist. They can advise whether or not surgery will be needed to alleviate the pain.

How Do You Know if the Knee Pain is Serious?

You will definitely know when your knee pain is getting more serious because you will find that the knee may begin to lock, it is swollen, you can’t put your weight on it, it gave out, it can’t be fully extended, or it is only hurting in a specific location. All of this means that you may have a serious knee injury that requires a medical evaluation.

Do You Need a Referral to See a Specialist for Knee Pain?

Some insurance companies may require you to speak with your primary care provider and get a written referral before you can consult with orthopedic specialists. Even if it isn’t a requirement of your insurance company, you should still discuss your knee pain with your primary care doctor first and then discuss whether or not you will need to see a specialist for further evaluation.

Do Chronic Medical Conditions Cause Knee Pain?

Some medical conditions, including gout, arthritis, and infections, can lead to knee pain. However, some more minor knee pains can be taken care of with some self-care measures along with physical therapy and knee braces.

Can a Doctor Prescribe Anti-Inflammatory Medications to Help with Knee Pain?

For knee pain, you can find over the counter anti-inflammatory medications like acetaminophen and ibuprofen to help with knee pain and provide you with short term and temporary relief. However, if the knee pain is more severe, your doctor can prescribe prescription-strength anti-inflammatory medications that can be used on a more long-term basis if needed.

Conclusion

We’ve discussed the two types of pain, acute and chronic, and their causes. And we’ve looked at how you can determine what stage you are at with your knee issue: Is it minor, moderate, or severe. For short term results, you can always self treat.

A good place to start is by looking at the various ways you can care for your own knees.

However, be realistic. If you have any of the symptoms discussed here and the related articles, seek a professional’s help.

Minimally Invasive Knee Surgery: Arthroscopy

Minimally Invasive Knee Surgery: Arthroscopy

Minimally Invasive Knee Surgery–Arthroscopy Can Treat Injuries Such As  Meniscus Tears

Minimally invasive knee surgery can treat meniscus tears.The meniscus is a cartilage cushion, which rests between the bones of the knee and acts as a shock absorber. Meniscus tears are often repaired arthroscopically.

Patients can either tear their medial (inside of the knee) or lateral (outside of the knee) meniscus. Medial meniscus tears are much more common than lateral meniscus tears.

Symptoms of a Meniscus Tear

Patients typically experience well-localized pain, popping or catching. Squatting usually increases the pain. There is often minimal swelling present.

view of the knee during arthroscopic surgery

knee brace for pain

If you have these types of symptoms, it’s probably time to see a knee doctor.

Unlike bone or muscle, meniscus tissue has very poor blood supply. As such it has a very low healing potential. Most patients tear along the thin, inner rim of the meniscus where there is no blood supply.

These tears cannot be repaired. Instead, Dr. Cunningham removes just the torn portion of the meniscus and preserves as much of the healthy, functioning portion of the meniscus as possible.

In a typical minimally invasive inee surgery,  meniscus tear requiring arthroscopy, 10–15% of the meniscus has to be removed. If a patient has minimal arthritis (wearing of the coating cartilage on the end of the femur and/or tibia), then the patient can expect a great outcome.

If there is a meniscus tear and arthritis, then the outcome is typically inversely related to how severe the arthritis (ie. the worse the arthritis, the less optimal the outcome).

There is less need for crutches or a brace after arthroscopic menisectomy.

Minimally Invasive Knee Surgery: Arthroscopy for Meniscus Repair

If the meniscus tissue is torn in the peripheral 3mm (where there is blood supply), the meniscus can be repaired and preserved. Repairing the meniscus is always Dr. Cunningham’s preference.

So called “bucket handle tears” where the meniscus tears longitudinally along the outer rim and then flips into the center of the knee like a bucket handle, are tears that Dr. Cunningham commonly repairs.

The alternative to repairing these bucket handle tears is to remove 50% or more of the meniscus. Removing this amount of the meniscus, which is the “shock absorber” cartilage, is known to predispose the knee to early arthritis.

The gold standard for repairing the meniscus is to pass sutures “inside-out.” While viewing through the arthroscope, sutures are precisely passed through the meniscus and tied over the capsule of the knee joint. There are newer “all inside” meniscal repair devices where sutures don’t have to be passed through a small incision outside the knee.

Dr. Cunningham uses these all inside devices for smaller tears or for hard to reach tears.

Recovery and Rehabilitation

Depending on the severity of the problem, the rehabilitation time varies. In some cases, you can start walking within a day of rest. In other cases, you may need a knee brace for a few weeks. It’s a good idea to see a physical therapist to help with your rehab program.

Of course, it’s a good idea to go easy on your knee during the recovery period. A knee brace or pain reliever may be helpful as well.

Dr. Cunningham says, “However, immediately after surgery, we encourage you to unlock the brace or remove it when sitting down and start gentle knee range of motion exercises.

After 6-8 weeks, the brace is discontinued, but no squatting is allowed for up to 12 weeks as this places high shear stresses on the repaired meniscus, and we want to be sure it has been given every opportunity to heal.”

Dr. Richard Cunningham notes that, unfortunately, not all meniscus repairs heal despite our best efforts. This is again due to the poor blood supply and compromised healing potential of the meniscus. He does not do follow up MRI scans to confirm healing as these are unreliable.

Instead, he looks out for symptoms of a meniscus that did not heal, which are very similar to the symptoms patients had before surgery (catching, locking, well localized pain over the meniscus).

To learn more about your surgical options, consult with Dr. Cunningham for more information. His Website is https://rcunninghamorthopedics.com/

 

Arthroscopic Knee Surgery Meniscus Tear

Dr. Richard Cunningham, M.D. of Vail Summit Orthopaedics in Vail, Colorado, explains how he repairs a torn meniscus.

 

Stem Cell and Platelet Therapy: 2 Alternatives to Treat Orthopedic Injuries

Stem Cell and Platelet Therapy: 2 Alternatives to Treat Orthopedic Injuries

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When Self Help Fails, Is There an Alternative to Surgery?

Recently, one of my customers sent me this article from Dr. Mercola’s website.  It discusses the new use of stem cell and platelet rich plasma therapy for healing joint injuries.

Noting that surgery is the least desirable option, the suggestion of rebuilding tissue with these therapies is certainly worth considering. Whether regular insurance will pay for them though, since they look experimental, is an open question/

Dr. Mercola then goes on to mention several supplements, such as melatonin, Others include:

 

Nutrients and combinations of nutrients that boost stem cell regeneration include vitamins C and D, glucosamine and chondroitin, curcumin, resveratrol, bitter melon, and the amino acid l-carnosine. Leiber recommends these to most of his patients. He also recommends taking a high-quality omega-3 supplement such as krill oil in higher amounts.

 

The video is definitely worth checking out.

 

It also includes a video interview between himself and Dr. James Lieber.

However, aside from foods that help generate our own stem cells, or for that matter Fasting, which may also stimulate stem cells growth to remove old damaged cells, you can now undergo a medical procedure, whereby a specially trained physician removes Stem Cells, or Platelet Rich Plasma from your body.

The stem cells grow over a period of time and are injected into the area, such as a knee with little cartilage. Those fresh cells promote the growth of the tissue that you want to grow, in this case, knee cartilage.

Platelet Rich Plasma works in a similar way. It is like getting a shot of extra rich blood which helps to heal an injury. Treatments like these may be better in the long run than shots such as cortisone, which do relieve pain but they don’t actually heal your joint.

Thus, these two treatments are administered by a physician, but are no where near as drastic as surgery, or especially knee replacement surgery.

Before taking the risks associated with surgery, do some research to see if these types of treatment can solve your problem. They are much less expensive, much less invasive than surgery, yet could do just as much good. Ask your doctor and get a second opinion, as many surgeons are not familiar with these new procedures.

What about Self Care Options?

Full Disclosure:  I am not a medical professional. I am someone over 70 with three knee injuries, who does a lot of research. Before relying on others, especially for expensive treatment, and invasive treatments, the most extreme being knee replacement, doesn’t it make sense to see what we can do for ourselves? For example, I put together a book that you can get:

The title speaks for itself.Check it out.  Many of the posts on this website deal with self care, that is, what you can do for yourself before spending a lot of time and money with professionals. It also talks about low risk forms of professional treatment, especially physical therapy.

You can talk to chiropractors, Traditional Chinese Medicine practitioners, Naturopaths, so you do have a lot of choices. And one in particular, is this method of stimulating healing within your joint.

Therefore, before going under the knife, stem cell and platelet therapy are medical alternatives you might consider, in my opinion.

Thanks For Reading!