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OA Knee Pain Blog
Discover the background of osteoarthritis treatment Osteoarthritis is one of the biggest causes of pain and misery in adults worldwide, affecting millions of mainly older people across the globe and costing governments and health providers billions of pounds. Overall, the condition - which is often abbreviated to OA - is estimated to affect more than 630 million people globally. More women than men are affected, and it is more likely to be seen in people over the age of 60 (though conditions can begin to materialise from 40 onwards). In the UK, around eight million adults have OA - nearly five million of whom have arthritis of the knee. What do the history books tell us? The word osteoarthritis was first used in the late 19th century, when modern medicine was beginning to be developed as a more advanced science; however, we know that the various forms of arthritis have been around for much, much longer. Evidence from literature, historical accounts, visual representations in books and paintings, analysis of skeletal remains of various ages and new understandings of the causes of arthritis mean we know that people have been suffering from the condition for as long as humans have been around.
The iliotibial band (ITB) is not a muscle but a thick band of connective tissue that stretches from the outside of the pelvis down past the knee joint to the outside of the shin bone (tibia). The ITB passes over the knee joint and so this can occur with other knee problems, such as issues with the cartilage. There is also a nerve that is called the peroneal nerve that passes very close to where the ITB inserts, and this too can be a source of symptoms in this area. So it is important to get an accurate diagnosis before thinking about what treatment is best.
What are the most common swimming injuries? Most injuries sustained by swimmers are related to overuse, but using incorrect techniques can also cause injury. Shoulder problems can be related to poor stroke mechanics used in front crawl and elbow issues can be caused by the arm pull in breaststroke and butterfly. Breaststroke can also cause knee stress injuries which are not seen in swimmers using different strokes.Injuries to the shoulder are the most common in swimming and, in fact, 90 percent of all swimming injuries are related to the shoulder. These can include shoulder instability, rotator cuff impingement and biceps tendinitis. All these conditions, collectively known as Swimmer’s shoulder, can result from weakness and fatigue of the muscles surrounding the shoulder blade and the rotator cuff.Injuries to the lower body are quite common in swimmers who use breaststroke. Breaststroker’s knee involves the ligaments and tendons of the knee and inflammation of the hip tendons can also cause hip pain. Preventing and treating swimming injuries The risk of injury can be reduced by various strategies. Learning and implementing good stroke techniques is important, as is performing cross training and core strengthening exercises at the beginning of the season, to make sure your condition is as good as it can be. Try to lessen any repetitive strokes that may be responsible for overuse injuries. Good communication between the swimmer, their coach and any medical professionals involved is very important, both for preventing injuries and for aiding recovery. Rest is needed for recovery from an injury, so only return to swimming when advised by a health professional.Some contributing factors to the development of a swimming injury include joint swelling or stiffness, poor rehabilitation following an earlier injury, an inadequate recovery period from training, poor warm up or warm down and poor core stability.
When is knee replacement surgery offered or suggested for osteoarthritis? The worst cases of OA - those that are creating considerable pain or restricting a patient’s everyday activities more than is acceptable - could be referred for surgery. Today, hip and knee replacements are common and highly successful operations that improve the lives of thousands of people every year, who find their mobility vastly improved by the procedure. The first knee replacement was performed way back in 1968. Early artificial knees were made like hinges; therefore, they would not allow the knee to move in a natural way. Perhaps unsurprisingly, many artificial knees failed soon after surgery; as a result, surgeons tended to only perform them in older patients, where a second operation would not be required.Over the decades, the artificial knee joints have been greatly developed, with improvements in both techniques and the materials used meaning that knee implants are now routinely performed on younger patients. Constant developments and improvements mean both hip and knee replacements continue to become more effective; in addition, new, longer-lasting materials mean the operation no longer has to be repeated every ten years or so.
What non-surgical options exist for the management of osteoarthritis? The pain of osteoarthritis of the knee can be almost unbearable, and as one of the most common forms of joint problems, it affects a huge number of patients every year. Eventually, when the knee joint becomes severely damaged, the only real solution is surgery, but there are plenty of options available to sufferers before reaching that point. Non-surgical solutions to knee pain Lose Weight: Being overweight, even only slightly, puts additional stress on the structures of the knee which causes increased levels of pain. Lessening the load on the knee can be extremely helpful. Gels and creams: From capsaicin creams, derived from the capsicum pepper plant, to gels containing ibuprofen, topical applications can provide good relief from pain for many sufferers. Painkillers: From paracetamol through ibuprofen, naproxen and opioids, there are plenty of options, so if you don't achieve success with one regime it's important to keep trying until you find a solution that works for you. Injections: Corticosteroid injections are usually a first line of defence before surgery, although the results are variable. Hyaluronic Acid Injection: A new treatment currently undergoing tests (currently inconclusive), but some people report good results from the treatment. The theory is that the hyaluronic acid provides fluidity to the damaged cartilage, allowing the bones of the knee joint to pass smoothly over the structures without snagging, thus relieving pain. With the life of a knee replacement reckoned to be around ten years, surgeons are understandably reluctant to perform knee surgery on younger patients who will need further surgery in the following years, which is leading to a greater uptake of conservative treatments to hold the disease at bay for as long as possible.