Knee pain ; Most surgeries don’t work says the NY Times but there are things you can do that can help.

  • Share:
  • facebook
  • linkedin
  • twitter
Knee pain has been a great business model for the medical profession.  Most of us know someone who had arthroscopic surgery or had injections that seemed to relieve the problem, yet eventually, their knees wore out anyway. Knee replacement surgery is a big business as well for the medical profession, and like arthroscopic surgery, many of us also know someone who had this done as well. Recent studies suggest that most knee procedures long-term are ineffective, and many people who have had a knee surgery will have another either in the same knee or a different knee. On the other hand, studies also conclude that physical therapy is likely to be as or more effective, at a lower cost and at a lower level of risk, yet therapy is a broad term that is essentially meaningless in the wrong hands. Perhaps, the myopic way most healthcare professionals evaluate your knees is the problem. Current studies suggest health care professionals need to do things differently to get a better result. After years of poor function and improper management, our knee joints may be already irreparably damaged and require a replacement now that the joint is bone on bone. The NY Times recently wrote an article concerning knee problems and how their reporter, like many others, had meniscus surgeries, injections such as Synvisc and assumed that her years of playing tennis is why her knees went bad.  You can read her article here. If tennis was the reason for knee pain, wouldn't all tennis players have bad knees? Her recommendations  included the following well-worn advice such as:
  1. 1. If you are overweight, lose weight. The more you weigh, the more pressure on your knees with every step and the more they are likely to hurt when walking or climbing stairs.
2. Pay attention to the activities that aggravate knee pain and try to avoid those that are not essential, like squatting or sitting too long in one place. 3. If the pain is bad enough, take an over-the-counter pain reliever like acetaminophen (Tylenol and others) or an NSAID (nonsteroidal anti-inflammatory drug) like ibuprofen or naproxen. 4. Probably most helpful of all, undergo one or more cycles of physical therapy administered by a licensed therapist, perhaps one who specializes in knee pain. Be sure to do the recommended exercises at home and continue to do them indefinitely lest their benefits dissipate. 5. Consider consulting an occupational therapist who can teach you how to modify your activities to minimize knee discomfort. While her advice sounds logical based on the current evidence,  knee pain is often a symptom of a gait-related problem, and the knee is just a conduit.   Perhaps, this is why core training helps improve knee pain, often better than many of these procedures do.   Medically speaking, doctors are taught to treat or manage the symptom of knee pain, rather than evaluate the mechanism that causes knee pain and treat the cause instead. If you follow her advice, you are likely to have a similar unacceptable outcome based on conventional thinking. A stable core can improve knee function because it reduces the loads on the legs.   In most of us, knee problems begin from the ground up.  Growing evidence showing that training the core can help.  You can read more here and here. To adequately diagnose a knee problem, your doctor must consider your core, your knees, your feet and your hips.   To be even more thorough, they must also look at your upper body since it can affect the way you walk in ways that seem unimaginable. This is why you want your healthcare practitioner to be holistic (looking at you) rather than reductionistic (looking at the symptomatic area). When the knees are already bad, you have waited way too long to see the right person for the right advice.   Most sports chiropractors will take a comprehensive holistic approach to evaluation and often, a treadmill evaluation and video can be a great diagnostic tool. Since most people who have chronic knee pain have inherited mechanical traits that have resulted in the problem later on in life, you can be a great help to your children by addressing these issues while they are young.   Most shin problems and running injuries are not as innocent as they look and the right advice can make all the difference at those young ages. Sports chiropractors are uniquely trained to help you change the rules of the game to alter the eventual outcome of bad knees.   The typical approach of seeing a number of specialists have been shown largely to be an expensive failure in helping people avoid bad knees.   Preventing degeneration by improving function is a much better approach to having replacement knees that take months of rehab and are likely never to work as well as the original ones did. See your sports chiropractor first to get the best evaluation and treatment for your knees.  Seeing the right person first is simpler, more cost-effective, and is a better overall approach to knee pain relief. Looking at you and understanding first why you hurt rather than where is the best approach to a diagnosis that can lead to more effective care and prevention of chronic knee pain.