Our Qi Tuina Clinic has saved more than 30 pairs of knees from knee replacement surgery to date and the figure is increasing rapidly. Most of them have healed and no longer need any more treatment.
Your knee joint is where your thigh bone (femur) and your shin bone (tibia) meet. Your knee is the largest joint in the body and also one of the most complicated. It needs to be strong enough to take our weight and must lock into position so we can stand upright.
What happens to a knee with osteoarthritis?
When your knee has osteoarthritis its surfaces become damaged and it doesn’t move as well as it should do. The following happens:
- The cartilage becomes rough and thin – this can happen over the main surface of your knee joint and in the cartilage underneath your kneecap.
- The bone underneath the cartilage reacts by growing thicker and becoming broader.
- All the tissues in your joint become more active than normal, as if your body is trying to repair the damage.
- The bone at the edge of your joint grows outwards, forming bony spurs called osteophytes.
- The synovium may swell and produce extra fluid, causing the joint to swell – this is called an effusion or sometimes water on the knee.
- The capsule and ligaments slowly thicken and contract.
These changes in and around your joint are partly the result of the inflammatory process and partly an attempt by your body to repair the damage. In many cases your body’s repairs are quite successful and the changes inside your joint won’t cause much pain or, if there is pain, it’ll be mild and may come and go.
However, in other cases the repair doesn’t work as well and your knee is damaged. This leads to instability and more weight being put onto other parts of the joint. This can cause symptoms to become gradually worse and more persistent over time.
What are the symptoms of osteoarthritis of the knee?
The main symptoms of osteoarthritis of the knee are:
- pain (particularly when you’re moving your knee or at the end of the day – this usually gets better when you rest)
- stiffness (especially after rest – this usually eases after a minute or so as you get moving)
- crepitus, a creaking, crunching, grinding sensation when you move the joint
- hard swellings (caused by osteophytes)
- soft swellings (caused by extra fluid in the joint).
Other symptoms can include:
- your knee giving way because your muscles have become weak or the joint structure is less stable
- your knee not moving as freely or as far as normal
- your knees becoming bent and bowed
- the muscles around your joint looking thin or wasted.
It’s unusual, but some people have pain in their knee that wakes them up at night. This generally only happens with severe osteoarthritis.
You’ll probably find that your pain will vary and that you have good days and bad days, sometimes depending on how active you’ve been but sometimes for no clear reason.
Some people find that changes in the weather (especially damp weather and low pressure) make their pain and stiffness worse. This may be because nerve fibres in the capsule of their knee are sensitive to changes in atmospheric pressure.
What causes osteoarthritis of the knee?
Many factors can increase your risk of osteoarthritis of the knee. It’s most common if:
- you’re in your late 40s or older – this might be because your muscles have become weaker, your body is less able to heal itself or your joints have gradually worn out over time
- you’re a woman – osteoarthritis is more common and more severe in women
- you’re overweight – this increases the chances of developing osteoarthritis and of it becoming gradually worse
- your parents or siblings have had osteoarthritis
- you’ve had a knee injury, for example a torn meniscus
- you’ve had an operation on your knee, for example a meniscectomy (to remove damaged cartilage) or repairs to your cruciate ligaments
- you do a hard, repetitive activity or a physically demanding job, for example farming or mining
- you have another type of joint disease which has damaged your joints, for example rheumatoid arthritis or gout.
What treatments are there for osteoarthritis of the knee?
There’s no cure for osteoarthritis as yet, but there are a number of treatments that can help ease symptoms and reduce the chances of your arthritis becoming worse.
Drugs for osteoarthritis of the knee
Painkillers (analgesics) help with pain and stiffness but they don’t affect the arthritis itself and won’t repair the damage to your joint.
- Painkillers are best used occasionally when you’re in pain or when you’re likely to be exercising.
- Paracetamol is usually the best and most well-tolerated painkiller, but make sure you take the right dose because many people take too little – try 1 g (usually 2 tablets) 3 or 4 times a day. You can buy them from your chemist or supermarket.
- Combined painkillers (e.g. co-codamol, co-dydramol) contain paracetamol and a second codeine-like drug, so they may be helpful for more severe pain. Because they’re stronger than painkillers, they’re more likely to cause side-effects such as dizziness and constipation.
Non-steroidal anti-inflammatory drugs (NSAIDs), for example ibuprofen or naproxen, may be recommended if inflammation is contributing to your pain and stiffness.
- NSAIDs can sometimes have side-effects, but your doctor will take precautions to reduce the risk of these. They may suggest the lowest effective dose for the shortest possible time and prescribe another drug called a proton pump inhibitor to help protect your stomach from digestive problems.
- NSAIDs also carry a slightly increased risk of a heart attack or stroke, so your doctor will be cautious about prescribing them if there are other factors that increase your overall risk (e.g. you smoke or you have circulation problems, diabetes, high blood pressure or high cholesterol).
Non-steroidal anti-inflammatory creams and gels are a good option if you have trouble taking NSAID tablets.
- Creams and gels can be applied directly onto painful joints three times a day and there’s no need to rub them in – they absorb through your skin on their own.
- They’re extremely well tolerated because very little is absorbed into your bloodstream.
- You can tell within a few days whether they’ll help with your pain.
Capsaicin cream is made from the pepper plant (capsicum) and is an effective and well-tolerated painkiller.
- Capsaicin cream is only available on prescription and needs to be applied three times a day.
- Most people feel a warming or burning sensation when they first use it, but this generally wears off after several days.
- The pain relief starts after a few days and you should try it for at least two weeks before deciding if it’s helped.
Stronger painkillers, for example opioids/anti-inflammatories, may be prescribed if you have severe pain and other medications don’t work well enough.
- Stronger painkillers are more likely to have side-effects, especially nausea, dizziness and confusion, so you’ll need to see your doctor regularly and report any problems.
- Some opioids can be given as a plaster patch to wear on your skin, which can give pain relief for a number of days.
- Stronger painkillers are only available on prescription.
Because these treatments work in different ways, you can combine them for greater pain relief. Ask your chemist or doctor for advice on safe combinations.
If you have trouble opening childproof containers, ask the pharmacist to put your drugs in a more suitable container. You can also order a child-resistant closure card.
Steroid injections are sometimes given directly into a particularly painful knee joint.
- The injections can start working within a day or so and may improve pain for several weeks or months.
- They’re mainly used for very painful osteoarthritis, for sudden attacks caused by shedding calcium crystals and to help you through important events (such as a family wedding).
Other treatments for osteoarthritis of the knee
Applying warmth or cold to your knee can relieve pain and stiffness.
- Heat lamps are popular, but a hot-water bottle or reheatable pad (available from most chemists) are just as effective.
- An ice pack can also ease pain.
- Don’t apply a hot or cold pad directly onto the skin.
Hyaluronic acid injections, which help to lubricate your knee joint, are sometimes given when steroid injections don’t work.
- You may be given a single injection or a course of several injections.
- This form of treatment isn’t approved by the National Institute for Health and Clinical Excellence (NICE) and isn’t widely used because the evidence that it works isn’t convincing.
Transcutaneous electrical nerve stimulation (TENS) can be used for pain relief, although research evidence suggests that it doesn’t work for everyone.
- A TENS machine is a small electronic device that sends pulses to the nerve endings via pads placed on the skin. The device produces a tingling sensation which is thought to modify the pain messages sent to the brain.
- TENS machines are available from pharmacies and other major stores, but a physiotherapist may be able to loan you one to try before you decide to buy one.
Knee braces are becoming more popular and more evidence to support their use for osteoarthritis is emerging.
- There are several types that can help to stabilise the kneecap and make it move correctly.
- You can buy knee braces from sports shops and chemists, but you should speak to your doctor or physiotherapist first. They may also be able to provide braces or recommend the best ones for you.
Surgery may be recommended if you have severe pain or mobility problems.
- A knee replacement operation can give substantial pain relief in cases where other treatments haven’t helped enough. Replacements now last on average over 15 years.
- If your knee locks, an operation to wash out loose fragments of bone and other tissue from the joint can be performed – this is called arthroscopic lavage.
Wu Zu Qi Tuina is a totally non-invasive, holistic and painless way to alleviate and heal osteoarthritic knee pain completely and is effective immediately as felt by almost all our patients so far.
The body absorbs debris, and our qi tuina enables this process to accelerate and negates the need for arthroscopic lavage. Wu Zu Qi Tuina also clears all the qi meridians blocked by these debris as well as the swelling of the joint.
Once the qi meridians are cleared of blockage, then we stimulate the patient’s qi to circulate in large volumes to allow holistic healing to take place.
We have saved more than 30 pairs of knees from knee replacement surgery, and they have healed to such an extent that the patients no longer need to seek further treatment.
Please go to Chin’s Qi Tuina Centre to read our patients’ reviews and book an appointment. Knee replacement surgery is NOT reversible. Stem cell treatment has its risks as well in that the stem cells may take on bone characteristics rather than cartilage.
Some references:- Dato’ Pardip Kumar Kukreja, Dato’ Tajudeen, Dato’ Seri Dr. Alif Aiman, En. Nafiz, Mr. Haridas, Dato’ Philip Loh, Dato’ Andy Seo, Ms. Regina Morris, Ms. Janett Lee, Ms. Annie Lim, and many many more.