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Archive for June, 2011

Acetaminophen

Acetaminophen

Acetaminophen is commonly used to relieve fevers, headaches, and minor aches and pains. It is a major ingredient in many cold and flu remedies. It is also used as a short term solution to treat mild knee arthritis. However it has no effect on the underlying inflammation, redness, and joint swelling.

Acetaminophen works by elevating the body’s pain threshold. It relieves pain by requiring the body to produce a greater amount of it before the pain is felt. Current recommendations for treating pain suggest that acetaminophen may be taken for up to 10 days. If symptoms persist, a doctor needs to be consulted to see if acetaminophen use should continue.



Corticosteroid

More on cortisone injections for knee osteoarthritis….

Though there isn’t a hard and fast rule, it is generally agreed upon within the medical community that injections of cortisone should not be given more than three times per year.  Long-term use can lead to:

  • Cartilage weakness
  • Weakening of ligaments and tendons
  • Thinning of the skin
  • Avascular necrosis  – death of the bone

Cortisone injections are a temporary treatment and when used correctly rarely produce side effects. Though uncommon those side effects can include:

  • “Steroid Flare” increased inflammation
  • Pain
  • Skin Discoloration
  • Thinning of the skin at the injection site
  • Infection

Cortisone should not be taken by people with:

  • Infections
  • Diabetes
  • High Blood Pressure
  • Congestive Heart Failure
  • Peptic Ulcers
  • Osteoporosis


Corticosteroid

Corticosteroid

Cortisone is a powerful type of synthetic medication (corticosteroid) that reduces inflammation. It resembles a naturally produced hormone within the body called cortisol, and works by slowing down the immune system.

Cortisone has been used for over 50 years to temporarily treat symptoms related to knee osteoarthritis. Though cortisone injections are used as a treatment for pain, it is not a pain reliever. When the injections reduce pain it is because the synthetic medication has decreased inflammation within the knee. Cortisone is not a cure for osteoarthritis, nor does it alter the course of the disease.

People react differently to Cortisone. Some experience pain relief for days others for months. There really isn’t a method to predict how the powerful drugs will react for any given individual. However, it is clear that if the first couple of shots have little or no effect, that repeated injections will seldom offer relief.  Also, the injections will decrease in effectiveness over time.



Ice Pack

Ice Pack

Ice packs are an effective treatment option for knee osteoarthritis for several reasons.  Ice will decrease swelling in the knee.  Also, cold therapy will slow the release of chemicals within the body that cause pain and inflammation.  Cold also reduces that ability of nerve endings to conduct pain impulses.  Ice will also limit the ability of muscles to reduce spasms.

An ice pack wrap is an effective means of delivering cold therapy to an arthritic knee.



Knee Arthroscopy

Knee Arthroscopy

Arthroscopy is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage to the interior of a joint is performed using an arthroscope, a small camera.  The “scope” is inserted into the joint through a small incision.

The advantage of arthroscopy over traditional open surgery is that the joint does not have to be completely opened.   Instead, two small incisions are made – one for the arthroscope and one for the surgical instruments to be used in the knee cavity to fully remove the knee cap.

Though arthroscopic surgery is widely recommended by the orthopedic community to treat knee osteoarthritis, the usefulness of the surgery is doubtful. A study on arthroscopic surgery for osteoarthritis of the knee was published in the New England Journal of Medicine in 2002. In this three-group study, 180 military veterans with osteoarthritis of the knee were randomly assigned to receive arthroscopic debridement with lavage, just arthroscopic lavage, or a sham surgery, which made superficial incisions to the skin while pretending to do the surgery. The study reported, “At no point did either of the intervention groups report less pain or better function than the placebo group. Because there is no confirmed usefulness for these surgeries, many agencies are reconsidering paying for a surgery which seems to create risks with no benefit.”