When dealing with chronic knee pain you may hear well-meaning friends advise you that a knee scope is likely in your future. This could be based on how they themselves have treated knee pain under their doctor’s guidance. And although it has been a popular option for years, when exactly is a knee scope or knee arthroscopy necessary? And are there any non-surgical alternatives for knee pain relief?
Understanding the Knee
The knee is the most complex joint in the human body. According to Medical News Today, it is made up of 3 bones. The knee joint is where the very large femur bone of the thigh meets the tibia or shin bone of the lower leg. A small plate-like bone capping the front of the knee is the patella or knee cap. It is lined with very thick cartilage which protects the joint. In addition to the bones, there are ligaments, tendons, and cartilage which all have a purpose of assisting the knee to act as a weight-bearing hinge joint.
What Could Be Causing Your Knee Pain
- Osteoarthritis and Degenerative Joint Disease – Inflammation and swelling of the knee joint and subsequent degeneration of the hardware of your knee.
- Meniscus Tears – Damage to the cartilage cushions that act as the shock absorber of the knee.
- Knee Clicking or Locking – Often a result of osteoarthritis, as the protective cartilage is thinned out and worn away.
Arthroscopy: A Common Procedure Overused
Knee arthroscopy is a procedure that diagnoses and treats problems in the knee joint through the aid of a tiny camera inserted through tiny incisions. Treatment can involve the surgical removal of or the trimming of bits of cartilage, bone, or tissue that could be contributing to inflammation and pain. NBC News explains that this procedure is so common that 700,000 of these surgeries are performed in the United States alone every year.
US News and World Report explain that although arthroscopic knee surgery “is useful in limited circumstances, research finds the procedures often provide no benefit.” This is certainly a surprising statement being that the procedure is touted as being a solution to knee pain. The article went on the say that in patients who had arthritis or degenerative joint disease, arthroscopy didn’t produce any long-term benefits for quality of life or pain reduction. And although adverse outcomes are rare, as with any surgery, there are potential risks such as blood clots and infection.
The Problem with MRI
Those desperate for answers may believe that an MRI is the best option for diagnosis as this is a non-invasive option. The problem with Magnetic Resonance Imaging for diagnosing conditions of the knee according to American Family Physician is that MRI may “provide clinically irrelevant information”. An MRI could potentially identify problems that are not causing any symptoms and are unrelated to the knee pain, which may lead to unnecessary surgery. Sometimes an MRI could also suggest a Meniscal tear when in fact there is none. The recommended course of action, therefore, is to pursue conservative care for 4-6 weeks. Physical therapy and the use of anti-inflammatory medications, after which there may likely be an improvement in symptoms. After trying this first, if pain persists, then perhaps MRI would be indicated.
Non-Surgical Options for Healing
The American College of Physicians advises that for most cases of knee pain with the exception of infection or suffering a break, conservative non-surgical methods should be tried first. Such methods might include RICE, Rest, Ice, Compression, and Elevation. Over-the-counter pain medications may be ordered by your physician. If persons are overweight or obese, great alleviation of knee pain has been had through a weight loss program that combines diet and muscle strengthening exercises.
Patients who are dealing with osteoarthritis-related knee pain are very good candidates for 6 weeks of physical therapy. PT is the best option for most candidates whether or not they will eventually need surgery. If they improve with physical therapy, surgery may not be warranted. Even if surgery is eventually needed, their leg muscles will be stronger aiding in rehabilitation afterward. See for yourself the difference that physical therapy can make at alleviating your knee pain. Contact Cawley Physical Therapy and Rehabilitation at 570-208-2787 or email cawleyptfrank@gmail.com
