Arthritis Treatment: Seven Myths About Knee Pain Treatment

Knee pain is a common problem...in fact one of the most common maladies seen by both rheumatologists as well as orthopedic surgeons.

Like most common medical problems there are several myths circulating about what to do with knee pain.

Myth #1: "Knee pain is something you just walk off..." Nothing could be farther from the truth. In fact, trying to "walk it off" can cause irreparable damage. Realistically, most people with a significant knee problem will have a great deal of difficulty walking at all.

Myth#2: Unless it's swollen, it's not serious..." Many serious knee problems can cause symptoms other than swelling. For example a ligament problem will cause significant pain yet, the swelling will be minimal.

Myth#3: "Just use a rub or put heat on it..." This is not completely wrong but is not a good idea with acute knee injuries. Ice and rest is what is usually recommended to help reduce swelling and pain.

Myth#4: "You'll need surgery..." Unless the knee problem involves significant internal damage to vital structures inside the knee such as a torn anterior cruciate ligament, torn meniscus, and such, surgery may not be the best approach. For example many types of knee problems such as bursitis, tendonitis, and ligament strains can be managed medically using physical therapy, ice, non-steroidal-anti-inflammatory medicines, and injections of platelet-rich plasma.

Myth#5: "All you need is a cortisone injection..." Corticosteroid injections have their place. For example, with degenerative arthritis, knee pain can be a serious problem. A recent Dutch study showed the prevalence of painful disabling knee osteoarthritis in people over 55 years is 10%, of whom one quarter are severely disabled. (Peat G, McCarney R, Croft P. Ann Rheum Dis 2001;60:91-97). In a situation like that, corticosteroid injections can afford great relief. But no more than three injections per year should be given for arthritis because steroids can lead to further cartilage deterioration. Alternatively, if osteoarthritis is the culprit, lubricant injections, viscosupplements, can be used to relieve pain and improve function.

Myth#6: "You need to see an orthopedic surgeon..." What do surgeons do? Surgeons "surgerize"... they cut. Knee pain should be managed by a rheumatologist unless there is clear cut evidence that damage to internal structures require surgery. This is particularly true when it comes to osteoarthritis of the knee where autologous stem cells, a patient's own stem cells, may forestall the need for knee replacement surgery.

Myth #7: "There are only a couple of causes of knee pain..." There are more than seventeen significant causes of knee pain and they are all managed differently. Examples include bursitis, tendonitis, ligament injuries, Baker's cysts, nerve related pain, referred pain from the hip, medial plica syndrome, and so on and so forth.