How is knee pain treated in the elderly?
About 60% of the elderly population has knee pain, mostly on one side of the joint, aggravated by walking, or even unable to squat in severe cases. Many people have taken painkillers or received intra-articular injections, but none of them can effectively solve the pain. Although the commonality of performance is pain when walking, there may be more than one cause, and simply taking medication for pain is not a cure.
So what are the common causes of knee pain in the elderly? And what treatments are needed?
First, the most common cause is age-related osteoarthritis. Due to the gradual increase in age, the cartilage of the articular surface in the knee joint gradually becomes thinner or falls off to varying degrees, and the body compensates for this by local bone growth, which occurs in the knee joint. Pain will occur.
The second is synovitis of the knee. There are two layers of synovial membrane protecting the joint in the human knee, and the innermost layer of synovial membrane is very rich in blood flow. The innermost layer of the synovium is rich in blood flow and normally secretes a small amount of mucus, which keeps the knee joint lubricated and allows the joint to move freely. When the body suffers from certain diseases or trauma, the synovial membrane of the knee joint may become hypertrophied and hypersecretory, resulting in swelling and discomfort in the knee joint, difficulty in walking, and fluid accumulation in the joint.
The main manifestation is pain in the knee joint when walking up and down stairs, sometimes with pins and needles pain, many elderly people have to take a break during the process of walking up and down stairs to relieve the pain.
When knee pain occurs in middle-aged and elderly people, they should go to regular medical institutions early for standardized and effective treatment. Be sure to pay attention to the following points.
1. Pay attention to the protection of joint cartilage
In daily life, you should pay attention to the “three don’ts”: don’t climb the mountain, don’t play Tai Chi, and don’t go up the stairs with weight to avoid aggravating the condition by overloading the knee joint.
2. Maintain a proper weight
Prevent obesity and aggravate the burden on the joints of the lower limbs. Once you are overweight, you should actively lose weight, pay attention to diet regulation and weight control.
3.Avoid prolonged squatting
Studies have shown that the weight of the knee when lying down is almost zero, standing up and walking flat when the weight is 1 to 2 times the weight, while squatting and kneeling is 8 times.
If the knee joint is in a long-term weight-bearing high-pressure state, it will increase the friction of the cartilage edge, accelerating the loss of cartilage, its cushioning, anti-pressure, shock-absorbing role is greatly reduced, resulting in knee pain, swelling, stiffness, activity is blocked and other symptoms.
For patients with osteoarthritis of the knee.
1, swimming and walking are the best exercises
Swimming and walking are the best exercises that do not increase the weight on the knee joint, but also allow the muscles and ligaments around the knee joint to be exercised.
2. Exercises that are suitable for you at home
Supine leg lifts and empty pedal bicycles are the best exercises for patients.
3.Medication can be used under the guidance of a doctor
If the joint pain is more obvious, you can take oral anti-inflammatory and analgesic drugs, cartilage supplements, and also feasible joint cavity injection to supplement the lubricant.
In the early stages of osteoarthritis, standardized treatment can effectively reduce symptoms and slow down the progression of the disease. Unfortunately, many patients do not have a proper understanding of this, thinking that they are just cold, so they wear a knee brace, strap on a warm water bag, and take some painkillers when they are bad, thinking that they can deal with it, but the pain is getting worse.
In clinical practice, many patients have had knee pain for several years or even more than 10 years without receiving standardized and effective treatment until they have severe pain or joint deformity and are unable to walk and are wheelchair bound or bedridden for long periods of time. What should not happen is that due to long-term bed rest, patients are prone to complications such as “three highs” – hypertension, hyperglycemia and hyperlipidemia, as well as accompanying osteoporosis, heart and lung infections, pressure sores, etc., which seriously affect the quality of life of middle-aged and elderly people.
So how to treat knee pain and osteoarthritis in the elderly?
The main goals of osteoarthritis treatment are to relieve pain, stop and delay disease progression, protect joint function, improve quality of life, correct deformities, and improve or restore joint function.
1.Non-pharmacological treatment
(1) Exercise and life guidance
Reduce unreasonable exercise, appropriate activity
Avoid poor posture, avoid prolonged running, jumping and squatting, reduce or avoid climbing stairs.
Reasonable joint muscle exercise
Flexion and extension activities of the knee joint under non-weight-bearing condition to maintain maximum joint mobility.
Low-weight-bearing, moderate-intensity aerobic exercise and muscle strength exercises are helpful for knee and hip osteoarthritis, such as walking, swimming, and bicycling. Studies have found that as little as 60 minutes of exercise per week can help with osteoarthritis symptoms. 150 minutes of moderate-intensity exercise and 2 days of muscle strength exercises per week can help reduce pain and improve joint function.
Obese people should lose weight
Reduce the load on the affected joints; canes, crutches, and walkers can be used. When knee osteoarthritis leads to unstable standing and walking, reduced joint motion and decreased ligament elasticity and absolute muscle strength, which cause great inconvenience, the use of assistive devices should be considered to reduce the load on the joint.
(2) Physical therapy
In the acute stage, pain relief, swelling reduction and improvement of joint function should be the main focus.
In the chronic stage, the main focus is to enhance local blood circulation and improve joint function.
Commonly used methods include acupuncture, massage, tui-na, heat therapy, etc.
2.Drug treatment
If non-pharmacological treatment is ineffective, drug treatment can be chosen according to the joint pain.
Topical medication: such as topical formulations of NSAIDs, creams, patches, etc.
Systemic analgesic drugs: including oral, injections and suppositories.
Joint cavity injection drugs: ① glucocorticoids; ② hyaluronic acid. Repeated injections are not advisable, no more than 3~4 times per year.
Improving drugs and chondroprotective agents: Generally the effect is slow, requiring several weeks of treatment to be effective, but there is still controversy about the effectiveness of these drugs. Commonly used drugs include glucosamine, chondroitin sulfate, etc.
3.Surgical treatment
For patients who have no obvious effect by conservative treatment, serious lesions and joint dysfunction, affecting daily life, surgical treatment can be considered to relieve pain, correct deformity and improve joint function. Treatment methods include osteotomy, artificial joint replacement, joint fusion, etc., of which artificial joint replacement is the most commonly used surgical method.