Osteoarthritis

Two most common causes for knee pain are:

OA Knee (Osteoarthritis)
Chondromalacia Patella

OSTEOARTHRITIS OF KNEE JOINT :

Osteoarthritis is the most common form of  arthritis of Knee. It is a  Joint Inflammation  that results from cartilage degeneration. It is usually a slowly progressive degenerative disease. It is affecting millions of people worldwide. It occurs when the protective cartilage on the ends of your bones wears down over time. It can damage any joint in your body. This most commonly affects joints in your hands, knees, hips and spine. It most often affects middle-aged and older people.

 

STAGES OF OSTEOARTHRITIS :

Stage 1-Doubtful

At this Stage, The cartilage may be slightly damaged. There is no clear sign of narrowing of the space between the bones to indicate the cartilage is breaking down. At this stage people are unlikely to feel any pain or discomfort.

 Stage 2-Mild

At this Stage the symptoms of OA begin to get more noticeable,  Bone spur growth increases and   the space between the bones appear normal and The cartilage will begin to slightly thin. People   experience joint pain. They feel stiffness around the knee joints stiff and uncomfortable, while sitting for long period, after rising in the morning or after a workout.

Stage 3- Moderate

At this stage the damage to the cartilage progresses and the gap between the bones become narrow and cartilage loss can be seen on X-rays.. The bones develop spurs at the joints and it becomes rougher. With the progression of osteoarthritis of the knee people feel frequent pain when walking, running, squatting, extending or kneeling and also stiffness after sitting for long or when waking up in the morning.

Stage 4- Severe

At this stage, the symptoms are very visible. The joint space between the bones reduces and  causes the cartilage to break down .The breakdown of cartilage leads to a chronic inflammatory response, with decreased synovial fluid that causes greater pain and discomfort when walking or moving the joint. The advanced stage of the disease shows development of more spurs causing excruciating pain.

 

SYMPTOMS :

  • Pain: —Pain and swelling are worse in the morning or after a period of inactivity. Pain may also increase after activities such as walking, stair climbing, or kneeling.
  • Tenderness: — Joint may feel tender when you apply light pressure to it.
  • Stiffness: —The joint may become stiff and swollen, making it difficult to bend or straighten the knee. Joint stiffness most noticeable when wake up in the morning or after a period of inactivity.
  • Loss of flexibility: —You may not be able to move your joint through its full range of motion.
  • Grating sensation:–You may hear or feel a grating sensation when you use the joint.
  • The pain may often cause a feeling of weakness in the knee and resulting in a “locking” or “buckling.”
  • Many people report that changes in the weather also affect the degree of pain from arthritis.

CAUSES AND RISK FACTORS :

Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. The surface of the cartilage becomes rough and the cartilage wears down completely.

  • Old Age: –The risk of osteoarthritis increases with age.
  • Obesity: – Carrying extra body weight contributes to osteoarthritis in several ways. The More Fatty You are, the greater your risk. Increased weight puts stress on weight-bearing joints, such as your hips and knees. Fat tissue produces proteins that cause harmful inflammation in joints.
  • Joint injuries: –Injuries that occur when playing sports or from an accident, increase the risk of osteoarthritis.
  • Certain occupations: – If your job includes tasks that place repetitive stress on a particular joint, the joint eventually develop osteoarthritis.
  • Genetics: –Some people inherit a tendency to develop osteoarthritis.
  • Mechanical stress
  • Loss of strength in muscles
  • Mechanical injury
  • Over stress joints
  • Diabetes

 ROLE OF PHYSIOTHERAPY

  • Physical therapy modalities to relieve pain and inflammation
  • Quadriceps strengthening
  • Hamstring stretching
  • Alignment correction through manual therapy
  • Taping technique
  • Laser therapy for instant pain relief

CHONDROMALACIA PATELLA :

Chondromalacia patella is the softening and breakdown of the tissue (cartilage) that lines the underside of the kneecap (patella).

It is a common cause of anterior knee pain.

There are Stages , ranging from Stage 1 to 4  designate the severity of Runner’s knee. Stage 1 is least severe, while Stage  4 indicates the greatest severity.

  • Stage 1:- At this Stage the cartilage in the knee area becomes
  • Stage 2:-It indicates a softening of the cartilage along with abnormal surface characteristics. This usually marks the beginning of tissue erosion.
  • Stage 3:- It shows thinning of cartilage with active deterioration of the tissue.
  • Stage 4:- It is the most severe stage. It indicates bone-to-bone rubbing with a significant portion of cartilage deteriorated

Problems begin when the kneecap does not move properly and rubs against the lower part of the thigh bone. This may occur because:

  • The kneecap is in an abnormal position (also called poor alignment of the patellofemoral joint)
  • There is tightness or weakness of the muscles on the front and back of your thigh
  • You are doing too much activity that places extra stress on the kneecap (such as running, jumping or twisting, skiing, or playing soccer)
  • You have flat feet
  • A grating or grinding sensation when the knee is flexed (moved so that the ankle is brought closer to the back of the thigh)
  • Knee pain in the front of the knee that occurs when you get up after sitting for a long period of time
  • Knee pain that worsens when you use stairs or get out of a chair
  • Knee tenderness

GOALS OF PHYSIOTHERAPY :

  • Improves pain through advanced modalities
  • Reduces inflammation
  • Reduces spasm
  • Reduces tightness
  • Increases strength resisted band exercises
  • Alignment correction through manual therapy
  • Taping technique
  • Laser therapy for instant pain relief

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