Knee pain can occur for various reasons. The most common cause of chronic knee pain is knee arthritis. Meniscus and cruciate ligament ruptures that develop after sporting activities or as a result of an adverse movement are among the causes of knee pain, and in these cases, surgical intervention may generally be required.
In cases of connective tissue injuries and partial ruptures (if there is no surgical indication), knee pain continues chronically. and the pain generally worsens with movement.
Knee calcification (OSTEOARTHRITIS)
They are also defined as osteoarthritis (OA), degenerative arthritis or degenerative joint diseases.
This The disease consists of damage to the joint cartilage and degeneration of the bone around the joint, which occurs as a result of a group of mechanical factors. Complaints may include joint pain, tenderness, limitation of movement, joint locking and sometimes joint edema. Various factors can initiate cartilage loss. Genetic structure, metabolic state and mechanical traumas cause damage to the cartilage, and over time, the bone underneath the damaged cartilage becomes defenseless and begins to deteriorate. The pain that occurs as a result of all these events leads to decreased movement and eventually atrophy (thinning) of the muscles in that area and loosening of the ligaments.
OSTEOARTRITIS It is the most common arthritis and the leading cause of chronic disability in America. Osteoarthritis is divided into 2 main categories. In primary osteoarthritis, there is no underlying cause and this disease occurs alone. In secondary osteoarthritis, osteoarthritis develops as a result of another disease. Primary Causes of OSTEOARTHRITIS;
Sports and running alone do not increase the risk of OA if there is no accident. Research has proven that the cause of OA is the mechanical stresses that the joints are exposed to. Excessive weight gain, lack of exercise, and not being active enough cause the muscles and ligaments to become weak and unstable over time, which means carrying the entire burden of the body to the joints. Complaints and Findings:
The main complaint is acute pain. Pain causes decreased movement and joint stiffness. The pain is generally a dull ache and can be described as a burning sensation in the muscles and tendons of the area. with OA Contractions may occur in the muscles and tendons around the joint. Sometimes water may collect in the joint.
Moisture and cold weather increase joint pain in most people. Osteoarthritis generally affects the hands, feet, waist, hip joints and knees. It is associated with old age, but old age is not its cause. In some 80-90 year old people, no clinical or functional signs of osteoarthritis were found. With aging, the amount of water and proteoglycan in the joint generally decreases. Proteoglycans protect collagen fibers; when they decrease, collagen fibers become more susceptible to degeneration and destruction begins. A slight inflammation may sometimes occur around the joint capsule. (There is not as much inflammation and swelling as rheumatoid arthritis) This inflammation occurs as a result of the deteriorated cartilage flowing into the joint fluid (synovial fluid).
Primary osteoarthritis is a chronic degenerative disease. As osteoarthritis progresses, the affected joint becomes larger and the pain increases, and mobility throughout the day generally causes the patient to feel worse. On the contrary, in rheumatoid arthritis, pain decreases as the joint is used. Hard and bony protrusions may be seen in small joints such as fingers. (Herberden's nodes) these may not be painful, but they greatly restrict joint movements.
Secondary causes of OSTEOARTHRITIS:
Other factors are the cause of OA, but ultimately the pathology is just like primary OA. Causes of Secondary Osteoarthritis:
*Congenital joint diseases
*Diabetes
*Inflammatory diseases (Rheumatoid arthritis, Perthes, Gout, etc.)
*Accidental joint injuries
*Septic arthritis (joint infection)
*Marfan syndrome *Obesity
*Wilson disease and…
OSTEOARTHRITIS treatment:
When osteoarthritis is mentioned, all the structures that make up the joint, that is, the joint The cartilage, various connective tissues surrounding the joint, joint fluid and even the muscles around the joint are affected, and various degrees of damage begin and settle over time.
Knee pain is the most common joint pain today. The main cause of knee pain is joint calcification or osteoarthritis. Today's living conditions, that is, our movement and muscle system do not have to move regularly compared to the past, weight increases, consumption of pure and natural calcium sources is low. We can say that avoiding calcium intake by consuming carbonated drinks is not absorbed and being less exposed to the sun (vitamin D deficiency) are the links of the osteoarthritis chain.
The use of anti-inflammatory drugs may be recommended if the pain is not too severe, it is mild and not advanced. In some cases, it reduces inflammation (in the first months when the pain begins) and relieves pain. As time progresses, the effects of the drug may be limited as the damage increases, and unfortunately, as the dose of the drug increases, side effects may occur (Gastritis, reflux, kidney failure, etc.).
Painkillers are the most commonly recommended and used drugs in the treatment of knee arthritis. These medications eliminate or reduce pain as long as you use them. These drugs only prevent the pain stimulus from reaching the brain. The problem causing the actual pain is still there and the situation is progressing. This effect is often likened to this; Your baby is crying and instead of finding and solving the real reason for crying (hunger, wet diaper, desire to burp, etc.), you cover his mouth or instead of having your painful tooth treated by a dentist, you wait with painkillers and cause your tooth to lose. The use of painkillers is recommended only for the acute period (the first 2 weeks), and if knee pain still persists, it would definitely be a better decision to start treatment for the cause. Let's not forget that our body and organs are our most valuable assets and the only alarm system of this complex mechanism is pain.
In summary, the goal in all chronic painful diseases is to slow down the process that causes pain and control the damage and disorder and stop it if possible. At this stage, if there is no real indication for surgery, it is necessary to benefit from modern medicine and complementary medicine opportunities to improve the patient's quality of life, that is, to foresee a painless and dynamic life. In countries such as Canada and England, where life expectancy and age rates are highest in chronic pain treatment, Soft Laser and Electroacupuncture treatment have been included in the Standard Protocol of Osteoarthritis Treatment for years. As a result: ensuring maximum recovery with a treatment without side effects, the elderly are not forced to suffer from pain, they become more dynamic and do not use medication. We can emphasize that they do not suffer from organ failure due to organ failure.
Let's take a look at the methods applied in pain treatment centers around the world as a result of Scientific Research:
Soft laser treatment:
Cold laser or soft laser treatment. In laser treatment, light energy is absorbed by the cells. The feature of this energy is that it is in a physiological dose, that is, from the moment the treatment is applied, the repair process is initiated on a cellular basis (photobiotherapy). Regardless of the reason, the cells of the damaged area are affected. As a result, cellular energy (ATP) production decreases or stops, the cell membrane (the membrane that ensures the integrity of cells) loses its water balance. Protein synthesis (production) also pauses in cells that are about to deteriorate. Synthesis (production) of special proteins is essential to ensure cell integrity. These protein production mechanisms are very sensitive, and when they are affected by external factors (physical trauma, stress, lack of oxygen, factors occurring in blood flow), a vicious cycle begins and the extent of damage gradually increases. Pain may be the leading symptom as a stimulus and defense mechanism. If the treatment method is to solve the main problem, such as ensuring and regulating oxygenation in the vessels and stimulating the immune system; The disease can be healed in a shorter time with treatment before it gets deeper. Cell metabolism is balanced, energy (ATP) production is supported, protein synthesis is stimulated, which means improvement in the functions of the cells. Since painkillers suppress the pain in these cases, they have a symptomatic effect and their therapeutic effect is out of the question.
Electroacupuncture treatment:
Electro Acupuncture and Acupuncture are a very effective treatment method for knee pain. It both relieves knee pain in patients with OA and improves knee function to a great extent, so it is included in the OA standard treatment protocol of modern medicine in the USA and Europe as an effective treatment method. It is performed with acupuncture needles or electro-bands for those who do not like needles. It is a modality that is very effective in the treatment of pain and allows us to get faster results. For body acupuncture points and trigger points, certain groups of points are selected according to each disease and the necessary frequency settings are made, and 15-30 minutes of electrostimulation are given to the points in each session. This treatment is ear When combined with acupuncture, it becomes more effective and activates the body systemically. Additionally, electroacupuncture and electrolipolysis have a local effect on the abdomen and hip area, reducing the appearance of cellulite and making the abdominal area tighter.
What are the advantages of Soft Laser and Acupuncture over painkillers for knee pain?
British Scientific research conducted by SWEDEN Laser Institute, published in the Medical Journal for the 4th time, revealed the restorative effects of Soft Laser and the superiority of this treatment over drug therapy (NSAIDs = Non-Steroidal Anti-Inflammatory Drugs) in the recovery of Osteoarthritis patients. In this study, 10,845 patients were divided into 3 control groups. Without ignoring the benefits of painkillers in short-term use in acute situations, we should also pay attention to the fact that they can cause serious side effects and organ disorders in long-term use in chronic diseases. In the UK alone, 2000 people a year die as a result of the side effects of painkillers (NSAIDS), because half of the 8.5 million osteoarthritis patients use painkillers regularly. (Swedish Laser Medical society) The laser used in cold laser treatment is low-intensity laser energy and its effects cannot be compared to the burning laser we know. Soft laser stimulates the cells of the target area and initiates the healing and repair process. Photon energy (energy particles of laser light) not only has regional effects in the applied area, but also has a systemic effect as it creates positive stimulation in the blood vessels of that area and in the blood and immune system cells. Thanks to these functions, inflammation and pain begin to ease from the first treatment. The laser used in this treatment method is painless and has no side effects due to its special frequency and intensity.
How is the treatment performed?
Laser is applied to the points included in the treatment plan for 30 seconds to a few minutes. After the treatment session, normal daily life and activities can be started immediately, there are no restrictions and side effects. In general, the duration of the treatment and the number of sessions it will consist of are determined by whether the condition is acute or chronic. If less than 6-8 months have passed since the symptoms of the disease, the treatment provides maximum effect and is often surprisingly effective.
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