Joint Pain Comprehensive Treatment Plan - Dr. Health

Joint Pain

Knee Pain:

About 50% of Singaporeans are afflicted by knee pain at some point in time in their life. Some of this knee pain may be chronic and can occur intermittently. 50% of them visited the doctor and they waited an average of 1 year before seeking treatment. These findings were found in a questionnaire by pharmacy firm Sanofi to commemorate Knee Arthritis Day.

Wearing out of the knee joint, also known as knee osteoarthritis, is the most common form of arthritis in a major weight-bearing joint. It involves destruction of the cartilage covering the bone ends of the distal femur and proximal tibia which constitute part of the knee joint. The joint cartilage that protects the bone ends, lubricates them and allows the knee to flex and extend, wears off. When the bone ends that constitute part of the knee joint go against each other without the protective effect of the covering cartilage, it provokes extreme pain and effusion in the joints. This results in decrease in mobility.

Three quarters of Singaporeans are at risk of degeneration of the knee joint secondary to certain way of life and habits. The three top risk factors are high impact sports (50%) , sedentary lifestyle (36%) , and family history of knee osteaoarthritis (33%).

In the management of their knee pain, 34% managed on their own, 55% saw a doctor, while 11% did nothing. On why no treatment was sought, 42% did not think the condition was serious enough to require treatment, 31% thought it was normal to have aches and pain and endured the pain, while 19% were not aware of the possible treatment options.

An interesting aspect of the survey also revealed that the men in the street have certain preconceived notions about knee pain. More than three quarters of the people sureyed believed that there is a cure. The truth is there is no cure as the worn out cartilage can never regenerate completely due to the degenerative process which is irreversible. Short of a total knee joint replacement surgery, there are non-surgical methods to slow down the wear and tear process and manage the pain. Even for knee joint replacement surgery, we advocate it for patients near to 60 years of age or above. The artificial knee joint that we use to replaced the naturally worn out one usually cannot last for more than 20 years, so if a patient undergoes joint replacement too young, the worn out artificial joint would need revision surgery later.

About half of the people think that knee osteoarthritis only happens to people who participates in vigorous activities or high impact sports. This is not entirely true. There are other contributing reasons like an inactive lifestyle, getting old, previous ligament or meniscus injury to the knee, over- weight and hereditary factors that also play a part in a person acquiring severe knee osteoarthritis. About less than half of the people think that a culture that emphasizes too much movement and activity may exacerbate the pain but the fact is that the knee joint likes to be moved and this is good for joint health and longevity. Mild activities like walking ( average of 3000-6000 steps per day ) have been shown to be beneficial to the functional outcome of people with knee osteoarthritis. This can be attributed to the fact that the joint movement involved in walking causes the synovium ( covering of the knee joint ) to produce lubricin, a substance that lubricates the joint and coats the cartilage. Walking also improves muscle strength especially the quadriceps muscles and the hamstring muscles and these further help to support and protect the knee joint. Movement is good. It reminds the knee joint that it is a joint and needs to keep moving. In contrast, a totally sedentary lifestyle may result in atrophied muscles and stiff knees.

We provide a comprehensive and detailed treatment plan which involves a detailed history taking, physical examination, Xrays, MRI, physiotherapy and synvisc (Hyaluronic acid) injections.