Knee Pain

Print

Collagen and Degenerative Knee Pain

When the doctor says: "I am recommending surgery, ultimately you will probably need a knee replacement  due to the damage in there." There are two choices to make when the doctor says these words to you. One, accept your destiny and continue to live with an unstable and painful knee until the surgeon calls, or find a solution to your pain now.

knee_pain1To someone wearing a knee brace, who regularly tapes ice on their knee and takes prescribed and over-the-counter pain medication, what else could there be but surgery? How about Prolotherapy?

Prolotherapy works on all knee problems with excellent results. Only in the case of a completely torn ligament is Prolotherapy somewhat limited. If there is a partial tear (sometimes on MRI these may look like complete tears), Prolotherapy can reconstruct the ligament and strengthen the joint.

But even with a complete tear, Prolotherapy is extremely beneficial because an impact with enough force to completely rupture a ligament will also loosen the entire knee structure. Prolotherapy in this situation can strengthen the surrounding tissues giving the patient/athlete a better chance of long-term success.

It is rare that a patient who is not active in sports or a competitive athlete needs ACL surgery. Many athletes function on an ACL deficient knee.

There are certainly instances in life when surgery is called for, but not nearly as often as it is currently performed. Even so-called "minor" surgery takes a drastic toll on the human body, physically traumatizing and permanently altering its structures, often to its detriment.

Is Prolotherapy The Answer To Chronic Knee Pain?

knee_pain2Prolotherapy is short for "proliferation therapy," Proliferation, of course, means "rapid production." What Prolotherapy rapidly produces is collagen and cartilage. Collagen is a naturally occurring protein in the body that is a necessary element for the formation of new connective tissue that holds the skeletal infrastructure together. These include, tendons, ligaments, muscle fascia and joint capsular tissue.

Prolotherapy helps make collagen through a series of injections, not of collagen, but of mild chemical or natural (such as dextrose -sugar) irritants, that stimulates the immune system's healing mechanism to produce collagen naturally. Making collagen makes for strengthened and restored joints. Restored and strengthened joints makes for permanent pain relief.

In non-injured ligaments or tendons, collagen fibers are flexible and have some elasticity. But, they are not supposed to stretch very far. Injuries can stretch these fibers beyond their designed lengths. Or, wear and tear through repetitive motion can fray or tear them. When these tissues are stretched beyond their normal limits, wear out, or tear, pain is perceived.

knee_pain3Inflammation  produces pain, which is a sign the body's healing process is occurring. So initially, inflammation occurs as the body tries to heal the damage. Since the tendons and ligaments have a poor and limited blood supply, it is important not to shut down the initial inflammatory response. Shutting down the inflammation is equivalent to shutting down the healing cycle and YOU prevent yourself from healing correctly. In all cases that require Prolotherapy, the ligaments and tendons, whether through the use of anti-inflammatories, or because of a weakened immune system, or because of the severity of the injury, did not heal sufficiently. Injured, loose, or stretched out ligaments are often referred to as the condition of ligament relaxation, or ligament laxity. This is what produces the pain and discomfort, especially with movement because the connection of the ligament or tendon to the bone may be inflamed and the joint may move beyond its normal range of motion.


Research

Total Knee Replacement - The Best Option For Everyone?

Researchers writing in the medical journal Knee say "there is increasing evidence, based on research using patient-based outcome measures, that a significant proportion of patients experience chronic knee pain, functional disability, a poor quality of life and dissatisfaction after TKR."

TREATMENT OPTIONS FOR ACL DAMAGE AND PAIN

knee_pain4When faced with the ACL treatment decision, a patient will usually weigh two options, surgery or no surgery. There are a lot of opinions offered as to which path the patient should take. Every ACL injury is unique to the patient, so this question is best asked of your physician and better yet, a second opinion physician.ACL surgery is an elective surgery and many athletes have chosen not to have it.

If the no surgery alternative is chosen, then the patient will then try to determine a course of action that will allow them to continue running or participate in other sports. Generally, you will know if you can run on your damaged knee or not by the amount of knee strength you still have and the level of pain you experience. Because the ACL is mostly used in supporting the knees in movement such as those found in playing tennis and basketball, (jumping, quick stopping, fast change of directions), these activities are usually stopped for fear of further damage. For the most part, many ACL damaged individuals are able to continue running or jogging and participating in certain sport activities.

Another option

Unfortunately doing nothing to a damaged ACL can also lead to physical problems later. Studies have shown that left untreated, knee weakness, arthritis, and other structural damage that may lead to a need for knee replacement  may occur. Of course, in this situation, running will no longer be an option.

knee_pain5A very conservative treatment we specialize in is prolotherapy because it works on most knee problems with excellent results. Prolotherapy is a simple injection of dextrose and a local anesthetic, like those used in dentistry work. What the dextrose does is start a very small inflammatory response in the body. Inflammation kicks up the immune system, the immune system brings up fibroblasts which are small cells that produce collagen. In other words the collagen metabolism spoken of before is stimulated. A few injections is of course a lot less invasive than surgery, not to speak of the rehabilitation effort following surgery in comparison.

Only in the case of a completely torn ligament is Prolotherapy somewhat limited. If there is a partial tear (sometimes on MRI these may look like complete tears) Prolotherapy maybe able to reconstruct the ligament and strengthen the joint. But even with a complete tear, Prolotherapy is extremely beneficial because an impact with enough force to completely rupture a ligament will also loosen the entire knee structure. Prolotherapy in this situation can strengthen the surrounding tissues giving the patient a better chance of long-term success.

ACL Injury and Reconstruction

"Anterior cruciate ligament reconstruction failed to restore normal rotational knee kinematics during dynamic, functional loading and some degradation of graft function occurred over time. These abnormal motions may contribute to long-term joint degeneration associated with ACL injury and reconstruction."