Chronic Knee Swelling Is Developing And Worsening Knee Osteoarthritis
In this video Danielle R. Steilen-Matias, MMS, PA-C offers a brief summary of the constant degenerative process going on in your knee that shows itself every day to you as swelling.
Summary and learning points:
- Many patients tell us that their other health care providers and doctors dismiss or ignore their complaints of knee swelling. However, as research suggests, such as the research examined in this article, is that chronic knee swelling signifies the early development of osteoarthritis.
- The reason the knee is swelling relates to the strength or integrity or lack thereof of the soft tissue around the knee. So the knee swelling can be coming from knee ligament injury or instability. Your body, in an attempt to provide stability for the unstable knee, will swell the knee as a protective mechanism to provide stability to the need temporarily. It should be temporary. Your body is swelling the knee until healing of an injury can take place. The fluid fills the knee to also prevent excessive movement to accelerate healing. When the injury is healed the swelling goes away.
- If you do a job that is very physically demanding, you are on your feet all day, you climb ladders or steps, etc, that is a lot of strain to be putting on your knees and your body does the best it can to provide the swelling necessary to keep your knee together. The problem is chronic swelling is causing a rapid degeneration in the knee.
How Is Pseudogout Diagnosed
If your doctor thinks you have pseudogout, they may recommend the following tests:
- an analysis of joint fluid by removing the fluid from the joint to look for calcium pyrophosphate crystals
- X-rays of the joints to check for any damage to the joint, calcification of the cartilage, and deposits of calcium in the joint cavities
- MRI or CT scans to look for areas of calcium buildup
- ultrasound also to look for areas of calcium buildup
Looking at the crystals found in the joint cavities helps your doctor make a diagnosis.
This condition shares symptoms with other conditions, so it may sometimes be misdiagnosed as:
Theres currently no treatment available to get rid of the crystal deposits.
Pain Swelling And Knee Stiffness
First lets talk about pain: Its the bodys way of preventing you from making an injury worse. Since pain may limit movement, it can cause stiffness in the knees, as can any ongoing injury.
Knees become swollen when excess fluid builds up inside the knee due to an injury, overuse, or medical condition. This can cause sensations of tightness as well as pain. Swelling may be subtle, so you may not always notice it unless its a severe injury. Since the swelling may not be visible, you may feel this as stiffness in the knee.
Any type of swelling will cause limited movement since theres less space in the knee. Irritation, internal bleeding, and injuries in the knee can lead to fluid buildup. Arthritis, gout, and tumors or cysts are conditions that can also cause swelling.
Pain and swelling are two mechanisms your body uses to protect itself. Together they can lead to stiffness in your knee. Next, lets look at possible causes.
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Comprehensive Prolotherapy For Problems Of Knee Instability And Wear And Tear And Bone On Bonerepetitive Inflammation As An Anti
Comprehensive Prolotherapy is an injection technique that uses a simple sugar, dextrose, and in some cases, it is combined with Platelet Rich Plasma Therapy to address damage and micro-tearing of the ligaments or soft tissue in the knee. A series of injections are placed at the tender and weakened areas of the affected structures of the knee. These injections contain a proliferant to stimulate the body to repair and heal by inducing a mild inflammatory reaction.
The localized inflammation causes healing cells to arrive at the injured area and lay down new tissue, creating stronger ligaments and rebuilding soft tissue. As the ligaments tighten and the soft tissues heal, the knee structures function normally rather than subluxing and moving out of place. When the knee functions normally, the pain and swelling go away.
In published research in the Journal of Prolotherapy, we investigated the outcomes of patients receiving Prolotherapy treatment for unresolved, difficult-to-treat knee pain at a charity clinic in Illinois. Here are the bullet points of our research:
If You Have A Lot Of Swelling Hyaluronic Acid Is Really Not Going To Help
You have a lot of swelling and pressure in your knee because you have too much water on the knee or in reality too much synovial fluid. That is a simple explanation. Many people find relief when this fluid is drained. So will people find relief if more fluid is added? It seems counterproductive for knee pain relief. This is why there is a debate over the long-term effectiveness of hyaluronic acid injections for knee osteoarthritis. We are only going to present one study here, please see our article: Research and reviews of Hyaluronic injections for Knee Osteoarthritis for more on this topic.
Getting back to the question above does injecting hyaluronic acid, putting more synovial type fluid in your knee, work when you already have an overabundance of this fluid? For some, the answer is yes it helps. For others, it does not help.
A January 2021 study in the medical journal Rheumatology explains it. What the researchers in this study set out to do was to determine whether ultrasound-detected synovitis affects the therapeutic efficacy of hyaluronic acid injection for treating knee osteoarthritis.
- The 137 patients in this study received hyaluronic acid injection two times at 2-week intervals.
- Initially, all the patients were helped. However, the patients who had ultrasound detected suprapatellar effusion had greatly reduced benefits from the injections.
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What Are Risk Factors For Knee Pain
Biomechanics: The knee joint is complicated in its operation and is used frequently throughout the day. Any change in the movement of the joint can cause subtle changes and cause pain and injuries.
Excess weight: The stress on the knee joint is increased with excess weight. Obesity also increases the risk of knee osteoarthritis as the cartilage breaks down more rapidly.
Overuse during repetitive motions as are found during certain exercises or work conditions can cause breakdown of cartilage and lead to pain.
Fluid Retention In Leg After Knee Surgery
Fluid retention after surgery affects almost every patient after surgery. Technically this condition is called edema. In the case of edema, the fluid becomes trapped in bodily tissue, particularly in the legs, feet, and ankle.
This condition leads to painful swelling, and you may notice one leg is bigger than the other. Edema may occur due to tissue death, circulatory problems, weight gain, kidney dysfunction, or IV fluid given during surgery.
To lower the symptoms of edema, you can follow the following tips.
- Lower the intake of salt
- Symptoms of infection redness, warmth, severe pain, pus drainage, red streaks, fever
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Chronic Knee Pain Relief
If your swollen knee pain is from a chronic condition like osteoarthritis, gout or an auto-immune disease like rheumatoid arthritis, chances are it’s a recurring problem. RICE can help, but it should be just one part of your overall care plan.
Losing weight, if that’s an issue, choosing low-impact exercise activities and strengthening thigh muscles to improve knee function should all help, according to the Mayo Clinic. A research review published in May 2019 in the journal Sports Medicine found that both cardio workouts and mind-body exercises, such as yoga and tai chi, can ease pain and improve function for arthritis in the knee as well as the hip.
And according to the American Massage Therapy Association, knee self-massage may help alleviate pain due to osteoarthritis of the knee.
Also be aware that a swollen knee first thing in the morning could be a sign of arthritis. If you start to experience this on a regular basis, especially if it comes with pain and stiffness, see your doctor for an evaluation, according to AAOS.
How To Prevent Bursitis
Follow these easy steps:
- Use kneepads or supports for any sports, work, or household tasks that strain your knees.
- Rest your knees from time to time. Stretch them so they stay limber. Donât overdo it. If one type of exercise leaves you hurting, try something else. Ice your sore joint after activity.
- Sit, donât squat. Use a stool when you weed the garden. Youâll put less strain on your knees.
- Stay at a healthy weight. Extra pounds put added pressure on your knees and could make your joint problems worse.
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Compression Support & Braces
Moderate compression to the knee provides support, warmth, and improves circulation resulting in reduced swelling, pain, stiffness, and fluid buildup. Here are some options for knee compression and support.
For the short-term, taping the knee can manage swelling, improve the biomechanics of the knee and kneecap, and provide gentle support. How Kinesiology Tape Works
Additionally, a compression system or compressive knee ice wrap can be utilized specifically as a designated treatment. These devices are not meant to be worn all day like the other choices, but rather to provide short-term compression a few times a day. Learn more about compression therapy.
Home Treatment For Swollen Knees
It is important to consult with your physician before choosing a treatment plan. If advised by your doctor, over-the-counter anti-inflammatory medications can aid in treating minor cases of knee swelling. Usually, these cases are due to knee osteoarthritis, non-septic knee bursitis, or a minor injury.
The RICE formula can also work. RICE is rest, ice, compression, and elevation.
- Rest: Rest for a period of 24 hours or longer to give the joint time to recover.
- Ice: Icing the area for 20 minutes three to four times per day can help decrease swelling and aid in healing. It is important to avoid putting ice directly on the skin.
- Compression: Wrapping the knee with an elastic bandage can help to limit swelling, but make sure it is not too tight.
- Elevation: Elevate the knee to help reduce blood flow to the area, which can help to reduce the swelling.
With RICE, swelling often goes down in one to three days.
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Swollen Foot After Knee Surgery
Swelling in the leg, foot, or knee following a knee replacement is primarily caused by fluid accumulations in the soft tissues.
After surgery, swelling is a normal part of the recovery process because, during the healing process, thousands of cells are sent to fix the surgical part this is called the inflammation phase the first phase of recovery. It is due to the influx of all these cells to the affected area that causes swelling.
Since the lower extremity is dependent and low to the heart, there is more swelling in lower appendage surgery. Furthermore, gravity makes it likely for more fluid to accumulate.
Edema is the accumulation of fluid in the bodily tissue. In particular, edema occurs most often in the feet, ankles, hands, legs, and arms after surgery. The result is painful swelling.
Often, edema occurs because of a chemical imbalance within cells caused by mechanical stress. There may also be pathological manifestations of edema.
An individuals pain and swelling following knee replacement may last up to three weeks and then subside gradually. In some instances, swelling may persist for 3 to 6 months. However, you can ease the pain and swell with medicines or home remedies.
How To Treat A Swollen Knee At Home
In many cases, a mild to moderately swollen knee may be treated at home. Home care typically involves Rest, Ice, Compression, and Elevation and medication. Read the descriptions of these treatments below to help maximize their benefit and avoid mistakes.
The 4-step R.I.C.E. Formula
1.Rest will give the joint time to repair and recover. Take a break from sports and other activities for 24 hours or longer. The joint should not necessarily be immobile people with knee swelling should try to gently flex and straighten the knee several times a day to maintain range of motion.
2.Icing is an easy, effective treatment for excess knee swelling. Cold therapy can ease symptoms by:
- Causing nearby blood vessels to constrict, decreasing blood flow and inflammation
- Slowing down the production of joint fluid in the knee
- Distracting the brain from pain signals to the brain
Apply a cold compress to the knee for no longer than 20 minutes at a time. This can be done several times a day.
Ice should not be applied directly to the skin. Prevent skin damage by placing a towel or another material in between the icepack and skin. Cold therapy may not be appropriate for people who have Raynauds Syndrome or nerve damage.
3.Compression involves wrapping the affected joint in an elastic bandage . Compression may help limit or reduce swelling.
Keep in mind that a compression bandage will not support the knee or protect it from further injury.
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Research: Patients Do Not Know How Bad Their Inflammation Is Or How Destructive It Is To Their Knees
This is really something that is hard to imagine. The patient does not know how bad swelling is for their knee. Knee osteoarthritis and the eventual development of bone on bone knees do not usually happen overnight. We say usually because there is the phenomenon of rapidly accelerated knee osteoarthritis where a patient can go from stage 1 to stage 4 osteoarthritis in a matter of months or a few years. So even in this rapid stage, bone on bone does not occur overnight. As this is a gradual progression it is easy to stay with the same management routine day after day, month after month, year after year of painkillers, anti-inflammatories, and knee braces. You know all the while your knees are getting worse but you need to work or be a caregiver or do the things you need to do so you manage your knees on a daily as needed basis. On a daily basis, unless there is an acute event, it is difficult to see how your knees are moving forward to a degenerative disease requiring knee replacement.
You Participate In High
Its important to stay active, and maintaining an exercise routine can actually help knee pain. But high-impact activities can make knee pain worse. Exercise like running, kickboxing, or high intensity interval training can jar your joints and make your knee pain worse. Some stretching exercises, like squats and lunges, can put extra pressure on your knees as well.
Whatever the cause of your knee pain, we can help. Dr. Shults and the team at Coastal Empire Orthopedics offer a range of knee pain treatments for patients. From physical therapy and bracing to reconstruction or knee replacement surgery, were committed to getting you back to your active lifestyle.
You shouldnt have to live with knee pain. Dr. Shults and his team can help diagnose your pain and find a treatment plan that works for you. Get back to enjoying your life with compassionate care at Coastal Empire Orthopedics. Call our Savannah, Georgia, office today or book your first appointment online and start finding relief from your knee pain.
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Use Ice Packs On Your Knees
In order to reduce swelling immediately after surgery, ice can restrict blood flow to the affected area and slow cellular metabolism. To deliver cold to a particular part of the body, you can use cold packs, ice baths, cryotherapy chambers, or ice baths.
In the first few days after an injury, apply ice every 10 to 20 minutes. Dont apply ice directly to the affected area wrap it in a thin cloth.
What Is Better For Knee Pain Heat Or Cold
When acute pain is hot and sharp, it’s likely that you’re experiencing swelling in and around the knee joint and the best swollen knee treatment here is going to be icing the injury. As a general rule, ice is best for acute pain, inflammation and swelling. Heat perpetuates the cycle of inflammation and can be harmful.
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What Are We Seeing In This Illustration
This illustration demonstrates the progression of knee osteoarthritis from a small tear or injury to degenerative joint disease. In this example a simple ligament injury, such as the medial collateral ligament depicted here) is not resolved, the resulting joint instability that this small injury can cause is the complete breakdown of the knee joint. As we are demonstrating in this article, a small unrepaired injury can spontaneously lead to osteoarthritis through swelling and inflammation.
How Long Does It Take For Swelling To Go Down After Knee Surgery
Recovery from knee replacement surgery is gradual, but it is well worth the effort, as it helps to improve mobility. Aside from that, you will not experience stiffness, pain, or swelling.
However, after a knee operation, you might be concerned about a swollen foot. Dont fret its just a recovery sign and will disappear within 2 to 3 weeks. Withal, swelling can last from 3 to 6 months in cases of fluid retention.
Therefore, it is recommended to visit your physician, or a rehabilitation center, frequently to prevent future complications. An experienced physiotherapist can also help you to recover faster from symptoms.
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