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Mon, Jul 28, 2014

For chronic knee pain, is WD-40 or 3-in-1 best?

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I always ask patients what they have tried before they came to see me. One of the oddest answers is WD-40. Many years ago a “rural” patient explained that he used WD-40 on his knees every day and has had not had pain since he began that regimen. While the popular lubricant can be used in a thousand ways around the house, please do not use it for joint pain.

Last week I told you there are manual procedures to treat knee pain in a way that can sometimes bring almost immediate relief. In many cases the patient finds it remarkable that the procedures can be so effective for problems that have existed for years.

Although all chiropractors, physical therapists, massage therapists and athletic trainers work on muscles and joints with manual procedures, not everyone in these professions is specifically trained to do the specific treatments I am telling you about. Advanced training is required to develop the skills necessary to do this specialized soft-tissue work. It is somewhat difficult for the consumer to determine who has had this advanced training, because it is referred to by several different names. There are many types of specialized protocols to address connective tissue conditions and most of them are highly effective.

To find a specialist that can help, ask your chiropractor, physical therapist or massage therapist if they have received special training in treating myofascial (my-oh-fashul) conditions with manual procedures. Myofascial refers to connective tissue. These procedures are also sometimes referred to as “soft-tissue manipulation”.

In many cases of chronic knee pain, specific muscles of the leg have been injured or are weakened from de-conditioning. Before you decide to get busy increasing your workout, though, realize that your efforts might worsen your condition. You should be evaluated by a joint specialist before attempting to create your own solution. After being evaluated, you can begin specific rehab activities designed to strengthen the muscles appropriately. This approach has been very successful for many patients.

You may benefit from wearing a support or brace on the affected knee. Supports can range from the type available from the corner drugstore to custom-fitted orthotic devices that cost hundreds of dollars. I recently reviewed all the various knee braces in my special-order catalogues and counted over 50 variations. I have found about four models that I like best, and order them according to specific application and patient size. Sometimes a fairly simple brace that is properly fitted can make a big difference.

For more advanced injury recovery or more severe chronic knee problems a patient may need a custom-fitted knee brace. This type of device is prescribed by your orthopedic specialist and then custom-made or fitted by a trained orthotic provider.

One solution that may be a consideration is joint injection. I will occasionally recommend this to patients that have dutifully tried more conservative options. There are some injections, such as steroids, that have been around for quite a while. For some patients with chronic inflammation or degeneration, this can bring a welcome relief that can last for months. For others, the injection is not effective. Because there is some risk to multiple steroid injections of advancing joint deterioration, it is typical to limit the injections to three tries.

Newer treatments include synthetic replacements for the normal cushioning fluid that has been depleted in an unhealthy joint. This option is becoming more popular for some patients that may be trying to delay a knee replacement. The benefits from this option may only last for four to six months, but can be very welcome by a patient in constant pain.

I almost failed to mention that acupuncture is an option that has been shown to be effective. One study found that acupuncture treatment helped about 75 percent of patients with knee arthritis.

Many of these options apply to other painful joints as well. These treatment options may lead to eliminating or reducing the need to take pain medication and enjoying a more fulfilling active life.

Next week I’ll tell you the single most effective product to help prevent colds and flu. Can you guess what it is?
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Dr. Kestner
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