Krishna Chhibber, 55, suffers from lower back and knee pain resulting from osteoarthritis. As a physical education instructor, she was once quite athletic and physically fit. She had a busy daily routine but due to her medical condition, she has been forced to stop running, even jogging. Doctors advised surgery for her knees but like many her age, she is too scared to go under the knife. In fact, she is quiet sceptical of surgeries.
But Krishna is not the only one suffering from osteoarthritis. According to a study done by Prognosis Management & Research Consultants Pvt. Ltd in association with the Agra chapter of the Indian Orthopaedic Association in 2013, knee osteoarthritis is the second most common rheumatologic problem and is most frequent joint disease with prevalence of 22% to 39% in India.
Knee, hip and low back pain are the most common types of pains that impede comfortable walking, and limit a person’s independence affecting his/her quality of life. And thanks to the sedentary lifestyle that most of us live these days, joints pains have become quite common, irrespective of age and gender.
The most common cause of these pains is wearing away of the soft tissue between two bones (a condition called osteoarthritis), others being sprains of muscle, tendon and ligament sprains or nerve disorders such as a “pinched nerve”. A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues, such as bones, cartilage, muscles or tendons. This pressure disrupts the nerve’s function, causing pain, tingling, numbness or weakness.
The good news is there are a wide variety of non-surgical ways to improve painful conditions in the knee, hip and low back. But the treatment is individualistic. Orthopedicians say that there is no one regimen that will suit every patient as the cause of the pain as well as lifestyle is different for different people.
Nevertheless, exercise, especially strength exercise, is an integral part of pain management. “Improving neuromuscular function (fine-tuning and optimizing joint movement) has been increasingly recognized as an important factor to improve function in people with painful arthritis,” says Dr Shiv Kumar, a practicing physiotherapist.
Other than exercise, a person also has to adopt several other measures that help relieve these musculo-skeletal pains. These include:
Lifestyle changes: Weight loss along with a balanced diet/nutritional support.
Muscular stimulation: Physical therapy for therapeutic exercise and modalities (such as electrical stimulation on skin and ultrasound).
Assistive devices: Shoe inserts, such as orthotics to shift how weight is distributed on the foot, knee braces for support while building back muscle, a cane to help with balance and a lumbar corset/brace to provide additional core support.
Pain medications: Oral and topical medications for pain control, steroid injections to reduce inflammation in extreme cases, gel solutions called visco-supplementation (an injection into the knee of a substance similar to the fluid naturally occurring in the knee to help lubricate the joint)
Regenerative medicine: Injection with platelet rich plasma (a concentrated component of one’s own blood), which can help your body heal.
“There is a lot of new research going on; A number of emerging new treatments like biomechanical manipulation using therapeutic shoes,” he says, adding, “Abroad they have Apos Therapy wherein the patients wear the personally adjusted footwear device whilst performing their daily routine tasks. Every patient has his/her own personalised treatment based around an individually adjusted unique biomechanical system,” he Dr Kumar.