Knee Pain

It is estimated that over 100 million Americans suffer with some form of knee and joint pain.

Billions of dollars have been spent in research and development in attempts to curb this pain. After careful study and several trials the FDA cleared a non-surgical treatment aimed at helping those with knee pain. This new treatment is a high tech answer for all those who think that surgery, dietary supplements and prescription medications are the only option to eliminate knee pain.

Don’t put yourself through surgery if it can be avoided! We have helped hundreds of people who were told that surgery was the only answer.

At Progressive Health & Rehabilitation we specialize in knee pain relief. Below are some common causes for knee pain that may be affecting you as well as some of the knee pain treatments we offer. Click on each section to reveal the information on each topic.

You CAN avoid expensive and painful surgery! Come see us and learn what type of treatment you are a candidate for.

+Knee Clicking

There are many reasons that our knees “click”. Some of these causes are severe and require medical attention although others are not so severe. Our knees support our entire body weight at all times while ambulation and sounds coming from our knees certainly can be alarming.

How do you know if the clicking is a serious problem or not?

The most important associated symptom to knee clicking would be pain. If pain is present there is a potential of a more serious underlying process and a further medical evaluation is needed. Small fractures, torn cartilage, and arthritic disease are examples of some of the possible causes for clicking.

“Pop”, as opposed to clicking, with no associated pain could be change in pressure within the capsule that surrounds the joint much like when we crack our knuckles.

Crunching has more of an ominous association. This noise may be the result of bones grinding against each other and one should be concerned.

Please contact us and schedule your appointment immediately!

+Knee Tendonitis

Tendonitis is an inflammation of the tendon fibers, which attach muscles to bones. In the upper extremities common sites are the shoulders and elbows. In the lower legs, the Achilles and the patellar area are the common sites.

Pain is the most common symptom and in knee tendons the area between the kneecap and the shinbone is usually the primary area.

Tendonitis is caused by repetitive stress on the tendon. Repeated jumps are commonly associated with knee tendonitis  (patellar tendonitis). This problem can occur in professional athletes as well as the “weekend warrior”. Excessive and repetitive flexion and extension of the knee causes the tendon fibers microscopically tear and inflame. The risk of getting knee tendonitis increases with age as the muscles and tendons get more brittle and lose their elastic properties. Poor technique in any motion can overload these tissues and increase the risk for tendon inflammation.

Most cases of knee tendonitis are self-limiting and do not require medical intervention. Rest is normally enough to allow the tissue to repair itself. However if the pain persists and proper diagnosis and care is not given, this tendon can tear and ultimately lead to complete rupture where surgical reattachment is the only option.

Chronic tendonitis is a problem caused by continued use of an already inflamed area. This is a very difficult problem to treat and will take a long time if ever to fully recover.

+Locked Knee

Lock knee is a generic term used to describe the inability to either flex or extend the knee. The normal flexion of the knee is about 135 degrees. The normal straightening (extension) of the knee is a fully locked position or zero degrees.

There are two primary causes of the inability to fully flex or extend the knee.

First, severe pain will cause a person to have a locked knee no matter what the cause. The pain is so severe that one can no longer use the knee medical help should be sought out immediately.

The second cause of locked knee is mechanical block of the normal knee motion. If there is something caught in the mechanism of the knee such as a large piece of torn cartilage the knee will not be able to flex or extend which will cause the knee to “lock up” until the blockage is removed.

+Meniscus Pain And Tear

There are two meniscuses in your knee. The menisci are made of tough cartilage and acts as if it were a shock absorber between the femur and tibia. They also act as smooth articulating surfaces that help the joints glide during the normal flexion and extension of the knee joint.

The meniscus also helps distribute weight evenly across the knee joint. The menisci are C shaped and wedged in profile. It also cups the rounded end of the femur to keep the femur stable on the flat tibial surface.

The two most common cases of meniscus tear are traumatic injury and degenerative process. Most common mechanism of traumatic meniscus tears occur when the knee is bent and twisted. This is often seen in professional athletes. Degenerate tears are seen in older patients when the cartilage becomes brittle. Pain and swelling are the common symptoms of meniscus tears.

Joint locking is also common as pieces of torn cartilage block the normal mechanism of knee movement.

The most common symptoms of a meniscus tear

  • Pain
  • Swelling
  • Locking
  • Popping and clicking
  • Loss of normal motion

Diagnosis of meniscus tear

  • Physical exam
  • X-Rays
  • MRI
  • Arthroscopic surgery

Treatment of meniscus tears

  • Rest
  • Therapy
  • Platelet rich plasma
  • Surgery
  • Bracing and support
+Hyperextension Of The Knee
A common mechanism of knee injury is hyperextension. This occurs with an extreme, forceful, straightening of the joint. Hyperextension of the knee may cause damage to ligamentous tissues, specifically the ACL (anterior cruciate ligament) and or the PCL (posterior cruciate ligament).

The severity of the injury and to whom it occurs will dictate care.  Strains and sprains may be rectified with physical therapy to reduce inflammation and pain. Ultimately, strengthening of the surrounding musculature is the long-term goal. Stability bracing may also be used. In the event of a tear surgical intervention may or may not be necessary depending upon the candidate.  Upon clinical presentation the physician and diagnostic tests will determine the extent of the injury and the care plan warranted.

+Viscosupplementation Therapy

Viscosupplementation therapy is a procedure involving the injection of gel-like substances (hyaluronates) into a joint to supplement the viscous properties of synovial fluid. This procedure has been shown to be 86% successful in alleviating pain associated with osteoarthritis and is covered by most major medical insurance providers and Medicare.

At Progressive Health & Rehabilitation we have elected to utilize Hyalgan as our injectable of choice for our viscosupplementation therapy program. Hyalgan was the first type of natural knee injection approved by the FDA in 1996. Hyalgan consists of a mixture of sodium hyaluronate that is found naturally and extracted from rooster combs. We have been able to help many residents in the Buffalo Grove, Arlington Heights, and Elgin areas.

We also utilize a breakthrough piece of medical equipment at our facility called fluoroscopy. This is a very important point because fluoroscopy allows our medical staff to look inside your joints in real time with the latest in imaging technology while administering any of our minimally invasive injection procedures. This instrument helps to insure that the injected material is introduced to the exact point intended and therefore provides the best possible outcome from each injection. That’s why if you have tried any type of pain reduction injection elsewhere without success we may still be able to assist you as your original injection may have never wind up in just the right place.

+Knee Scope

Arthroscopy is a term used to describe an examination of a joint space by inserting a scope surgically into the joint space. It is possible to do the procedure in every joint in the body. Commonly, arthroscopy is done on the knee, hip, shoulder, elbow, wrist, ankle, and foot.

Arthroscopy of the knee is done both for diagnostic and therapeutic purposes. Usually two small incisions are made at the knee joint. One incision is used as the site where the arthroscope is inserted for viewing. The second site is used to insert instruments to repair any damaged tissue.

Common arthroscopic repairs are done for loose cartilage, torn meniscus, ligament repair, and treating infection. The advantage over traditional surgery is the small incisions and the rapid healing time. There is less scaring and led potential for infection.

+ACL Knee Brace

The ACL or anterior cruciate ligament is one of 4 major ligaments in the knee. It provides stability to the joint and is the most frequently injured, more so in women than in men. When injuring the ACL people will often report hearing a “pop.” Athletes are more predisposed to injuring the ACL, taking into consideration that stops and starts and quick lateral movements are precipitating factors of the injury

Those wishing to protect the ACL from injury or those people who have already injured the tissue may wear ACL braces. An ACL brace will simply provide stability and safeguard against overextending the joint. The braces used here at Progressive Health & Rehabilitation are “unloading braces” which are designed specifically for osteoarthritis of the knee. These osteoarthritis braces do not necessarily provide stability for the ACL but will provide relief for those people suffering from knee arthritis. On occasion we do have patients who suffer from both osteoarthritis of the knee and ACL instability or rupture. In this situation a custom brace can be manufactured that will provide benefit for both conditions.

 

Cost Of Knee Replacement Surgery

Knee replacement surgery can be very expensive and reports of the total cost of this procedure vary with the hospital, physician and demographic region of the country. Most major insurance companies including Medicare cover knee replacements. According to the federal agency for healthcare the average cost in 2008 was $45,783.

These charges include:

  1. the hospital stay
  2. implant, physician, surgical fees
  3. inpatient physical therapy

Added costs would include medications, out patient physical therapy, visiting nurses and doctors office fees. Depending on the patient, a rehab facility may be needed before a discharge to home care. Physical therapy post operatively usually last about two months.

The table below shows a clear comparison of the cost, risk, pain, and recovery of knee surgery and our knee injection treatments. The more favorable option should be clear to see.

Knee Injection Treatment  Surgery
 Cost Covered by most insurance plans including medicare Deductible, co-pay, medications, time-off work, etc.
 Risk No known side effects Complications, poor outcome, addictions to pain medication
 Pain  Little to none Can be severe for months
 Recovery  Immediate  Months/Years