Arthritis knee pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Arthritis knee pain can result from a number of factors.

The exact reason why the knee hurts with osteoarthritis is still not known but it is suspected to be multifactorial.

Cartilage has no nerves and no blood vessels... so why does the knee hurt with arthritis?

Depending on the type of arthritis- and since osteoarthritis is the most common form of arthritis, the discussion will focus on this- multiple causes of pain exist.

The first reason is probably related to inflammation involving the synovium, the capsule surrounding the joint. Cytokines, protein messengers that promote inflammation are produced and cause pain.

The second reason is exposure of underlying bone with growth of spurs that irritate the joint lining.

The third reason is as the disease progresses, there are mechanical factors that come into play leading to stretching of adjacent tendons and ligaments.

Derangements inside the knee such as meniscus tears can cause stretching of the joint capsule leading to pain.

Patients who have knee effusions experience pain because of stretching of the joint capsule by the fluid as well as the development of Baker's cysts behind the knee.

Some people with OA of the knee also have associated bursitis and tendinopathy which can also cause pain.

Hip arthritis can cause referred pain down the front of the thigh to the knee. Knee pain may actually be due to a hiop problem.

Rheumatoid arthritis often affects people at an earlier age than osteoarthritis. It causes a more destructive type of problem, attacking all the structures inside the knee.

Other forms of arthritis which can affect the knee and cause swelling heat redness, and pain include Reiter’s syndrome,psoriatic arthritis, ankylosing spondylitis, gout, pseudogout, and Lyme disease.

In addition to pain, there is swelling and restricted range of motion in many cases.

Sometimes the joint locks or clicks when the knee is bent and straightened.

Laboratory tests may be helpful for diagnosing arthritis, but other tests may be needed too. Analyzing fluidfrom the knee joint may be helpful in diagnosing some kinds of arthritis. For example, patients with gout and pseudogoutmay have crystals in the fluid that helps with diagnosis. The doctor may use arthroscopy to directly investigate the problem.

Most often osteoarthritis in the knee is treated with anti-inflammatory medicines given either orally or topically.Exercise to restore joint movement and strengthen the knee are beneficial. Losing excess weight can also help people with osteoarthritis. Mechanical factors as well as leptins- inflammatory cytokines produced by fat cells both aggravate knee arthritis in obese patients.

Rheumatoid arthritis in the knee may require more powerful medications, such as biologic therapy.

An "end-stage" knee may need to be replaced with an artificial one.

On a brighter note, stem cells are being used now and the combination of autologous stem cells (stem cells obtained from the patient's own hip using a small needle) and platelet rich plasma (obtained from the patient's whole blood) has been demonstrated to rebuild cartilage. The growth factors in the platelet rich plasma help stimulate the stem cells to differentiate into cartilage cells. This is a minimally invasive procedure done entirely with local anesthetic. For more information on this technique, contact the Arthritis Treatment Center at (301) 694-5800.

Get more information about arthritis knee pain as well as...

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Click here Second Opinion Arthritis Treatment Kit

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