My patient asked me for a “Lube Job”

August 6, 2014 - purehealth1

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lubeJob

I was talking with a patient the other day and after our routine check-in, I asked if she had any new concerns she would like to be addressed on this visit. Her response took me by surprise…

“Well, nothing you can help with. I feel like the Tin Man without The oil can. My knees have been bothering me more and more, do you have a lube job for them?”

After some further questions, I learned that she has pain in the mid line of the joint in both knees the right greater than the left, pain going up stairs, after long periods of rest and after walking greater than 20 to 30 minuets. Her pain has progressively been increasing the last several weeks. I indicated to her that these are all classic indicators of Osetoarthritis (OA).

I found it interesting, she then said “let’s not worry too much about it, my mom had knee replacement surgery and I don’t want to go down that road.”

Isn’t it really interesting that we as humans can truly trick ourselves into the idea that the more we ignore a problem we make ourselves think that just maybe it will go away. I have tried this approach many times throughout my life and it has yet to produce the desired outcome.

So after further discussion, we agreed that ignoring the problem was not helping it get any better and in fact, just maybe if we take some preventative steps and start with conservative approaches maybe we could handle the condition and all together avoid “going down the road to surgery.” You see, the old saying a ounce of prevention is worth a pound of cure is exactly the focus of our offices philosophy. Often times in the cases of progressive conditions like degeneration or OA we have been told to just wait until its bad enough and then we will do something about it. As I instructed this patient: the earlier we start with the most appropriate and conservative solution the greater likelihood of a positive solution.

Here’s my list from most conservative action items to address OA:kneeStuff

  • 1. Strengthen the knee
    • Strong muscles help share the stress to the knee
  • 2. Exercise Modification
    • Too much and more damage can occur
    •  Avoid impact exercises and modify types frequently
  • 3. Nutritional Supplementation
    • Limited evidence on how much this might help
    • Not all supplements are created equal
    • Work with a health care expert for proper formulas and sources
  • 4. Chiropractic, Physical Therapy, Rehabilitation
    • Working with a knee expert can make a huge difference
    • Proper modalities along with stable knee mechanics are key to successful outcomes
  • 5. Over the counter medication
    • Short term pain and inflammatory management
    • Consult a health care provider is you need for use becomes routine (greater than 2x/ week)
  • 6.  Medical Management or Co-management with Rehabilitation
    • Prescription medications can be considered for short term (some risk associated)
    • Injections in the joint of the knee
      • Steroids (risk associated)
      • Hyaluronic Acid aka Viscosupplementation
    • Surgical Considerations

In the event that you have tried the first three or four suggestions either on your own or with a health care provider, and yet feel like the condition is progressing or results are not what you have desired; consider an integrative approach.

At Pure Health, under the direction of our Medical Director (Dr. Volkan Sumer) we have a complete trademarked integrated approach that is FDA approved that combines the best of all these solutions.

We call it KNAP: the Knee Arthritis Program.

Knee arthritis has a habit of being poorly handled with limited results and risky surgery. Osteoarthritis, also known as degeneration, occurs over a long period of time as a result of previous injury, repeated injury, family history and time. Typically, until surgical knee replacement is seriously considered, the other options for management have limited outcomes building frustration and often progressing to surgical intervention. But we’ve found the answer, we may not be able to cure arthritis but we can give it a KNAP.

Hyaluronic acid is a substance that occurs naturally in your joints to help maintain spacing and lubricate motion.

As we age, our body loses the ability to produce this necessary substance, decreasing the space in your knees and producing that locking, catching, and grating that is associated with knee arthritis. Our KNAP program is a series of viscosupplementation (Hyalgan) injections that replace the hyaluronic acid over a 5 week period. Coupled with a specific rehabilitative and exercise program to strengthen the surrounding musculature, KNAP is generating awesome results. Our KNAP patients have experienced less pain, improved range of motion, ability to return to routine activities and in most cases; put a pause on knee replacement surgery.

Nothing is better than your natural knee; limit the pain and not the activity! If you have been thinking a lube job is in order, our KNAP program might be just what the doctor ordered. Medicare and most insurance carries cover our “lube” job.

purehealth1

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