Managing Knee Pain | Understanding Osteophytic Changes and the Role of Physiotherapy | Blog by CB Physiotherapy, Active Healing for Pain Free Life.

 Knee pain is a common complaint that affects people of all ages, often hindering their daily activities and reducing their quality of life. One of the primary causes of knee pain is osteophytic changes, commonly known as bone spurs. These bony outgrowths can significantly impact joint function and mobility, leading to discomfort and chronic pain. In this blog, we will explore how and why osteophytic changes contribute to knee pain and how physiotherapy can play a crucial role in managing and alleviating this condition.

What Are Osteophytic Changes?

Osteophytes, or bone spurs, are bony projections that develop along the edges of bones, particularly where bones meet at joints. These outgrowths typically form in response to joint damage and inflammation associated with conditions like osteoarthritis. Osteophytes can develop in any joint but are most commonly found in the knees, spine, hips, and hands.

The formation of osteophytes is a protective mechanism by the body in an attempt to stabilize a deteriorating joint. However, these bony projections can cause more harm than good, leading to pain and restricted movement.

How Osteophytic Changes Lead to Knee Pain?

Osteophytic changes can cause knee pain through several mechanisms:

1: Joint Space Narrowing: Osteophytes can reduce the space within the knee joint, causing bones to rub against each other. This friction leads to pain, swelling, and further joint damage.

2: Soft Tissue Irritation: Bone spurs can irritate surrounding soft tissues, including ligaments, tendons, and the synovial membrane. This irritation causes inflammation, resulting in pain and decreased mobility.

3: Nerve Compression: Osteophytes can press against nerves that run through or around the knee joint. This compression can lead to nerve pain, numbness, or tingling sensations in the knee and lower leg.

4: Impeded Movement: Large or strategically placed osteophytes can physically block normal joint movement, causing stiffness and limiting the range of motion. This restriction can lead to compensatory movements and further pain.

5: Cartilage Damage: The presence of osteophytes often indicates underlying cartilage degradation, a hallmark of osteoarthritis. As cartilage wears away, bones lose their cushioning and protection, resulting in painful bone-on-bone contact.

Role of Physiotherapy in Managing Osteophytic Knee Pain

Physiotherapy is a cornerstone of non-surgical management for knee pain caused by Osteophytic changes. It aims to reduce pain, improve function, and enhance the overall quality of life. Here’s how physiotherapy can help:

1: Pain Management:
Physiotherapists use various techniques to alleviate pain, including manual therapy, massage, and modalities such as TENS, laser therapy, ultrasound, etc. These methods help reduce inflammation and improve blood circulation to the affected area.
2: Strengthening Exercises:
Building strength in the muscles around the knee can provide better support and stability to the joint. Physiotherapists design individualized exercise programs to strengthen the quadriceps, hamstrings, and calf muscles, reducing the load on the knee joint.

3: Flexibility and Stretching:
Improving flexibility through stretching exercises can help alleviate stiffness and enhance the range of motion. Stretching the muscles and tendons around the knee can reduce tension and improve joint function.

Manual techniques such as joint mobilization can help restore normal movement patterns and reduce pain. These techniques involve gently moving the joint through its range of motion to improve flexibility and reduce stiffness.

5: Posture and Gait Training:
Poor posture and abnormal gait patterns can exacerbate knee pain. Physiotherapists can assess and correct these issues, teaching patients how to walk and move correctly to minimize stress on the knee joint.

6: Functional Training:
Physiotherapy often includes functional training to improve daily activities and sports performance. This training helps patients regain confidence in their movements and return to their normal routines.

7: Use of Assistive Devices:
Physiotherapists can recommend and train patients in the use of assistive devices such as braces, orthotics, or canes to offload pressure from the knee joint and provide additional support.

Osteophytic changes in the knee can lead to significant pain and disability, affecting a person’s ability to perform everyday activities. Understanding the mechanisms by which osteophytes cause pain is crucial for effective management. Physiotherapy offers a comprehensive approach to managing osteophytic knee pain, focusing on pain relief, strengthening, flexibility, and functional improvement. Through individualized treatment plans, physiotherapists help patients achieve better joint function, reduce pain, and enhance their quality of life, making it an essential component of conservative management for Osteophytic knee pain

 

12 Best Postoperative Exercises For Knee Replacement

Total Knee Replacement

The most common questions asked by the patients after the knee replacement are, what is the expected time of recovery? or when can I get back to work? Or when can I start driving? Etc. The answer to these questions is that there is no absolute way to tell how quickly a patient will respond. There is no way to tell what kind of challenges he will face but typically after knee replacement surgery, most people would be expected to return to work between 6 - 12 weeks post-surgery. After knee replacement surgery the patients are encouraged to keep themselves as active as possible and therefore bed rest is discouraged. Certainly, the whole aim of the knee replacement surgery is to keep people active by alleviating their pain and a key part of that is their rehabilitation which helps them to achieve an optimum range of movement, muscle tone, strength, and general level of fitness so that they can live active lives. Physiotherapy is a part of rehabilitation after knee replacement. One of the main risks after the replacement is stiffness and loss of range of movement in the joint. Your physiotherapist designs an exercise program that helps the patient to prevent such risks.

Giving below are some general easy to do knee replacement exercises that require less effort and can be done easily by the patient:

 Ankle pumps: While lying on the bed over your back. Keep your knees extended, bend your ankle up and down as far as you can, repeat with the other leg.

 Knee press: While sitting on the bed, keep your legs straight. Keep a towel roll under your ankle, press down by contracting your thigh muscle. Hold for 10 seconds, relax and repeat with the other leg.

 

Heel slides: While lying on the bed over your back with your knees extended, placing the foot on the surface, slowly slide your heel towards your buttock and then take it back to the starting position. Repeat with another leg.

 

Straight leg raise: While lying on your back with your healthy leg bent and your foot flat on the surface, tighten your thigh and lift your involved leg till 300 keeping the knee straight. Repeat with the other leg.

 

Sitting knee extension: While sitting in a chair, put another chair in front, putting your operated knee on the chair straighten the knee, and hold for 10 seconds. Repeat with another leg.

 

Side-lying abduction: While lying flat on the healthy leg bend your leg forward and raise the operated leg up to 300 and then bring it back to its starting position. Repeat with the other leg.

 

Knee bending: While standing hold on to a supportive surface, bend your operated knee so that your foot touches your buttock, without twisting your knee. Then perform with your uninvolved leg.

 

Hip bending: While standing hold on to a supportive surface, lift your knee by bending at the hip and knee and bring it towards your shoulder. Repeat with your involved leg.

 

Hip abduction: While standing hold on to a supportive surface, bring your operated leg out. Repeat with your healthy leg.

Hip extension: While standing hold on to a supportive surface, keeping your knee straight take your operated leg backward. Then repeat with your healthy leg.

Heel raises: While standing hold on to a supportive surface, lift both heels off the ground. Hold for 10 seconds and then slowly return to the starting position.

Knee bend: While sitting in a chair with your healthy leg cross in front of your operated ankle, push your operated foot backward, assisting with the bending of the knee. Hold for 10 seconds.

 

Initially, the patient uses a walker and then a cane, from the third week there is an increase in strength, endurance, and range of motion. The two weeks after knee replacement are probably the most challenging ones.  Always follow the special instructions of your surgeon or physiotherapist to get back to work.