In this video I am going to share with some key reasons why people are not able to heal their knee arthritis pain. Arthritis is one of the most common reasons why someone can have knee pain. A large number of people suffer from knee arthritis and billions of dollars are spent every year on health care costs.
Hi everyone! This is Manu Kalia, a physical therapist and Ayurveda herbalist. Today I want to talk to you guys about knee arthritis.
I see a fair amount of patients who have all sorts of different knee problems. Knee problems are probably one of the more common orthopedic issues that we deal within our society.
More and more people are getting knee replacement surgeries, arthroscopic surgeries whether to clean up the joint, debride the tissue and also for injuries whether repairing a meniscus or your ligaments ACL, PCL or others. That’s why I thought this will be appropriate topic since I get asked a lot of questions and lot of people are coming with arthritis of the knee also.
This is applicable not just for an average person but people who are engaged in sports and athletic activities. For example, I see a fair amount of runners also who are trying to stay competitive and they continue running but are starting to have knee issues, arthritic problems or degenerative problems in those joints.
First of all, what are we talking about exactly when we say knee arthritis? I think better word to use would be knee arthrosis; it would be a better word instead of arthritis.
Anytime you have ‘itis’ at the end of a word basically it means that there is inflammation involved like conjunctivitis, sinusitis, and any kind of ‘itis’ means inflammation.
Arthritis essentially means that the joint is actively inflamed, which is not always the case. So I think the word arthrosis is a better word because it’s degeneration of the joint, so it’s the wear and tear that has taken place.
Whether over the course of time — and most of the time these problems take a while to develop and they progressively get worse over time if they are not managed properly — or sometimes fairly quickly when somebody has an accident or injury and so right after that there is so much trauma to the joint, it does get degenerated and worn out.
Essentially you are wearing out the cartilage within the joint. So if this is my knee joint, the top bone is your femur coming together meeting with your tibia — the bottom bone. So it makes a hinge joint essentially.
And on top over here sits your kneecap or your patella, which also creates your patello femoral joint. So whether it’s cartilage between those two bones or underneath your patella that is getting worn out or degenerated, or for that matter your synovium which is the covering around these joints or fraying or degeneration of the meniscus for that matter.
So any of these things can be termed more towards arthritis or arthrosis — degeneration of that joint.
Wearing out these tissues, whether it is because of poor lifestyle choices or injuries or excessive athletic activities or person’s constitution or your genetic makeup — some people just have better knees than others so there is some component of family history here also.
With lifestyle choices whether you are overweight or obese, so it’s going to wear out basically all those weightbearing structures even more. Or, if I have been playing basketball for 20-30 years, a lot of jumping and pounding on hard ground is going to reduce the life of those knees also.
Diet makes a huge impact also. Poor foods or diets, and especially poor combinations of foods for the individual person’s constitution are also going to lead to problems in the system.
Overall poor health will lead to poor health of your joints also. Just as you can lead to poor health of your other systems, like your cardiovascular system or like diabetes mellitus, all of those things will affect your joints also.
So whether it’s the diet, whether it’s the activity level, whether it’s the environment you live in can result in those changes that might take place in a joint. These are things that are impacting the joints.
Once you have those changes and you are having problems, how to effectively treat those problems and be able to do the things you want to do? I think here the eastern perspective is much better.
I have seen thousands of patients with knee problems and I find that the eastern medicine perspective is much better at defining, and also be more specific as to the different types of degenerative conditions that are going on in a particular joint.
What I mean by that is that the ayurvedic perspective lists different types of arthritic conditions going on, for example, in the knee. I will give you examples. My first knee patient comes in and the person has moving, shifting pain of the joint, it comes and goes. The joint is not swollen, it’s not hot to touch, and in fact it’s cold to touch. There is more cracking and popping in the joint, possibly even the skin is kind of dry around the area.
The person doesn’t like excessive movement; if they move around too much or do much activity the joint hurts more. Weather changes — if it becomes cold or it’s cold and windy the joint feels more pain and there is stiffness in the joint.
The joint responds better to rest, warmth and support, so if you are wearing a brace or unloading the joint by using a crutch or something else or a cane, any of those things to take the pressure off the joint makes the joint feel better. So that is one type of person or the condition that is coming in.
Second arthritic condition that comes in, the person says that the joint gets little bit swollen, it’s red or hot to touch and does not like massage on it, and it does not like too much movement either.
Excessive heat aggravates that joint and even weather or temperature for that matter. And if the person is consuming heating foods like hot spicy food, alcohol; any of those things is going to increase the hot quality in the system which might aggravate the joint even further. That’s a different kind of joint or arthritic condition that is there.
The third patient comes in who might present with something like stiff, achy joint that has swelling in it but it’s not hot to touch. That condition might feel better with movement and with some warmth it feels better.
The person says that if I stay in one position too long it gets stiff and achy, but when I get up and move around it warms up and it feels better to me. When I first wake up it’s very stiff. If it’s cold it gets stiffer. But when it gets warm and I walk around on it and move a bit more, it feels warmer and it feels easier for me to get around.
Each of those patient is very different and so you have to look at individual differences as to how specifically your arthritic condition is presenting; whether it gets aggravated by excessive activity or whether some activity makes it feel better and allows you to move better, whether the massage feels better for the joint, whether the unloading feels better for the joint, whether the heat feels better for the joint, whether certain foods make the joint feel better and whether rest or certain exercises are better for that joint.
In terms of treatment, you have to keep all those things in mind and then also in terms of treatment you have to say, okay, this joint does better with the application of some warm oil — and there are different herbal oils too pertaining to specific conditions and of course there is a bit of overlap between different conditions also. So you have to keep in mind that you might be having two separate conditions going on within the joint. So you have to make up your strategy based on that information also.
As I said, whether I want to use certain warm herbal oils for massaging the joint to improve the circulation, remove metabolic waste products out of that joint, and facilitate the healing process, bringing fresh nutrition into that tissue, plus increase the lubrication of that tissue by doing a warm oil massage and application of heat again to allow ease of movement.
And exercises, non-weightbearing exercise that I talk about in my videos at length about how important I feel is to first start up with non-weightbearing exercises till you can tolerate the weightbearing positions more.
Use of bike or walking in water, so all of these things are much better to do because you are not loading that joint, not irritating it. Application of heat, I have already mentioned. Supporting the joint — using a brace or Ace bandage or any of those types of things to give a little bit of compression, little bit of support around that joint.
And oral herbal products that are out there. There are quite a few wonderful things in ayurvedic medicine and traditional Chinese medicine too that are very good for addressing arthritic problems, I think probably the best compared to most of the things out there that I have seen.
Certain Guggulu formulations are very good. Turmeric, Ashwagandha and there are host of other herbs that are very good and formulations that are very good not only for detoxifying the joint, improving the health of that tissue, improving mobility, controlling the pain and just allowing the joint to heal better and faster.
You have to really look at lots of these other things and then look at all of the other treatment oriented things that you need to do for a particular condition. I hope it just kind of gives you at least basic framework of how you want to look at when you are saying arthritis of the knee and I have this kind of problem going on with kind of framework you want to look at, your individual problems and then look at your treatment strategy and how you want to implement it?
If you have any questions, please feel free to leave a comment and I have lots of information on my site on knee problems and various injuries and rehabilitation and also make sure you subscribe to the channel. Thank you.