Conservative Care Options for Knee Osteoarthritis
Physicians, now more than ever are recommending conservative treatment including but not limited to: low-impact exercise, acupuncture and manual therapy as part of a multi-modal approach for patients suffering from osteoarthritis knee pain.
This post gives a brief overview of non-pharmacological pain management strategies for osteoarthritis related knee pain.
Manual Therapy for Osteoarthritis of The Knee
Degenerative meniscus and osteoarthritis of the knee is common in the general population. In this condition sensitization of nociceptive pathways may result in patients with osteoarthritis perceiving relatively low level stimuli as being overtly painful.
Why Does Manual Therapy Work?
A biopsychosocial framework helps put into context the interconnected and multidirectional interaction between: physiology, thoughts, emotions, behaviors, culture, and beliefs.
In terms of clinical responses to massage therapy manual therapy and oscillatory joint mobilization has an effect on supraspinal processes which influence nociceptive processing and therefore OA-related pain.
Acupuncture for Knee Pain
Evidence based acupuncture has been shown to yield short and long-term improvement in function and pain relief in patients who suffer from osteoarthritis related knee pain (Lin et al. 2016, MacPherson et al. 2017, Vickers et al. 2018, Woods et al. 2017).
Why Does Acupuncture Work
If you use Occam's razor, the insertion of an acupuncture needle is a form of novel stimuli, that functions by sending anti-nociceptive input to the neuroimmune system.
Preferential sites for acupuncture stimulation are associated with areas rich in specialized sensory receptors such as muscle spindles, Golgi tendon organs, ligament receptors, Paciniform and Ruffini’s receptors (joint capsules), deep pressure endings (within muscle belly), and free nerve endings (muscle and fascia).
All of these areas are highly innervated and as a result there are a number of physiological changes across different areas of the peripheral and central nervous systems including: peripheral receptors, dorsal horn of the spinal cord, brainstem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas (Chen et al. 2017).
Low Impact Exercise
Good Life with osteoArthritis in Denmark (GLA:D™) is an evidence-based education and supervised neuromuscular exercise program. This program has been shown to have a significant impact not only on patient symptoms and physical function, but also on intake of painkillers and sick leave (Skou et al. 2017).
Non-pharmacological therapeutic interventions are being embraced by the medical community because they are often simple to carry out, economical, and have relatively minor side effects.
There are a number of non-pharmacological options for osteoarthritis that patients can discuss with their physician. None of these options are a panacea, but they may help you put together a individualized multi-modal program to manage osteoarthritis related symptoms.
More to Explore
Massage Therapy: Injury Specific Treatments
As the body of knowledge to support the use of massage therapy continues to grow, understanding the basic science behind what we do and the guiding principles of adaptability enable us to apply this work to a number of conditions including, but not limited to:
• Sports Related Aches and Pain
• Shoulder Injuries
• Carpal Tunnel Syndrome
• Post-Operative Patients
• Compartment Syndrome
• Dupuytren's Disease
• Low Back Pain
• Neck Pain
• Post-Concussion Syndrome
• Temporal Mandibular Disorder (TMD)
• Scar Management
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