Knee Pain Do’s and Don’ts

You can do many things to help knee pain, whether it’s due to a recent injury or arthritis you’ve had for years.

Follow these 11 dos and don’ts to help your knees feel their best.

Don’t rest too much. Too much rest can weaken your muscles, which can worsen joint pain. Find an exercise program that is safe for your knees and stick with it. If you’re not sure which motions are safe or how much you can do, talk with your doctor or a physical therapist.

Do exercise. Cardio exercises strengthen the muscles that support your knee and increase flexibility. Weight training and stretching do, too. For cardio, some good choices include walking, swimming, water aerobics, stationary cycling, and elliptical machines. Tai chi may also help ease stiffness and improve balance.

Don’t risk a fall. A painful or unstable knee can make a fall more likely, which can cause more knee damage. Curb your risk of falling by making sure your home is well lit, using handrails on staircases, and using a sturdy ladder or foot stool if you need to reach something from a high shelf.

Do use “RICE.” Rest, ice, compression, and elevation (RICE) is good for knee pain caused by a minor injury or an arthritis flare. Give your knee some rest, apply ice to reduce swelling, wear a compressive bandage, and keep your knee elevated.

Don’t overlook your weight. If you’re overweight, losing weight reduces the stress on your knee. You don’t even need to get to your “ideal” weight. Smaller changes still make a difference.

Don’t be shy about using a walking aid. A crutch or cane can take the stress off of your knee. Knee splints and braces can also help you stay stable.

Do consider acupuncture. This form of traditional Chinese medicine, which involves inserting fine needles at certain points on the body, is widely used to relieve many types of pain and may help knee pain.

Don’t let your shoes make matters worse. Cushioned insoles can reduce stress on your knees. For knee osteoarthritis, doctors often recommend special insoles that you put in your shoe. To find the appropriate insole, speak with your doctor or a physical therapist.

Do play with temperature. For the first 48 to 72 hours after a knee injury, use a cold pack to ease swelling and numb the pain. A plastic bag of ice or frozen peas works well. Use it for 15 to 20 minutes three or four times a day. Wrap your ice pack in a towel to be kind to your skin. After that, you can heat things up with a warm bath, heating pad, or warm towel for 15 to 20 minutes, three or four times a day.

Don’t jar your joint(s). High-impact exercises can further injure painful knees. Avoid jarring exercises such as running, jumping, and kickboxing. Also avoid doing exercises such as lunges and deep squats that put a lot of stress on your knees. These can worsen pain and, if not done correctly, cause injury.

Do get expert advice. If your knee pain is new, get a doctor to check it out. It’s best to know what you’re dealing with ASAP so you can prevent any more damage.

The Psychology of Pain

Many experts believe that, while the treatment of pain often includes prescribing
pain medication, the psychology of pain and coping with it are also key.
Dr Amanda Williams, a reader in clinical health psychology at University
College London, says: “If a Primary Care Physician (PCP) explains pain effectively to the individual with
pain, making clear that (after proper assessment) it is not a sign of actual or
imminent damage or disease, but that the pain system has ‘got stuck’ on the
pain message and the best thing to do is to try to work back towards a normal
range and amount of activity, then the longer term risks of chronic pain may well
be mitigated.
“But PCPs are in a difficult position, concerned not to miss the rarer but
possibly treatable serious problems, and unable to give convincing reassurance
that there is nothing seriously wrong until they’ve assured themselves of that.
That often means investigations, and just ordering those tends to push the
thinking of doctor and patient into the ‘something wrong to be discovered’ groove,
from which it is harder to find a way back to promoting normal activity and not
worry about sinister undiscovered problems.
“PCPs do this all the time, treating coughs as viral infections but checking
some for possible lung cancer… but then we are all used to coughs having trivial
causes rather than representing major disease, whereas we assume pain is a
message about damage and find it hard to override that,” she adds.
Dr Ann Taylor, reader in medical education at Cardiff University, agrees:
“Even if you have a magic bullet, you still need psychological and social
support to manage long-term pain effectively. Tiredness, anxiety, depression,
catastrophisation, social isolation, the inability to work and absenteeism are just
some of the issues that need addressing to help a patient successfully manage
this chronic condition in the best possible way.”

Natural Alternatives for Pain Management

Manual therapy
For back pain, physical therapy, osteopathic care, or chiropractic care usually includes spinal manipulation, which is a kind of manual therapy. It involves working on the head, shoulders, neck, back, or hips. It can range from massage and slow pressing to a quick thrust. Your care provider may also use hot and cold therapy to relieve pain.
You may also learn stretching and range-of-motion exercises to maintain strength, flexibility, and mobility.


TENS
Transcutaneous electrical nerve stimulation (TENS) applies brief pulses of electricity to nerve endings in the skin to relieve chronic pain.


Counseling
It’s common to respond to chronic pain with feelings of frustration, depression, anxiety, fear, and even anger. These feelings can make it harder to manage chronic pain, especially if you use alcohol or drugs to deal with your symptoms.
A counselor may use treatments such as cognitive-behavioral therapy to help you cope with your pain.


Chronic Pain: Using Healthy Thinking


Support groups
A support group is made up of people with similar experiences who can understand your feelings and provide comfort. They can keep you from feeling isolated and alone.

Being around others who share your problem can help you and your family learn how to accept and manage chronic pain.
To find a group near you, contact the American Chronic Pain Association at 1-800-533-3231 or online at www.theacpa.org.

Complementary therapies
Complementary therapies may help you feel better by reducing your pain or stress. These therapies include:


Acupuncture
Biofeedback
Guided imagery
Healing touch
Massage
Meditation
Yoga


If you decide to try one or more of these complementary therapies to treat your chronic pain, find a health professional who has special training and, whenever possible, certification in the particular therapy.
You may get a referral from someone you trust such as your doctor, family, or friends. Make sure all of your health professionals know every type of treatment you are using to reduce chronic pain