Knee OA is often debilitating since it progresses to maximal pain and increasing impairments, which limit daily activities in grade III. The symptoms usually interfere with sleep. Many patients take early retirement and some are usually physically or socially isolated. OA is a major cause of disability and the greater improvement in functional status is the issue for these patients. Weight reduction has the potential to produce substantial improvement in symptoms, especially in pain and physical function. It has been demonstrated that a weight loss of 5% over 20 weeks resulted in a 28% reduction in pain. The explanation for the patient is that for each pound lost, there is a 4-fold reduction in load exerted on the knee for each step ascent and a 6-fold reduction for each step descent. High reduction in pain was also sustained in patients with higher weight losses. Measures of performance of physical function, such as the timed-up and go and walking speed, improved proportional to the weight lost. The beneficial effects of weight loss for the symptoms of knee OA are sustained for 21 months after intervention. Weight loss is safe for these patients as there was no increase in symptoms in subjects with at least 10% weight loss over 56 weeks.
Osteoarthritis (OA) is a common disease in middle and old age, especially in women. Obesity and overweight are important risk factors for knee OA. Weight loss has been shown to be a powerful tool in controlling symptoms and slowing the progression of disease in overweight patients. The effect of weight loss on the improvement of clinical symptoms in knees has been well documented. Weight loss decreases the load placed upon the knee, thereby reducing symptoms and maybe cartilage loss. Several reports have shown that joint space narrowing is lower in subjects with less weight gain. Weight loss has also been shown to be effective in relieving symptoms in obese patients with knee OA. The control group in a long-term study also showed greater improvement in symptoms, home physical performance, and mobility. In recent clinical trials, a weight management program producing substantial weight loss was shown to have beneficial effects on symptoms and was associated with reduced structural disease progression in overweight and obese patients with knee OA. This is a relevant message for these patients since now there is some evidence to suggest that the best way to lose weight is by combining exercise with dietary intervention rather than exercise alone.
Factors to Consider When Choosing a Knee Pain Specialist
The knee pain specialist‘s ability to provide a wide array of treatment options is important for two reasons. First, it shows that the doctor is not simply predisposed to one or two treatments which he applies to all patients. Different options are more suitable for different conditions, and a doctor who can offer various treatments is more likely to make a recommendation based on what is best for the patient. Next, offering a wide array of services means that should something go wrong, the doctor is able to continue treating the patient. If a specialist has focused solely on one treatment and later the patient develops a problem which cannot be treated with that method, the patient will be referred to someone else.
Reputation is an important factor in choosing a doctor. A doctor’s reputation is developed through years of good service, and is a good indicator of the quality of his or her work. One of the easiest ways to judge a doctor’s reputation is through reviews and ratings. Many healthgrades-type websites have patient ratings and comments on doctors. While these can be helpful, it is important to keep in mind that each rating is just one person’s opinion.
When searching for the right knee pain specialist, there are several important factors to consider. The first is the level of experience and expertise the doctor has. It is essential to seek out a doctor who specializes in knee problems. A specialist will have focused primarily on knee issues and will be up to date on the latest treatment options. A specialist will also be more familiar with the anatomy and function of the knee, which will aid in accurate diagnosis. It is often more comforting to have an experienced doctor work on the knee. Higher volumes of certain procedures are often associated with better outcomes. It is important to not only inquire as to how much experience the doctor has had, but also his or her results in the procedures. Many doctors will have outcome data readily available.
Experience and Expertise
When it comes to your health, it is important to trust professionals that you seek help from. Seek a specialist who has the relevant expertise and experience. Orthopaedic surgeons are specifically trained to deal with bone and joint problems. However, some surgeons may sub-specialize in specific areas of joint problems such as trauma, sports medicine or joint replacement. It is important to consult a surgeon with the relevant experience in knee problems. Some surgeons may have certain areas of interest within knee problems such as meniscus and ACL injuries or degenerative problems like osteoarthritis. Surgeons who take a special interest in a certain area will usually have more exposure and experience in managing such problems. This may affect the treatment options that they offer to you. Do not hesitate to ask the specialist about his experience and outcomes in dealing with a certain knee problem. A confident specialist would be able to tell you if he has managed many similar cases and whether there has been any complications.
Reputation and Reviews
Then consider the other alternative to the reviews and the reputation. A medical research journal ACE, Vol. 14, pp. 44-46, by Dr. Wong Keng Yean, mentioned that you can ask the other doctor for the best referral. This is influenced by the fact that the other doctor already has the medical knowledge. By having a good referral, you can easily trust the doctor, with clear reasons why the doctor is the best choice for your knee pain treatment. And don’t forget to ask about the treatment from the doctor who has the good referral because having the referral is a complicated doctor-to-doctor relationship.
To compare the quality of a knee pain Singapore clinic, you must consider the testimonials made by the patients. A good testimony from the ex-patients to the clinic generally shows the quality of the treatment in the clinic. If you read a good testimony, surely you gain trust in the clinic. But before taking action to visit and make an appointment, be sure to browse the reputation of the clinic and the doctor to avoid a different picture between the actual clinics and the testimony. Because sometimes it’s just a fake testimony to attract the patients.
If you have chosen a few clinics to visit and consult, repeat the first step of listening to the doctor’s reputation or going to search the reviews of the clinics. Find the patients’ experiences on the internet or website about the clinic. People often say that experience is the best teacher, thus by having the same experience. With a better reputation of the doctor than the others. Because people wouldn’t recommend something bad or a worse experience that they had, so by having the recommendation you can review the doctor and compare it to what they said.
When you are given the doctor’s name and ask your relative about the doctor or simply go online to search for the doctor’s name, you often want to listen or read the reviews about the doctor. Whether the doctor is good or simply why people say the doctor is good.
Treatment Options Offered
There are many different types of treatments available for knee pain. The best method of treatment is determined by the severity of the pain and its cause. It is always best to know your options so that you can make an informed decision. Different specialists may offer different forms of treatment. Orthopedic surgeons specializing in arthroscopy may suggest keyhole surgery, while other orthopedic surgeons not trained in arthroscopy may still prefer open surgery. Some orthopedic surgeons specialize in microfracture or cartilage transplant procedures. Rheumatologists may suggest disease modifying drugs. All these forms of treatment are valid, but whether or not the treatment will be effective depends on the appropriateness to the problem. It is important to discuss your options with your specialist and to weigh the potential benefits against long-term effects and invasiveness of the treatment recommended.
Accessibility and Location
The government has also built many new polyclinics and public health institutions located outside of the central region and sees it’s possible to get quality knee pain treatment at a cheaper rate. The downside to visiting public institutions would be the longer waiting times and shorter consultation periods. As knee pain may have many causative factors and require thorough consultation, patients may feel rushed and have to make multiple visits to get a good understanding of their condition. While there are exceptions, your choice of a knee pain specialist in Singapore may need to take into account the trade-off between convenience and consultation time.
Accessibility is a key factor to consider when choosing a knee pain specialist in Singapore. For elderly patients, it may be difficult if the clinic is located on the 3rd floor of a shophouse without a lift. While many patients may only consider specialists in the central region, it’s good to note that there are many other well-qualified knee pain specialists located in other regions such as the west, north, and east.
Questions to Ask a Knee Pain Specialist
An effective doctor-patient relationship begins with the patient being well informed. The following questions are important to ask the knee pain specialist: Firstly, you need to ask your specialist ‘what is the underlying cause of my knee pain?’ As this will instigate a discussion and will clear any uncertainties. It is extremely important for you to understand the nature of your condition and how it will affect your knee over the course of both short and long term. This will also help you in deciding if and when to proceed with any of the recommended options. Secondly, find out what treatment options he or she recommends. This will give you a clearer understanding of the various options and their benefits. Ask about the odds of success for each option and how the specialist came to that conclusion. Usually if a specialist has recommended an option with a higher rate of success, it is because they have previous experience and success treating similar conditions. Finally, ask the specialist ‘how long will the treatment process take?’. This will allow you to prepare mentally or organise time off work. Most treatment options for knee pain are non-operative and will often require a couple of weeks to a few months, dependent on the diagnosis and nature of the condition. If he or she recommends an operation, this will give you time to plan for any time off work or any extra assistance you may require postoperatively. By discussing these questions with your specialist, you should come away with a clearer understanding of your diagnosis and options available. This will in turn give you confidence in your specialist and your decisions going forward.
What is the underlying cause of my knee pain?
A precise diagnosis: sometimes it is important to pinpoint exactly what is wrong within the knee. For example, a general diagnosis of an anterior cruciate ligament injury may not be sufficient for an elite athlete aiming to return to their sport, as there are different grades and types of ACL injuries which will require different treatments. A 22-year-old netball player with pain at the front of the knee may be concerned that she has patellar tendinopathy (jumper’s knee), but an ultrasound or MRI may sometimes show that the pain is in fact coming from a fat pad behind the kneecap. This leads us into the next section on asking your healthcare provider about the best treatment for your condition.
An understanding of the anatomy: many people want to know exactly what is wrong within their knee. A good healthcare provider will be able to explain to your understanding what has gone wrong and how it is causing your pain. This may involve drawing pictures or using models to help you understand.
Understanding the mechanism of injury: often how and when it started is an important key in finding out what structure in the knee is damaged. For example, did the knee suddenly give way, which may indicate a ligament tear; or did the knee swell up after exercise, which may indicate an injury to the meniscus or a pre-existing cartilage problem. A good healthcare provider will ask you detailed questions and may even ask you to demonstrate the movement which caused the injury.
When many people seek medical attention for knee pain, the most likely questions they ask are “What is wrong?” and “How can it be fixed?” When seeking the diagnosis of pain and an effective way to treat it, the best place to start is by understanding your condition. Special tests such as MRI, diagnostic ultrasound or CT scans are often not needed to diagnose the cause of your knee pain. A healthcare provider such as an orthopedic surgeon, physiotherapist, chiropractor or osteopath with good history taking and physical examination skills can many times determine the cause of pain. These are some of the things to look for.
What treatment options do you recommend for my condition?
The most important aspect of making an accurate diagnosis is obtaining a clear history from the patient. Often the physical examination and tests are simply used to confirm a diagnosis that was already suspected from the patient’s subjective complaints. This approach allows for a more efficient diagnosis and treatment plan. For instance, if an older patient presents with a two-month history of pain and stiffness on the inside of the knee with a grinding sensation, they may have an arthritic condition and should be sent for an x-ray of the knee. A younger patient with chronic knee pain and intermittent swelling, who plays soccer and has recently felt a “pop” in the knee may have torn his ACL and could need an MRI scan. Obtaining the correct imaging is a vital part of making an accurate diagnosis.
After determining the nature of the symptoms, the knee pain specialist should then conduct a physical examination to test the knee’s strength and stability. Different orthopedic tests will be used based on the nature of the pain symptom. An x-ray may also be needed to rule out any type of arthritis and to also identify any malalignments or congenital problems in the knee.
Knee pain can be caused by a multitude of problems, and it is important for the patient to know the cause of their symptoms. First, the knee pain specialist must clarify the exact nature of the pain symptom. Pain located around the patella or front portion of the knee is commonly seen in runners with patellar tendonitis or chondromalacia of the patella. Pain located on the inside portion of the knee may be a signal of a medial meniscus tear or osteoarthritis. Pain on the back portion of the knee can be caused by a popliteal cyst from a tear in the meniscus or a problem with the ACL. These are just a few examples of pain symptoms and their potential causes.
How long will the treatment process take?
When considering the merits of prescription pain, patients also receive treatments known as “conservative intervention” before knee replacement is considered. Please also refer to the informational pages on knee osteoarthritis treatments, knee strengthening, and knee pain. Since none of these trials have yet been proven to reduce the need for knee replacement, patients should make sure they understand the goals, risks, and benefits of the treatment they receive. This is critical when considering treatments known to be “arthroplasty-sparing” such as cortisone injection or hyaluronic acid viscosupplementation, though both of these can also effectively relieve pain. Time required for treatments can range from a single physical therapy appointment lasting around an hour for instruction in strengthening exercises, to a series of hyaluronic acid injections given weekly over four to five weeks. Patients considering surgical intervention should be well informed about how long they can expect to be dealing with postoperative pain and functional limitation as well as how long it should be before significant improvement is noticed. Icing, and cross-linking agent for articular cartilage. Age or presence of other inflammatory arthritides may affect treatment prioritization. Duration of treatment and expected healing may also reasonably affect decisions regarding transition from work or work retraining to disability. Step down off the treatment timeline for knee joint replacement, you will find a detailed explanation of the course and likely functional and pain improvement following knee arthroplasty.
Knee pain is not an uncommon ailment. It is the result of a large number of factors and conditions. The most important factor in finding relief is to find a right knee pain specialist. Often, depending on location, specialty, and even the clinic set-up, the choice can become arduous. Knee surgery can result in a good or bad outcome primarily dependent on the knee surgeon’s skill and experience. It is difficult to find a good knee surgeon. Current medical registries do not list the surgeon’s specialized area, and there are many cases of surgeons performing procedures that they are only vaguely familiar with. Recommendations from friends or family who have had similar surgery is perhaps the best way to find a good knee surgeon. A sports physician is a good starting point for fulfilling criteria. A correct and accurate diagnosis of any secondary cause of knee pain is important in the treatment of knee pain. There is little point in treating the inside of the knee joint for pain with an anti-inflammatory drug if the pain is due to a problem on the outside of the knee. The wrong dose or the wrong type of medication can result in little benefit and side effects, so it is important to consult your doctor for the best treatment. Physiotherapy aims to gain full function of any stiff or painful knees and to prevent recurrence of pain. A referral to a physiotherapist is a vital link in the treatment of knee pain. High-quality intervention by skilled physiotherapists can produce good results. A good physiotherapist is someone who works by precise diagnosis and has a wide range of treatments at his or her disposal. For example, a physiotherapist that only does ultrasound and gives exercises is perhaps not getting to the result as quickly as one using manual therapy and progressing to ultrasound if the manual therapy is not working. It is important that the physiotherapist knows the specific diagnosis and has various contacts with other health professionals if the condition is not improving.