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Non-surgical treatments for knee osteoarthritis

1 April 2014 / by / 9 comments

Non-surgical treatments for knee osteoarthritis

Surgery may not always be the first step to treat knee osteoarthri­tis as some have found suc­cess going the non-​surgical way.

BY: Eleanor Yap

[cap­tion id=“attachment_4477” align=“alignleft” width=“224” caption=“Inliven looks at the root cause of each individual’s knee osteoarthri­tis.”][/​caption]

A 57-​year-​old woman (who does not want to be named) had been suf­fer­ing many years of knee pain. This affected her mobil­ity so much that she could only walk 30 min­utes at a time. She had seen a num­ber of doc­tors and was repeat­edly rec­om­mended for surgery. How­ever, she decided to look at the non-​surgical approach at Inliven Cen­ter for Osteoarthri­tis Solu­tions at Novena Med­ical Cen­ter, which opened its doors July last year. Its par­ent com­pany is Ossur, a global leader in non-​invasive orthopaedics that spe­cialises in the research and devel­op­ment of award-​winning tech­nolo­gies that assist peo­ple to improve their mobility.

Shared its clin­i­cal direc­tor, Dr Lim Yii Hong of the patient, “Our diag­no­sis was that she had mod­er­ate knee osteoarthri­tis, which was dete­ri­o­rat­ing due to her weak mus­cle func­tion. To delay the pro­gres­sion of her knee osteoarthri­tis, we pre­scribed her with an unload­ing knee brace to reduce the pres­sure on her knee joint, which was the under­ly­ing cause of her dis­com­fort. With this pain relief she was able to move on to phys­io­ther­apy ses­sions, which we are now work­ing with her to improve her mus­cle function.” 

He shared that she is con­tin­u­ing to progress well with her on-​going treat­ment plan. “This has not only reduced her pain and increased her mobil­ity, but it has also given her the new­found con­fi­dence to enjoy a more active lifestyle, to the extent of being able to go off for an exten­sive over­seas shop­ping hol­i­day within the first month of treatment!” 

Look­ing at the root cause

Inliven is the first and only clinic in Sin­ga­pore that focuses on non-​surgical treat­ments for those liv­ing with knee osteoarthri­tis and offers a com­pre­hen­sive range of treat­ment plans tai­lored to the indi­vid­u­als’ needs.

Shared Dr Lim, “Address­ing the root cause of the pain, which is caused by stress to their knee joints, we believe that the pro­gres­sion of knee osteoarthri­tis can be curbed with­out patients hav­ing to resort to the pain, stress and risks that come with inva­sive sur­gi­cal treatments.”

He added the treat­ment modal­i­ties “have been clin­i­cally proven to not only delay or pre­vent the need for surgery, but also help patients regain nor­mal func­tion and mobil­ity to return to their active lifestyles again”.

These can include a com­bi­na­tion of phys­i­cal ther­apy such as phys­io­ther­apy and reha­bil­i­ta­tion, and advice on nutri­tion and lifestyle; pain man­age­ment includ­ing acupunc­ture, injec­tions of hyaluronic acid and med­ica­tion (such as painkillers, anti-​inflammatory creams and cor­ti­cos­teroids); and bio­me­chan­i­cal inter­ven­tion such as knee bracing.

[cap­tion id=“attachment_4478” align=“alignright” width=“224” caption=“A knee brace being used here.”][/​caption]

Accord­ing to Inliven, the phys­io­ther­apy and reha­bil­i­ta­tion focuses at improv­ing the knee joint func­tion by reduc­ing the pain, swelling and stiff­ness. Treat­ments can include cold ther­apy to decrease swelling, heat ther­apy to increase blood cir­cu­la­tion and decrease stiff­ness, strength­en­ing exer­cises to increase the mus­cle sup­port around the knee joints and flex­i­bil­ity exer­cises to increase the range of motion and restore nor­mal knee joint func­tion. The Cen­ter also helps design bal­anced diet plans for their patients.

Com­mon form of knee pain

Knee osteoarthri­tis, which occurs when the car­ti­lage on the ends of your bones wear down, caus­ing pain on move­ment, is one of the most com­mon forms of knee pain. Signs and symp­toms can include pain in the knee joints when doing sim­ple activ­i­ties such as get­ting up from bed or a sit­ting posi­tion, walk­ing up and down the stairs, play­ing sports, or when the knee joints are pressed; inflam­ma­tion in the knees; and sud­den swelling in the knee joints, with or with­out pain.

An inde­pen­dent sur­vey spon­sored by Wellchem Phar­ma­ceu­ti­cal to mark World Arthri­tis Day in 2012 found that about 40 per­cent of older Sin­ga­pore­ans suf­fered from knee pain. The study sur­veyed more than 200 respon­dents aged 50 to 69 years on their per­sonal expe­ri­ence of osteoarthritis.

Accord­ing to Dr Lim, all of its patients have not required any knee surgery and have been pro­gress­ing well with the non-​surgical treat­ments. How­ever, if surgery is needed, a con­sul­tant sur­geon is on standby to con­sult the patient.

He added that the length of treat­ment depends on a num­ber of fac­tors such as the sever­ity of the con­di­tion and how com­pli­ant patients are at adher­ing to the treat­ment plan. “From our expe­ri­ence, we have patients who have started to see improve­ments in their move­ment and pain relief from just a few days into doing their exer­cises in the treat­ment plan,” said Dr Lim.

Pre­ven­tive measures

[cap­tion id=“attachment_4479” align=“alignleft” width=“224” caption=“One of Inliven’s treat­ments include a com­bi­na­tion of phys­i­cal ther­apy such as phys­io­ther­apy and reha­bil­i­ta­tion.”][/​caption]

To avoid osteoarthri­tis, here’s some advice from Dr Lim:

• Keep your joints mov­ing – Move­ment is essen­tial in keep­ing our joints healthy and the lack of phys­i­cal activ­ity increases the risk of degen­er­a­tion of our car­ti­lage. Our mus­cles become tight and stiff when we sit for long peri­ods of time, this places stress on the knee joints when we try to stand up from the sit­ting posi­tion. So, take a minute or two to stretch your legs and get the cir­cu­la­tion going to avoid stiff­ness and stress on the knee joints when you stand up from a pro­longed sit­ting position.

• Set aside time for exer­cise as part of your daily rou­tine – There are sim­ple low-​impact exer­cises older adults can do to help strengthen the mus­cles around the knees to improve sup­port to the knee joints. If you have not already been exer­cis­ing on a reg­u­lar basis, start pro­gres­sively and prop­erly so as not to cause more dam­age than good.

• Eat well – Con­sume foods that are high in nutri­tional value and low in calo­ries to main­tain a healthy and bal­anced diet, ensur­ing that your body has all the nour­ish­ment it needs for growth and repair. Eat­ing right would also pre­vent obe­sity, which places addi­tional stress on the knees.

• Avoid activ­i­ties that strain the knees – Tasks that place repet­i­tive stress on the knee joints with­out pro­vid­ing them enough time to heal, pose a risk of devel­op­ing osteoarthri­tis. Though an active lifestyle is impor­tant, older adults should avoid engag­ing in tasks such as car­ry­ing heavy weights, kneel­ing down, walk­ing on uneven ter­rain, etc.



Surgery may not always be the first step to treat knee osteoarthritis as some have found success going the non-surgical way.

BY: Eleanor Yap

Inliven looks at the root cause of each individual's knee osteoarthritis.

A 57-year-old woman (who does not want to be named) had been suffering many years of knee pain. This affected her mobility so much that she could only walk 30 minutes at a time. She had seen a number of doctors and was repeatedly recommended for surgery. However, she decided to look at the non-surgical approach at Inliven Center for Osteoarthritis Solutions at Novena Medical Center, which opened its doors July last year. Its parent company is Ossur, a global leader in non-invasive orthopaedics that specialises in the research and development of award-winning technologies that assist people to improve their mobility.

Shared its clinical director, Dr Lim Yii Hong of the patient, “Our diagnosis was that she had moderate knee osteoarthritis, which was deteriorating due to her weak muscle function. To delay the progression of her knee osteoarthritis, we prescribed her with an unloading knee brace to reduce the pressure on her knee joint, which was the underlying cause of her discomfort. With this pain relief she was able to move on to physiotherapy sessions, which we are now working with her to improve her muscle function.” 

He shared that she is continuing to progress well with her on-going treatment plan. “This has not only reduced her pain and increased her mobility, but it has also given her the newfound confidence to enjoy a more active lifestyle, to the extent of being able to go off for an extensive overseas shopping holiday within the first month of treatment!” 

 

Looking at the root cause

Inliven is the first and only clinic in Singapore that focuses on non-surgical treatments for those living with knee osteoarthritis and offers a comprehensive range of treatment plans tailored to the individuals’ needs.

Shared Dr Lim, “Addressing the root cause of the pain, which is caused by stress to their knee joints, we believe that the progression of knee osteoarthritis can be curbed without patients having to resort to the pain, stress and risks that come with invasive surgical treatments.”

He added the treatment modalities “have been clinically proven to not only delay or prevent the need for surgery, but also help patients regain normal function and mobility to return to their active lifestyles again”.

These can include a combination of physical therapy such as physiotherapy and rehabilitation, and advice on nutrition and lifestyle; pain management including acupuncture, injections of hyaluronic acid and medication (such as painkillers, anti-inflammatory creams and corticosteroids); and biomechanical intervention such as knee bracing.

A knee brace being used here.

According to Inliven, the physiotherapy and rehabilitation focuses at improving the knee joint function by reducing the pain, swelling and stiffness. Treatments can include cold therapy to decrease swelling, heat therapy to increase blood circulation and decrease stiffness, strengthening exercises to increase the muscle support around the knee joints and flexibility exercises to increase the range of motion and restore normal knee joint function. The Center also helps design balanced diet plans for their patients.

 

Common form of knee pain

Knee osteoarthritis, which occurs when the cartilage on the ends of your bones wear down, causing pain on movement, is one of the most common forms of knee pain. Signs and symptoms can include pain in the knee joints when doing simple activities such as getting up from bed or a sitting position, walking up and down the stairs, playing sports, or when the knee joints are pressed; inflammation in the knees; and sudden swelling in the knee joints, with or without pain.

An independent survey sponsored by Wellchem Pharmaceutical to mark World Arthritis Day in 2012 found that about 40 percent of older Singaporeans suffered from knee pain. The study surveyed more than 200 respondents aged 50 to 69 years on their personal experience of osteoarthritis.

According to Dr Lim, all of its patients have not required any knee surgery and have been progressing well with the non-surgical treatments. However, if surgery is needed, a consultant surgeon is on standby to consult the patient.

He added that the length of treatment depends on a number of factors such as the severity of the condition and how compliant patients are at adhering to the treatment plan. “From our experience, we have patients who have started to see improvements in their movement and pain relief from just a few days into doing their exercises in the treatment plan,” said Dr Lim.

 

Preventive measures

One of Inliven's treatments include a combination of physical therapy such as physiotherapy and rehabilitation.

To avoid osteoarthritis, here’s some advice from Dr Lim:

• Keep your joints moving – Movement is essential in keeping our joints healthy and the lack of physical activity increases the risk of degeneration of our cartilage. Our muscles become tight and stiff when we sit for long periods of time, this places stress on the knee joints when we try to stand up from the sitting position. So, take a minute or two to stretch your legs and get the circulation going to avoid stiffness and stress on the knee joints when you stand up from a prolonged sitting position.

• Set aside time for exercise as part of your daily routine – There are simple low-impact exercises older adults can do to help strengthen the muscles around the knees to improve support to the knee joints. If you have not already been exercising on a regular basis, start progressively and properly so as not to cause more damage than good.

• Eat well – Consume foods that are high in nutritional value and low in calories to maintain a healthy and balanced diet, ensuring that your body has all the nourishment it needs for growth and repair. Eating right would also prevent obesity, which places additional stress on the knees.

• Avoid activities that strain the knees – Tasks that place repetitive stress on the knee joints without providing them enough time to heal, pose a risk of developing osteoarthritis. Though an active lifestyle is important, older adults should avoid engaging in tasks such as carrying heavy weights, kneeling down, walking on uneven terrain, etc.

 


 

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9 Comments

  1. Stephen Teng says:

    Yes, surgical treatments should be the last resort for knee osteoarthritis. All joint pains are the result of wear & tear over the years from birth to senior years. This wear & tear is brought about by the cartilage & the surrounding weakening tendons. When one clenches one’s fist, 38 tendons are supporting it. So, it is only natural over the years for the tendons to weaken with no maintenance at all with supporting nutrients. Important nutrients should include glucosamine (form of lubrication), MSM (strengthens cartilage) & collagen type II (strengthens tendons). This formulation has worked well for me & others.

  2. Maria says:

    Hi…my hubby has been having pain on his knee for sometime now and did try all sorts of home remedies and has seen doctors but they just prescribed some pain killers the most! Until last year when he was referred to see a specialist …done some x-Rays and was told that he is suffering from OA! He wanted to try wearing knee braces and see if it’s help…how and where to get the right fit for his knee?

    • agelessadmin agelessadmin says:

      Hi, Maria, thanks for your comment. I am getting the folks from Inliven Center who I interviewed to see if they can answer your query. Please bear with me as I wait for an answer. Thanks.

  3. Tan Ai Lay says:

    I am a 62 years old lady and suffering from Osteoarthritis in recent months, so may I know, please:
    (1) Does Inliven accept CHAS card and
    (2) what is the cost for a Ossur UnloaderOne Knee Brace.

    Please reply asap to my email address. Thank you

  4. Tim Pang says:

    My wife is suffering from post-traumatic arthritis.

    Do you have a suitable unloader brace for her?

    What is the cost for Ossur UnloaderOne Knee Brace?

    • agelessadmin agelessadmin says:

      Hi, Tim, sorry for the delayed response. I have since e-mailed the company and waiting for a reply. Once I get it, I will forward to you. Thanks for your patience.

  5. Hi – I suffer from slight arthritis on right knee and pain in left knee.
    Mr surgeon has recommended physio.

    What are your charges and is there a discount for seniors.

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