Nonsurgical Treatment Options
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Pain Reduction Without Surgery
There are 6 common nonsurgical options for treatment including use of a knee brace, shoe orthotics, BioniCare Knee System, medications and physical therapy.
Option 1 - Unloader knee brace:
A custom knee brace that reduces the stress on the medial compartment. Patients generally have less pain and greater function while using it. The brace may be worn as much or as little as desired. It is generally only effective while it is being worn. The brace is custom fitted by a representative from the company. If properly worn, there should be no significant risks associated with it. Any brace worn too tightly, however, has the potential to cause blood clots.
Option 2 - Shoe orthotics:
These simple and inexpensive shoe inserts feature a small wedge in the outer aspect that reduces stress on the medial compartment of the knee by tilting the foot slightly outward. It provides effective relief of pain and pressure for most patients, but some patients find orthotics bothersome in their shoes. There is no significant risk associated with using orthotics.
Option 3: BioniCare Knee System:
BioniCare is an FDA approved system that uses electrical impulses transmitted through the knee to relieve the pain and symptoms of arthritis. Animal studies suggest that the impulses stimulate cartilage growth. The process is totally painless but does take several weeks of use to be effective. The device can be integrated with a knee brace so that it is easy to wear and compliments the positive effects of the brace.
Option 4: Hyalgan, Synvisc or Supartz injection:
These are hyaluronic acid substitutes. This is the natural lubricant made by your body for joints. It is obtained for medical purposes from rooster combs. Although the substance only stays in the joints for a few days, its effects may be long lasting. It is not entirely clear why, but one theory is that the injections decrease inflammation. Patients must receive the injection at their doctor’s office. The newest version of Synvics can be done with one injection. All the other varieties of hyaluronic acid require 3 to 5 injections at one week intervals. The injections are quick and relatively painless. There have been no common side effects associated with the use of such injections. The success rate is somewhat variable and controversial. These injections appear to be effective less than 50% of the time.
Click below to see a video of a knee injection:
Option 5: Glucosamine/chondroitin:
These substances decrease pain in some patients. They may help cartilage nutrition or they may help by decreasing inflammation. They are sold over the counter. Chondroitin that is not derived from cows is recommended to avoid potential disease transmission.
Option 6: Physical Therapy:
Arthritic and non-arthritic joints may develop “arthrofibrosis.” In this condition the knee fails to straighten fully. Persons with this condition walk with the knee bent to varying degrees. Physical therapy can usually diminish and often eliminate this “flexion contracture.” This improved motion decreases pain in the overwhelming majority of patients to some degree. At times it can allow a patient who needed surgery to function adequately without it. It takes hard work on the part of the patient and therapist but our expert physical therapist is quite experienced in using and teaching this technique to achieve this goal.