A joint lesson about pain

In an effort to make Fostoria residents more aware of the causes, symptoms and effective actions of reducing specific joint pains, ProMedica Fostoria Community Hospital offered an Eat with an Expert Lunch N’ Learn session Wednesday at the hospital.
In a room full of roughly 30 area residents, Dr. Brian Hecht, MD, gave a brief presentation on knee pain, followed by an opportunity for Q&A.
In his presentation, Hecht focused on the anatomy of the knee and commonly seen age-specific knee problems, as well as provided examples of specific knee diagnoses.
Hecht advised that there are extensive causes of knee pain that don’t always originate from the knee. Some of the most common causes of knee pain include pain in the meniscus or ligaments, fractures and arthritis.
“Arthritis is extremely common,” Hecht said. “Twenty percent of people all ages have it. That number is increasing with traumatic injuries and the aging population. About 10 million people are afflicted everyday with arthritis of the knee. It is also important to realize that one out of every five in the US population will develop knee arthritis.
“Arthritis occurs when the cartilage degrades and the bones get closer and closer. And as they do, the bone actually deforms.”
Hecht said the best way to make arthritis symptoms feel better is weight loss. For every 10 pounds someone gains, the knee will feel it as 100-150 pounds because of its distance from the core of the body.
Hecht said that cycling can add 1.2 times the body weight across the knee, walking can add 3-5 times the body weight across the knee, stairs can add 5-7 times the body weight across the knee and running can add 15 times the body weight across the knee. Carrying heavy objects also adds weight to the knees.
Weight-loss can improve 40 percent of all knee pain, according to Hecht.
Other ways to decrease arthritis pain is to take an anti-inflammatory, physical therapy or a variety of programs.
Total knee replacement is only considered if medical therapy, including an anti-inflammatory, fails; if arthritis can be seen in an x-ray of the knee; and if the pain is disabling, interferes with sleep or limits the individual’s lifestyle.
“Physical therapy is extremely helpful,” Hecht said. “The stronger the muscles are around the knee, the more protection they provide to the joint.”
The patella, often called the knee cap, is surrounded by other bones, cartilage, ligaments, muscles and tendons that all work together to create movement and stability.
“When you think of the knee, think of it as a transmission,” Hecht said. “The knee really transmits energy to the ground and propels us forward. It’s a very important joint; it keeps us upright, allows us to walk, run, jump, and gets us up and down stairs.
Your knees are one of the most-used joints in your entire body, and are responsible for bearing a great deal of the body’s weight as you move around.”
The knee can be aggravated by standing, walking, running, twisting, squatting, kneeling, gym exercises or injury, said Hecht.
There are two ways in which knee pain can occur; atraumatically and traumatically.
Atraumatic knee pain is caused by some other element other than an injury, while traumatic knee pain is caused by an injury to a part of that knee.
Hecht said that 45 percent of all sports-injury surgeries are a result of an injury to the knee. Other common traumatic causes of knee pain include falls, crushing and automobile crashes.
Most knee injuries create swelling, said Hecht. To treat swelling, Hecht suggested a rule of thumb: RICE, or rest, ice, compression and elevation.
During the Q&A, one member of the audience asked how often or how long pain medicine or anti-inflammatory pills should be taken.
Hecht said to “use what you need, not more.” He warned of severe stomach pain from the medications that can cause bleeding ulcers.
Another asked, “How long does it take for all the nerves and muscles and all that to grow back (after having a knee replacement)?”
Hecht answered that typically the pain from the incision should subside anywhere from 18 to 24 months.
“We move the arthritis and get rid of the bad arthritic pain. But the original muscles, tendons, etc., that’s still there,” Hecht answered. “If you’re talking about numbness around the incision, sometimes that feeling never comes back. As far as the pain, you got to be looking at another cause of that pain in that knee, whether it’s being produced from the knee itself or being brought in from somewhere else.”
Hecht’s Q&A was cut short because he had a total knee replacement scheduled for that afternoon.
Hecht specializes in total joint replacements/adult reconstructions and general orthopedics. He has an office in Findlay at Northwest Ohio Orthopedics and Sports Medicine and an office in Fostoria at the hospital.
“Sometimes when people deal with pain, they are fearful about what treatments are out there,” said Julie Reinhart, senior specialist, marketing communications at FCH. “This gives them an opportunity to learn more and it gives doctors the opportunity to share their knowledge and connect with people outside the office.”
For more information or to inquire about other Lunch N’ Learn sessions, contact ProMedica Fostoria Community Hospital’s Wellness Center at 419-436-6688.



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