The knees are joints made up of three bones: femur, tibia and patella. Among these is a structure made up of a substance called cartilage, which acts a bit like a cushion. In certain pathological situations, such as in the case of osteoarthritis, the protective cartilage deteriorates and the bones can then rub against each other, causing pain and a clicking or creaking noise called "crepitus". This article describes some solutions to prevent and treat this painful condition.
Steps
Part 1 of 2: Treating Knee Crepitus Caused by Osteoarthritis
Step 1. Know the symptoms of osteoarthritis
Unlike the "normal" crunch that can occur when stretching and does not cause pain, crepitus due to arthritis is often painful. Fortunately, there are several ways to recognize this pathology:
- Watch for signs of pain, redness, swelling, and stiffness when you walk. The most common place for arthritis crepitus is usually on the inside of the knee.
- Place one hand over the joint as you bend and extend it to feel the friction between the bones. Typically, the touch brings back a feeling of softness, but at the same time of something "crunchy".
Step 2. Reduce swelling in the area
If you also feel pain and notice signs of inflammation, apply an ice pack (wrapped in a towel) to your knee. Cold temperatures reduce swelling due to inflammation and relieve associated pain.
- You can also take a reduced dose of over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen (Brufen) or naproxen (Momendol) to find quick relief. However, do not rely on these medications to soothe discomfort for an extended time, as overuse can lead to kidney and gastrointestinal problems.
- The advantage of NSAIDs (which are anti-inflammatory drugs) is that, in addition to reducing pain, they also decrease inflammation.
- You can take NSAIDs with an over-the-counter pain reliever, such as acetaminophen (Tachipirina). Keep in mind, however, that this drug does not reduce inflammation, but it can help relieve pain. taking both classes of medicines (NSAIDs and acetaminophen) can be very effective and allows you to carry out normal daily activities without feeling pain.
Step 3. Get a prescription for anti-inflammatory drugs
Indomethacin, oxaprozin, and nabumetone are some of the strongest prescription NSAIDs. These prescription medications have a stronger action than the over-the-counter medications and are more effective in treating the pain and inflammation associated with knee crepitus. However, these are medicines that can only be prescribed by the doctor, so a clinical examination of the knee must have been performed previously.
Prescription NSAIDs can have side effects, the most common being stomach irritation; in severe cases (and in those of overdose), however, gastric ulcers and kidney damage can also occur. Always take these medicines strictly following the directions and never exceed the dosage recommended by your doctor
Step 4. Get a cortisone injection
It is a steroid hormone that is naturally produced by the body in response to stress (note that it is not the steroids that athletes and bodybuilders sometimes use). These steroids suppress the body's immune system, greatly reducing inflammation. In cases of pain due to knee crepitus, cortisone will be injected directly into the joint to reduce the pain and inflammation of the specific site.
- There is evidence that cortisone injection is useful for treating "acute crises" of crepitus. However, one should not overdo it, as repeated and frequent injections can deteriorate the cartilage over time, thus aggravating the pain. For this reason, this procedure is not suitable as a long-term cure.
- It is not recommended to inject cortisone more than once every three months, but it can be done for an extended time, as long as it is effective; in some cases even for several years.
Step 5. Undergo a treatment called "viscosupplementation"
There is a substance in the knee, called synovial fluid, which is intended to lubricate and stabilize the movement of the joint. In some patients suffering from osteoarthritis this fluid loses "viscosity"; in other words, it becomes less dense. As a result, friction between joint structures can increase resulting in abnormal movement. In these cases, the doctor recommends that you undergo such a procedure, which involves injecting a new fluid (often hyaluronic acid) inside the knee to strengthen and lubricate the joint.
- This treatment generally involves a series of three or five injections to be given over several weeks.
- Keep in mind that about half of people who undergo viscosupplementation find relief from their symptoms.
Step 6. Put on a brace
In some cases, patients with knee arthritis are advised to use a specific brace that supports part of the workload done by the inner knee (the area most frequently affected by crepitus). This knee brace also can stabilize and support the knee, ensuring you bend it in a healthy way, protecting it from further damage and irritation.
You can find braces for free sale in pharmacies and orthopedics at affordable prices; However, there are others, better from a therapeutic point of view, which must be customized to fit the knee, but are more expensive. Talk to your orthopedist for pricing information if you are interested in this type of knee brace
Step 7. Talk to your doctor about surgery
In severe cases of knee crepitus associated with arthritis, this may be a viable option. If your quality of life has been severely compromised by pain and you have already tried non-surgical treatments with no results, you can discuss this possible solution with your orthopedist.
- Your doctor will be able to recommend different types of surgical procedures; among the most common are partial or total knee replacement, arthroscopy, cartilage repair and osteotomy.
- Keep in mind that surgeries can be effective for some people, but not for others. Arthritis is notoriously difficult to treat, so be sure to discuss all options with your doctor before making your decision.
Part 2 of 2: Avoid Worsening Knee Crackle
Step 1. Make sure you get the correct diagnosis
Knee pain can be caused by various conditions, including osteoarthritis (due to wear caused over time by mechanical movement of the joint), rheumatoid arthritis (caused by autoimmune problems), septic arthritis, previous injuries knee or patella dysfunction, just to name a few. It is extremely important to consult an orthopedist to establish the exact diagnosis, since to find an adequate cure and to manage the problem correctly it is necessary to locate the cause of the disorder.
For the same reason, if, for example, you have been diagnosed with osteoarthritis, but are not seeing improvement with treatments, you should talk to your doctor and consider looking for other possible underlying causes
Step 2. Monitor your weight
Each excess kilo corresponds to six kilograms of extra pressure on the knees. Therefore, overweight people tend to develop arthritis more frequently than those of normal weight. To prevent future knee pain (and reduce symptoms already present) try to maintain a healthy weight, first of all through diet (physical activity may be limited by pain).
People with arthritis should avoid fried and processed foods, sugars, refined carbohydrates, salt, preservatives, and corn oil; they are all foods that aggravate joint inflammation directly or as a result of weight gain
Step 3. Exercise
The muscles around the joint act as "pads" that absorb trauma, help to support and stabilize the knee both in physically demanding situations (such as during a sport or training) and in normal daily activities. The stronger the musculature, the better it can absorb shocks. To try to avoid crepitus (and to reduce it, if it is already present), you should gradually increase the muscle mass around the joints through strength exercises.
- A great exercise for knee crepitus is thigh contractions, which strengthen the muscles surrounding the joint. Place a rolled-up towel under your knee and contract your thigh muscles. Hold the tension for 5 seconds and then release; repeat 10 times.
- Isometric exercises, such as straight leg raises (with the knee locked), quadriceps contractions, and wall squats, can strengthen the joint without overloading the knee with excessive movement. This avoids aggravating pain and inflammation in the joint.
- Low-impact cardio exercises, such as cycling or swimming (you should do them at least three times a week) are perfect for this problem, because they increase the strength of the calf and thigh muscles. In addition, they help to lose weight, thereby reducing future pain.
Step 4. Try a combination of hot and cold packs
Both have been shown to help reduce pain often associated with knee crepitus. Take several attempts in cold and / or heat to see which solution works best for you.
Step 5. Take dietary supplements with great caution
Some arthritis patients take nutritional supplements, such as glucosamine sulfate and chondroitin sulfate, to treat and / or prevent crepitus. However, keep in mind that there is no scientific evidence to prove their effectiveness; there is also little information regarding side effects in the long run. Clinical trials are still ongoing to assess whether these products can be used for medical purposes. In the meantime, ask your orthopedist or a trusted person who has already tried these supplements for more information before you start taking them.
