Severe, pain, pain at rest or night time, failure of physical therapy are the indication of the total knee replacement. So you may contact an orthopedic surgeon about the replacement. Meanwhile following can be tried for the pain relief;
1) Physical therapy; this is the mainstay of the management of the osteoarthritis. Stretching exercises, strengthening exercises, mild weight bearing exercises, swimming on the week-ends etc would be helpful.
2) Deep electrotherapy; this entails going to physical therapy center and take care of specific issues which are more painful.
3) Glucosamine and chondroitin supplements
4) Diacerin too can be tried which suppose to regenerate the cartilage.
5) Local analgesic sprays
6) Mild massage
7) Consideration of hyaluronic acid injection in the joints which are more painful. Some physician may inject steroid too for the pain relief.
8) Warm shower in morning would open up the joints.
9) Capsaicin (Zostrix, ArthriCare) is an irritant derived from chili peppers that provide relief by depleting a chemical that transmits pain from nerve endings. Various strengths are available without prescription. (It causes a burning sensation thus one has to be careful while applying and should wear a disposable plastic glove).
10) Acupuncture; most popular forms of alternative or complementary medicine, particularly for pain relief.
11) Analgesic patches too are available for the pain relief.
These are the exercise resources for the knee. You can pick the exercises which suits you;
If overweight is an issue; long term is achieved by weight reduction. High impact exercises should be avoided; like kneeling and bending. These supplements help in rebuild the cartilage;
1) Omega-3 fatty acids, such as fish oil,
2) SAMe (s-adenosyl-L-methionine), 600 mg daily.
3) Glucosamine/chondroitin, 1,500 mg daily.
4) Bromelain, 250 mg twice a day.
Following herbs are suppose to be good;
2) Cat's claw
3) Willow bark
5) Devil's claw
To summarize: Following measures would be helpful in the knee arthritis;
1) Knee care in the activities of daily living. Few simple self-care measures can be remarkably effective in ending pain cycle.
a) Avoid prolonged standing or walking or sitting with joint in a single position.
b) whenever you sit, keep the knee stretched and fold them intermittently.
c) Squatting, sitting cross legged should not be done.
d) Avoid climbing stairs.
e) Avoid sitting legs unsupported or hanging.
f) Reduce weight if over weight/obese.
2) Rest: Taking a break from your normal activities reduces repetitive strain on your knee, gives the time to heal and helps prevent further damage.
3) Anti-inflammatory medications
4) Physical therapy; the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Ideal is supervised physical therapy. Stretching exercises are also part of the physical therapy regime.
5) Orthotics and bracing.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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