Natural Relief for Knee Pain

nee pain is an increasingly common cause of dysfunction and disability. Diagnosis is critical and certain symptoms require immediate medical care, such as numbness, fever, deformity, inability to bend or bear weight on the limb, and excessive bruising, bleeding or swelling. But when knee pain is minor, natural therapies are often good alternatives or adjuncts to conventional treatment. Exercise, nutritional supplements, botanical medicines, and hydrotherapy can relieve pain, reduce inflammation, and speed healing.

The standard prescription for acute knee pain is known as "RICE," an acronym for rest, ice, compression, and elevation. Resting prevents further injury while ice, compression, and elevation reduce blood flow to the area, limiting swelling and bleeding. Ice also has a numbing effect and helps to relieve pain. It should be applied for ten to twenty minutes every one to two hours as needed.

Although rest is critical at the time of injury, physical activity actually promotes tissue growth and repair once injuries start to heal. A study in Germany recently examined the impact of exercise on recovery from knee surgery. Researchers followed 118 patients who underwent surgery to replace damaged areas of knee cartilage with cartilage cells taken from a non-weight bearing part of the joint. Post-surgically, patients who engaged in sports at least once per week showed significantly improved knee function and cartilage repair (evaluated by MRI) compared to those who exercised only one to three times per month or not at all. Results were apparent after six months and active patients continued to improve during the three years of follow-up. Doctors concluded that patients recovering from knee surgery should engage in sports several times per week for at least two years after their operation, excluding high-impact activities and those that require pivoting, like basketball, football, soccer, and tennis.

Exercise not only stimulates healing of injured tissues, it helps to prevent future injury by strengthening muscles and bones surrounding vulnerable joints and improving flexibility. Stronger tissues and a greater range of motion allow forces to be distributed more evenly across the knee, minimizing stress on the joint. Exercise also helps overweight individuals lose weight, reducing pressure on knee joints. The best activities are low-impact sports such as cycling, walking, weight lifting, swimming, and other aqua-exercise.

Glucosamine and chondroitin are structural components of cartilage in joints. They are naturally produced by the body and supplements are derived from animal cartilage (chondroitin) and shellfish (glucosamine). Several randomized clinical trials support their effectiveness in relieving knee pain and there are no significant side effects in individuals without shellfish allergies. Chondroitin is related to heparin, so it should not be used with anticoagulant medications because it can increase the risk of bleeding.

Several herbs have anti-inflammatory effects and can be used to relieve knee pain as well. These include boswelia, ginger, devil’s claw, tumeric, and bromelain, an enzyme extracted from the pineapple plant. These herbs have a long history of traditional use and in vitro and animal studies have demonstrated their anti-inflammatory effects. Although they are non-toxic and well tolerated, interactions and allergic reactions are possible. Always talk to your doctor before taking any new medicines. She or he can recommend the best dosage and identify any potential interactions with other medications you are taking.

The therapeutic use of hot and cold water, known as hydrotherapy, can also provide long-term support after acute inflammation subsides. Hot water dilates blood vessels on the surface of the skin and cold water constricts them. When hot and cold applications are alternately applied, circulation to the area is increased, bringing white blood cells and nutrients needed to stop tissue damage, destroy any foreign elements, remove waste materials, and rebuild tissues.

Alternating hydrotherapy can be done daily or as needed after activity. To perform the treatment, you will need two towels, tongs, a container of ice water, and a microwave or a large pot of simmering water. Place one towel in ice water. If using a microwave, wet the other towel, ring it out well, and heat it until hot. If using a pot of water, bring it to a simmer, remove it from the heat and add the towel. Exercise caution with the hot towel and use tongs to extract it from the pot or microwave, letting steam evaporate for a few seconds until the towel is cool enough to handle. Wrap it around the knee, taking care not to burn skin, and leave it in place for 3 minutes. Wring out the cold towel and apply it to the knee for 30 seconds. Repeat these steps for two additional cycles, reheating the hot towel and returning the cold towel to the ice water as needed.

Dr. Sarah Cimper-man is a Doctor of Naturopathic Medicine in private practice in New York City. For more information, call 646-234-2918 or visit www. drsarahcimperman.com