Case Study: “Pain Reduction in a Patient with Knee Osteoarthritis Using Myofascial Correction and Other Techniques: No Drug Therapy Used at All”
An article about the effectiveness of using manual and physical methods of osteoarthritis therapy.
This case will be presented in brief.
My maternal uncle came to me for help. He considered pain to be the main problem with his illness.
A. Here is what the patient’s examination revealed:
- The patient is a man. Age – 66 years. Occupation – own farm.
- Patient’s complaints:
- pain in the knees and front of the thighs, closer to the knees. The pain intensifies while walking. Lower back pain, which sometimes appears and then disappears.
- difficulty squatting, since the legs do not fully bend at the knee joints.
3. Physical examination of the patient.
- externally visible deformities of both knee joints, more on the left.
- the range of passive movements in the knee joints during flexion is moderately reduced due to shortening of the anterior thigh muscle groups.
- pronounced crunching in the knee joints during passive movements in them.
- moderate Baker’s cyst on both sides.
- pronounced pain in the soft tissues covering the knee joints, as well as the projection of the so-called “goose foot” (the inner surface of the inner epiphysis of the femur on both sides).
- pain in the quadriceps (quadriceps muscle of the thigh) in the area close to the knee joints during deep palpation.
- pain in the calf muscles on both sides during deep palpation.
- pronounced signs of flat feet on both feet.
- pain in the soft tissues of the sole during deep palpation.
- pain in the gluteal muscle group during deep palpation.
B. Hypothesis on the development of the disease.
It can be assumed that during life, for various reasons, trigger points appeared in the muscles serving the knee joints, which worsened the nutrition of the joints. Also, changes in the soft tissues covering the knee joints could also worsen the nutrition of the knee joints. More precisely, the quality and quantity of synovial fluid produced in the knee joints changed. It is known that it is the synovial fluid that carries nutrients to the cartilage of the joints, and movements in the knee joint deliver nutrients to the cartilage tissue by diffusion. In addition, the appearance of flat feet in the feet could aggravate the development of osteoarthritis.
C. Treatment plan.
- Correction of flat feet as much as possible.
- Reduction of pain in the soft tissues of the knee joints.
- Reduction of pain in the muscles of the thigh and lower leg.
- Therapeutic exercises.
- Correction of flat feet. The foot acts as a kind of shock absorber in the body. If flat feet are not treated, then it is impossible to achieve success in the treatment of osteoarthritis of the leg joints. At first, pressure was applied to the painful areas of the sole (as a rule, such patients often suffer from plantar aponeurosis). Then exercises for the foot (stretching, walking barefoot on hot medium-sized gravel).
- Reducing the pain of the soft tissues of the knee joints. The pain was more determined from the front of the knee joint, more from the inner edges of the kneecaps. And also pain in the area of the “crow’s feet”. Deep periodic pressure with the fingers of these areas was used. This should improve blood circulation in the knee joints.
- Reducing pain in the muscles of the thigh and lower leg. The muscles serving the joints play a large role in ensuring sufficient blood circulation to these joints. Here, deep pressure was applied to the painful areas of the muscles with the fingers or the elbow.
- Therapeutic exercises. Kneading and stretching the muscles that serve the joint.
D. Frequency and duration of treatment.
I visited the patient 3 times a week. The treatment lasted for two months.
E. What was the result?
Joint pain during movement and muscle soreness decreased significantly. The range of motion in the knee joints improved slightly. The condition of Baker’s cysts did not change. The patient was advised to continue doing the exercises.
Note: the patient tends to be careless in following recommendations!
Be healthy!
