top of page
    • Sep 4, 2023
    • 6 min read

5 EASY Home Treatments for Knee Arthritis Pain Relief



Did you know that muscle pain is a major contributor to knee arthritis? I want to discuss how targeting treatment towards the muscles around the knee can decrease pain and improve function related to symptomatic knee osteoarthritis. I’ll give you five specific treatments, all of which you can do at home to treat your muscles and get your knee feeling better.

Knee osteoarthritis is a condition where the cartilage in the knee is damaged and lost over time. This causes the bone to rub against each other leading to pain, swelling, stiffness, and catching of the knee. And when you go to a doctor who is trying to assess if your symptoms are related to knee arthritis, they really focus on examining the structure of the knee. They evaluate the bones, the joint, the ligaments, the tendons, and the meniscus. But very rarely do they evaluate the muscles.

What many physicians don’t realize and what many people don’t understand is that muscle problems contribute a significant amount of pain to those who suffer from symptomatic knee osteoarthritis. This study found that the prevalence of myofascial trigger points in the muscles around the knee was up to 50% in patients with mild to moderate symptomatic knee osteoarthritis. Moreover, this study found that those with moderate degree of knee osteoarthritis had significantly more myofascial trigger points in their muscles when compared to asymptomatic age matched subjects.

So there is pretty good literature data that people with knee arthritis have myofascial trigger points in the muscles around their knee, but what are the outcomes when we start to treat these muscles? This study looked to answer that question. They enrolled people with knee osteoarthritis who were waiting for a total knee arthroplasty also known as a joint replacement surgery. The authors wanted to know if these patients would get pain relief if the muscles around the knees were treated with trigger point injections.

First and foremost, the authors report that myofascial trigger points were identified in all patients enrolled in the study. 100% of them. This does make sense because all of these patients have severe arthritis and are waiting for a joint replacement surgery. The authors then performed trigger point injections to treat the muscles. They found that by only treating the muscles, the patients experienced significantly reduced pain intensity, pain interference, and improved mobility.

The most commonly affected muscles were the medial head of the gastrocnemius followed by the vastus medialis oblique. They report that there was an acute reduction in pain and notable improvement in function immediately following the intervention and that the results persisted over an 8 week course of investigation.
The authors go on to conclude that 92% of patients enrolled in the study experienced significant pain relief with trigger point injections, indicating that a significant proportion of osteoarthritis knee pain was myofascial in origin. This means that a huge proportion of the pain that people experienced from knee osteoarthritis came from the muscle, not necessarily the joint.

This next study found similar results. The authors looked at if dry needling would help reduce pain in patients with mild to moderate symptomatic knee osteoarthritis. They found that the application of one session of dry needling in the quadriceps and gastrocnemius muscles led to significant decreases in pain scores over the 1 month period of investigation.

So in my other videos, I make the argument that it’s a really good idea to treat knee osteoarthritis with injection therapy using either platelet rich plasma injections or hyaluronic acid injections. These injections help to keep the biochemical environment inside the knee as healthy as possible and helps to reduce pain and improve function. And now I hope I’ve convinced you that we also need to treat the muscles around the knee. This is why it is so important to take a multi modal approach to treating knee osteoarthritis.

So what muscles are typically involved in those who have knee arthritis and how do you go about treating them? If you have pain in the inside of your knee, also known as the medial compartment, then chances are you have myofascial trigger points within the medial head of the gastrocnemius as well as the vastus medialis oblique muscles.

If you have pain towards the outside of your knee, also known as the lateral compartment, then chances are you have myofascial trigger points within the lateral head of the gastrocnemius as well as the vastus lateralis muscles. Other muscles that can be affected include the rectus femoris, the hamstring muscles, the adductor muscles, as well as the popliteus muscle.

Trigger point injections and dry needling are excellent treatments that can treat the muscles and the underlying trigger points to decrease pain and improve function. But not everyone has access to health care providers who offer these treatments and not everyone wants to try needling therapy. The good news is that there are a lot of things that you can do at home to try to treat the myofascial trigger points in the muscles and I want to go through 5 of these options.

The first is heat. Heat therapy is much more effective than ice when it comes to myofascial pain. Applying heat helps increase blood flow to the muscle. This allows the muscles to loosen up and decrease tightness of the knee. This can help tremendously with knee stiffness. Many people with knee arthritis actually discover heat therapy on their own as they find that when the weather gets cold, their pain gets worse. Applying heat is simple and can be incredibly beneficial. You want to make sure you cover the entirety of the calf, the inner thigh, and the outer thigh muscles. This is best done with a larger heating pad.

The second option is acupressure therapy. These come in many forms such as massage guns, soft tissue massages, and foam rollers. All of these are designed to help relieve muscle tension and improve blood flow. I’ve found foam rolling to be by far the most effective in treating trigger points in the leg. It’s much more effective than even the most expensive massage guns. Now with that said, figuring out a comfortable position to foam roll can be tricky, so I encourage you to google how to foam roll each muscle group.

So let’s take the vastus medialis oblique as an example. This is a muscle that needs to be treated in those who have inside knee pain from medial compartment osteoarthritis. When you are foam rolling the VMO, you want to try to get into this position. Then you want to foam roll the entire area between the inside of the knee all the way up to the inner thigh. When you hit a tender spot, hold that area for at least 30 seconds before moving on. As you move up the thigh, you might get more tender spots. If you do, hold each of those areas for 30 seconds.

So when you first start foam rolling, you may find that you are spending up to 5 minutes on just one muscle of one leg. And that’s ok. That just means there is a lot to work on. And the more you treat the muscles, the less trigger points you will have and the less time you need to spend on foam rolling in the future.

The third modality is a TENS unit, also called a transcutaneous electrical nerve stimulation unit. This is a small portable device that delivers low voltage electrical signals through the skin to stimulate the nerves and the muscles. TENS units have been shown to have excellent pain relieving effects when used to treat chronic muscular pain. They are thought to work by altering neuromuscular signaling and releasing endorphins which are natural pain relieving chemicals in the body.

If you’ve never used a TENS unit, you’ll want to reference google to see where to place the electrodes. For example, I can search “TENS unit medial head gastrocnemius” and I can see where I need to apply the electrodes on my body. You can play around with how often and how long you need to apply the TENS unit, but most people will do fine with a few 15 minute sessions per day.

The fourth modality is walking. Now walking seems almost too simple and even counter-intuitive right? But there is a simple explanation for why this works. When you walk, your joints increase the production of lubrication, one of which is called hyaluronic acid. This helps to reduce stiffness and reduce pain. This is also why hyaluronic acid injections help reduce pain and improve function related to knee arthritis. When you stop walking, you stop producing lubrication and all your symptoms tend to get much worse. Try to work yourself up to 7,500 steps per day for maximum health benefits.

The fifth modality is stretching and strengthening. Both of these exercises will target muscle tightness and muscle spasms. They work by remodeling the muscle to try to break down the trigger points. The other benefit of muscle strengthening is that stronger muscles help offload the joint and decrease the pressure on the bones. Decreasing pressure means less irritation and less inflammation.



Comments

1
2345
bottom of page