This article gives the reader a basic knowledge of the knee structure. Points covered will be different ligaments and cartilage that interact to enable correct function of the knee. The treatment and causes of housemaids knee (bursitis) will also be described. Pharmaceuticals can be used to reduce pain and inflammation. These can range from the fairly mild paracetamol to the strong opoids such as morphine. Herbal remedies tend to work on inflammation. The reduction of inflammation itself can often reduce pain levels. This article aims to help the reader suffering knee problems to be able to make considered choices in their treatment.
Basic Structure Of The Knee.
The knee consists of four bones, namely the femur, tibia, the fibula and the patella. The knee joint is located between the femur and tibia and is traditionally classed as a hinge joint, having movement in only plane. This means that the knee only bends or straightens. However, it is also classed as a ellipsoid joint because it does allow a small amount rotation of the lower leg. The patella (kneecap) is situated at the front of the knee. The femur has two ellipsoid surfaces and joins the fibia with the menisci (commonly known as cartilage) between. The fibula does not directly move with the femur but works on the lateral (outer) side of the tibia. There thirteen ligaments attached around the knee. These are patellar, patellar retinaculum, oblique popiliteal, arcuate popiteal, medial collateral, lateral collateral, anterior cruciate, posterior cruciate, coronary (2), transverse, and meniscofemoral (2). It is not in the remit of this article to describe in detail the function of all of these ligaments.
Housemaids Knee’, A Common Cause Of Knee Pain.
Housemaids knee is a common name given to Bursitis. This occurs in the subcutaneous prepatellar bursa. This can, as the common name suggests, be caused by prolonged work performed on the knees. This type of bursitis can affect roofers, carpet layers, miners, plumbers amongst other groups who kneel for long periods. Bursitis may also cause another condition of slow accumulation of fluid in the knee commonly called ‘water on the knee’.
Another cause of a swollen knee can be caused following an injury. If the swelling appears immediately after the injury the swelling is often an accumulation of blood within the joint called ‘hemarthrosis’.
Treatment For Housemaids Knee Using Pharmaceutical Drugs.
There are many pain relief and anti-inflammatory medicines readily available. In this article some general ones will be described.
Paracetamol: Also called Acetaminophen. Paracetamol relieves pain and fever in adults and children. Its pain relief (analgesic) and fever relief (antipyretic) effects are similar to those of aspirin and it works in a similar way. Unlike aspirin, however, increasing the dose does not result in clinically useful anti-inflammatory activity. Paracetamol is therefore not of value for reducing inflammation in the treatment of bursitis (housemaids knee). The recommended adult single dose of paracetamol is two standard 500 mg tablets. Although paracetamol is widely available it should be treated with respect. An overdose to a healthy person of taking 30 tablets at once will result in liver damage and possible death.
Co-Codamol. Co-codamol contains a combination of two pain-killing ingredients paracetamol and codeine. It is used to stop pain. The amount of codeine in the combination determines the strength of the preparation. There are three different strengths of co-codamol available. Codeine/Paracetamol 8/500mg, 12.8/500mg, and 30/500mg. Common side effects are feeling sick, dry mouth and constipation amongst others.
Codeine Phosphate. Codeine phosphate is a pain killer. It comes in 3 tablet sizes, 15mg, 30mg, and 60mg. Common side effects include skin rash or itchy skin, difficulty breathing, increased sweating, redness or flushed face, constipation, feeling or being sick, dry mouth, a slow or fast heart rate, palpitations, low blood pressure, low blood pressure on standing, pain and difficulty in passing urine and a less frequent need to do so, dizziness, and blurred vision amongst others.
Ibuprofen. Ibuprofen is in the group of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). It works by reducing hormones that cause inflammation and pain in the body. Ibuprofen is used to reduce fever and treat pain or inflammation caused by many conditions such as bursitis (housemaids knee). Common side effects are an increase in asthma symptoms, increased risk of stomach ulcers, and damage to the intestines amongst others.
NaproxenNaproxen is a NSAID. It is used to reduce pain and inflammation in many conditions including knee pain. Common side effects include ringing in the ears, headaches, dizziness, drowsiness, heartburn, and constipation amongst others.
Voltarol. Also called Diclofenac Sodium is a NSAID. Voltarol is available in tablet form and a gel that is rubbed into the affected area. Voltarol is used in the treatment of many conditions including acute musculo-skeletal disorders such as periarthritis (for example frozen shoulder), tendinitis, tenosynovitis, bursitis. Some common side effects include nausea, constipation, vomiting, indigestion, loss of appetite, headache, dizziness, skin rashes, drowsiness, depression, insomnia, fluid retention and ringing in the ears amongst others.
Treatment Of Housemaids Knee using Natural Methods.
Chondroitin Sulfate: Chondroitin Sulfate is also naturally found in the body. It prevents other body enzymes from degrading the building blocks of joint cartilage.
Devils Claw: Devils claw has been shown to be effective in reducing inflammation and pain in such problems of arthritis and bursitis, during clinical trials. This should not be taken by people with stomach ulcers.
Glucosamine: Glucosamine is a form of amino sugar that our bodies naturally manufacture. It is considered one of the major building blocks for joint protection. It is usually found in conjunction with Chondroitin Sulfate, and is widely used to relieve pain and inflammation in such health problems of back ache, tennis elbow, and housemaids knee.
MSM: Is the shortened form of methylsulfonylmethane. MSM provides sulfur, which is a vital building block of joints, cartilage, skin, hair and nails. It also supports the production of energy. It helps normal re-building of connective tissue.
Turmeric: Turmeric has been shown in clinical studies to be as effective as some NSAIDs, without the unpleasant side effects. High doses of turmeric should not be taken if the user suffers intestinal problems.
White Willow Bark: The active ingredient in willow bark is salicin. Records show people have been using willow bark since the time of Hippocrates in 400 B.C. It is used to ease discomfort.
It appears that for mild bursitis natural remedies are well worth giving consideration. Pharmaceutical drugs are preferred for more severe pain but have many more unpleasant side effects.