Impact of Chronic Knee Pain on Elderly - The Silent Agony

Introduction

The knee comprises four bones, starting with the femur bone (thigh bone), tibia, fibula, and knee cap. These bones are covered in cartilage which is an important part of the joints as it allows motion and function. Cartilage is made up of 80 % water and gets its nutrition from knee fluid. The important fact about cartilage is that it does not contain any blood vessels; hence when it gets injured, it does not heal. Chronic knee pain is the major cause of functional limitations and disability in older people and accounts for many visits to health care providers. Although chronic knee pain in older people is usually attributed to progressive and degenerative joint changes associated with knee osteoarthritis, the functional impairments in this population do not seem to be an inevitable consequence of increased structural damage and disease severity.

What Causes Chronic Knee Pain?

Chronic knee pain may occur due to

• Arthritis - Inflammation of the joints causing pain and stiffness.

• Osteoarthritis - Wearing away of the cartilage surrounding joints causes pain, stiffness, swelling, and loss of flexibility.

• Rheumatoid Arthritis - An autoimmune inflammatory disorder of joints causing swelling and stiffness.

• Gout - A type of arthritis that causes severe pain, redness, and tenderness in the joints.

• Osteoporosis - A condition that makes the bone weak and brittle.

• Bursitis - Inflammation of the bursae causing sharp shooting pain, redness, and swelling in the affected area.

• Infection - Infection of the tissues of the knee joint can cause severe pain.

• Chondromalacia Patella - It is the damage to the cartilage causing knee pain.

• Illiotibial Band Syndrome - It is a condition in which the connective tissue rubs against the thigh bone, causing pain.

• Post-Traumatic Arthritis - It is the inflammation of the joints after a trauma.

What Are the Signs of Chronic Knee Pain?

The symptoms of chronic knee pain may vary for each patient as it has various causes. Some of the common signs are-

1. Constant pain in the knees.

2. Sharp and shooting pain in the knees.

3. A dull and burning discomfort on the knees.

4. Swelling of the joints.

5. Stiffness while moving.

6. Redness and feeling of warmth.

How Chronic Knee Pain is Diagnosed?

Physical examination, blood tests, X-rays, computed tomography (CT scan), and magnetic resonance imaging (MRI scan) can help diagnose chronic knee pain.

Why Chronic Knee Pain Often Occurs With Aging?

One of the key roles of the knee is to support the body weight, and with every step, it puts huge pressure on the knees. Chronic knee pain can occur due to overuse injury in which the muscle, tendon, or ligament is damaged. Chronic knee pain is also a result of osteoarthritis that comes with aging. The fibrous tissues that lie between the knee bones become thin and brittle and can tear easily with increasing age. The cartilage also starts to disappear, causing bone pain in older people.

What Are the Effects of Chronic Knee Pain on Older People?

The following are the effects of chronic knee pain on older people-

• Chronic knee pain can negatively affect the older person’s psychological stage and overall quality of life.

• Knee pain is associated with poor balance in older people, and it increases the risk of falls.

• It also develops a fear of movement and avoiding activities in older people.

• Knee pain causes major sleep disturbances in patients impacting their sleep cycle.

• It also creates social isolation among elderly people.

• Knee pain makes the older person dependent on people for their daily activities.

What Are the Treatment Options?

Some of the treatment options for chronic knee pain are mentioned below-

1. Medications - Anti-inflammatory drugs can be prescribed by a physician to relieve the symptoms.

2. Physiotherapy - It focuses on the type of problem and helps to relieve pain and other symptoms. This can be performed after consulting a healthcare professional.

3. Surgery - When the knee pain becomes severe, a doctor may recommend surgery options such as partial or total knee replacement, arthroscopy, patellar or tendon repair, etc.

4. R.I.C.E - The rest, ice, compression, and elevation is a home-based therapy that comprises taking more rest, putting ice on knees to relieve pain, using a compression bandage to prevent swelling, and keeping the knee at a particular position for rest and reducing inflammation.

How to Prevent Knee Pain in Old Age?

There are many methods by which chronic knee pain in elderly people can be managed, such as

• Maintain Ideal Body Weight - The more obese a person is, the more they are to develop knee pain.

• Regular Exercise - One aspect is to keep oneself fit. It is especially recommended for the old age group to do some form of lightweight exercise like walking, swimming, or cycling for at least 30 to 40 minutes every day. Exercise maintains good blood circulation to the knee joints and makes them pain-free.

• Strengthening Exercise - This should be done to improve the functioning of the muscles of the knee joint.

• Well-Maintained Diet - A combination of fruits, nuts, and green leafy vegetables provides good and long-lasting health for the cartilage.

• Lifestyle - Reduce alcohol consumption, avoid caffeine intake and quit smoking.

• Sleeping Pattern - The patients are advised to sleep in a comfortable position with pillows in between the legs and use a firm mattress to help distribute the weight.

• Ice Therapy - Keep the ice on the knees for about 15 minutes if it aches, and the ice should not be applied directly to the knees; a towel can be used. Physicians advise purchasing an ice massager for relieving knee pain.

• Choose Appropriate Footwear - Sanding on hard surfaces for a longer period of time can make the knees hurt; hence cushioned footwear or orthopedic shoes should be used.

Conclusion

In conclusion, chronic knee pain is a significant problem for the elderly population, which can significantly affect their quality of life. It is associated with reduced mobility, increased risk of falls, depression, anxiety, and decreased participation in social activities. Early diagnosis and management of chronic knee pain are essential to prevent further deterioration and improve overall health outcomes. Exercise, weight management, physical therapy, and medication management are some of the effective strategies for managing chronic knee pain. It is essential to raise awareness among healthcare providers, caregivers, and the elderly population about the importance of managing chronic knee pain to improve the overall health and well-being of the elderly population.