Joint Pain Forum – News you can use!
Brace Yourself For Knee Pain
Relief
26
Sept 2007
As
edited by Joint-Pain-Forum.com
If
you're among the estimated 10 million Americans who have been diagnosed
with osteoarthritis of the knee, take heart in knowing that several
nonsurgical options, pharmacologic and otherwise, are available for
easing the pain of an arthritic knee, according to Cleveland Clinic's
Arthritis Advisor. In addition to the judicious use of nonsteroidal
anti-inflammatory drugs (NSAIDs) and corticosteroids, options include
weight control, leg-strengthening exercises, and the use of assistive
devices, such as a cane or walker.
According to
Robert Molloy, M.D., an orthopaedic surgeon at Cleveland Clinic,
another option for many patients is a knee brace a device, either soft
or rigid, that is worn around the knee to provide support and reduce
excessive loading on a damaged joint.
The knee
comprises three components: the medial compartment (on the inside of
the joint), the lateral compartment (on the outside), and the
patellofemoral compartment (the area behind the kneecap). Knee braces
are primarily recommended for patients whose loss of knee-joint
cartilage is "unicompartmental" that is, confined to only one of these
three compartments. "The devices are most frequently prescribed in
cases involving the medial compartment, since that is where OA most
often develops," says Dr. Molloy.
Bracing
options
The simplest type of brace is a
one-piece sleeve made of an elastic rubber neoprene that fits snugly
around the knee area. Appropriate for use by patients with relatively
mild OA, these sleeves, available over the counter at most pharmacies,
compress the affected area, providing warmth and a moderate amount of
support. "Some patients, especially those who are comparatively active,
may benefit from wearing one of these devices," says Dr. Molloy.
"Sleeves
may decrease pain, and a fair number of patients claim that to be the
case, but we don't really know why, since these devices don't have any
structural effect on the joint."
Of greater value
for patients with more advanced knee OA, says Dr. Molloy, is an
"unloader" brace a semi-rigid device made of molded plastic and foam,
with reinforcing steel struts on each side to limit the knee joint's
lateral movement.
"It's a custom-fit brace that's
most often prescribed for people with arthritis in the medial
compartment," he says. "When some people with arthritis in this part of
the knee walk, you can actually see the knee wobble toward the inside.
It's not dangerous, but this wobbling called a varus thrust can be
painful.
"The unloader brace is designed to provide
three points of pressure on the thigh bone, which forces the joint to
bend away from the inside of the leg. In effect, it relieves pain by
transferring pressure from the inside part of the knee to the outside
part."
----------------------------
Article
adapted by
www.Joint-Pain-Forum.com from original press release.
----------------------------
Postponing surgery
Although
unloader braces are used primarily by patients with OA in the medial
compartment, a brace also can be designed to increase mobility and
reduce pain stemming from cartilage destruction in the lateral
compartment, allowing the patient to walk more rapidly and for greater
distances.
In addition to easing moderate to severe
pain, unloader braces are often prescribed as a temporary source of
relief for those with advanced cartilage damage who will ultimately
need to undergo joint-replacement surgery. "Some patients," notes Dr.
Molloy, "can get along quite well for six to 18 months before the brace
is no longer effective and they have need for surgery."
Choose
right
Unloader devices are unique in
structure and differ significantly in purpose from other types of
braces that are commonly found in pharmacies and sporting-goods stores.
A "prophylactic" brace, for example, is designed to prevent injury to
an arm or knee. A second category includes "rehabilitative" braces,
which are designed to be worn by someone who has had a recent injury or
surgery involving the ligaments in the knee joint. A third category
includes "functional" braces, which are designed to help control
abnormal motion in an unstable knee. Unloader braces, for people whose
knee instability is the result of cartilage loss, fall into this third
category.
"You'll need a prescription from an
orthopedic specialist in order to purchase an unloader brace," says Dr.
Molloy, "and you'll need to purchase it at a store that specializes in
orthotic devices, where they will construct the brace so that it
delivers the proper amount of force to the joint. "
Starting
out
Obtaining maximum benefit from wearing
an unloader brace, which may not feel comfortable at first (it may take
a week to a month for you to get used to how it feels on your leg),
will require a certain amount practice. And although Dr. Molloy says
"The more you wear a brace, the better it works," he urges patients not
to neglect other important therapeutic measures, such as exercises to
strengthen the muscles surrounding the knee (see below). Also be wary
of over-reliance; wearing a brace all the time doesn't permit
exercising and strengthening your leg muscles.
The
only "drawback" of an unloader brace, he says, is that it tends to be
bulky, making it difficult for a patient to wear one, for example,
under a pair of snug-fitting slacks. Furthermore, he adds, unloader
braces tend to be relatively expensive, typically priced to $500 or
more. However, Dr. Molloy points out, most health insurance providers
will partially cover the cost of a brace.
What
You Can Do
-- If you're considering a knee
brace:
-- Consult an orthopaedic specialist on the
potential value of using such a device.
-- Don't
expect a brace to feel good from the start. It may take weeks before it
feels comfortable.
-- Don't become over-reliant.
Wearing a brace all the time doesn't permit exercising and
strengthening of the muscles surrounding the knee.
--
Don't neglect your other therapies, no matter how well the brace works.
Belvoir
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7820 Holiday Drive So., Suite 315
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