What are the most effective treatments for knee osteoarthritis pain. How do corticosteroid and hyaluronic acid injections compare to other pain relief methods. Which non-pharmacological approaches can help manage arthritis symptoms in the knees.

Understanding Knee Osteoarthritis and Treatment Options

Knee osteoarthritis is a degenerative joint condition that causes pain, stiffness, and reduced mobility. Finding effective pain relief is crucial for managing symptoms and maintaining quality of life. A comprehensive meta-analysis of 137 studies involving over 33,000 participants has shed light on the most effective treatments for knee osteoarthritis pain.

Most Effective Treatments According to Research

The study revealed that corticosteroid and hyaluronic acid injections were the most effective treatments for knee osteoarthritis pain. These injectable medications outperformed oral medications and other interventions in providing relief. On the other hand, acetaminophen was found to be the least effective treatment option.

Considering Injectable Treatments

If you have knee osteoarthritis and haven’t tried corticosteroid or hyaluronic acid injections, it may be worth discussing these options with your healthcare provider. These injections can provide significant pain relief and improve joint function. However, it’s important to note that while injections can alleviate pain, they do not address the underlying joint degeneration.

Non-Pharmacological Approaches to Knee Osteoarthritis Management

While medications and injections can provide relief, several non-pharmacological treatments have shown effectiveness in managing knee osteoarthritis symptoms:

• Knee exercises
• Physical therapy
• Heat and ice therapy
• Topical medications
• Weight loss

These approaches can complement medical treatments and help improve overall joint health and function. Are you incorporating any of these non-pharmacological methods into your arthritis management plan?

The Role of Weight Loss in Knee Osteoarthritis Treatment

Weight loss is a crucial factor in managing knee osteoarthritis. Excess body weight puts additional stress on the knee joints, exacerbating pain and accelerating joint degeneration. By losing weight, individuals can significantly reduce the load on their knees and experience improved mobility and reduced pain.

Tips for Effective Weight Loss

1. Set realistic goals
2. Adopt a balanced, nutrient-rich diet
3. Engage in low-impact exercises
4. Stay hydrated
5. Get adequate sleep
6. Seek support from healthcare professionals

How much weight loss is necessary to see improvements in knee osteoarthritis symptoms? Studies suggest that even a modest weight loss of 5-10% of body weight can lead to significant reductions in pain and improved function.

Exploring Alternative Exercise Options for Knee Arthritis

Traditional exercise routines may be challenging for individuals with knee osteoarthritis. However, there are alternative options that can provide the benefits of physical activity while minimizing stress on the joints:

Treadmill vs. Sidewalk Walking

Walking or jogging on concrete sidewalks can be harsh on arthritic knees. A treadmill offers more cushioning and reduces the overall compressive load on the joints. When using a treadmill, it’s best to avoid inclines to minimize stress on the knees. Alternatively, walking on groomed earthen trails can provide similar benefits.

Low-Impact Exercises

• Swimming
• Water aerobics
• Stationary cycling
• Elliptical machines
• Tai Chi
• Yoga (with modifications)

These exercises can help maintain joint mobility, strengthen muscles, and improve overall fitness without putting excessive strain on the knees. Which of these low-impact exercises appeals to you the most?

The Importance of Proper Footwear and Orthotics

Footwear plays a crucial role in managing knee osteoarthritis symptoms. Improper foot alignment can lead to knee joint misalignment, causing increased friction and strain on soft tissues.

Benefits of Shoe Inserts

Custom shoe inserts or orthotics can help correct foot pronation issues and promote proper knee alignment. This can reduce pain and improve overall joint function. A physician or podiatrist can assess your gait and recommend the most suitable insert for your needs.

Choosing the Right Shoes

When selecting shoes, consider the following factors:

• Adequate cushioning
• Proper arch support
• Wide toe box
• Stable heel counter
• Flexible sole

Investing in high-quality, supportive footwear can make a significant difference in managing knee osteoarthritis symptoms. Have you noticed a difference in your knee pain when wearing different types of shoes?

Therapeutic Injections for Knee Arthritis: A Closer Look

As mentioned earlier, corticosteroid and hyaluronic acid injections are among the most effective treatments for knee osteoarthritis pain. Let’s explore these options in more detail:

Corticosteroid Injections

Corticosteroid injections deliver powerful anti-inflammatory medication directly into the joint. They can provide rapid pain relief and reduce swelling. However, their effects are typically short-term, lasting several weeks to a few months.

Hyaluronic Acid Injections

Also known as viscosupplementation, hyaluronic acid injections aim to supplement the joint’s natural lubricating fluid. These injections can improve joint mobility and provide longer-lasting pain relief compared to corticosteroids, with effects potentially lasting up to six months or more.

While these injections can be highly effective, it’s important to note that they should be used judiciously. Overuse of corticosteroid injections, in particular, can lead to joint damage. Your healthcare provider will determine the appropriate frequency and type of injection based on your individual needs.

Complementary and Alternative Therapies for Knee Osteoarthritis

In addition to conventional treatments, several complementary and alternative therapies have shown promise in managing knee osteoarthritis symptoms:

Acupuncture

This traditional Chinese medicine technique involves inserting thin needles into specific points on the body. Some studies suggest that acupuncture may help reduce pain and improve function in individuals with knee osteoarthritis.

Massage Therapy

Regular massage can help improve circulation, reduce muscle tension, and alleviate pain associated with knee osteoarthritis. It may also help improve joint flexibility and range of motion.

Herbal Supplements

Certain herbal supplements, such as turmeric, ginger, and Boswellia, have anti-inflammatory properties that may help reduce osteoarthritis symptoms. However, it’s crucial to consult with a healthcare provider before starting any new supplement regimen.

Mind-Body Techniques

Practices such as meditation, mindfulness, and relaxation techniques can help manage pain perception and reduce stress associated with chronic conditions like knee osteoarthritis.

While these complementary therapies can be beneficial, it’s important to use them in conjunction with, not as a replacement for, conventional medical treatments. Have you tried any of these alternative therapies for your knee osteoarthritis?

The Role of Physical Therapy in Knee Osteoarthritis Management

Physical therapy is a cornerstone of knee osteoarthritis treatment. A skilled physical therapist can develop a personalized exercise program to address your specific needs and help you achieve the following goals:

• Strengthen muscles supporting the knee joint
• Improve flexibility and range of motion
• Enhance balance and coordination
• Reduce pain and inflammation
• Improve overall function and quality of life

Common Physical Therapy Techniques for Knee Osteoarthritis

1. Manual therapy: Hands-on techniques to improve joint mobility and reduce pain
2. Therapeutic exercises: Tailored exercises to strengthen muscles and improve joint function
3. Gait training: Instruction on proper walking techniques to reduce stress on the knees
4. Balance training: Exercises to improve stability and reduce the risk of falls
5. Modalities: Use of heat, cold, or electrical stimulation for pain relief

How often should you attend physical therapy sessions for knee osteoarthritis? The frequency of sessions will depend on your individual needs and the severity of your condition. Initially, you may need to attend 2-3 sessions per week, gradually decreasing as you progress and learn to perform exercises independently at home.

Emerging Technologies and Treatments for Knee Osteoarthritis

As research in the field of osteoarthritis continues to advance, new technologies and treatments are emerging that show promise in managing knee osteoarthritis:

Platelet-Rich Plasma (PRP) Therapy

PRP therapy involves injecting a concentrated solution of platelets derived from the patient’s own blood into the affected joint. This treatment aims to promote healing and reduce inflammation. While more research is needed, some studies have shown promising results in reducing pain and improving function in knee osteoarthritis patients.

Stem Cell Therapy

Stem cell therapy is an experimental treatment that involves injecting stem cells into the knee joint to potentially regenerate damaged cartilage. While still in the early stages of research, this approach holds promise for future osteoarthritis treatment.

Wearable Technology

Advanced wearable devices can now track joint movement, provide real-time feedback on gait patterns, and even offer pain relief through electrical stimulation. These technologies may help patients better manage their condition and improve their quality of life.

Gene Therapy

Researchers are exploring the potential of gene therapy to modify the expression of genes involved in cartilage breakdown and inflammation. This cutting-edge approach could potentially slow down or halt the progression of osteoarthritis.

While these emerging treatments show promise, it’s important to note that many are still in the research phase and may not be widely available or approved for general use. Always consult with your healthcare provider about the most appropriate and evidence-based treatments for your specific condition.

The Importance of a Holistic Approach to Knee Osteoarthritis Management

Managing knee osteoarthritis effectively requires a comprehensive, multidisciplinary approach. While individual treatments can provide relief, combining various strategies often yields the best results. Consider the following components of a holistic management plan:

Medical Management

• Appropriate use of medications (oral and topical)
• Therapeutic injections when indicated
• Regular follow-ups with healthcare providers

Physical Interventions

• Customized exercise programs
• Physical therapy
• Use of assistive devices when necessary

Lifestyle Modifications

• Weight management
• Dietary changes to support joint health
• Stress reduction techniques

Environmental Adaptations

• Home modifications to improve safety and accessibility
• Ergonomic adjustments at work

Psychological Support

• Cognitive-behavioral therapy for pain management
• Support groups or counseling

By addressing all aspects of knee osteoarthritis management, individuals can achieve better overall outcomes and improved quality of life. How many of these components are currently part of your osteoarthritis management plan?

Remember, the journey of managing knee osteoarthritis is ongoing, and it’s essential to work closely with your healthcare team to adjust your treatment plan as needed. By staying informed about the latest research and treatment options, you can play an active role in managing your condition and maintaining optimal joint health.

The Best Way to Relieve Knee Arthritis Pain

There’s no shortage of medications that can be used to treat the pain of knee osteoarthritis, so you may feel confused about which treatment option is best for you.

Treatment of knee osteoarthritis can ease symptoms and slow degeneration. Watch: Knee Osteoarthritis Video

A meta-review of studies may shed some light on which oral or injectable medications are the most effective.

See Knee Osteoarthritis Treatment

Researchers compared 137 studies that involved more than 33,000 participants. These studies compared 10 common treatments for knee osteoarthritis, including over-the-counter and prescription non-steroid anti-inflammatory drugs (NSAIDs) and injectable medications.

¹
"Comparative Effectiveness of Pharmacologic Interventions for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis." Ann Intern Med. 2015 Jan 6; 162(1):46-54.

See: Pain Medications for Arthritis Pain Relief

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The results revealed the most and least effective treatments:

• Most effective: corticosteroid and hyaluronic acid injections
• Least effective: acetaminophen

So what does this mean for you? If you have knee osteoarthritis and have not tried corticosteroid or hyaluronic acid injections to relieve your pain, you may want to ask your doctor if it’s right for you.

See Therapeutic Injections for Knee Arthritis

Keep in mind that there are several non-pharmacological treatments that have been shown to help with the pain and mobility difficulties of knee OA, including:

• Knee exercises
• Physical therapy for knee OA
• Heat and ice therapy
• Topical medications
• Weight loss

See How Effective is Weight Loss for Treating Knee Arthritis Pain?

Another point to keep in mind is relieving the pain of a degenerating joint though medication—oral or injectable—does nothing to improve the condition of the joint. In fact, too many cortisone injections can actually harm the joint’s soft tissues, which is why your doctor will restrict how often you can receive them.

See Cortisone Injection Risks and Side Effects

In order to improve the joint’s condition, the best method is to use the window of pain relief provided by medication to get going with a physical therapy or exercise program.

Learn more:

4 Knee Stretches to Reduce Arthritis Pain

Why Do My Knees Pop?

Knee Osteoarthritis Symptoms

Stephanie Burke is the CEO, Co-Founder, and Editor-in-Chief of Veritas Health. She and her brother, Dr. Peter F. Ullrich, started Spine-health in 1999 with the vision of providing people with high-quality health information online.

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• 6 Little-Known Remedies for Knee Arthritis Pain

• Topical Pain Relief for Arthritis

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• How Effective is Weight Loss for Treating Knee Arthritis Pain?

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• Supplements and Medications for Knee Osteoarthritis Video

6 Little-Known Remedies for Knee Arthritis Pain

The first line of treatments for knee arthritis pain often include physical therapy, periodic rest, and non-steroidal anti-inflammatory medications. In some cases, these first-line treatments do not work, and people must continue to look for ways to reduce their knee pain. Below are 6 lesser known, nonsurgical treatments for arthritis knee pain.

See Knee Osteoarthritis Treatment

1. Switch from the Sidewalk to the Treadmill

Walking or jogging on a sidewalk made of concrete can be hard on the knees. A treadmill has a little more spring and decreases the overall compressive load on the knees. When walking on a treadmill, resist the urge to walk at an incline.

Walking on a groomed earthen trail (such as packed dirt) will have a similar positive effect.

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2. Get Shoe Inserts

When the foot under- or over-pronates, the knee joint can become misaligned. Specifically, the top of the tibia (shin bone) may not line up properly with the bottom of the femur (thigh bone). The misalignment causes friction and puts excess strain on soft tissues. A shoe insert can help correct under- or over-pronation, encouraging proper knee alignment.

A physician or podiatrist can help identify what type of insert is best suited for a person’s body mechanics. In some cases, a custom insert may be ordered.

3. Try Gait Retraining

Gait refers to how a person walks. Some people’s gaits produce poor knee alignment, which can lead to worsening knee arthritis and pain. A doctor or physical therapist can look at a patient’s gait and decide if specific changes to gait could make long-term differences in knee pain and joint degeneration.

A physical therapist can help a person change their gait. Some institutions have gait retraining programs.

Changing gait can be challenging and requires active thinking while walking. However, changes to gait can lead to positive changes to knee alignment, improved function, and possibly reduce pain.
Similarly, making changes to how a person climbs stairs can reduce knee pain.

¹
Yocum D, Weinhandl JT, Fairbrother JT, Zhang S. Wide step width reduces knee abduction moment of obese adults during stair negotiation. J Biomech. 2018 May 15. pii: S0021-9290(18)30350-6. doi: 10.1016/j.jbiomech.2018.05.002. [Epub ahead of print] PubMed PMID: 29776821.

4. Take Vitamin D

Several studies have examined the effects of taking vitamin D supplements on knee osteoarthritis. Results are generally mixed, with some studies suggesting a benefit and others not. More study is needed in this area, but some experts recommend that patients who have both low vitamin D and knee osteoarthritis try taking a supplement.

²
Khalaj N, Abu Osman NA, Mokhtar AH, Mehdikhani M, Wan Abas WA. Effect of exercise and gait retraining on knee adduction moment in people with knee osteoarthritis. Proc Inst Mech Eng H. 2014 Feb;228(2):190-9. doi: 10.1177/0954411914521155. Epub 2014 Jan 23. Review. PubMed PMID: 24458100.

5. Start a Food Journal

Certain foods can cause inflammation in the body. This inflammation can cause pain in the knees or other joints, particularly if there is already arthritis damage. Inflammatory foods can be hard to identify because:

• Which foods cause inflammation varies is individual, meaning it varies from person to person
• Inflammation may not appear for the day or two after eating the food

See An Anti-Inflammatory Diet for Arthritis

Keeping a food journal can help a person identify if specific foods or categories of foods, such as dairy, exacerbate knee pain.

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6. Lose Weight

Truthfully, losing weight is not a little-known remedy for knee pain. Rather, it is a well-known and effective but under-utilized treatment for knee pain. Weight loss takes pressure off the damaged knee joint.

See How Effective is Weight Loss for Treating Knee Arthritis Pain?

Specifically, losing weight reduces friction between the bottom of the femur (thigh bone) and top of the tibia (shin bone), where protective cartilage has been damaged or worn away. Losing weight also puts less strain on the knee’s soft tissues, including ligaments and tendons.

See Tips for Losing Weight to Treat Knee Pain

Patients interested in reducing knee pain through nonsurgical treatments are encouraged to talk to their doctor.

Dr. Lee Kneer is a physiatrist specializing in sports medicine and musculoskeletal injuries. He practices at Emory Orthopaedics & Spine Center and serves as an Assistant Professor of Orthopaedics at Emory University School of Medicine. Dr. Kneer has several years of experience in diagnosing and treating acute injuries.

• 1
  Yocum D, Weinhandl JT, Fairbrother JT, Zhang S. Wide step width reduces knee abduction moment of obese adults during stair negotiation. J Biomech. 2018 May 15. pii: S0021-9290(18)30350-6. doi: 10.1016/j.jbiomech.2018.05.002. [Epub ahead of print] PubMed PMID: 29776821.
• 2
  Khalaj N, Abu Osman NA, Mokhtar AH, Mehdikhani M, Wan Abas WA. Effect of exercise and gait retraining on knee adduction moment in people with knee osteoarthritis. Proc Inst Mech Eng H. 2014 Feb;228(2):190-9. doi: 10.1177/0954411914521155. Epub 2014 Jan 23. Review. PubMed PMID: 24458100.

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Editor’s Top Picks

• An Anti-Inflammatory Diet for Arthritis

• How Effective is Weight Loss for Treating Knee Arthritis Pain?

• Tips for Losing Weight to Treat Knee Pain

• Ways to Get Exercise When You Have Arthritis

• Knee Osteoarthritis Treatment

• Physical Therapy for Knee Osteoarthritis Video

Human papillomavirus – symptoms, causes, treatment

Human papillomavirus (HPV) affects epithelial cells and has a particle diameter of 55 nm. A feature is the proliferation of the epithelium of the skin, as well as the mucous membranes. At the initial stage, the pathogen usually affects the basal cells of the epithelium, penetrating into them through microtraumas. Localized papillomas are usually found on the skin of the neck, in the armpits, in the groin and on the genitals (most often), the oral mucosa and in the nasopharynx.

This virus can exist without symptoms for many years. To detect HPV, electron microscopic or molecular hybridized methods are used.

Human papillomavirus types

In humans, HPV is distinguished, which affects the mucous membranes and skin. Among a large number of papillomaviruses, species with low and high oncogenic risk are distinguished. It has been proven that oncogenic properties are associated with the ability to integrate DNA into the genome of human cells.

The virus is activated in 10-20% of cases. Depending on its type, it can lead to benign or malignant lesions. Some HPVs are not oncogenic. They lead to the appearance of warts and genital warts. The most common are HPV 6 and 11.

HPV oncogenes are those with a high risk of developing cancerous lesions, especially on the cervix or anus. With regard to the skin, HPV 16 and 18 are more common, as well as 5 and 8, which can lead to skin cancer. The best known form of cancer caused by HPV is cervical cancer. But men can also contract the papilloma virus, which in worst cases causes cancer of the penis or anus.

Often women encounter HPV 16 – this is a form in which introsomal parasitism is observed, that is, outside the cellular chromosome (benign). HPV 18 is characterized by a high risk of developing oncology – benign tumors are first formed, which after some time degenerate into cancer. Virions in this case are tiny in size (up to 30 nm).

Various types of HPV infections lead to:

• cervical neoplasms;
• invasive or pre-invasive oncology;
• genital warts of the urinary tract and genital organs.

Entering the pathogen into the body does not always lead to disease. It all depends on predisposing factors: increased sexual activity, beriberi, pregnancy, hypothermia, endometriosis, smoking, alcohol abuse, etc.
It should be noted that a viral infection can occur even in an organism with a good immune system.

Features of infection

The human papillomavirus is highly contagious. It is usually transmitted through direct contact, skin to skin or mucosal to mucosal, with an infected person. With a genital infection, it most often occurs during vaginal or oral sexual contact. A large number of sexual partners or other STIs (sexually transmitted infections) increase the risk. Indirect transmission through objects, contaminated clothing or bedding is also possible, but is quite rare.

In 7% of cases, mother-to-child transmission of the virus can occur during childbirth when the infection is active. The risk increases to 40% in case of infection with HPV 16 or 18.

Penetrating into the epithelium, violating the integrity, human papillomavirus infection promotes the growth of the lower layer of epithelial cells in the form of warts or warts. This form of the disease is contagious and quickly spread to others. As a rule, warts and condylomas do not cause metastases and often disappear spontaneously.

HPV symptoms

The incubation period lasts up to 9 months (average 3 months). HPV can be present in the body without obvious symptoms. The virus may go undetected for months or years. Even at this stage, it is contagious.

Skin warts usually occur in groups and increase in number when scratched. In the two most common forms, the papillomas are either greyish, hard, elevated, with a broken surface (common wart) or flat and reddish (flat wart). Prickly warts occur on the soles of the feet or on the heels, grow inwards and are therefore often painful.

The causative agents of genital warts occur in moist and warm areas of the body, therefore they are localized in the folds and on the mucous membranes. They can cause symptoms such as itching or burning. The incubation period, that is, the time between infection and the onset of symptoms, for genital warts ranges from 3 weeks to 8 months.
There are several forms of genital warts caused by different pathogens:

• Genital warts. Pale or reddish nodules that often appear in groups and occur on the labia, vagina, penis, urethra, anus, and rectum. They are highly contagious.
• Flat warts. They appear as flat nodes and are found mainly on the female genital organs. They increase the risk of developing cancer.
• Giant warts (Buschke-Levenshtein tumors). They grow into huge formations, destroying the surrounding tissues. In rare cases, they can degenerate and lead to squamous cell carcinoma.

Infection of the mucous membranes in the upper respiratory tract is also possible. The conjunctiva of the eyes may be affected, resulting in pink stem growths.
It is more difficult to detect an asymptomatic course, which the doctor can only see with the help of aids such as acetic acid (causes discoloration of warts) or a microscope.

In addition, the virus can also take up residence in cells without any tissue changes. Then they talk about a latent infection, that is, the presence of pathogens, but without symptoms. After infection, this phase can last from several weeks to several months.

Possible consequences

When infected, viruses penetrate into the cells of the integumentary tissue of the skin and mucous membrane, settle in the nuclei of cellular structures and multiply there. Usually, such HPV infections go unnoticed and heal on their own without consequences, as the immune system successfully fights the pathogen.

However, some types of HPV create skin changes, ie growths. Possible forms include genital warts or warts and papillomas, which may affect, for example, the face, arms or legs.

The resulting tissue changes are mostly benign, but can also degenerate and lead to cancer. For example, cancer can occur decades after HPV infection. Cancer of the external female genital organs (cancer of the vulva and vagina), anal cancer, cancer of the penis, and cancer of the mouth and throat (tumors of the head and neck) are also possible.

Diagnosis

An HPV test is performed on women as part of preventive visits to a gynecologist. During a gynecological examination, a smear is taken from the mucous membrane of the cervix, this is called a Papanicolaou test (cytological examination). The resulting material is studied for tissue changes to determine precancerous conditions.

In addition, an HPV test may be performed in which cellular material from a mucosal swab or tissue sample is tested in a laboratory for the presence of certain viruses. However, this allows only the infection of the affected area to be proven, and no statements can be made about whether tissue changes have occurred. Thus, an HPV test makes sense, especially when combined with a Pap test, and can help detect cancer precursors at an early stage.

If the test is positive, this is not a cause for concern, since infection does not always lead to cancer. Regular examination is recommended to detect tissue changes at an early stage. Conversely, a negative test result does not allow us to state whether there was an infection in the past that the body successfully fought against.

For men, there is no preventive screening where the test is carried out regularly. If there is a corresponding cancer, tumor testing can determine whether HPV infection underlies the cancer.

Specialized DNA techniques are also used in laboratory diagnostics such as real-time PCR. Anogenital warts caused by HPV types 6 and 11 are easily detected during a gynecological examination.

How to cure human papillomavirus

In most cases, the disease does not require treatment because it goes away on its own, and then no more viruses are found. However, if this is not the case, the infection may last longer and persist for months or years.

To date, there are no methods of systemic exposure to this virus, due to which it would be possible to completely destroy it. However, treatment of warts that have formed reduces the number of viruses, so in many cases the immune system can fight the rest of the viruses and thus get rid of them. In some cases, pathogens survive and can cause symptoms of the disease again and again.

Treatment depends on the type of HPV and associated disease pattern:

• Plantar and genital warts can be treated with topical salicylic acid-based drugs.
• Cryotherapy is also a method often used for HPV. In this case, the wart is burned with cold, using liquid nitrogen.
• Lasers or electrocautery are equally applied methods.

Since the recurrence rate is quite high, it is advisable to check yourself regularly and use condoms even after a few months after the lesions disappear, so as not to infect the sexual partner.

In the case of cancer caused by HPV, treatment is much more difficult. In cervical cancer, it is often advisable to remove the uterus, respectively the upper part of the vagina and the ovaries. This can be supplemented with radiation therapy to eliminate the possibility of recurrence. Other cancers caused by HPV are most commonly treated with targeted therapies, such as radiation or chemotherapy.

It should be remembered that the operation is not a cardinal solution, but only solves a cosmetic problem, because after removal, the virus is able to remain in the surrounding tissues and warts may appear again.

Prevention of infection

Two vaccines are available: a bivalent vaccine against HPV 16 and 18 and a quadrivalent vaccine against HPV 6, 11, 16 and 18. Vaccination is recommended for all young girls 14 years of age and older.

Vaccination does not protect against all types of HPV. Therefore, all women aged 25 to 65 years, even if they are vaccinated, are advised to have regular check-ups through a smear.

Timely detection and complete removal of genital warts reduces the risk of disease. The effectiveness of condom use in protecting against transmission can greatly reduce the risk of developing this disease. The most promising way to prevent and treat the initial stages of the disease caused by this infection is a specific polyvalent vaccine.

Literature:

1. https://www.msdmanuals.com/
2. https://medi.ru/info/8459/
3. https://cyberleninka.ru/article/n/papillomavirusnaya-infektsiya-klinika-diagnostika-lechenie
4. https://www.rlsnet.ru/articles_473.htm

Knee pain – what pharmaceuticals can help?

The knee is a unique mechanism that nature has endowed us with. The knee joint is both simple and complex at the same time, we live with it and, unfortunately, we often notice it only when it starts to hurt. Of all the joints in the body, the knee is at the highest risk of injury, wear and tear, and inflammatory disease.

The structure of the knee joint is not easy – it is a complex of ligaments, muscles, nerves, blood vessels, cartilage and bones. The basis of the joint is 3 bones: the femur (top), tibia (bottom) and the patella, or patella (in front). They are connected to each other by tendons and ligaments, the main task of which is to securely hold the bones and ensure the stability of the knee during any type of movement. The surfaces of the bones inside the joint are covered with cartilage, and all together it is surrounded by the articular bag, the inner shell of which produces synovial fluid into the joint cavity, which includes hyaluronic acid. Synovial fluid is essential for lubricating and nourishing the joint. It is its sufficient presence that ensures the ability of the knee to fully move, without pain and crunch.

The service life of cartilage depends on many factors: a person’s lifestyle, weight, nutrition, past injuries, work, and most often is 40-60 years.

The main symptoms by which you can understand that something is wrong with the knee are: swelling, a change in the temperature of this part of the body, impaired mobility of the joint, and, of course, pain during movement and even at rest.

Pain can be acute or chronic. Acute pain occurs suddenly, causes severe discomfort, accompanied by swelling and difficulty in movement. The most common cause is injury or overexertion.

Chronic pain – can last for a long time, is characterized by an undulating course: periods of inflammation and intensification of symptoms are replaced by remission, when pain in the knee may not remind of itself or manifest itself only as stiffness of movement in the morning. Chronic pain is more insidious. A person gets used to living with them, does not go to the doctor, and at this time the processes of destruction of the joint are hidden.

Why do my knees hurt?

1. Injuries:

• bruises;
• stretching;
• dislocations;
• fractures.

2. Degenerative-dystrophic diseases:

• arthrosis – “drying” and destruction of cartilage. Initially, pain appears, and then the range of motion decreases. The most common joint disease.
• osteochondropathy is a violation of the nutrition of bone tissue, which causes bone destruction.

3. Inflammatory diseases:

• arthritis – inflammation of the joint and periarticular tissue, which leads to joint deformity and cartilage destruction;
• bursitis is an inflammation of the joint capsule, due to which the amount of synovial fluid in it increases and its composition changes;
• tendovaginitis – inflammation of the synovial membranes of the tendon;
• synovitis is an inflammation that affects the synovial membrane of the joints and the sheath of the ligaments, in which excess fluid accumulates in the joint.

How to treat knee pain?

There is no one effective way to solve knee problems. We need a set of measures. Medicines, orthopedic products, physiotherapy exercises and physiotherapy are the main means that help to cope with the disease.

Before you get rid of the pain yourself, it is advisable to be examined by a specialist. The doctor will identify the causes of the disease and prescribe the necessary treatment for you.

Medicines and dietary supplements:

1. Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation of the joint. These are drugs containing diclofenac, meloxicam, ketoprofen, nimesulide and others.

2. Local irritants are topical agents in the form of ointments, gels or rubs that are applied to the skin of a problem joint. They relieve pain and have a pain-relieving effect. Also, due to the medicinal substances contained in their composition (methyl salicylate, allyl isothiocyanate, dimethyl sulfoxide), the capillaries of the skin expand, more oxygen enters the tissues and the removal of toxins is accelerated.

It should be remembered that locally irritating medications are used for chronic pain. With severe swelling and inflammation, you can not use them!

3. Chondroprotectors stimulate the formation of collagen, stop the process of cartilage destruction. They can be used in the form of injections, intramuscular injections and gels. These are drugs based on glucosamine and chondroitin.

4. Synovial fluid prostheses are substances that replace lost synovial fluid. They are administered by a doctor, by injection, directly into the joint bag. The main active ingredients used for these procedures are sodium hyaluronate and collagen.

5. Biologically active additives (BAA) are prescribed as an additional treatment. Most often, they contain plant components and methods of traditional medicine.

Knee orthotics.

1. The main orthopedic product is a knee brace. It is put on the knee joint and is designed to fix it, stabilize it, unload it and reduce pain when moving. Wearing a knee brace can significantly shorten the period of treatment and recovery of the knee. The range of knee pads is huge! We will talk more about how to choose a knee brace below.

2. In addition to knee pads, it is useful to wear orthopedic insoles, which reduce the shock load on the diseased joint and shorten the period of exacerbation. It is possible to choose insoles taking into account various additional features, such as: for different seasons, in different shoes, and so on. You can read more about insoles in the article.

Therapy.

1. Physiotherapy is a treatment with the help of devices and various procedures: laser therapy, magnetotherapy, current therapy, therapeutic massage, ultrasound, etc. The treatment is aimed at interrupting pain, reducing inflammation and accelerating joint recovery.

2. Exercise therapy (physiotherapy exercises) – special physical exercises during the period of treatment and rehabilitation, the most important task of which is to restore the blood circulation of the joint. And the normalization of blood circulation will restore the nutrition of the joint, eliminate the oxygen deficiency in the tissues of the joint, remove the edema and stabilize the joint.

In order for the pain to decrease already in the first day, you need to fix the joint and thereby remove the load from it when walking. This is what knee pads are for.

The knee brace is an important orthopedic device that shortens the period of treatment and rehabilitation, and may also be needed for permanent wear in case of chronic diseases of the musculoskeletal system. In our pharmacy you will find knee pads of various types, differing both in their functions and in price.

To make a decision: which of the knee pads to buy, you should understand how they differ from each other and what problems they solve.

Material .

Knee pads are made from different materials: natural and synthetic. The main requirement: to fix the joint well, to be wear-resistant, to pass air and moisture.

Classics are woolen and cotton knee pads. Wool has a massage and warming effect, improves blood flow to the joint, thereby reducing knee pain. Cotton “breathes” well and is comfortable when wearing the retainer for a long time.

An alternative to natural fibers is synthetic materials made using modern technologies. They are resistant to wear, hypoallergenic, durable and lightweight.

The most popular polyamide and elastane: provide air and moisture permeability, strength and lightness. Knee pads made of them do not rub in places of bends, do not wrinkle, dry quickly and are not subject to the formation of fungus.

Aeroprene or neoprene: has a pronounced massage and warming effect. And in order to prevent excessive overheating of the joint, they are perforated (with many micro-holes) throughout the surface.

The main difference between different knee pads is in the degree of fixation of the joint and in the design, due to which fixation is ensured.

The main principle of the use of orthopedic products: the more serious the damage, the stronger the fixation.

And we will start with products of easy fixation.

Light hold products.

Made from elastic fabric that helps reduce swelling, massages and reduces pain.

As a rule, this is bandage – elastic fitting knee bandage. Fits snugly to the leg and distributes the load on the joint, while maintaining full mobility. The degree of fixation of the bandage can be increased with the help of additional tension tapes.

Warming bandage – made of neoprene or knitwear with the addition of natural wool. It has micromassage and warming effects, enhances the effect of ointments, gels and other agents applied to the joint.

Important! Woolen bandages are not used in the acute period after injuries or in the first week of an exacerbation of a chronic disease – heat dilates blood vessels, and with them the focus of inflammation increases.

Medium hold products.

There are the most of these fasteners on the market. Also, like bandages, they are made of elastic materials. Often they have inserts: silicone or flexible metal.

Another name for them: Orthosis is a bandage that, due to a more complex design, coordinates the biomechanics of the damaged joint. Orthoses differ in their effect on the joint, which is provided by such structural elements as:

• Suprapatellar ring in the area of ​​the patella. The ring supports the kneecap, reduces swelling or prevents its occurrence.
• Stiffeners and metal plates. Thanks to them, the fixation of the joint will be even stronger. These inserts limit the “reeling” of the joint in a certain plane, prevent pathological movements and prevent the bandage from twisting.
• Detachable design. Facilitates donning, redistributes pressure above and below the knee.
• polycentric hinges. They are used in such a product as a brace. This is an even more complex orthosis that fixes the joint at a certain angle of extension. Adjustment of flexion/extension occurs simultaneously in different planes, which corresponds to the natural physiology of movements.
• Telescopic side rails. Allows you to adjust the height of the product.

Strong hold products.

The main task of such products is to immobilize the joint as much as possible for a certain time, to ensure the conditions of orthopedic rest necessary for treatment. They have powerful stiffening ribs and they are made of dense low-stretch or completely in-stretch fabric, because their main task is to immobilize the knee until it is fully restored. Also in such products there are additional belts for better fixation.
Splint or immobilizing splint – has no amplitude of flexion and extension of the knee joint, and completely limits the movement of the limb. Such devices are used instead of gypsum.

Warning! The degree of fixation of the orthosis on the first day after a severe injury is selected by the doctor.

How can I find out the size of the knee brace?

To choose the right size knee brace, you need to follow a simple algorithm of actions:

1. Measure the circumference of the knee joint (at the level of the patella), in a slightly bent position at the knee;
2. Measure the circumference of the leg 5 cm below and 15 cm above the kneecap.

Each manufacturer of goods on our website has its own size chart.

How to wear an orthopedic knee brace?

1. Carefully read the instructions on the packaging to avoid confusion;
2. Put on the orthotic immediately after sleep, before the leg begins to swell;
3. Sit in a comfortable position, bend your leg, and carefully place the brace on it so that the kneecap does not move. Tighten the straps starting at the joint;
4. Do not overtighten the leg with the straps. The product should sit tightly, but not to the point of pulsation.

If a knee brace is needed to prevent and relieve pain when moving, then it is better to wear it during activity. In this mode, you can use it for a long time – about 12 hours and periodically remove it.

The orthosis is worn approximately the same way: up to 12-14 hours a day. Unless, of course, the doctor prescribes otherwise.

If this is a splint, then you do not need to remove it – the doctor will determine the period of wearing.

Unfortunately, it is not always possible to prevent knee pain. And sometimes, after treatment, it can resume again and develop into a chronic one. Therefore, always remember about prevention and support measures:

• Move more. Walk, walk, use every opportunity to move! And of course, always warm up before your workout;
• Eat right.