The Second Most Common Cause Of Knee Pain
January 21, 2010
The other day, I got another email from one of my subscribers, who had an interesting, but not uncommon story. Seems he had knee pain located right on his inner (medial joint line). He saw his doctor, and was sent for an MRI.
Sure enough, he had a torn medial meniscus. He also had some degenerative changes (read that as “early arthritis”), not uncommon in a middle aged guy. His question for me was, do I REALLY need to have an arthroscopic surgery?
He was understandably reluctant to go “under the knife,” and was hoping that I could give him some less aggressive treatments that would relieve his pain, but help him avoid surgery. He also didn’t understand why these structures simply didn’t heal.
So, I tried to explain. I used to have to do this a dozen times a week, in my practice–meniscal injuries were the second most common cause of knee pain that I saw, after kneecap problems. So here’s the short story.
In each knee, there are two crescent shaped fibrocartilage structures that guide and cushion the knee in motion. They help to spread out the stresses of weightbearing over a larger surface area, kind of the way snowshoes work to keep you from sinking into a snow bank.
I have a great illustration of this principle in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN http://www.drbillsclinic.com/eliminate_knee_pain.html which I drew myself. (I used to work for the comics as an artist, back in the 70′s.)
Here’s the thing he didn’t understand, though, that makes all the difference: These structures are mostly avascular. That means that they mostly lack a blood supply. There is virtually no circulation within these cartilage cushions, at least in the inner 2/3 to 3/4. There IS a marginal circulation at the periphery, where the medial (but NOT the lateral) meniscus attaches to the fibrous capsule of the knee joint.
If a tear occurs within this so-called “red zone,” it does have the potential to heal. But only 10% of tears occur there. The remainder occur in the avascular part, and therefore CANNOT heal (at least not without fairly sophisticated surgical help), because nothing heals without blood.
This anatomical fact governs the behavior of meniscal tears AND determines what constitutes effective treatment.
Given that he has a positive MRI, he probably SHOULD have an arthroscopic examination. If pathology is confirmed at surgery, it can be fixed on the spot. This is a prime example of what I like to call a NECESSARY surgery. And, it’s a simple, outpatient procedure, with a fairly rapid recovery. I know. I’ve not only done thousands of them, but I’ve had the surgery myself, too.
Had he presented with the same pain pattern, but NOT had an MRI, I probably would have urged him to try the non-surgical treatments I teach in my healing program, HOW TO AVOID KNEE SURGERY, which you can get here:
http://www.drbillsclinic.com/avoid_knee_surgery.html
With methods from across the entire medical spectrum, including many effective alternative treatments, it can provide relief of pain and help you avoid surgery, in many cases.
In this way, if pain is relieved, you’ve avoided an UNNECESSARY surgery. If not, you’ve “burned no bridges” and can still get an MRI and if that is positive, arthroscopy, if needed. But it gives your knee a chance to heal itself.
Except in case of a completely locked knee, which is a surgical emergency, it can buy you time, perhaps heal you, and you lose nothing.
For other causes of knee pain, like chondromalacia patellae, or arthritis of the knee, it may be definitive treatment. I teach you how to relieve pain fast, but also how to stay pain-free for the long term, with special, modified exercises and the anti-inflammatory properties of my pharmaceutical grade fish oil, DR. BILL’S POWERHOUSE OMEGA FORMULA: http://www.favoriteformulas.com
an ultra pure, highly concentrated omega 3 formulation, with a special enteric coating that prevents virtually all the fishy aftertaste and fish burps that plague other, lesser brands.
But in this man’s case, he already had a demonstrated, through and through tear in the avascular zone. The probablity of healing was poor to none. And further delay would accomplish nothing good, but might result in degenerative damage to the articular cartilage, which is permanent damage. This must be avoided.
THAT’S why I recommended that he proceed with surgery. And now, you can understand the thought processes that led me to that conclusion, too.
In the end, judgment has to be based on the anatomical and pathological facts. And that’s another good reason to get your doctor involved early in the course of your knee problem. Til next time, my friend, be well.
Yours for a pain-free tomorrow and optimal health,
Dr. Bill
“The Wellness Warrior” TM
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
http://drbillsclinic.com/exercise_eliminate.html
P.P.P.S. For conventional and alternative treatments and exercises to relieve knee pain without surgery click on http://drbillsclinic.com/avoid_knee_surgery.html
P.P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
http://drbillsclinic.com/advanced_masters.html
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
Copyright, 2010 by William Thomas Stillwell, MD, FACS
All rights reserved
Tags: anti-inflammatory, avoid surgery, knee pain, knee pain exercises, meniscus, non-surgical treatments, pharmaceutical grade fish oil, relieve pain, torn medial meniscus