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Do You Have Chronic Knee Pain?

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Treating Chronic Pain With Chiropractic

Chiropractic care is an essential part of a broad-based approach to the treatment of various types of chronic musculoskeletal pain. Medication alone is never an effective solution to chronic pain because it does not address the underlying causes of the problem. On the other hand, if biomechanical issues are a component of the overall cause, chiropractic care is able to provide a great deal of benefit.

Chronic musculoskeletal pain often has its origins in spinal misalignments. These restrictions in spinal joint mobility may be due to long-term postural problems or to an old injury - often a motor vehicle accident or fall, or perhaps a severe back spasm that was triggered by bending-and-lifting and never completely healed. If spinal misalignments persist, other structures begin to compensate. Sacroiliac joints and ligaments get tight. Hip joints will eventually lose some mobility. Knee and ankle motion are compromised, and eventually chronic back pain, hip pain, and/or knee pain develops.

Chiropractic care addresses the cause of these many problems by analyzing, identifying, and correcting spinal alignments. As the biomechanical function of your spine improves, so does the mobility of all other weight-bearing joint such as your hips, knees, and ankles. As a direct result of chiropractic care, chronic pain begins to reduce and resolve.

Chronic knee pain is well-known for being difficult to treat successfully.  People with chronic knee problems often become discouraged as they consult specialist after specialist - rheumatologists, orthopedist and others - often with little to no improvement.  The lack of progress becomes more understandable when one realizes that typical evaluation and treatment are directed at the symptoms rather than the cause. But, as is also the case with most other pain syndromes, it is usually most beneficial to address the underlying biomechanical problems instead of the trying to cover up the symptoms.
Poor biomechanics are at the root of many chronic knee problems. Of course, it is important to rule out various other diseases and orthopedic conditions which can also cause the same type of ongoing pain. Rheumatoid arthritis, lupus, and ankylosing spondylitis are a few rheumatologic conditions which may result in sporadic or chronic knee pain.1   
However the most common cause of chronic knee pain is osteoarthritis or "wear and tear" arthritis. But what cause the excessive wear and tear and pushed the osteoarthritis to a chronic state establishing a diagnosis of biomechanical knee pain. Osteochondritis dissecans, a torn meniscus, and synovial effusion are all frequently encountered in persons over age 40 with chronic knee pain. 
When these medical entities have been eliminated as possibilities, a biomechanical causation becomes likely. How does a person develop "faulty biomechanics"?  The majority of us have never received effective instruction in how to use our bodies properly. We sit and stand in all sorts of unsound postures, slumping, slouching and just generally giving in to every available force of gravity. We stand with all our body weight on one leg or the other, neck and shoulder muscles gripped tightly and abdominal muscles sagging and protruding. When we sit we slump down, stressing the lower back with poorly tolerated mechanical forces, and many of us regularly sit for hours with legs crossed, stressing the knees as well as the hips and low back.
Over the course of a lifetime, our bodies have continually tried to adapt to a range of inefficient and stressful postures and habits. But eventually no more adaptation is possible.2 The result is that muscles, tendons, ligaments and joints eventually break down and fail. We experience this failure as pain. And once this type of pain has started, it is not going to go away unless the underlying causes are corrected. Specifically, the person's biomechanics need to be restored closer to normal.
Correction of posture takes time and can only be accomplished gradually. The key is to learn what to do, learn how to do it, and to be working on posture every day.3 The most important thing is to begin. Three basic biomechanical corrections are as follows: (1) When standing, be sure to have your weight over the balls of your feet and to have your weight evenly distributed on both legs. (2) Activate your deep abdominal muscles by visualizing an "inner lift". (3) Have straight lines of force running down your legs (rather than lines of force crossing at your knee, creating torsion and tension). Visualize "straight energy" flowing from your hip sockets, straight down through the center of your knees, straight down to your feet, between your first and second toes.

Visualizing and implementing these three biomechanical corrections on a daily basis represents the first series of steps toward improving knee mechanics and reducing chronic knee pain.

If you have an area where you can safely walk barefoot - ideally in soft grass or on a sandy beach - this can be very helpful for restoring proper biomechanics to your feet, knees and hips.  If you are allergic to bees and/or other insects, walking barefoot is probably not worth the risk.  But if you're not and you have a safe place to walk barefoot, you should notice the benefits from even a short barefooted walk, as your body often easily begins to adapt a more natural gait.

1Yusuf E, et al: Do knee abnormalities visualised on MRI explain knee pain in knee osteoarthritis? A systematic review. Ann Rheum Dis 70(1):60-67, 2011
2Suri P, et al: Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 62(12):1715-1723, 2010
3Bennell KL, Hinman RS: A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport 14(1):4-9, 2011

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