If you google knee pain relief, you see a host of adverts from chiros, physios and some non medical doctors claiming to have the one size fits all solution to your knee pain. Hmm… We all experience knee pain as we age. As an avid runner, who used to wake up at 530am to do morning runs in my younger years, these days, i tend to get clicking sounds in my knee, and my left knee sometimes gives way when i climb stairs and chase after my forever active kids. *sigh* A sign that I am getting old.
What are home measures you can do to reduce symptomatic knee pain?
In my clinical practice, i share with my patients the RICE principle as a firstline non surgical option.
Rest your knee
Ice your knee
Tie a compression bandage around your knee
Elevate your knee
And watch your diet. Reduce your weight and you reduce the load on your knee. Exercise to strengthen your quads muscles. Supplement with painkillers and glucosamine.
And if all these fails after a trial of 3 months, you may consider the next step, which is HA injection to your knee joint.
What exercises can I do to help strengthen my knees?
- Sit on the floor with your legs stretched out. Place a folded towel under your knee. Press down into the towel for 10 seconds, then relax. Repeat this 10x per affected knee x 3 sets.
- Again sitting on the floor, you point your toes to the ceiling and raise your knee straight up 15cm from the floor. Hold for 10 seconds, then relax. Repeat this 10x per affected knee x 3 sets.
- Turn your toes inward 30 degrees, and repeat step 2.
- Turn your toes outwards 30 degrees, and repeat step 2.
What are the brands of hyaluronic acid injection that can help with knee pain relief?
- Synvisc
- Orthovisc
- Monovisc
Who are the best doctors for knee joint HA gel injections?
- Orthopedic surgeons who specialise in the knee
- Sports physicians who have interest in the knee
- Medical doctors with special interest in OA Knees
What is Synvisc?
Synvisc-One® (hylan G-F 20) is a hyaluronic acid injection. It supplements the fluid in your knee to help lubricate and cushion the joint, and can provide six months of osteoarthritis symptomatic knee pain relief.
What is the science behind hyaluronic acid injection into your knee joint?
In osteoarthritis, the joint fluid (called synovial fluid) in your keen can breakdown. Hence the volume is reduced, and your knee will lack the cushioning it requires. Hyaluronic acid supplements your knee joint fluid to relieve the pain and improve your knee joint’s natural shock absorbing abilities.
How safe and effective is Knee HA gel injection?
In the last 10 years, more than 5 million knee HA gel injections have been adminstered in the US.
What is Synvisc made from?
The injection contains a gel called hyaluronan derived from rooster combs. Hyaluronan is a natural substance found in our body, skin of your face etc. It is present in huge volumes in our knee, shoulder elbow joints etc. Our body’s own hyaluronan acts like a pocketed spring in our joints. It absorbs shock, cushions the impact of a landing and is required for smooth functioning of our joint.
Who is suitable for Synvisc?
Synvisc-One is suitable for people with mild – moderate knee osteoarthritis who experience persistent knee pain DESPITE diet, exercise and over-the-counter pain medication. It is not a magic bullet, and in majority of cases achieves relief for 6 months. In patients who this fails, the next step is surgical management.
How is Synvisc administered?
Synvisc-One is a single-dose 6ml treatment that is injected directly into your knee by YOUR doctor. It is a 5 min procedure done in an office sitting.
For synvisc, its a 2ml syringe, so 3 weekly sessions is adminstered.
Both last for 6 months and up, so repeat treatment can be adminstered in 6 months time.
Who provides Synvisc-One?
Synvisc-One is commonly administered by a specialist trained in treating knee osteoarthritis, such as an orthopaedic surgeon, a sports physician, a wellness lifestyle physician.
What is the cost of Synvisc-one in Singapore?
Prices start from $900 per syringe. Most patients knee 1-2 syringes over 6 months, for the affected knee.
What is the medical indication for HA injection to your knees?
Synvisc-One® (hylan G-F 20) is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics, e.g., acetaminophen.
Who are not suitable for HA injection into the knee?
Synvisc-One is only indicated for your knee. Pls tell your doctor if you have had an allergic reaction, such as swelling of the face, tongue or throat, respiratory difficulty, rash, itching or hives to SYNVISC or any hyaluronan-based products. Allergic reactions, some which can be potentially severe, have been reported during the use of Synvisc-One. Should not be used in patients with an infected knee joint, skin disease or infection around the area where the injection will be given, and should be used with caution when there is swelling of the knee ( effusion ) or legs due to problems with venous stasis or lymphatic drainage.
Tell your doctor if you are allergic to products from birds – such as feathers, eggs or poultry – or if your leg is swollen or infected, or pain worsens after injection.
Synvisc-One has not been tested in children (≤21years old), pregnant women or women who are nursing. You should tell your doctor if you think you are pregnant or if you are nursing a child. Talk to your doctor before resuming strenuous weight-bearing activities after treatment.
What are the side effects of Synvisc?
The side effects sometimes seen after Synvisc include (<2% each):
Pain, swelling, heat, redness, and sensation of fluid fullness around the knee.
This is temporary and dissipates with knee stretching exercises. Tell your doctor if you experience any side effects after treatment with Synvisc. Your doctor will prescribe you post care exercises to improve the distribution of your HA.
So I wish you a pain-free, stiffness-free, swelling free, knee boosting day, today, tomorrow, everyday.
– Dr Daniel Chang
Good write up!!
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