Do you suffer from chronic knee pain? Degenerative arthritis of the knees unfortunately is a very common and growing condition. As the knee cartilage grows older and supports more weight, it tends to degenerate and become thinner. This thinning of the knee cartilage as well as calcifications, which form as a result of wear and tear and trauma, contribute to the degenerative processes that occur in the knee.

Pain is initially intermittent, usually better with rest and worst with excessive walking or ambulating stairs. With time, as the cartilage further thins out and the structural integrity of the knee joint becomes compromised, fluid may accumulate inside the joint, further causing pain and discomfort.

There is no cure for “wear-and-tear” related osteoarthritis of the knee.  However, thankfully, there are many different therapeutic options now to help alleviate pain, improve range of motion, and enhance an arthritis sufferer’s quality of life.

Quadriceps muscle strengthening is very important and rheumatologists (arthritis specialists) instruct patients on how to achieve this via exercises and physical therapy. In addition, most rheumatologists are equipped to evaluate an arthritic knee with an ultrasound, to assess the extent of degeneration and to detect any fluid. Drainage of this fluid can be quite therapeutic. In addition, rheumatologists can inject corticosteroids directly into the knee joint while visualizing the joint with ultrasound guidance. If the above modalities don’t fully alleviate symptoms viscosupplementation is another option.

Viscosupplemenation is a procedure whereby hyaluronate, a naturally-occurring, lubricating, gel-like substance is injected into the knees.Due to the lubricating effects of hyaluronic acid, these injections allow bones to move over each other more easily, and serve as shock absorbers.

The technique was originally used in Europe and Asia, and became FDA-approved for knee osteoarthritis in 1997.It has been shown to be effective in many patients who do not improve with other non-surgical therapies.

Currently, there are five FDA approved hyaluronates which include: Hyalgan, Supartz, Synvisc, Euflexxa, and Orthovisc.The number of injections performed varies with the type of viscosupplement used; most require three to five injections for optimal response.

Knee Pain
Dr. Mahsa Tehrani

Dr. Mahsa Tehrani, M.D.  is co-founder of Arthritis and Rheumatology Clinical Center of Northern Virginia located in Fairfax. Dr. Tehrani is double board certified in Internal Medicine and Rheumatology.  She can be reached at 703-734-2222.

Arthritis and Rheumatology Clinic of Northern Virginia proudly serves  Vienna, Tyson’s Corner, Fairfax, Great Falls, Mclean, Falls Church, Dunn Loring, Sterling, Herndon, Chantilly, Reston, Ashburn, Leesburg, Burke, Annandale, Arlington, Oakton, Washington D.C., Bethesda, Potomac, Silver Spring, Gaithersburg, Rockville and more.