Wounded Knee: Which Doctor Do You Call When Your Knee Hurts?

Knee Pain? When you’re knee(s) hurt, where do you turn?  – Guest post by Angie Picardo.

knee pain

National Institute of Health

A knee injury can make you feel a hundred years old, even if you’re only twenty-five. Grounded. Stopped in your tracks. It takes an emotional toll.

You watch your days of carefree jogging flash by in the review mirror. Skiing is a distant memory. Tennis looks iffy. You shelve your stilettos in favor of flats. Struggle to wrap your entrepreneurial sights around the concept of the cane as a fashion accessory.

In the middle of a business presentation, a five-foot long Ace bandage unfurls itself beneath your pants leg and falls onto the floor.

You’re not alone. You’ve entered the world of knee pain, ubiquitous side affect of an active lifestyle. Weekend warriors often strain muscles and self-medicate with OTC pain relievers, patches, and packages of frozen peas. The classic recipe for a minor sprain is RICE: Rest, Ice, Compression, and Elevation.

Knees are not like knuckles. If you hear a pop, get yourself to a doctor. That popping sound is a sign of serious injury. It won’t get better on its own.

No-brainer: If you suspect your knee is broken, or it’s swollen so badly you can’t stand or walk without limping, go to the ER.

Which doctor do you call? Searching for the right doctor can be the worst pain of all, since you don’t know where to start—orthopedist, sports doctor, neurologist, chiropractor – too many choices can make your head spin, and your knee still hurts.

For serious knee injuries, you need an orthopedist. Yes, that’s an orthopedic surgeon, but they won’t wheel you into the operating room the minute you walk in the door. If you hurt your knee during sports, or a bout of clumsiness (been there!), and you can barely stand—you may have torn a tendon or ligament.

Your chiropractor can treat less serious knee wounds, like strains or sprains, and ameliorate the persistent pain of arthritis. Chiropractors can apply what they call “conservative” treatments to alleviate pain after surgery—diminishing the need for medication. A chiropractor that specializes in Sports Medicine is a great option.

In the words of Dr. Nick Campos, a sports chiropractor in California: “Chiropractic sports rehabilitation is phenomenal for treating certain injuries and chronic pain; however, some injuries fall outside the scope of chiropractic. Those that do, usually require the help of an orthopedic surgeon.”

One of the injuries that can heal with chiropractic is a torn meniscus. And if it doesn’t, you’ve only postponed the inevitable surgery. It’s worth a try!

A Sports Medicine Doctor, a.k.a. Orthopedic Surgeon who specializes in athletic and exercise related injury treats conditions of the bones, muscles, joints, nerves, tendons and ligaments. The Sports Medicine category also comprises Trainers, Chiropractors, and Physical Therapists. Wonderful when you need them. Most knee injuries require a trip to the Orthopedic Surgeon.

You’ve watched football games where a star athlete limps off the field with a hurt knee. He goes straight to the (Sports) Orthopedic Surgeon, gets that wound fixed, does physical therapy, and six weeks later he’s back in the game. Surgery is not for everyone, but it’s the fastest way to get back into athletic activities. That’s not to say you won’t still have pain.

A neurologist? While your family practice or general physician can rule out systemic conditions like infection, gout, or arthritis through blood tests, X-rays, or a visual exam, some patients suffer from chronic pain—even after successful surgery and physical therapy. That’s when a neurologist might prescribe meds for conditions like neuropathy. A sharp, electric shock in the knee may be due to damaged cartilage rather than nerves. Call an orthopedist first.

Rehabilitation: After knee surgery, or in lieu of it, the first steps toward healing will be treatment with prescription anti-inflammatory medications and Physical Therapy—not the type of exercise that gets you a better swimsuit body— but specific moves essential to alleviate pain. Your Physical Therapist will guide you through a program to strengthen the muscles that support your knees, especially the quads and hamstrings. Health plan coverage varies, but PT is an investment in your quality of life.

Here’s where Chiropractic comes in, too. Goodbye Lotus, Hello, Pilates! With a hurt knee, you can’t always do what you did – like your favorite sports. Even yoga can be tough on knees. Don’t try to “breathe through” the pain. When it comes to your joints, the “no pain, no gain” mantra is bad advice. Some physical therapists have adopted the system Joe Pilates developed in the early 20th century to treat injured dancers. The Pilates workout elongates and strengthens muscles, corrects imbalances caused by injury – especially those of the knee, ankle, and back.

A Few Common Knee Conditions—take these to a doctor:

Tendonitis – inflammation of the tendons around the knee. Extremely painful due to excess accumulation of fluid that leads to swelling and stiffness. Treat with PT and meds: Othopedic, Chiropractic.

Osteoarthritis: Degeneration of joints from overuse, obesity, and inflammatory conditions. Often leads to knee replacement surgery.

Meniscus Tear: cartilage tears when the knee is bent and twisted. Sometimes requires surgery. May heal with meds, Chiropractic, and PT.

Unhappy Triad: Damaged Meniscus, ACL, and MCL: Football players get this when hit from the side. You need an Orthopedic Surgeon.

Knee Sprain, Muscle Strain: minor but painful. PT helps. Use protective measures like wrapping the knees with Ace Bandages prior to sports activity. Use “RICE” afterwards, Chiropractic.

Water on the Knee: Accumulation of fluid, often caused by injury or Arthritis. Can get so painful you can’t bend or stand on it. Orthopedist.

Runner’s knee:  Irritation of the cartilage under the kneecap. Chiropractic, Orthopedist. Untreated infections can destroy your joints. The aftermath of a tick bite can mimic symptoms of Arthritis. Untreated, the pain can last for years. See your family physician.

Will you ever run again? Maybe. Athletes play sports in spite of pain. With advances in surgery and physical therapy, many recover to an optimum level. Take smart precautions, like wearing braces during sports activities. Use RICE afterward. It lessens swelling, bruising, and pain.

Supplements and Natural Remedies? Check with your doctor first. DO NOT use any supplements prior to surgery. They may increase bleeding. There are conflicting studies, so the verdict is still out on the following supplements: Glucosamine Sulfate, Condroitin, and MSM to support cartilage repair. Fish Oil and Flax Seed Oil for inflammation; Turmeric and Bromelain for arthritis.

Is there any “cure” for knee pain? Yes and no. Physical Therapy may prevent or delay knee replacement surgery. It’s a lifetime commitment, so you won’t have a stopping point, much like brushing your teeth. The benefits far outweigh any inconvenience.

Prognosis:  Chances are, those stilettos in your closet will still be in style when you’ve recovered, but even so, lookout for grates in the road. You may ski again, but skip the moguls. Now and then, you’ll step off a curb, land too hard, and your knee will complain, but remember: pain management is hard work. A sense of humor never hurt. Nothing lasts forever, not even pain… And certainly not knees!

RESOURCES: (Besides personal experience!):

Great article by Dr. Nicolas Campos: Most knee injuries require a trip to the Orthopedic Surgeon. http://www.drnickcampos.com/health-newsletter/Meniscus.htm

Torn Meniscus: http://orthopedics.about.com/cs/meniscusinjuries1/a/meniscus.htm

Yoga Postures That Are Bad For Your Knees: http://www.livestrong.com/article/387607-yoga-postures-that-are-bad-for-knees/

Bromelain for arthritis: http://www.livestrong.com/article/394864-bromelain-dosage-for-arthritis/

Health Benefits of Turmeric and Bromelain: http://www.livestrong.com/article/369227-the-health-benefits-of-turmeric-and-bromelain/

What is Water on the Knee? http://orthopedics.about.com/od/kneesymptoms/f/waterontheknee.htm

Condroitin studies, University of Maryland: http://www.umm.edu/altmed/articles/chondroitin-000293.htm

Angie Picardo is a staff writer for NerdWallet. Her mission is to help consumers stay financially savvy, and save some money with a free online checking account. Angie is not a physician and does not provide medical advice. Rights Radio does not provide medical advice. However, we extend appreciation to Angie Picardo for her excellent research and comprehensive article. This post is copyrighted by Angie Picardo and Rights Radio, 2013, All Rights Reserved.