The human knee is made up of three bones, namely the femur, tibia, and patella, or kneecap. Between these bones is a soft material called cartilage, which acts as a cushion. If you have a certain disease such as osteoarthritis, the protective cartilage will deteriorate so that the bones of the knee rub against each other and produce a crackling or popping sound called crepitus, which can be accompanied by pain. Here are some strategies to prevent and treat this painful condition.
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Part 1 of 2: Treating Knee Crepitus Due to Osteoarthritis
Step 1. Recognize the symptoms of osteoarthritis
In contrast to the "normal" popping sound that usually occurs when stretching and is painless, knee crepitus from arthritis is very painful. Fortunately, there are several ways to detect osteoarthritis:
- Look for symptoms of pain, redness, swelling, and stiffness while walking. The most common site of crepitus from arthritis is on the inside of the knee.
- Feel the presence of crepitus by placing one hand on top of the other while flexing and straightening the joint. Usually, crepitus produces a soft and crunchy sensation.
Step 2. Relieve local swelling
If the crepitus is accompanied by pain and symptoms of inflammation, apply an ice pack wrapped in a towel to the painful area. The ice pack will relieve the swelling of the inflamed area and relieve the existing pain.
- You should also take a small amount of a commercial non-steroidal anti-inflammatory drug (NSAID or non-steroidal anti-inflammatory drug) such as Ibuprofen or Naproxen for quick pain relief. However, do not rely on these drugs for long-term pain relief because they can affect the kidneys and small intestine.
- The advantage of NSAIDs (which are anti-inflammatory drugs) is that they not only reduce pain, but also reduce inflammation.
- You can combine an NSAID with a commercial pain reliever such as acetaminophen. This medication does not reduce inflammation, but it can help reduce pain; The combination of taking NSAIDs and acetaminophen can be very effective and helpful in your daily life.
Step 3. Get a prescription for anti-inflammatory drugs
Some prescription NSAIDs include Indocin, Daypro, Relafen, and various others. Prescription NSAIDs are stronger than commercial drugs and more effective in treating and fighting pain and inflammation from knee crepitus. However, this drug requires a doctor's prescription which means that your knee crepitus will need to be tested clinically.
Prescription NSAIDs have side effects, usually stomach irritation, but in severe cases (and overdose), they can cause stomach ulcers and kidney damage. Always take the drug according to the dose, and do not exceed the doctor's recommendations
Step 4. Get a cortisone shot
Cortisone is a steroid hormone that is naturally produced by the body in response to stress. (Note: this steroid is not the type that athletes and bodybuilders typically use or abuse.) For very painful crepitus, doctors may choose to inject cortisone directly into the knee joint to reduce pain and inflammation.
- Cortisone injections have been shown to be useful in treating periodic recurrences of knee crepitus. However, frequent and repeated injections can actually worsen the cartilage, making the pain of crepitus worse. This is why cortisone injections are not suitable as long-term treatment.
- Cortisone injections should not be taken more than once every three months, but can be used as long as they are effective, which in some cases can take years.
Step 5. Undergo a treatment called "viscosupplementation"
A substance called "synovial fluid" in the knee joint is used to lubricate and stabilize joint motion. In some people with osteoarthritis, the synovial fluid is "thin," which means it's less thick. This causes increased knee friction and abnormal joint motion. In this case, the doctor may suggest "viscosupplementation", which is a procedure that injects new fluid into the knee to strengthen and lubricate the knee joint.
- Usually, this treatment is done in a series of 3-5 injections over several weeks.
- It should be noted, of all patients undergoing " viscosupplementation ", about half the symptoms of pain are reduced.
Step 6. Put on the knee brace
Special medical braces are sometimes given to people with knee arthritis. This brace shifts some of your body weight away from your knee, where crepitus usually occurs. A knee brace can also stabilize and support the knee joint, ensuring it doesn't bend incorrectly, and protecting it from further damage and irritation.
Although commercial knee braces can be purchased cheaply, most medical quality braces must be designed to fit the joint and are therefore more expensive. Consult the price of this brace with your doctor if you are interested in wearing it
Step 7. Discuss surgery options with your doctor
In cases of severe crepitus associated with arthritis, sometimes surgery is necessary. If your daily life is getting worse due to knee pain and you've tried non-surgical options, talk to your doctor about knee joint surgery.
- There are several types of knee surgery that your doctor can suggest. Some of the common options include total or partial knee replacement, and knee osteotomy.
- Note that knee surgery that works for one patient may not be effective for another. Arthritis is known to be difficult to treat, so make sure you discuss it with your doctor before making a decision.
Part 2 of 2: Preventing Knee Crepitus from Worsening
Step 1. Make sure the diagnosis is correct
Knee pain can result from a variety of diagnoses, including osteoarthritis (due to mechanical “wear and tear” of the knee joint over time, which is common), rheumatoid arthritis (caused by an autoimmune disorder), infectious arthritis, old knee injuries, or patellar dysfunction. Doctors are key in making the right diagnosis because the best course of treatment and management depends entirely on what's really going on in your knee.
For example, if your diagnosis indicates you have osteoarthritis, but treatment doesn't work, talk to your doctor to find other potential diagnoses
Step 2. Manage your weight
For every gram added in body weight, the load on the knee joint will increase. So, people with excess weight tend to be more prone to arthritis than people with a healthy weight. To prevent joint pain (and reduce existing symptoms), try to maintain a healthy weight, primarily through diet as exercise needs to be limited due to joint pain.
People with arthritis should reduce their consumption of processed or fried foods, sugar, refined carbohydrates, salt, preservatives, and corn oil because all of these can exacerbate joint inflammation directly or through weight gain
Step 3. Practice
The muscles in the joints act as shock absorbers and help support and stabilize the joints during activities that require physical strength (such as during sports and exercise) and in everyday life. The stronger the knee joint muscles, the greater their absorption capacity for impact. To help prevent crepitus (and reduce it, if you already have it), gradually strengthen the muscles through strength training.
- For knee crepitus, thigh contractions are a great exercise to strengthen the muscles in the knee joint. Place a rolled-up towel under your knees and tighten your thigh muscles. Hold for 5 seconds and relax; repeat 10 times.
- Isometric exercises such as straight leg raises (with locked knees), quad sets, or wall sits can strengthen a joint while limiting movement in the associated joint. This exercise prevents the deterioration of the joint condition so that it is less painful and inflamed.
- Light impact cardio exercises such as cycling or swimming can also be done (recommended at least 3 times a week) to increase the strength of the thigh and calf muscles. This exercise also helps to lose weight so that the pain of crepitus can be reduced.
Step 4. Try a combination of ice and heat
Both have been shown to reduce pain associated with knee crepitus. Try experimenting with cold and/or hot compresses to find what works best for you.
Step 5. Consider the use of dietary supplements carefully
Certain nutritional supplements, including glucosamine sulfate and chondroitin sulfate, are commonly used by people with arthritis to treat and/or prevent crepitus. However, this supplement has not been regulated by the Indonesian Doctors Association and is still not scientifically proven. In addition, there is not much information regarding the side effects of long-term use of this supplement. Clinical studies are underway to assess the suitability of this supplement for its medical use. Meanwhile, consult with your doctor about the use of this supplement before using it.
