| A sixty-five-year-old recently retired man came in with right knee pain. I had previously treated him for arthritic changes in the left knee, which eventually required a total knee replacement due to intractable pain. There was a history of two low-back fusions, rotator cuff repairs at both shoulders, bilateral carpal tunnel releases, and recent surgery for an enlarged prostate. He awakened one morning and the pain was there. An x-ray showed moderate osteoarthritis (normal aging changes). Treatment was standard. |
| Her past medical history included attention deficit disorder, depression, migraine headaches, and chronic bilateral knee pain, precluding physical education class in school. Further history revealed poor school performance and drug and alcohol use. Her father left home when she was an infant and the patient never met him. She lives with her mother, who has had numerous male relationships.
In contrast to the first patient with neck pain, this patient has a number of factors that point toward a psychosomatic etiology of her neck pain. First, her pain developed two days after the accident. |
| A fifty-five-year-old woman came to my office complaining of a right knee pain she awoke with approximately one month earlier. She had recently convalesced from low back surgery for sciatica, and upon becoming more active, her knee became extremely painful. Prior to her back surgery, she underwent a total left knee replacement due to osteoarthritis. Her past history also included bilateral carpal tunnel surgery, a total hip replacement due to osteoarthritis, plantar fasciitis, obesity, chronic obstructive pulmonary disease from heavy smoking, and depression. |
| I believe this patient's knee pain was closer to the structural end of the spectrum.
THOUGHTS ON TREATMENT OF PSYCHOSOMATIC DISORDERS
Acceptance and understanding are the foundation for successful treatment of a psychosomatic disorder. When patients request an appointment with me to treat their musculoskeletal disorder through the methods outlined by Dr. Sarno, they are first screened by a phone conversation to determine their level of acceptance and ability to understand the basic principles of a psychosomatic disorder. Their one-hour visit with me consists of the following:
1. |
| In another case a seventy-six-year-old man came to me with moderate right knee pain and swelling after going up and down a ladder putting up Christmas lights. In the past he had occasional aching in his knee if he "overdid it." Physical examination revealed a small effusion of the knee, decreased range of motion, and pain with flexion. Radiographs revealed severe osteoarthritis of both knees. The patient received a cortisone shot in his knee, and his pain resolved, except for the occasional intermittent aching he described earlier. |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
See book keywords and concepts |
 Another reader discovered an odd side effect when she started taking turmeric for knee pain. Her desire to gamble disappeared. This has not shown up anywhere in the medical literature. One might even dismiss it as totally ludicrous, except the opposite effect has also been reported. Some patients on a drug to treat Parkinson's disease have experienced a compulsion to gamble.9
"* All my life my knees have ached at night. I would use Aleve, arthritis-strength aspirin, or Tylenol and usually woke up and had to take more about 3 a.m. |
Mark Blumenthal
See book keywords and concepts |
 Alpinia galanga] rhizomes) or placebo
Ginger extract produced greater reduction in the primary efficacy variable, knee pain on standing, compared with placebo (63% vs. 50%; p= 0.048). Ginger extract also produced a greater response in the secondary efficacy variables compared with placebo, when analyzing mean values: reduction in knee pain after walking 50 ft (15.1 mm vs. 8.7 mm on a visual analog scale; p=0.016), reduction in the Western Ontario and McMaster Universities OA composite index (12.9 mm vs. 9.0 mm on a visual analog scale; p=0.087). |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
See book keywords and concepts |
| One well-conducted clinical trial published in the journal Arthritis and Rheumatism reported that a standardized, highly purified ginger extract reduced knee pain.140 The product is made by the Danish company Euro-vita and sold under the name Zinaxin. Because this is such a concentrated ginger formula, side effects and drug interactions (especially with anticoagulants) are possible. Some subjects reported belching, indigestion, and nausea related to this formulation.
Another herb for rheumatism is stinging nettle (Urtica dioica). |
| The researchers reported: "All patients receiving drug [boswellia] treatment reported decrease in knee pain, increased knee flexion, and increased walking distance."138
Side effects seem uncommon (digestive tract upset is one possibility), but there have been relatively few long-term studies of any of these anti-inflammatory herbs or spices. It is hard to predict the consequences of regular dosing at levels that are significantly higher than those found in food. It is also unclear whether compounds like curcumin or boswellia will interact with prescription medicines. |
Phyllis A. Balch, CNC
See book keywords and concepts |
 Good for knee pain. Caution: Do not take niacin if you have a liver disorder, gout, or high blood pressure. Especially for rheumatoid arthritis; vital for the production of steroids in the adrenal gland. Reduces swelling in tissue.
Vitamin B12
and folic acid
1,000 meg daily. 400 meg daily.
Needed for proper digestion, the formation of cells, production of myelin, and the protective coating surrounding the nerves. Prevents nerve damage.
Vitamin C
plus bioflavonoids
3,000-10,000 mg daily, in divided doses.
500 mg daily. |
Joseph E. Mario
See book keywords and concepts |
 Hip Joint disease Is indicated by knee pain.
Knee Joint Pain From trauma or overuse. Take Comfrey and Lobelia packs; 1000-3000mg. Bioflavonoids.
Knee Ligaments Massage and packs of Apple Cider Vinegar, Iodine, and Seasalt.
Housemaid's Knee/Bursitis Irritated bursa lubricant sac.
Runner's Knee Cartilage breakdown under the kneecap, esp. in people with inward-pointing feet; leads to dislocating the kneecap out of its groove.
Periostitis Inflammation of the bone-covering fibrous membranes; draw the infection to the surface with the Baunscheidt-Pyonex treatment; C lay poultices. |
| Microlight 830 laser is reported to relieve arthritic joint pain; neck, shoulder, lower back, and knee pain; torn knee cartilage, sprains, dry sockets, headaches, sinuses, gum disease, temperomandibular joint misalignment (TMJ), 2nd and 3rd degree bums, surgery and wounds, injured nerves, and 70% of carpal tunnel syndrome cases (by Dr. Wayne Good at General Motors). |
Mike Adams
See book keywords and concepts |
 The Egoscue Method, a postural correction system developed by Pete Egoscue, works wonders for Carpal Tunnel Syndrome as well as back pain, hip pain, knee pain and virtually any repetitive motion disorder. Visit www.Egoscue.com to learn more.
In terms of physical therapy, Carpal Tunnel Syndrome requires several things.
First, stop doing the motion that's causing the problem. If you have a job doing data entry, and you continue to follow the same repetitive motion that's causing Carpal Tunnel Syndrome, then step one is to stop doing the motion.
Step two is to rest those muscles and joints. |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
See book keywords and concepts |
| The investigators did report that "an exploratory analysis suggested that the combination of glucosamine and chondroitin might be effective in osteoarthritis patients who had moderate to severe knee pain." This subset of patients with worse pain did appear to get statistically significant benefit: 79.2 percent on G&C experienced pain relief compared to 69.4 percent on Celebrex and 54.3 percent on placebo. These results were not overwhelming, though, since the researchers were careful to qualify the data as "exploratory" and the result as "might be effective. |
Leo Galland
See book keywords and concepts |
 In most cases of chronic knee pain, the illness experienced by the patient is not directly caused by the disease identified by the doctor. The knee pain and its associated disability result from personal characteristics of the patient that determine the function of the knee joint, such as weakness of the thigh muscles. The most effective long-term treatment for knee pain is not rest and medication, but regular physical exercise. |
Bruce H. Lipton
See book keywords and concepts |
 A Baylor School of Medicine study, published in 2002 in the New England Journal of Medicine evaluated surgery for patients with severe, debilitating knee pain. [Moseley, et al, 2002] The lead author of the study, Dr. Bruce Moseley, "knew" that knee surgery helped his patients: "All good surgeons know there is no placebo effect in surgery." But Moseley was trying to figure out which part of the surgery was giving his patients relief. The patients in the study were divided into three groups. Moseley shaved the damaged cartilage in the knee of one group. |
Alan R. Gaby, M.D., Jonathan V. Wright, M.D., Forrest Batz, Pharm.D. Rick Chester, RPh., N.D., DipLAc. George Constantine, R.Ph., Ph.D. Linnea D. Thompson, Pharm.D., N.D.
See book keywords and concepts |
 Glucosamine has been used in connection with the following conditions (refer to the individual health concern for complete information):
Rating Health Concerns
*** Osteoarthritis (page 328) (glucosamine sulfate)
•k-kiz knee pain (glucosamine HCI)
•ktiix Minor injuries (page 319)
Osteoarthritis (page 328) (glucosamine HCI) Sprains and strains (page 412) Wound healing (page 319) (oral)
Who is likely to be deficient?
A glucosamine deficiency in humans has not been reported.
Which form is best?
Glucosamine is available in several forms. |
The Editors of FC&A
See book keywords and concepts |
| After three months, she had less knee pain and more flexible joints.
Treating OA with guggul is still experimental in the Western world, so see your doctor before trying it yourself.
Cat's claw. This Amazon herbal remedy seems to work as both an antioxidant and an anti-inflammatory, throwing OA a double punch. People in a recent study took either a placebo pill or 100 mg of freeze-dried cat's claw once a day. Within four weeks, those who received the herb felt less joint pain.
Some evidence suggests it could also protect your stomach from the side effects of NSAIDs. |
Heather Boon, BScPhm, PhD and Michael Smith, BPharm, MRPharmS, ND
See book keywords and concepts |
 Overall, significantly more participants in the ginger group experienced a reduction in knee pain on standing compared with the placebo group. Reduction of knee pain on walking and reduction in the Western Ontario and McMaster Universities osteoarthritis composite index were also noted. Another randomized, controlled double-blind, double-dummy, crossover study (with a 1-week washout period) compared the effectiveness of ginger (170 mg of EV.ext-33 extract), ibuprofren (400 mg) and placebo in 56 patients with osteoarthritis of the hip or knee. |
Leo Galland
See book keywords and concepts |
| In most cases of chronic knee pain, the illness experienced by the patient is not directly caused by the disease identified by the doctor. The knee pain and its associated disability result from personal characteristics of the patient that determine the function of the knee joint, such as weakness of the thigh muscles. The most effective long-term treatment for knee pain is not rest and medication, but regular physical exercise. |
Textbook of Natural Medicine 2nd Edition Volume 1Michael T. Murray, ND
See book keywords and concepts |
| Outcome measurements included knee pain at rest, at movement, and at pressure; knee swelling; overall improvement rated by the investigators, and adverse effects.
Knee pain (average score)
Time
Glucosamine sulfate Ibuprofen
Before treatment Week 2 Week 4
2 weeks after treatment
8.42 5.54 3.60 3.26
8.46 5.63 4.18 3.84
Knee swelling (average score)
Time
Glucosamine sulfate Ibuprofen
Before treatment Week 2 Week 4
2 weeks after treatment
1.43 0.77 0.47 0.36
1.48 0.89 0.48 0. |
Earl L. Mindell, RPh, PhD with Virginia Hopkins, MA
See book keywords and concepts |
| Vitamin C Saves Joint Tissues
A study from a researcher at Boston Medical Center in the journal Arthritis and Rheumatism reported that people with rheumatoid arthritis who had higher levels of vitamin C had significantly less progression of the disease and less knee pain, due to a reduction in the loss of cartilage. Cartilage is made from collagen, and vitamin C is a key component of collagen. You can take up to 3,000 mg daily in divided doses to prevent and treat arthritis. |
Mark Blumenthal
See book keywords and concepts |
| Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum. 2001 Nov;44(l l):2531-8. API. See: Ayurvedic Pharmacopoeia of India.
Arfeen Z et al. A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care 1995;23(4):449-52.
Ayurvedic Pharmacopoeia of India (API, Part I, Volume I, 1st Edition). New Delhi, India: Government of India Ministry of Health and Family Welfare Department of Health; 1989; 103-4.
Ayurvedic Pharmacopoeia of India (API, Part I, Volume II, 1st Edition). |
| Ginger extract also produced a greater response in the secondary efficacy variables compared with placebo, when analyzing mean values: reduction in knee pain after walking 50 ft (15.1 mm vs. 8.7 mm on a visual analog scale; p=0.016), reduction in the Western Ontario and McMaster Universities OA composite index (12.9 mm vs. 9.0 mm on a visual analog scale; p=0.087). The researchers concluded that this highly purified and standardized ginger extract statistically significantly reduced symptoms of OA of the knee. |
Jack Challem
See book keywords and concepts |
 A study in Arthritis & Rheumatism found that patients taking a ginger extract benefited from moderate improvements in knee pain. The study confirmed ginger's use as an antiinflammatory agent in Chinese medicine, dating back more than twenty-five hundred years.
Two topical treatments also can help. Several studies have found that creams containing capsaicin, the pungent component of hot peppers, can reduce the pain of osteoarthritis. Capsaicin blocks the transmission of pain chemicals to the brain. |
Mark Blumenthal
See book keywords and concepts |
| Both OA and RA patients had significant reduction of knee pain severity (categorical scale and visual analog scale [VAS]).
Other
Author/Year
Subject
Design
Duration
Dosage
Preparation
Results/Conclusion
Vickers et al., 1998
Atypical
odontalgia
(AO)
O
n=50
duration of pain from 3 months to 32 months (ages 21-82 years)
1 month
Topical anesthetic mouthwash (benzo-caine 15%), application for 3 minutes 2x/day, follow-up for at least 3 months
Capsig® (0.025% capsaicin)
Of 30 subjects, 19 responded positively, with pain reduction ranging from 10-100% (mean=58 ± 25 [SD]; p<0. |
Bill Gottlieb
See book keywords and concepts |
 Often, the conventional medical approach to treating knee pain is to focus attention solely on the area that hurts—the knee itself," says Sharon Butler, a certified practitioner of Hellerwork (a structural bodywork and movement therapy) in Paoli, Pennsylvania. "Proper pain-free function of the knee relies on the balance of all muscles, tendons, and ligaments that wrap the knee joint. When one or more of these elements is tighter or more restricted than the others, knee pain is often the result."
Butler first evaluates the alignment and balance of the ankle joints. |
Mark Hyman, M.D.
See book keywords and concepts |
 Three months later her knee pain and stiffness were completely gone, and she was back to playing tennis and golf. She was even ballroom dancing again. She felt so good that she'd begun giving her pet poodle, Maxine, some glucosamine and chondroitin, and Maxine's response was similar to hers. Neither of them, noted Sylvia, experienced any side effects.
Submyth: Diabetes Isn't Curable
Diabetes, the fifth leading cause of death in our country, may exemplify aging better than any other condition. |
The Life Extension Editorial Staff
See book keywords and concepts |
 At the end of the study, about 80% of the subjects who took SAMe reported improvement: 70% of the subjects with the most severe knee pain improved significantly. Side effects were minimal, and only 2.3% of the gtoup stopped taking it because it did not work. The most severe side effect reported was gastrointestinal upset.
In four double-blind studies, SAMe was compared either to placebo ot to NSAIDs. SAMe was generally better tolerated than the NSAIDs (Glotioso et al. 1985; Maccagno et al. 1987; Vettet 1987; Domljan et al. 1989). |
| The authors suggested that "low-amplitude, extremely low frequency magnetic fields are safe and effective for treating patients with chronic knee pain due to osteo-arthritis" (Jacobson 2001). (The range of magnetic field amplitudes used was from 2.74 x 10'7 to 3.4 X 10'8 G, with corresponding frequencies of 7-7-0.976 Hz.) Treatment of other common conditions such as lumbar radiculopathy (for example, sciatica) and whiplash syndrome have also been helped by magnetic field therapy (Thuile et al. 2002). |
Email this page to a friend
