Meniscal Tear of Knee - Self Treatment Options for Pain

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This is a reproduction of an article from Palmer Chiropractic College published in National Library of Health concerning a tear in right lateral meniscus treated with ice and interferential.  What makes these type articles interesting is if the tissue being injured is capable of repair ( not so with lateral meniscus as we presently treat ),  then will the frequent use of interferential treatment provide for acceleration of heal time, as happens with non-union fractures and wound repair?

   I personally do not pretend to understand how certain tissues heal,  and to my best understanding the meniscus is incapable of healing itself,  but with many injuries to our body the body is capable of finding other options to replace the function of the damaged tissues.  Much of the present knowledge of tissues being capable, or incapable, of repair/replacement is predicated upon our understanding of how basic cells replicate and are capable of  cellular specialization.
  One of the most promising aspects of this process we are only beginning to understand is neural tissue as is relates to spinal cord injuries.  Advances are being made every day, whether how to treat immediately post injury ( cooling ), or how potential stem cells can be injected for duplicative replacement of the damaged, destroyed neural cells.
   An example is with the anterior cruciate ligament ( ACL) where if not repaired surgically then  the body will compensate by strengthening muscles in the area, assuming rehab. is done, to offset the loss of stability the ACL provided.

The Benefits of Carryover Pain Relief

    In this specific the interferential treatments were apparently intended for pain relief and possibly there was edema reduction going on.  It seems the carryover pain relief may have lasted only a short time and the patient would return for treatment.  In this situation the patient could have self treated, while working, with the Infrex Plus on interferential mode.   My personal interest is when the patient can now self treat, rather than go to a clinic for treatment, then what new therapies will we see? 

Management of a patient with calcium pyrophosphate deposition disease and meniscal tear of the knee: a case report.

Alcantara J, McDaniel JW, Plaugher G, Alcantara J.

Palmer College of Chiropractic-West, San Jose, CA, USA.

OBJECTIVE: To describe the chiropractic management of a patient suffering from a right lateral meniscus tear concurrent with calcium pyrophosphate dihydrate (CPPD) deposition disease. CLINICAL FEATURES: A 51-yr-old bus driver suffered from right knee pain (7 on a 1-10 pain scale). The onset of the pain was gradual and increased during braking and accelerating. Palpatory tenderness was noted at the right lateral knee joint line and the inferior lateral margin of the patella. Active resistive range of motion (ROM) in the knee during extension was painful throughout the full ROM, whereas passive ROM was restricted in flexion at 110 degrees. A positive McMurray's test reproduced pain at the knee. Radiographic analysis revealed CPPD deposition disease, and magnetic resonance imaging revealed a probable "parrot's beak" tear in the posterior horn of the right lateral meniscus. INTERVENTION AND OUTCOME: The patient was treated conservatively. He was instructed not to put weight on the knee and not to return to work for 5 days. Initial treatments involved the use of ice and interferential electrical stimulation along with glucosamine sulfate supplements. Bicycling, weight lifting for general fitness and general knee strengthening exercises were prescribed. Approximately 5 months after initial treatment, the patient was lost to follow-up; 12 months later, he returned for treatment because of a recurrence. Physical examination at that time revealed knee pain rated at 3/10 but there was no pain upon palpation, McMurray's test was negative and right knee ROM was full without pain. CONCLUSION: A patient suffering from CPPD can be managed by conservative means. The pathophysiology, clinical features and management considerations in the treatment of the patient's condition(s) are also discussed.

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