By Dr. Mercola
Arthroscopic knee surgery is one of the most common unnecessary surgeries performed todayalong with back and hip surgeries, pacemakers, cardiac angioplasties, hysterectomies, and Cesarean sections.
Several studies over the past decade have highlighted questions about arthroscopic knee surgery, and now, you can add one more to the pile. The meniscus inside your knee is a thin crescent-shaped disc of cartilage that serves as a cushion between your femur and tibia and helps stabilize your knees.
Over time, your meniscus can develop tears, especially if you have arthritis. The standard orthopedic surgeons intervention for meniscal tears is performing an arthroscopic partial meniscectomytrimming the torn meniscus and smoothing the jagged edges of what remains, which assumes the tear is whats causing your pain. However, that may be a faulty assumption.
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This latest study, conducted in Finland, examined 146 patients with degenerative meniscal tears (caused by wear and tear, not acute injury).1Researchers divided patients into two groups.
One group received the standard surgery, and the other received a sham surgeryin other words, a fake or placebo intervention where no actual surgery takes place. The study excluded people with knee arthritis, because they tend not to benefit as much from meniscus surgery and the researchers wanted to ascertain if the surgery helps under ideal circumstances.2
The sham surgery involved the physicians making an incision and poking around without any actual cartilage shaving or cutting. Many of the patients were given epidural anesthesia, so they were awake, making it necessary for surgical staff to use their theatrical talents to pull off a believable sham surgery.
The outcome? One year later, both groups reported equally favorable responses to the procedureprimarily, reduction in knee pain. In the end, the researchers concluded that the real knee surgeries offered no better outcomes than the sham surgeries.
Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the US, and according to this study, is performed about 700,000 times a year to the tune of $4 billion. Any surgeon who tells you this is the best or only option for your osteoarthritic knee pain will not have a leg to stand on when you show him or her all of the evidence to the contrary.
Arthroscopic Surgeries Have an Embarrassing Track Record
Prior to the Finnish study, there were already three prior studies of note that should have orthopedic surgeons rethinking how they treat their knee patients:
See the pattern emerging here? Its hard to miss! Eighty percent of meniscal tears develop from wear and tear over time.6If you have pain in your knees from ordinary activities or arthritis, you may be better off skipping the surgery and going straight to physical therapy.
Or better yet, get some treatments with an infrared laser that I discussed in detail withDr. Harrington.
Of course, there are other non-invasive therapies that can be helpful as well. But its becoming quite clear that a torn meniscusat least, the wear-and-tear varietyis not going to be helped by a surgical trim. Surgeries come with all sorts of risks, and there is no point in exposing yourself to these without some clear advantage.
If you have a torn meniscus from an accident or injury, the scenario may be different, but I would still recommend you getting a second or even third opinion before going under the knife.
The Power of Placebo
With TWO studies now highlighting the benefits of placebo knee surgeries, the power ofplacebojust cant be ignored. Placebos typically have far fewer side effects (if any) than prescription drugs, injections, or actual surgeriesand they often work just as well as the standard of care.Studies have shown that if youthinkyoure receiving a treatment, and you expect that treatment to work, it often doeseven if you know youre receiving aplacebo.
This was beautifully demonstrated in the Finnish studythe knee surgery patients knew they might be having a sham surgery, yet they experienced the benefits anyway. But how do placebos work? How can your brain produce healing just because youbelieveit should be happening?Although the exact mechanisms of the placebo effect are not well understood, it seems related to changes in your brain in response to different psychosocial stimuli. Areas of your brain associated with expectations, anxiety, and rewards seem to be involved.Scientific Americanreported:7
In recent decades reports have confirmed the efficacy of various sham treatments in nearly all areas of medicine. Placebos have helped alleviate pain, depression, anxiety, Parkinsons disease, inflammatory disorders and even cancer.
Placebo effects can arise not only from a conscious belief in a drug but also from subconscious associations between recovery and the experience of being treatedfrom the pinch of a shot to a doctors white coat.Such subliminal conditioning can control bodily processes of which we are unaware, such as immune responses and the release of hormones Researchers have decoded some of the biology of placebo responses, demonstrating that they stem from active processes in the brain.
You can tap into your own placebo effect with techniques such asEFT or Emotional Freedom Technique.This is a new way of thinking about healing for most people that can be extremely powerful, especially when combined with a positive outlook and a proactive,disease-preventive lifestyle.
Your Secret Weapon Against Knee Pain: Exercise
Exercise is the real medicine for pain in your joints.Exercisehelps prevent and relieve joint pain through a number of mechanisms, including strengthening key supportive muscles, improving flexibility and range of motion, improving bone strength, and helping you optimize your weight. The notion that exercise is detrimental to your joints is a serious misconception; there is no evidence to support this belief. Its simply a myth that you can wear down your knees just from average levels of exercise and/or normal activity.
This is not to say that traditional pavement-pounding, likedistance running, is going to be of any benefit to your kneesIm talking about low-impact but effective exercise, such ashigh-intensity interval training (HIIT),high-intensity cardio,weight training,stretching, and core work. If you find youre in pain for more than an hour after your workout, you should slow down or choose another form of exercisethere really are plenty to choose from.
If youve already developed osteoarthritis in your knees, youll want to incorporate exercises that strengthen your quadriceps muscle at the front of your thigh. And, rather than running and other high-impact activities, you may be better off with non-weight-bearing exercises like swimming and cycling. Strengthening and stretching the areas around, above, and below your knee is key to reducing most knee pain, which is the goal of the exercises I demonstrate in the video above. I recommend a qualified physiotherapist to properly assist you with your exercises to avoid injury. Make sure to wear appropriate footwear for all of your daily activities. Spiked heels and very flat soled shoes place unnatural stresses on your knees. Goodpostureis important as well.
For joint pain, many physicians commonly recommend anti-inflammatory drugs (non-steroidal anti-inflammatories or NSAIDs) and analgesics (such as Tylenol) to their osteoarthritis patients. I dont recommend the chronic use of these drugs due to significant side effects, which may include kidney and/or liver damage. There are safer and more effective natural options for relieving joint pain. Although popular, I am also not much of aglucosamine and chondroitinfan because studies have failed to demonstrate their effectiveness. However, there are some very effective natural remedies that are truly backed up by science. The following are my favorites:
Sun exposure is your best option, because your skin produces two types of sulfur in response to sun exposure: cholesterol sulfate and vitamin D3 sulfate. Sulfur plays a vital role in the structure and biological activity of both proteins and enzymes. If you dont have sufficient sulfur in your body, this deficiency can create a number of health problems, including negative impacts on your joints and connective tissue. Which brings us to the next item
Methylsulfonylmethane (known asMSM) is another alternative you might find helpful. MSM is an organic form of sulfur and a potent antioxidant naturally found in many plants, and is available in supplement form. For more on the benefits of MSM, I recommend listening to this interview.
Eggshell membrane also contains transforming growth factor-B, a protein that helps with tissue rejuvenation, in addition to other amino acids and structural components that provide your joints with the building blocks they need to build cartilage.
Sources and References
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