Pandemic knee

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? a real problem?

Did your lifestyle change because of Covid? For better or worse, Covid lockdowns altered all of our lives. What about the physical impact on our joints?

Shahnaz Fraser of Spire Norwich Hospital spoke to Professor Iain McNamara, Consultant Orthopaedic Surgeon about the so-called `Pandemic knee'.


Mr Am Rai, Consultant Orthopaedic Surgeon at Spire Norwich Hospital, tells us about sciatica.

I have been suffering from lower back pain and a tingling sensation down one leg for the last few days. I am normally fit and well. I wondered if it might be sciatica?

Responses to lockdown were varied, but all of us have changed our lifestyles because of Covid. As well as the obvious additions to daily life, such as hand sanitiser and mask wearing, what changes were enforced on your exercise routine?

Did you reduce the amount of exercise you did as a result of working from home, shielding or not being able to go out as much? Or maybe you started a new exercise routine and raised your activity levels because you found yourself with more time? Perhaps you have noticed more joint pain as a result.

If, specifically, you've noticed an increase in knee pain, it could be `Pandemic knee'. During our catch-up, Prof McNamara explained some of the reasons for this phenomenon, and what we can do about them.

Joe Wicks knee I think most of us had a stint at trying Joe Wicks before the novelty wore off (I managed about a week with the kids). While exercise is great for your body ? helping with weight loss and increasing heart rate, a sudden change in the amount or type of exercise that you were doing may have led to injury.

Even undertaking all those DIY jobs could have led to injuries, especially if the job involved squatting or twisting. One of the most common knee problems is a torn cartilage (meniscus), which can happen as a consequence of a trivial injury or during exercise or activity like DIY.

"Each knee has two menisci within it; they act like cushions between the top of the shin bone and bottom of the thigh bone, protecting the joints as they move next to each other and this can easily get damaged when moved in the wrong way," says Prof McNamara. "Often patients never know what caused the pain, they just know that it hurts, when three weeks ago it didn't.

Changes in our lifestyle during the pandemic, such as inactivity or, indeed, starting a new exercise routine, may

have resulted in `Pandemic knee'


"There are ways of rehabilitating a knee with a torn meniscus, but if the pain still doesn't go away or there are other symptoms as well, then surgery to repair or trim the cartilage may be recommended."

Netflix knee Many of us have increased the amount of time we spent sitting during the last 18 months. Both `normal' and arthritic knees can hurt during activity when there is poor muscle tone.

"Spending more time sitting ? be it online shopping, watching telly or working from home ? rather than engaging in physical activities, even activities such as walking around the supermarket or the daily commute, may have led to a loss of muscle tone and/or strength," says Prof McNamara. "This loss of tone in turn can lead to or worsen knee pain or feelings of knee instability. The solution in this case is working on a supervised exercise programme to improve muscle tone."

Pandemic pounds Reportedly, 48pc of adults gained weight during lockdown. An increase in body weight increases the load on the knee, which in turn may lead to knee

pain, especially if there is already an underlying knee problem. This is especially true when linked to other problems as mentioned in this article.

General aging While aging doesn't specifically cause knee pain, many of its causes are due to age-related changes, and wear and tear. It may be that an underlying arthritic knee has progressed and now symptoms are such that it needs to be examined to decide what can be done to help.

"Knee pain will often go away after a few weeks, sometimes with the help of pain relief and activity modification ? with or without physiotherapy," says Prof McNamara. "If the pain still does not improve or it gets worse, then visit your GP, a physiotherapist or knee surgeon for examination and further investigation. Much of knee pain will improve with physiotherapy prescribed exercises and rehabilitation, or possibly with pain relieving injections.

"A knee surgeon will be able to determine the cause of the pain by history, examination and usually, some kind of investigations such as an x-ray or MRI scan.

"For those knees that can't be

improved, then surgery can be discussed. These days knee surgery doesn't need to be major, sometimes a knee arthroscopy can be performed to help the problem. This is a smaller procedure, in which a thin telescope is passed into the knee through a small incision to repair or trim a cartilage tear. Alternatively, if the joint is worn then sometimes a partial or whole replacement can be performed to replace the arthritic area."

For further information on knee pain arrange an appointment with your GP. Alternatively, call 01603 255 614 to make a private appointment with Consultant Orthopaedic Surgeon Prof Iain McNamara, or a Spire Healthcare Physiotherapist. More information about Prof McNamara can be found on his profile at spirenorwich. com

All surgery carries an element of risk and the content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professionals.

It does sound like it could be sciatica, but first you should seek advice from your GP to determine a diagnosis. Although sciatica does present with a `tingling' sensation down one leg and commonly in the buttocks too, it's important to rule out any other issues with your spine. Your GP will examine you and ask you to perform a few simple exercises to determine the likely diagnosis.

The sciatic nerve is the longest nerve in your body, which travels from the back of your pelvis, through your buttocks, and down both legs and ending at your feet. If this nerve is compressed, or irritated in some way it can cause pain or the tingling sensation you describe.

This is often caused by a protruding or `slipped' disc, which occurs when the vertebrae that sits between the bones of the spine is damaged. Damage to the vertebrae can be caused by heavy lifting, for example, or poor posture. But sometimes it can just be a simple case of wear and tear.

Sciatica will often be temporary and should pass after a few weeks. Symptoms may be helped by anti-inflammatory medication. Physiotherapy is another option to ease symptoms, as it can provide you with an exercise programme to strengthen your back.

If there is considerable longerterm discomfort, a spinal surgeon can perform an operation that will `trim' away some of the disc, easing the pressure. The relief felt by patients is instant and this procedure has a high success rate.

There are some more serious causes for numbness and tingling sensations down your legs and in your buttocks, so it's important that you seek immediate medical attention if you experience recent loss of bladder or bowel control, numbness in-between your legs and sciatic pain in both legs. These symptoms can relate to a spinal condition called cauda equine, which requires immediate surgical intervention.

For further information arrange an appointment with your family doctor, or call 01603 255 614 to make a private appointment with Mr Am Rai, Consultant Orthopaedic Surgeon.

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