A. KNEE PAIN

Question 1

I am 48 years old and have been suffering from painful knees. I have sought treatment from an orthopaedic specialist and was told that my problem is associated with ageing. Can you give me some advice on my problem?

Answer 1

From your description, you could be having a worn out layer of the knee joint which is known as osteoarthritis. This situation normally occurs as a result of ageing. It could even occur at a younger age if one previously had knee injury. Apart from osteoarthritis, the same symptoms can also be caused by gouty arthritis and rheumatoid arthritis. X-ray images of both knees and blood tests can assist the doctor in making the diagnosis.
Treatment for osteoarthritis involves:

1. Losing body weight as much as possible to the level of individual’s ideal body mass index.

2. Carrying out moderate activities that do not involve lifting heavy objects such as hydro exercises (exercising in the water), static cycling, stretching quadriceps of the thigh (quadriceps strengthening) and any other exercise within one’s own personal ability.

3. Applying joint protection techniques such as reduce climbing up and down the stairs, avoid walking long distances, avoid sitting at levels which are too low that can then cause pain when getting up, and avoid doing work involving heavy objects. .

4. Treatment that includes applying oil or ointment may also help to reduce pain.

5. Analgesics/anti-inflammatory drugs such as paracetamol, mefenamic acid and non-steroidal anti-inflammatory drugs (NSAIDs) can also be taken on the advice of a doctor to reduce pain.

6. Other drugs that can also be used to control the deterioration of joints such as Glucosamine Sulphate, Chondroitin, and Diacerein.

7. Injection techniques using lubricants or steroids into the knee joint may be used to reduce pain as an alternative in some cases.

8. Prosthesis such as the walking stick (‘tongkat’) can help to reduce stress on the knees.

9. Traditional treatment such as acupuncture may reduce pain in some cases.

10. Surgery performed for severe cases by orthopaedic specialist.

My advice is that you discuss and seek further advice from your orthopaedic specialist to get the best treatment option that suits you.

B.PAINFUL HEEL

Question 1

What is the cause of painful heel?

Answer 1

Among the causes of painful heel are: –

1. History of injury to the heel – heel injury such as bone fracture or ligament tear.
2. Overweight – being overweight will exert more pressure on the heels upon standing.
3. Age factor – The older the age, the higher the risk of heel pain.
4. Walking for long distances.
5. Wrong way of walking.
6. Inappropriate size and form of footwear.
7. Wearing high heels.
8. Excessive physical activity.
9. Health problems caused by diseases such as calcaneal/heel spur.

Question 2

How to overcome the problem of painful heel?

Answer 2

• Maintain an ideal body weight.
• Wear appropriate and comfortable shoes.
• Walking the right way.
• Reduce wearing high heels.
• Seek treatment if an injury occurs on the heels, have health problems due to diseases (such as heel/calcaneal spur, plantar fasciitis, varicose veins) and experiencing a situation where the actual cause of heel pain cannot be identified.

Question 3

Can a massage relieve painful heel?

Answer 3

Yes, if it is due to tensed muscles.

Question 4

What is the treatment for painful heel?

Answer 4

1. Conservative
   • Applying hot /cold packs
   • Medication
     • Pain relievers (pills, ointments, sprays)
     • Steroid injection at the heel (if the pain is unbearable, chronic and cannot be controlled with pain relievers)
   • Physiotherapy – Wave therapy
   • Traditional therapy
     • Massage
     • Drugs/herbs
     • Acupuncture
     • Reflexology
2. Surgery such as removal of calcaneal spur

Last Reviewed : 30 January 2012