30 Mar Study: Relationships between Pain, Function and Radiographic Findings in Osteoarthritis of the Knee
20 years ago I was in an automobile accident and had an injury to my lower back. I was having pain running down my leg. I went to an MD who prescribed an MRI and the MRI showed I had a herniation in L5/S1 level. He then sent me to an orthopedic surgeon and the surgeon looked at the MRI and told me I would need surgery when it got bad enough. Shortly after I met my first prolotherapist. He was a friend and a recent grad from osteopathic college. He wasn’t so interested in the MRI but more so on the function and quality of the ligaments. He was the first doctor to actually touch my spine. He mixed lidocaine with dextrose, which was a common substance that is used for prolotherapy and injected my ligaments in my spine. The pain was relieved and it marked the beginning of my journey in regenerative therapy. I tell this story in my lectures often as it is important for folks to understand that the MRI is not the end all be all. Many times we see patients in our office that have been improperly diagnosed. A lidocaine challenge is often used to determine the pain producing tissue in our office. As the ultrasound technitian at our clinic I am using a high definition ultrasound machine to see where the damage is and to guide injections for Dr. Chen. Whats nice about the US image is that it shows dynamic studies. Meaning I can see joints and tissues as they move. Also it shows inflammation which MRI does not. The below study clearly demonstates what I’m speaking about.
John Lieurance, DC, ND
Objectives. The aim of this study was to investigate the relationships between pain, disability, and radiographic findings in patients with knee osteoarthritis (OA). Patients and Methods. A total of 114 patients with knee OA who attended the physical medicine and rehabilitation outpatient clinic were included in this study. Conclusions. Knee pain, stiffness, and duration of disease may affect the level of disability in the patients with knee OA. Therefore treatment of knee OA could be planned according to the clinical features and functional status instead of radiological findings.
In this cross-sectional study we investigated if there was any association between pain, disability, and radiographic features in patients with knee OA. Our results demonstrated that age and disease duration were found to be positively associated with Kellgren-Lawrence grading scale. Also disability scores were significantly associated with pain and stiffness scores as measured by WOMAC. However, we could not establish an association between Kellgren-Lawrence grading scale and WOMAC subscores.
This means we could not correlate MRI finding to functional findings in these patients.