Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In treating many types of knee pain, a common goal is to break the inflammatory cycle. The inflammatory cycle starts with an injury. After an injury, inflammation invades the knee, which causes further injury, and further inflammation, and so on. This cycle of inflammation leads to continued or progressive knee pain. The cycle can be broken by fighting the inflammation (through medications or other therapies) and by limiting further injury to tissue.
Some common home-care remedies that control inflammation and help to break the inflammatory cycle are protection, rest, ice, compression, and elevation. This regimen is summarized by the mnemonic PRICE.
PROTECT the knee from further trauma.
This can be done with knee padding.
A pad over the kneecap, for example, helps to control the symptoms of some knee injuries (an example is a form of bursitis
sometimes called housemaid's knee) by preventing further repetitive injury to the prepatellar bursae.
REST the knee.
Rest reduces the repetitive strain placed on the knee by activity.
Rest both gives the knee time to heal and helps to prevent further injury.
ICE the knee.
Icing (cold application) the knee reduces swelling and can be used for both acute and chronic knee injuries.
Most authorities recommend icing the knee two to three times a day for 20-30 minutes each time.
Use an ice bag or a bag of frozen vegetables placed on the knee.
COMPRESS the knee with a knee brace or wrap.
Compression helps accomplish two goals:
First, compression is another way to reduce swelling.
Second, in some knee injuries, compression can be used to keep the patella aligned and to keep joint mechanics intact.
ELEVATE the knee.
Elevation also helps reduce swelling.
Elevation works with gravity to help fluid that would otherwise accumulate in the knee flow back to the central circulation.
Prop your leg up when you are sitting or use a recliner to elevate the legs.
Over-the-counter pain-control medications: Commonly used pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen
(Aleve or Naprosyn) and ibuprofen (Advil or Motrin) also play a role in the treatment of knee pain.
These drugs directly control pain and, at higher doses, act as anti-inflammatory agents, helping to stop inflammation. Like all medications, however, these drugs have potential side effects.
You should not use NSAIDs if you have a problem with bleeding