Table Of Contents
- Meniscus Tear Treatment Without Steroid Injections Or Surgery
- The Knee’s Meniscus
- Meniscus Tear Medial (Medial Meniscal Tear)
- Meniscus Tear Lateral (Lateral Meniscal Tear)
- Torn Meniscus The ACL & PCL
- Are There Difference Meniscal Tear Types?
- Can Meniscus Tear Heal?
- Importance Of Meniscus’s Red, Red-White, And White Zones & What They Mean?
- What Are The Six Possible Complication Of Torn Meniscus Left Untreated?
- Meniscus Tear Symptoms
- What Is The Mechanism Of Pain In Damaged Or Torn Meniscus?
- Meniscal Tear Treatment
- What Is The Best Non-Invasive Treatment For A Tron Meniscus
- Recovery From A Torn Meniscus
- Why Steroid Injections Into The Knee Must Be Stopped
- Types Of Meniscal Tear Surgery
- Meniscectomy For Torn Meniscus
- Arthroscopic Surgery For Meniscal Repair
- Meniscal Reconstruction Surgery
- Arthroscopic Surgery For Meniscus Tear
- The Outcome:
- Best Home Remedy and Exercise For Torn Meniscus
- Knee Pain Treatment In Kuala Lumpur For knee Pain Including Torn Meniscus, Knee Arthritis, Torn Ligaments & Damaged Cartilage
Meniscus Tear Treatment Without Steroid Injections Or Surgery
Meniscus tear is treatable without steroid injections or surgery. Over the years, much research has surfaced about various treatment options available for patients with meniscus tears. The one common thing we have discovered in the published literature is that meniscus tear treatment is better without surgery or steroid injections. Non-surgical meniscal treatment offers better results for younger and older patients than arthroscopic surgery for a meniscus tear or steroid injections.
Chiropractic Specialty Center® (CSC) offers holistic, safe, natural, and non-invasive meniscal tear treatment through advanced integrative methods incorporating evidence-based chiropractic with clinical physiotherapy and customized rehabilitation. Our centers provide personalized meniscus treatments for all types of meniscal tears. In short, CSC gets you better without steroid injections or surgery.
The two most common invasive treatments for a torn meniscus are steroid injections or arthroscopic knee surgery for meniscus. Published studies in the New England Journal of Medicine and the Journal of Radiology have questioned steroid injections and refuted the clinical benefits of arthroscopic knee surgery. This article provides in-depth information about the meniscus, meniscal tears, types, symptoms, remedies, and treatment options.
The Knee’s Meniscus
The meniscus is a pair of essential, tough, resilient rubber-like structures made of cartilage that helps form a hinge joint at the knee by separating your thigh bone (femur) from the shinbone (tibia). There are two menisci (plural for meniscus) in each knee:
- The Medical Meniscus
- The Lateral Meniscus
The medial and lateral menisci disperse the body’s weight, provide shock absorbance, reduce friction, and enable smooth movements at the knee joint. The medial meniscus is a “C” shaped structure, while the lateral meniscus is more circular.
- It covers 50% of the medial tibial plateau
- It is immobile
- The commonly injured meniscus
- Firmly attached to the tibial plateau
- Cover 70% of the lateral tibial plateau
- This is the mobile meniscus
- Associated with a Discoid meniscus
- Anterior & posterior horns are closer, terminating near the ACL
Meniscal damage, injury, and pain are too common and can impact the young and elderly. Actual meniscal tears are the most common cause of meniscal pain in younger individuals. In the elderly, degenerative artists known as wear and tear arthritis is the leading cause of meniscal pain. Regardless of the reason, meniscal tears, injuries, and tears are treatable and repairable without surgery.
- The peripheral 1/3 of the meniscus is vascular which is classified as a “Red Zone” or “red-red zones”
- The middle 1/3 is classified as a mixed zone “Red-White Zone” sometimes called the “pink zone”
- The inner 1/3 is vascular but nourished by the synovial fluids and classified as the “White Zone” or “white-white zone”
Meniscus Tear Medial (Medial Meniscal Tear)
Medial meniscus and ACL tear happen when a flexed knee is twisted inwards (medially) with the foot firmly planted on the ground. The medial meniscus is a “C” shaped immobile structure covering nearly 50% of the medial tibial plateau. It is the most commonly injured meniscus. Most medial meniscal tears occur when the knee is twisted while the foot is firmly planted on the floor. Moreover, medial meniscus tears always accompany damage to the ACL.
The ACL (Anterior Cruciate Ligament) gets injured when the medial meniscus is torn because the medial meniscus gives rise to the ACL. Therefore, if the force of the knee injury is sufficient to hurt the meniscus, it will also damage or tear the ACL. And by the same token, an Anterior Cruciate Ligament injury or tear will always present with a medial meniscal tear.
Suppose you are diagnosed with a meniscal tear. In that case, you should avoid arthroscopic knee surgery as it was found ineffective in a double-blind clinical trial published in the New England Journal of Medicine. Medial meniscus tears can heal if you get focused physiotherapy combined with knee-and-meniscus-specified chiropractic treatment methods.
Meniscus Tear Lateral (Lateral Meniscal Tear)
The lateral meniscus is more of a circular-shaped mobile meniscus attached to the lateral tibia plateau. The lateral meniscus covers about 70% of the lateral tibial plateau. The lateral meniscus will be larger and cover most of the lateral tibial plateau on rare occasions. A larger lateral meniscus is referred to as a “Discoid” meniscus. You can have a discoid meniscus and not know and never experience any pain.
Lateral meniscal injuries are not as common as medial meniscal injuries because the lateral meniscus is mobile. A lateral meniscus tear occurs when the knee joint is rotated or twisted outwards. Also, an injured or torn lateral meniscus will often accompany a damaged Posterior Cruciate Ligament or PCL.
Torn Meniscus The ACL & PCL
Patients with torn medial or lateral meniscus must also have their cruciate ligaments (ACL & PCL) carefully assessed. MRI assessment is the gold standard for diagnosing ACL, PCL, and meniscal issues. However, MRI reports are rarely detailed. Often time, they leave out co-conditions and injuries that are mild. Therefore, if you have been diagnosed with ACL, PCL, or meniscal tears, you will need your doctor to carefully review your MRIs for co-tears in other structures, including the medial and lateral collateral ligaments and the ACL & PCL ligaments.
Are There Difference Meniscal Tear Types?
The menisci (medial and lateral meniscus) assist in mobility and provide shock absorbance as it separates and cushions the knee joint-degenerative changes and injuries lead to a damaged or torn meniscus. A torn or damaged meniscus can be excruciatingly painful.
Meniscus tears are classified into six categories or types:
- Intrasubstance or the incomplete meniscal tear
- Radial tear
- Horizontal tear
- Bucket-handle tear
- Complex tear
- Flap tear
Can Meniscus Tear Heal?
Tears of the medial and lateral meniscus can heel with targeted and focused therapies given by an expert team familiar with medical and knee issues. The meniscus meets its nutritional requirements from the direct blood supply and synovial fluids. The speed at which your healing occurs is dictated by the zone where the tear is. The outer part of the meniscus heals at a much faster pace than the innermost part.
Healing time with proper treatments that incorporate high-intensity Laser Therapy, chiropractic, and nutritional supplementation can occur within 4-6 weeks for mild to moderate tears, while complicated rips and tears in white zones can take eight weeks to two months to heal.
Many surgeons erroneously tell patients that the avascular nature of the meniscal makes it difficult for a tear to heal. Here’s the truth:
Every cell in your body has a route through which it gets nutrients. The meniscus is no different. The meniscus gets its nutritional demands met by one of two routes:
- Direct blood supply
- Synovial fluids circulating in the joint
The outer and middle parts of the meniscus have a direct blood supply, while the innermost part is avascular. While the innermost part is avascular, it still gets nutrients from the synovial fluids. Surgeons often use the avascular nature of the innermost part to justify arthroscopic surgery for meniscal tears. However, if you get focused and targeted treatments from our clinical teams of chiropractors. and physiotherapists, you should never need surgical intervention for a torn meniscus.
Importance Of Meniscus’s Red, Red-White, And White Zones & What They Mean?
The medial and lateral menisci are divided into three zones depending on nutrient and blood flow:
The “RED” zone or outer zone of the meniscus is the most vascularized zone where healing occurs faster.
“RED-WHITE,” the middle, or the pink zone, is in the middle. The “Red-White” zone has less direct blood flow than the “Red” zone, as such healing occurs at a slower pace when compared to the RED zone.
“WHITE,” or the innermost part of the meniscus, is void of direct blood supply. The “white” zone of the meniscus fulfills its nutrient requirements from the synovial fluids.
What Are The Six Possible Complication Of Torn Meniscus Left Untreated?
If you have been diagnosed with a meniscal tear, you need chiropractic combined with physiotherapy treatment to help you heal faster. The dangers of an untreated meniscal tear include premature degenerative and arthritic changes in the knee joint. As mentioned in earlier parts, torn meniscus also presents with some degree of ACL or PCL damage. A common complication of a torn meniscus is PCL or ACL ligament tears. Here are some additional complications when a meniscal tear is neglected or poorly treated:
- Degeneration of the femoral condyles
- Degeneration of the meniscus and cartilage
- Osteoarthritis along the edges of the knee joint or at attachment points of ACL & PCL
- Flap tears of the meniscus are more common in long-standing chronic meniscal issues.
- Development of Baker’s Cyst
- Thighbone and leg bone damage (subchondral bone damage, degeneration, and edema)
Complications for untreated meniscus tears can be severe and life-altering; therefore, heed the warning and get your meniscal tear treated before complications arise.
Meniscus Tear Symptoms
Patients with a torn meniscus complain of localized pain that worsens during rotation or twisting movements or when squatting.
- Swelling & reduced motion or mobility
- A locking or catching sensation
- Pain & discomfort walking up and downstairs
- Localized pain and tenderness at the joint line
- A feeling of deep ache within the knee joint
- Difficulty turning the body when feet are firmly planted on the ground
- Difficulty and pain when bending at the knees or squatting
What Is The Mechanism Of Pain In Damaged Or Torn Meniscus?
Innervate the outer 1/3 of the anterior and posterior horns of the medial and lateral meniscus. Published studies have documented nerves innervation of the menisci. A study published in the Journal of Arthroscopy reported findings of research conducted on twenty-three cadaver knee tissues studied under a microscope. The authors said the meniscus has nociceptive nerve innervation (pain-sensing nerves) and the outer 1/3 In both horns of the lateral and medial meniscus.
Direct meniscus pain:
The synovium, ligaments, and menisci of the knees have pain-sensing nerves. Degenerative changes and tears trigger these nerves and transmit the sensation of pain. Additionally, a 2016 study published in the Annals of the Rheumatic Diseases compared healthy meniscal tissues from asymptomatic donors to meniscal tissues of damaged and symptomatic knee patients. The authors of this study noted a significant increase in nerve proliferation in damaged missus tissues instead of meniscus tissues studied from healthy asymptomatic donors.
The study in the Annal of the Rheumatic Diseases suggests that meniscal damage leads to the sensation of pain and a significant increase in the number of pain-sensing nerve fibers or cells.
Subchondral meniscus-related pain:
The subchondral bone of the knee joint is the layer directly under the cartilage that covers the condyles of the knee joint. The cartilage has no nerve supply, but the subchondral bone is richly innervated. A torn meniscus exposes the tibial surface to the condyles of the femur. Direct contact between the femoral condyles and the tibial plateau results in cartilage degeneration on the femoral condyles and the tibial plateau. Progressive degenerative changes on the femoral condyle’s cartilage or the cartilage attached to the tibial plateau cause irritation and damage to the subchondral bone and, as such, irritate the subchondral network of nerves, causing pain in the knee joint.
Meniscal Tear Treatment
Meniscal tears are treatable and recoverable without surgery or steroid injections. The consensus on meniscal treatment is a non-surgical approach. Surgical interventions and steroidal steroid injections have been found ineffective and harmful. According to published studies, the invasive procedures are linked to arthritic and degenerative changes so severe that most need a Total Knee Replacement (TKR) within a few short years after meniscal surgery.
What Is The Best Non-Invasive Treatment For A Tron Meniscus
If you have knee pain and the cause is identified as a meniscal tear or ligamentous tears, you should consider therapy. The best non-surgical treatment for a torn meniscus is a focused and targeted treatment through meniscus-specific methods of chiropractic adjustments combined with physiotherapy, rehabilitation, and dietary supplements. Steroid injections (steroid, PRP & STEM cells) have not yielded the improvements many with torn meniscus hope.
Physiotherapy alone for meniscal tear is not adequate. To heal a torn meniscus, you will also need the thigh bone (femur) and the shinbone (tibia) to align correctly. Aligning the knee joint through issues manipulations is challenging as it needs specificity, a specialized set of skills, and experience. Moreover, you should avoid body alignment or knee realignment provided by bonesetter (tit-tar) and physiotherapists as they are meniscus specific.
Rehabilitation and exercises for patients with meniscal tears need customization. General knee exercises can cause more harm. To date, six different types of meniscal tears have been identified. Therapy and exercises must be diagnosis-based to avoid further tears or chipping of the meniscal tissues, resulting in a “locked knee” syndrome. Chiropractic Specialty Center® provides customized meniscal tear treatment through advanced therapy devices, meniscus-specific chiropractic treatment, the Activator methods, lifestyle changes, rehabilitation, and nutrition. In short, we provide holistic options that increase the recovery rate so you can avoid the pitfalls of a meniscus tear, including arthroscopic surgery or TKR (Total Knee Replacement).
Recovery From A Torn Meniscus
Recovery from a torn meniscus depends on the type of treatment you receive. For patients who choose the non-surgical route that combines physiotherapy with chiropractic, the recovery period is 4-6 weeks. However, it must be noted that most chiropractors or physiotherapists are not well familiarized with meniscal injuries, and to increase your chances of recovering without surgery; we encourage you to visit Chiropractic Specialty Center® in Kuala Lumpur.
Why Steroid Injections Into The Knee Must Be Stopped
Numerous studies discourage patients and doctors from using corticosteroids to help patients recover from meniscal tears and knee pain. A published study in the Journal of Radiology called for a stoppage in steroid injections for knee and hip patients as they cause more harm than good.
Another published study in the Journal of Bone and Joint reported that patients who opted for steroid injections for knee pain had a much higher risk for total knee replacement surgery or TKR. Therefore, if you are in pain and need help, consider non-invasive methods of knee treatment for your meniscus before going in for surgery or steroid injections.
Types Of Meniscal Tear Surgery
Before we discuss the surgical options that surgeons may provide you, it is good to inform you that surgery for meniscus should be considered when you have exhausted a proper course of care that incorporates chiropractic with physiotherapy, as mentioned above. Also, according to published studies, surgeons should strive for non-surgical interventions as meniscal surgical interventions have failed to provide lasting relief for knee pain sufferers. The type of surgery offered to patients with meniscal tear depends on the various factor that surgeons note during their assessments, some of which we have listed below:
- Meniscal tear depth and pattern
- Meniscal tear length and location
- Quality of the meniscal tissue
There are three different types of surgery available for a torn meniscus. The actions of the orthopedic surgeon define meniscal tear surgery. The three meniscal tear surgery procedures are as follows:
- Meniscectomy surgery.
- Meniscal repair surgery
- Meniscal reconstruction surgery
Meniscectomy For Torn Meniscus
Meniscectomy can be total or partial. It is commonly prescribed to patients with a radial meniscal tear in the white-white zone (meniscal zones with no direct blood supply) or flap tears. Moreover, it can be an open knee surgery or arthroscopically and may be combined with meniscal reconstruction surgery. However, you should avoid all forms of meniscectomy as it can lead to degenerative changes, requiring additional surgical interventions.
We encourage effective multi=disciplinary non-surgical treatments that target the meniscus tear before any surgical intervention. Short-term results are good, but the long-term effects are unfavorable as they always lead to degenerative and arthritic conditions. Therefore, meniscectomy should be performed only when you have exhausted an effective means of therapy that combines physiotherapy with meniscus-specific chiropractic treatment.
Arthroscopic Surgery For Meniscal Repair
The clinical outcomes of a double-blind study involving arthroscopic surgery for meniscus failed to show any benefit at all. Also, a separate study with over 4,600 participants showed that arthroscopic surgeries were associated with eventual knee replacements due to degenerative changes induced by arthroscopic procedures. Therefore, we discourage all forms of arthroscopic surgery for the meniscus as it can lead to more harm.
However, in the event you still want information, we have provided a brief description of surgical repair of a torn meniscus:
Meniscus tear repair through open or arthroscopic surgery is exclusively performed on meniscal tears that are recent or acute and located within the peripheral walls of the meniscus in the vascularized red-red zones of healthy younger patients. This surgical intervention is often recommended for:
- Horizontal tears in younger athletes
- Root tears
- Radial tears and, at times, tears in red-white zones
Meniscal Reconstruction Surgery
Meniscal reconstruction surgery is often recommended for patients with total or partial meniscectomy. Meniscal reconstruction surgery aims to fill the gap resulting from a meniscectomy. The procedure is accomplished through one of the two commonly used methods:
- Meniscal scaffolds
- MAT (Meniscal Allograft Transplantation)
Arthroscopic Surgery For Meniscus Tear
Some surgeons use the old slogan for meniscal tears, “If it’s torn, cut it out & throw it away!’ However, recent literature advises against cutting or removing the meniscus, and as such, a newer slogan is now encouraged, “Do everything to Save the meniscus!”
The New England Journal of Medicine published a study of the effectiveness of meniscal surgery. What sets the study apart from others is that it published the results of a randomized double-blind sham-controlled partial meniscectomy (arthroscopic meniscal tear surgery) of 146 patients aged 35-65. The outcomes call into question the use of arthroscopic surgery for patients with a torn meniscus.
No Difference in Outcomes At 12-Months Between the Shame (Fake) & Real Surgical Intervention.
Another eye-opening study published in the peer-reviewed Journal of Osteoarthritis and Cartilage reported that patients that received meniscal tear surgery had a 300% increased chance of getting a TKR (total knee replacement) within 2 years of the meniscal surgery.
This study suggests that it is prudent for people who suffer from knee pain resetting from arthritis or meniscal tears to consider getting focused knee treatments at Chiropractic Specialty Center® from our chiropractors and physiotherapists combined before considering knee surgery.
Best Home Remedy and Exercise For Torn Meniscus
For patients with a torn meniscus, the best home therapy is PRICE:
- Protect: Protract your meniscus from excessive weight-bearing activities to speed the recovery rate. For example, go up the stairs one step at a time with your good knee up first. Coming down the steps should also be one step at a time with the bad knee first.
- Rest: Rest is vital in healing and when it comes to your meniscus is essential. Stop all sports-related activities during your healing phase.
- Ice: Icing the knee joint every two hours for 15 minutes while awake will help cut your recovery time. Inflammation is a needed part of healing, but often when it comes to the meniscus, the inflammatory process becomes non-ending. Therefore, by icing y9ur knee joint, you stop or minimize the inflammatory component of your injured meniscus.
- Compress: Wrap your injured knee with an elastic bandage to stabilize the joint, support the damaged areas and minimize the swelling.
- Elevate: Elevating the injured knee will help decrease swelling and pain, resulting in faster recovery
Knee Pain Treatment In Kuala Lumpur For knee Pain Including Torn Meniscus, Knee Arthritis, Torn Ligaments & Damaged Cartilage
Chiropractic Specialty Center® (CSC) in Kuala Lumpur provides holistic clinical knee treatments for all knee problems causing pain, instability, or weakness. CSC’s knee pain treatment protocols are integrative and combined care methods from the top-rated award-winning team of holistic clinical physiotherapists with evidence-based chiropractors in Kuala Lumpur.
Holistic clinical physiotherapy pertains to knee pain and knee injuries and targets injured and degenerated need tissues, including the cartilage, ligaments, tendons, muscles, and meniscus, by advanced therapeutic devices such as high-intensity laser therapy and targeted shockwave therapy to help your recovery. Evidence-based chiropractic starts with a thorough assessment that helps formulate a customized holistic approach to help the injured knee recover faster. Dr. Yama Zafer, DC (Doctor of Chiropractic), Has treated thousands of knee pain patients for over 25-years. His clinical knowledge and expertise have helped many recover from knee injuries and knee with lasting relief. Learn more about our knee pain treatment for meniscus, ACL, and arthritis by visiting us today.