Combination of Fever, Neurological Injury Strongly Linked to Poorer Outcomes

Many studies associate fever with poor outcome in patients with neurological injury, but this relationship is blurred by divergence in populations and outcome measures.
In the most comprehensive meta-analysis to date, researchers have shown fever is strongly associated with worse outcomes in stroke and other types of neurological injury across multiple outcome measures.

Investigators at Massachusetts General Hospital, in Boston, analyzed data from 39 studies that included 14,431 patients with stroke and other brain injuries and found fever/elevated body temperature was consistently linked to poor outcomes regardless of the type of neurological injury or the outcome measured. “Whether a neurological injury is ischemic, hemorrhagic, or traumatic, or the outcome measured is clinical, functional, or economic, this study provides conclusive evidence that fever is consistently associated with poor outcomes,” said principal investigator David M. Greer.

The study was recently presented at the Neurocritical Care Society annual meeting and is published in the November issue of Stroke. Fever is a common condition in stroke and other types of brain injury, and previous research has shown a strong link to increased length of intensive care unit (ICU) and hospital stay, higher mortality, and worse overall outcomes.

However, said Dr. Greer, a direct causative link has been difficult to establish. “Historically, there has been a lot of research that has correlated fever in brain-injured patients — whether from stroke, traumatic brain injury, cardiac arrest, or subarachnoid hemorrhage — to poor outcomes. However, the wide variation in study populations and outcome measures in these studies have made it challenging to determine the true impact of high body temperatures in brain-injured patients,” he said.

To level the playing field, investigators incorporated all recent studies that addressed fever in brain-injured patients into a comprehensive meta-analysis to evaluate these disparate clinical findings. Researchers conducted a Medline search for articles published since January 1, 1995 and identified 1139 citations. Of these, they retained 39 studies with 67 tested hypotheses contrasting outcomes of fever/higher body temperature and normothermia/lower body temperature in patients with neurological injury.

Patients in the selected studies included individuals who had ischemic and hemorrhagic stroke and neurological ICU populations including traumatic brain injury (TBI) patients.
Outcome measures included clinical, functional, and economic outcomes as assessed by mortality, the Glasgow Outcome Scale (GOS), Barthel Index, modified Rankin Scale (mRS), Canadian Stroke Scale (CSS), ICU length of stay (LOS), and hospital LOS.

“Collectively, the meta-analyses presented a consistent result. In each of the 7 outcome measures evaluated, the meta-analysis indicated that fever/higher body temperature was significantly associated with worse outcome as indicated by higher mortality rate, greater disability, more dependence, worse functional outcome, greater severity, and longer stays in the hospitals and the ICU,” the authors write.

The investigators report the effect size of fever/higher body temperatures ranged from moderately small for the GOS to large for mRS, ICU LOS, and hospital LOS. In addition, in comparison with individuals with stroke or TBI who did not have fever/higher body temperatures, their counterparts with fever had a 1.3 to 3.2 times odds of a longer hospital LOS.

The results also suggest fever is associated with greater mortality and greater neurological dysfunction in patients with neurological injury. “It didn’t matter what measure we looked at, the outcomes were all significantly and consistently worse across the board in patients who were febrile,” said Dr. Greer. Whether fever actually causes worse outcomes or whether it is largely an effect of other causative factors is beyond the scope of this study. However, the investigators point out it is noteworthy that no other covariate examined “comes close to reaching the consistency of significance found with fever/higher body temperature.”

Although induced hypothermia is not standard medical practice in the management of all brain-injured patients, it is recommended by the American Heart Association in the treatment of resuscitated cardiac-arrest patients.

However, said Dr. Greer, although many in the neurocritical care community use hypothermia to treat neurologically injured patients, it remains an unproven therapy in this patient population. “At this point, induced hypothermia is not ready for prime time. We still can’t say conclusively that it improves outcomes for brain-injured patients. We suspect that it does, we see at the bedside that when we cool brain-injured patients their intracranial pressure comes down, but we still need hard scientific evidence,” he said.

According to Dr. Greer, the current findings point to a need for a major prospective, randomized study to confirm whether aggressive efforts to prevent and control fever in neurologically injured patients improves outcomes. Studies are currently ongoing for using induced hypothermia for such conditions as ischemic stroke and traumatic brain injury.

Government and the Royal Caribbean Cruise Line (RCCL) signed a US $122-million contract for the development of a new cruise ship terminal on November 7th in Falmouth that promises significant increase in stopover visits to the north coast.

“They have guaranteed 400,000 visitors coming into the Falmouth port every year for the next 20 years,” said Prime Minister Bruce Golding, who signed the agreement along with Adam Goldstein, CEO of Royal Caribbean International.

The contract forms part of a US$224-million project that includes the establishment of themed retail shopping areas, entertainment facilities and restaurants in the Trelawney north coast town.

According to Golding, completion of the new pier and landside development is expected in May 2010 to coincide with the arrival of the Oasis of the Seas, the world’s largest cruise ship.

“Royal Caribbean has already started marketing Falmouth,” Golding said at the signing held at the Hilton hotel in Kingston. “We are going to have to do everything possible to assure that we meet the deadline,” he added. Transport & Works Minister Mike Henry, who also spoke at the signing, said that project would employ more than 700 workers during the construction phase and “hundreds others on a permanent basis afterwards”.

Under the contract, RCCL will be responsible for the landside development of sections of the town surrounding the pier that will retain the Georgian architectural ambiance for which Falmouth has been designated a world heritage site. “We have to recreate that as much as possible,” Golding remarked.

The RCCL chief said that he welcomed the opportunity to participate in the infrastructure development of the town, noting that Falmouth was ideally placed between the established ports of Montego Bay and Ocho Rios and would benefit the entire North coast.

“It’s a central location, we have an opportunity to make Falmouth and the north coast an even stronger attraction than it was before,” Goldstein said adding that the improvements around the pier would become a permanent tourist destination.

“When cruise ships are not there it will still be an attraction,” he added. At the same time Golding affirmed that environmental safeguards were observed and all of the issues addressed. “The project must become friendly to the ecology that we have there,” said the prime minister.

The multi-million-dollar pier works include dredging the Falmouth harbor, raising the elevation of low-lying areas and the building of a sea wall and promenade.

One thing to keep in mind about RCCL’s new investment is that Kingston is the most dangerous city in the Caribbean. Make sure to take more precautions here than you would elsewhere. The major problem facing most foreigners is mugging: Robbery is commonplace. If you are travelling in Kingston, stay with a group of people and if you do find yourself alone, return to your ship immediately. Make sure to get back to your ship, in order to depart on time to avoid being left behind by the cruise lines.

Marilyn Shaver knows all too well how hard life becomes for someone who suffers from an acquired brain injury.

When her son Tim was 17, a serious ski accident changed his life forever. Now 31, his mother says his path has taken many difficult turns. “In the 14 years that have passed, he has fallen through the cracks in the system,” she said. “He‘s been in jail, he‘s been homeless, he‘s been inappropriately served in psychiatric institutions, and he’s received a patchwork of services.”

After much hard work and doubtless heartache, the family was finally able to find the right services for him. Now living in a facility where he can receive consistent 24-hour support, Tim has been able to make some “amazing gains” in the past few years, including participating in a drama group, Shaver said.

“But he‘s been through the gamut.” Experiences like Tim‘s are unfortunately all too common, says Ontario Alliance for Action on Brain Injury (OAABI) representative John Kumpf, who noted that nearly 500,000 people in Ontario are currently living with a brain injury-related disability.

“That‘s not including the families. One of the things I often say is brain injury doesn‘t happen to individuals – it happens to families,” said Kumpf. “It has a tremendous impact on families.”

The OAABI was in Thunder Bay on November 11, 2008 as part of a provincial tour to raise awareness among the public and policy-makers about the multitude of struggles faced by people affected by brain injuries. “If you‘re not aware of the challenges they face, it‘s hard to accommodate them. It‘s hard to have any empathy for them,” Kumpf said. Since brain injuries are a “very invisible disability,” it‘s easy for the condition to slip by unnoticed, undiagnosed and unsupported, he said, adding that no two brain injuries are alike.

“The range in brain injuries is substantial – that would include everything from concussions to severe brain injuries that leave people with physical, cognitive, emotional or behavioral disabilities,” said Kumpf. “There‘s no cookie-cutter response either, that‘s the other thing.”
See our website for information on what to do in the event of an accident involving traumatic brain injuries or death: www.hickeylawfirm.com. See also www.cruiseshipassault.com. The bottom line is get medical care immediately, take photos of the area where you were injured, get the names and contact information of witnesses, and report the accident at once. Also, CALL HICKEY LAW FIRM, P.A., TOLL FREE AT: 1.800.215.7117. Our consultations are always free. We work on a contingency fee basis; If we don’t recover, you don’t pay. Personal injury, wrongful death, sexual assaults, and medical malpractice. We have handled these types of claims for 28 years.

I stumbled on this article on a Diver’s blog. The blogger explains accidents which he has experienced on dive excursions and how the Divers Alert Network has helped him these situations. It is great to know that there are communities of people that are taking preventative measures to ensure proper and timely medical treatment in the event of an injury.

See below for excerpts of the article:
(Also visit: http://blog.scubadiving.com/stephenfrink/DAN+To+The+Rescue+Again.aspx)

“From anywhere in the world, for any diving related emergency, my go-to guys are the Diver’s Alert Network.

The first thing I did was to pick up a sat phone and call DAN in Durham, North Carolina. It was two in the morning there, but the on-call physician Dan Nord (sorry to wake you Dan) talked to my guest, and then went the extra mile to seek out a cardiac consultation from his network of specialists. He called back in less than 20-minutes and we had reassurance that this was not a life-threatening cardiac event, and so long as he took it a little easy we could carry-on with the trip.

That episode along cost DAN insurance providers over $50,000, and that was back in mid-eighties dollars. I can easily envision a $200,000 tab for evacuation and treatment these days, and without that kind of an upper limit on a personal credit card, there is the very real possibility the airplane and doctors and chambers would simply not be available if they weren’t certain they would be paid. That’s the power of deep pockets and serious insurance. That’s the power of DAN.

For others who may ever have had need for emergency treatment, or even the reassurance of a free phone consultation far from home, the importance of DAN may not be readily apparent. But, of all the things we do as recreational divers, the small cost of DAN membership and insurance is the best bargain in our industry. Some may take it for granted, but not me. We require DAN insurance for all participants in our photo-tours, and most live-aboard worldwide want that same proof of recompression treatment and evacuation insurance for all their guests. Really, don’t leave home without it. Don’t even think about it. By the way, this year’s trip was aboard the Seven Seas, and it was awesome. Great boat, and great crew, with diverse and spectacular photo opportunities. In the end we had nothing to worry about, nothing worth being insured for. That’s the very best kind of insurance … the kind you don’t need.”

See our website for information on what to do in the event of an injury aboard: www.hickeylawfirm.com. See also www.cruiseshipassault.com. The bottom line is get medical care immediately, take photos of the area where you were injured, get the names and contact information of witnesses, and report the accident or incident at once. Also, CALL HICKEY LAW FIRM, P.A., TOLL FREE AT: 1.800.215.7117. Our consultations are always free. We work on a contingency fee basis; if we don’t recover, you don’t pay. Personal injury, wrongful death, sexual assaults, and medical malpractice. This all happens on cruise ships and we have handled these types of claims for 28 years.

Nissan Motor Co., Ltd. announced that it will demonstrate its advanced “All-Around Collision Free” prototype vehicle—complete with two all-new accident avoidance technologies—at the 15th World Congress on Intelligent Transport Systems (ITS). The ITS World Congress, to be held at New York City’s Jacob K. Javits Center, from Nov. 16 - 20, 2008, showcases future vehicle-to-vehicle and vehicle-to-infrastructure communications systems.

This is the first time the “All-Around Collision Free” prototype will be displayed in the United States and the world’s first demonstration of Back-up Collision Prevention (BCP). The prototype also incorporates Side Collision Prevention (SCP) and two current production technologies, Distance Control Assist (DCA) and Lane Departure Prevention (LDP).

The “All-Around Collision Free” prototype vehicle further extends Nissan’s “Safety Shield” concept to help protect the vehicle and its occupants from potential risks coming from multiple directions. Following is a brief overview of the key systems:
Side Collision Prevention: As the vehicle begins to change lanes, side-mounted sensors activate a warning if another vehicle is detected in the intended lane. A yaw mechanism is then activated through brake control of individual wheels on the opposite side of the vehicle, to help prevent a potential collision by moving the vehicle toward the center of the original lane of travel.

Back-up Collision Prevention: During a backing maneuver, such as backing out of a parking space, rear and side-mounted sensors detect objects in the path of the vehicle. If an object is detected, an alarm sounds and then the brakes are activated to help avoid a collision.

Distance Control Assist and Lane Departure Prevention: Distance Control Assist (DCA) detects the distance to objects in front of the vehicle. When the vehicle is approaching an object, DCA will display a warning symbol, sound an alarm, and move the accelerator pedal up against the driver’s foot. If the throttle is not being applied, DCA will gently apply the brakes to help encourage deceleration.

Lane Departure Prevention (LDP) assists with maintaining lane position by detecting lane markers and calculating position relative to them. If the vehicle approaches the lane markers, a warning illuminates and an alarm sounds. If the vehicle continues to travel toward the lane markers, the system activates the yaw mechanism (described in SCP above) to help move the vehicle toward the center of the lane.
Both the DCA and LDP systems complement the SCP and BCP to move toward an “All-Around Collision Free” prototype. These warning systems and preventive safety features are designed to help support the driver in an intuitive manner with minimal intervention.

About Nissan Safety Shield
As part of its commitment to continuously improve the safety of its vehicles, Nissan has developed and advanced many pre-crash and crash protection technologies. These innovations are part of Nissan’s “Safety Shield” concept: an advanced, proactive approach to safety issues based on the idea that advanced technology in vehicles helps protect people. This approach provides various measures to help the driver and passengers better avoid dangers in ways that are optimized to each of a wide range of circumstances that the vehicle may be in, from “risk has not yet appeared” to “post-crash.”

Video of these Safety Shield technologies in action is available at http://nissannews.com/show-video-gallery.do?method=view&cID=11&key= .

On a global level, Nissan is committed to building safe vehicles equipped with advanced safety technologies. In Japan, the company’s safety vision is to halve the number of traffic fatalities or serious injuries involving Nissan vehicles by 2015 compared with the level in 1995.

SOURCES:
http://www.NissanUSA.com

The cruise lines design the interiors of their ships. They have in house architects and engineers in their New Build Departments create designs right here in Miami, or they contract the design of certain areas out to design firms around the world.

These designs and plans are then sent to the ship yard for the building. The cruise lines even send designers, engineers, architects, and construction supervisors to the ship yards to oversee construction at various stages. These personnel usually live for a time, sometimes years, in the city in Europe where the ship is being built. Cruise ships typically are built in shipyards in Germany, Italy, and Finland.

These ships are completely custom made. The cruise line creates the plans and therefore the cruise ship. The ship is supposed to represent and to symbolize the brand of each cruise line. For Carnival, it is “the Fun Ships”. For Royal Caribbean, it is “way more than a cruise”. For Norwegian Cruise Lines, it is “Free styling”. For Celebrity, it is a more stately, art appreciating feel. For Disney, it is all about the fantasy.

Because the cruise lines have so much control over the design and construction of these ships, they have control over the safety of the ships. They choose where to have marble and where to have carpet. They also of course choose what to put on the marble at the factory and later of course on a regular maintenance basis.

See our website for information on what to do in the event of an injury on a cruise ship: www.hickeylawfirm.com. See also www.cruiseshipassault.com. The bottom line is get medical care immediately, take photos of the area where you were injured, get the names and contact information of witnesses, and report the accident or incident at once. Also, CALL HICKEY LAW FIRM, P.A., TOLL FREE AT: 1.800.215.7117. Our consultations are always free. We work on a contingency fee basis; if we don’t recover, you don’t pay. Personal injury, wrongful death, sexual assaults, and medical malpractice. This all happens on cruise ships and we have handled these types of claims for 28 years.

The MRI and CT scan may one day have a robotic cousin capable of following and peering into patients as they move around. A University of Florida engineer has designed a robot to shadow and shoot X-ray video of sufferers of orthopedic injuries as they walk, climb stairs, stand up from a seated position or pursue other normal activities—and maybe even athletic ones like swinging a bat.

University of Florida mechanical and aerospace engineer Scott Banks’ goal is to augment static images of patients’ bones, muscles and joints with an interior view of these and other parts in action during normal physical activity. By merging such full-motion X-rays with computerized representations, orthopedic surgeons will make better diagnoses, suggest more appropriate treatments and get a clearer idea of post-operative successes and failures, he said.

“Our goal is come up with a way to observe and measure how joints are moving when people are actually using them,” Banks said. “We think this will be tremendously powerful, not only for research but also in the clinical setting as well.”

Complaints about orthopedic injuries are among the most common reasons people visit the doctor, according to the American Academy of Orthopedic Surgeons. More than 8 million people were hospitalized in 2003 for musculoskeletal conditions or injuries, which are estimated to cost the United States at least $215 billion annually.

Orthopedic surgeons have long diagnosed patients by touch or with static X-rays, MRI and CT scans. They also may use X-ray video, but current technologies provide only a tight view of a very limited range of motion in a controlled laboratory setting.

While all of these techniques can be effective, they do not work well with injuries that manifest themselves when a joint is in motion, Banks said. These include, for example, injuries to the patella, or kneecap, and injuries of the shoulder. Surgeons sometimes have to operate to diagnose these and other injuries, which can lead to unnecessary surgeries.

After operations, surgeons have few tools beyond the patient’s experience to tell them whether a procedure worked as intended and whether it will forestall additional joint damage.

Banks hopes his robot – actually, a system that uses two robots because one robot will be necessary to shoot the X-ray video and another to hold the image sensor — will lead to a radical improvement.

He has one working robot currently. The robot, which has a one-meter mechanical arm, is a commercial product normally used in robotically assisted surgeries and silicon chip manufacturing that Banks and his graduate students have re-engineered. The robot can shadow a person’s knee, shoulder or other joint with its hand as he or she moves.

In its completed form, the hand will hold lightweight equipment capable of shooting X-rays, while another robot will hold the sensor that captures images of the body as moving videos. Although the robots will be attached to a fixed base, there is room for a person to move around normally within their reach. And in the future, said Banks, “we could put these robots on wheels and they could follow you around.”

Mike Moser, a UF orthopedic surgeon working with Banks on the project, said he thinks the robot system would be very useful to surgeons.

“The biggest thing that this technology could offer in treating orthopedic injuries is that it has the ability to visualize joint motion dynamically, as it changes,” he said. “I think this would be good for many different conditions of the shoulder, knee, elbow and ankle. And I think it could be extrapolated to pretty much any orthopedic injury or condition.”

Although it is not yet available, this is something we have the pleasure of looking forward to in the future.

A SLAP tear is an injury to a part of the shoulder joint called the labrum. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable. To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within.
A specific type of labral tear is called a SLAP tear; this stands for Superior Labrum from Anterior to Posterior. The SLAP tear occurs at the point where the tendon of the biceps muscle inserts on the labrum.

There are several injury mechanisms that are speculated to be responsible for creating a SLAP lesion. These mechanisms range from single traumatic events to repetitive microtraumatic injuries. Common reasons for a SLAP tear include:

• Fall onto an outstretched hand
• Repetitive overhead actions (throwing)
• Lifting a heavy object

The area of the labrum where the SLAP tear occurs is susceptible to injury because it is an area of relatively poor vascularity. Other parts of the labrum often heal more easily because the blood supply delivers a healing capacity to the area of the tear. In the area of SLAP tears this is not the case, and chronic shoulder pain can result.

Although everyone is different the most typical symptoms of a SLAP tear is a catching sensation and pain with movement. These are made worse by overhead activities such as throwing ironically the very activity that most likely caused the tear in the first incidence. Patients usually complain of pain at the back or deep within the shoulder. Patients find it hard to pinpoint symptoms to a specific isolated area, unless the biceps tendon is also involved.

How is a SLAP tear diagnosed?

Most patients with SLAP tears will respond to non surgical or conservative treatment. The most important factor after the initial injury is to rest to allow the injured tissue to cool down and for the inflammation to subside. This may alleviate symptoms and in many cases no further intervention will be needed.

If symptoms persist then other treatments are often tried other than surgery these treatments include:

• Physical therapy
• Anti-inflammatory medication
• Cortisone injections

If symptoms persist then arthroscopic surgery of the shoulder is a good idea. SLAP tears often occur along with other shoulder problems such as rotator cuff tears, and even shoulder arthritis. Arthroscopy the shoulder to be fully explored and any further surgery will then allow for all problems.

Common treatment options for SLAP tears are:

Debridement of the SLAP tear:
Debradment is shaving away the torn portion of the labrum in order to leave a smooth edge. This option is only suitable for very small tears that do not involve other tendons or factors in the shoulder.

Biceps tenodesis:
This cuts the biceps tendon from the labrum attachment and reinserts it in another area. This decreases the pull on the SLAP region and thus alleviates symptoms. This procedure is often performed on patients over 40 years of age or those patients with additional biceps tendonitis or tearing.

SLAP repair:
A SLAP repair done arthroscopically and re-attaches the torn labrum down to the shoulder socket. It is suitable for those patients with no other problems in the shoulder and for those who are very active. Once healed, the SLAP repair allows normal function to occur. The disadvantage is that the shoulder is prone to reoccurrence of the tear and both the debraidment and the SLAP repair should be accompanied with extensive physiotherapy

Your surgeon will go over these fully with you and discus which method is suitable for you.

Everyday more names add to the growing list of people living with an acquired brain injury.
But these are just people who KNOW they have a brain injury, how many have slipped through the cracks?

Far too many, if you ask John Kumpf. He’s the executive director of the Ontario Brain Injury Association and a representative of the Ontario Alliance for Action on Brain Injury, a group advocating for better support services for survivors.

“We want the Ontario government to realize this is not just a health concern,” Kumpf said yesterday during a visit to Kitchener’s Opportunity Centre. Operated by Participation House Waterloo-Wellington, the King Street West facility offers programs and support to people living with brain injuries.

Survivors are often overrepresented in the homeless and prison populations, Kumpf said. Others lose their homes, their jobs, even their families, with precious little information on where to turn for help.
In many cases, the injuries aren’t readily apparent, and victims suffer in silence.

Tax dollars go toward things like incarceration, Kumpf said, when they should be funneled into supportive living, day programs like those at the Opportunity Centre, case management and training for teachers, police and others who may encounter people with brain injuries.
The government does spend millions of dollars on primary health care and rehabilitation, Kumpf said. But it can’t end there.

“It’s a lifelong debilitation and it needs lifelong support,” said Rachel Sa, who is accompanying Kumpf on his province wide tour.

An acquired brain injury is one caused by damage to the brain after birth. It could stem from a non-traumatic event, such as an aneurysm or infection, or from something traumatic such as an assault, a near-drowning, slip and fall, or a crash. It’s been about 12 years since Dana King joined the club.

A former forensics officer with the Ontario Provincial Police, King had taken a job with the Walkerton force to set up its identification unit. Used to working days, he’d switched to cover a night shift as a favor to a colleague. A call came in. Neighboring Hanover officers were chasing a stolen van and they were headed King’s way.

He got his cruiser into position to try to stop the van with a rolling road block. The driver plowed into King’s moving car from behind at 100 mph and kept going. Numerous hospital stays eventually healed most of King’s injuries. But the worst, the damage to his brain, wasn’t diagnosed for nearly a year.

“I didn’t know what was happening to me,” he said. He was saddled with a stutter so bad he wouldn’t talk. He suffered from memory loss and could no longer count. Small tasks became insurmountable.
The stress took its toll on those closest to him. Friends stopped calling, his marriage dissolved. King, for a time, gave up. But he fought back. Having relocated to Kitchener, King became a frequent visitor to the Opportunity Center.

“With us, it’s a lose-win,” he said. “After we’ve lost everything, you get into a place like this and you win every day.”

There are only four other facilities like the Opportunity Center in Ontario, though. And more people become eligible for their services each day.

“The good news . . . is that we know what to do for people,” Sa said. “The bad news is we really don’t have enough for everyone with acquired brain injuries.”

These days, knee pain has become a common complaint among many people. Most people will suffer from knee pain at sometime or another. While it is easy ease knee pain, you need to know the actual cause behind your knee pain before you do so.

Knee pain can occur because of a variety of reasons. If you are suffering from any of the following conditions: gout, arthritis, ligament injuries, cartilage injuries, patellar tendonitis, baker’s cyst, bursitis, Plica syndrome or Osgood-Schlatter disease, then you will have frequent bouts of knee pain. Once you diagnose the root cause behind your knee pain, you can use the following methods to help reduce knee pain.

1. Complete bed rest:
Often knee pain is caused because either you are living a stressful life or are under too much work pressure. Take a short leave from work and take a complete bed rest. Often rest is the only thing you will need to cure knee pain. When you rest your knee and joints, the acute inflammation of the joint subsides, and you are relieved from pain.

2. Applying extreme temperatures can help you to reduce knee pain fast.
You can use either ice packs or heat pads. Just apply either the ice pack or the heat pad on your knee cap. If you are undecided on when you apply ice and when heat, consult with your physician.

3. Many times stretching helps people to reduce knee pain.
Stretch your joints and tendons in an appropriate manner and see if it alleviates knee pain. Of course, you should do stretching daily as a routine and not just once in a blue moon. If you don’t know about specific stretching exercises an orthopedic may be able to help you out.

4. Physical therapy is yet another way to alleviate knee pain.
Many orthopedic doctors use different types of physical therapy on their patients in order to strengthen and give vitality to their knees.

5. Yet another way to reduce knee pain is by using non-steroidal anti-inflammatory medications, commonly referred to as NSAID’s.
These medications are specially prescribed for patients whose knee pain is caused by conditions such as arthritis, bursitis, and tendonitis. Non-steroidal anti-inflammatory medications have helped many people alleviate the pain associated with knee problems.