Expert: Dr. Paul Newhart - 5/21/2009

Question
I am 18 years old and have had knee pain for the last two years.  I went from
being a very active person to not being able to do the things I use to do
because of the pain.  The doctors diagnosed it as patella femoral pain.  I was
born with cerebral palsy which makes treatment of the knee pain even harder.  
The cerebral palsy mainly affects my lower legs causing severe spasticity and
weakeness.  As a result of the decreased strength in my hips and legs I have had
to  use a walker to get around on a daily basis since I was born.  About a year
and half ago I had femoral osteotomy to fix the deformity in my femur with the
hopes that, that would make the knee pain go away, but no such luck.  Five
months later I had my knee scoped.  They found nothing except for a contusion
underneath my kneecap, but nothing that would fix the pain.  Then I had a
cortisone injection that provided complete relief for just a day due to the
litocane.  After that I had euflexa injections, but got no relief at all.  The
doctors considered doing a lateral release, but after my visit to the mayo
clinic they decided this would probably put me in a wheelchair for the rest of
my life due to the lack of strength i have in my hips and legs.  I have also
done physical therapy and taken many different medications, but had no luck with
either.   

I have never received any type of chiropractic treatments, but decided to give
the option a try after all the previous failed options.  I read up on
acupuncture and went to my local chiropracter to give it a try.  I have received
about 16 treatments and had no luck yet.   He also adjusted the cartilage in my
knee.  What else can the chiropractor do for the knee pain???  Is it normal for
the acupuncture to take this long to be effective???

Also I recently started having si joint pain.  My chiropractor confirmed this to
be facet joint pain.  How is si joint pain related to facet joint pain?  Is the
pain going to go away in time with stretching??

Thank you for taking the time to read and or comment on what I wrote.  Any
comments or answers to questions you can provide would be more than helpful.

Answer
I am not sure how long the acupuncture should take to work, but I have seen it happen within 3-5 visits.  The knee pain can also be addressed by using muscle stim, ultrasound, myofascial release, and low level laser treatment.  all of these can be quite effective in helping with the pain.  The pain in the SI joint can be related to the knee in that the change in mechanics with walking will put more stress on that joint.  The SI joint IS different than a facet joint; the facet joints are on the vertebrae themselves.