1. Knee Pain: Osteoarthritis in some religious sectors due to biomechanical postural loading. A literature review Karol A. Donaubauer, BA, DC, CCSP Palmer College of Chiropractic Community Outreach Clinic Davenport, IA APHA Conference: Boston November 2-6, 2013 1

2. DISCLOSURE The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Karol Donaubauer, BA, DC, CCSP I have no relationships to disclose 2

3. Osteoarthritis: AKA: Hypertrophic osteoarthritis; Osteoarthritis; Degenerative joint disease; DJD; OA; Arthritis – osteoarthritis 2 types: Idiopathic (localized) or Secondary (traumatic, congenital, metabolic/endocrine/neuropathic and other medical causes). Most frequent chronic musculoskeletal disorder and leading cause of disability in US and the world 43 million Americans and approx. 15% of the world are affected Aging process: wear and tear on joints, esp. hands, hips, knees, spine. 3

4. Continued Hyaline joint cartilage is the main target that causes OA NO cure for OA Symptoms: pain, swelling, stiffness Begins after the age of 40 KNEES: 45+ years: 18.7% women; 13.5% men 60+ years: 13.6% women; 10% men Costs: $7.9 billion est. of knee and hip replacements in 1997 4

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7. 7 Squatting position NOTE: knees positions

8. From: Dtsch Arztebl Int. 2010 March; 107(9): 152–162.Dtsch Arztebl Int. 2010 March; 107(9): 152–162. 8

9. TREATMENT for OA: knees The best treatment for OA of the knee is prevention; otherwise: Focus on relieving symptoms and improving function Includes any combination of: – Patient education or RE-EDUCATION – Physical therapy – Weight control – Use of medications (anti-inflammatory) – CHIROPRACTIC ADJUSTMENTS Full spine Patellas Knee joints 9

10. TREATMENT: continued Pillow Knee pads Not perform position (last resort) Need to be culturally sensitive REFERENCES upon request 10

11. 11 THANK YOU !!!