A Holistic Approach to Knee Pain: Understanding the Patient Beyond the Joint

A Clinical Case Experience at Shri Sivalaya Holistic Natural Healing Hospital

A 70-year-old female presented with left knee pain and swelling for approximately two months, associated with difficulty and discomfort during movement. Clinical examination revealed crepitus and mild restriction of range of motion, with visible swelling around the affected knee. Pain was reported to reduce with rest.

While the presenting complaint appeared to be primarily musculoskeletal, a detailed clinical evaluation and laboratory investigation revealed several important underlying health concerns that required attention.

Looking Beyond the Knee

The patient's investigations revealed severe microcytic hypochromic anaemia, with a haemoglobin level of 6.9 g/dL, along with reduced MCV and MCH and increased RDW. Further evaluation also identified severe vitamin B12 deficiency, with a reported B12 level of 100 pg/mL, and vitamin D insufficiency.

The metabolic evaluation showed:

• Fasting blood glucose: 141.53 mg/dL
• HbA1c: 8.0%
• Vitamin B12: 100 pg/mL
• Vitamin D: 21.1 ng/mL
• TSH: 7.95 µIU/mL
• Free T4: 0.897 ng/dL
• Haemoglobin: 6.9 g/dL

The clinical assessment also raised concerns regarding hypothyroid pattern, newly detected diabetes, nutritional deficiencies and possible fatty liver disease, highlighting the importance of looking at the patient as a whole rather than focusing solely on the painful joint.

Knee Assessment

The presence of knee pain, swelling and crepitus was clinically suggestive of degenerative osteoarthritis of the knee.

However, managing the joint alone would not provide a complete picture of the patient's health. Her nutritional status, severe anaemia, endocrine abnormalities and metabolic health also needed appropriate medical attention.

A Multidimensional Approach to Care

At Shri Sivalaya, the case was approached with an emphasis on individualized, holistic care.

The treatment plan included appropriate medical management and further evaluation of the severe anaemia, including assessment of iron status and other nutritional factors. Vitamin B12 and vitamin D deficiencies were addressed, while thyroid function and blood glucose control were also taken into consideration.

For the knee complaint, the approach focused on supporting mobility, reducing discomfort and improving overall functional well-being through an individualized integrative programme.

The patient's care was therefore not limited to treating the symptom of knee pain—it involved understanding the nutritional, metabolic, endocrine and musculoskeletal factors contributing to her overall health.

The Bigger Lesson

This case reminds us that a symptom may be only one part of a much larger health picture.

Knee pain in an older adult may be associated with degenerative changes, but a comprehensive assessment can uncover conditions such as anaemia, nutritional deficiencies, thyroid dysfunction and altered glucose metabolism that may otherwise remain unnoticed.

At Shri Sivalaya Holistic Natural Healing Hospital, our approach is centred on seeing the person, not just the disease combining careful clinical assessment, appropriate investigations, medical care and individualized holistic therapies to support the patient's overall well-being.

Every symptom tells a story. A comprehensive evaluation helps us understand the whole story.