Knee pain is a common problem and it can be caused by a myriad of things from running and ligament damage to arthritis. 

More than one in five people over the age of 40 have a form of chronic knee pain, according to global estimates.  

But just because it is common, doesn’t mean you should put up with it.

Chronic pain can impact how active you are and experts say basic exercises can significantly help most knee problems.  

Here, MailOnline asks the experts what causes knee pain and how you can treat it.  

Causes of knee pain 

In most cases, knee pain is caused by trauma due to a sports injury or at work. 

Damage to the cartilage inside the knee and ruptured ligaments, which hold the knee together, are common injuries that happen due to trauma. 

While cartilage tears can heal on their own, experts warn damage to the ligaments can require surgery.  

But experts say the most common culprit of knee pain differ with age. 

In younger people, knee pain is most often caused by injury or sudden movements that put strain on the knee, leading to sprained or strained knee ligaments, torn cartilage or tendon inflammation from overuse, according to Professor Karen Barker, an expert in physiotherapy at Oxford University. 

‘In young adults knee pain may result from sporting injuries where tendons around the joint, or cartilage inside the joint, is damaged,’ says Professor Philip Conaghan, an expert in rheumatic and musculoskeletal medicine at University of Leeds. 

This pain can be felt at the front of the knee and is usually related to problems with the tendon that the kneecap sits in. It can also be caused by the position of the knee cap. 

He added: ‘Another cause in young people is pain at the front of the knee which can mean inflammation of the tendon that surrounds the kneecap, and this might be more common in people with stretchy joints also known as hypermobility.’

However, for people over 40 knee pain is commonly a sign of arthritis. 

‘For most people over the age of 40, the most common cause of knee pain is likely a mixture of tendon problems and underlying osteoarthritis, the sort of arthritis most people get with age and the accumulation of minor knee damage over many years’, says Professor Conaghan.

The symptoms to watch out for

Swelling, pain and stiff joints are all symptoms of arthritis. 

It affects millions of people across the UK and can affect people of all ages including children.

Professor Barker explained it can cause the joint to feel warm to touch. 

She added: ‘There may be popping or crunching grating noises on movement, known as crepitus.

‘Other signs in more severe cases include an inability to fully straighten the knee and pain on walking or when taking weight through the leg.’

But there are many triggers for knee pain and types of arthritis. 

‘There are many different kinds of arthritis, but we try to distinguish mechanical joint problems, such as tendon problems and osteoarthritis which are very common, from inflammatory arthritis, such as rheumatoid arthritis or gout’, says Professor Conaghan.

Both mechanical and inflammatory joint problems can cause swelling, but there is a difference between the two.  

Mechanical joint problems are often associated with having stiff joints in the first 10 to 15 minutes after getting out of bed or after sitting for a prolonged period of time and then improve with moving around, according to Professor Conaghan.

He said: ‘Generally they get worse the more you are on your feet over the day. We know that people with osteoarthritis often start to get their symptoms when using stairs.’ 

But when it comes to inflammatory arthritis, people experience morning joint stiffness for hours or severely painful acute flares as in gout, he explains. 

Infections including salmonella can also cause an acute inflammatory arthritis with a large swollen knee, experts say. 

Although clicking joints is not usually a cause for concern, Professor Conaghan warns the ‘sensation of the knee “giving way” most often means weak thigh muscles rather than ligament damage’.

When should you see a doctor? 

Knee pain that gets worse with movement and pain that does not appear to be getting better, are both warning signs that you should see a doctor.    

Professor Conaghan said: ‘If you’ve had an obvious knee injury with acute and large knee swelling within an hour, it’s worth getting a checkup to see if you’ve torn a knee ligament. 

‘If you develop a lot of knee swelling without any trauma then you may need to see a doctor especially if the knee feels very hot or tender, or you’re running a temperature. 

‘If you have known arthritis like gout or rheumatoid arthritis and you get increased knee pain or swelling, you may need a change of medication.’ 

But Professor Barker says if the ‘onset is gradual or non high impact traumatic injury’ patients should use ice and rest the joint to counteract the swelling and use over the counter pain killers , such as paracetamol, to manage the pain. 

People that are 45 and over and have activity-related joint pain as well as stiffness in the mornings can get an osteoarthritis diagnosis without am X-ray or MRI scan, according guidelines by regulator NICE.

But even after a diagnosis surgery is a ‘last resort’, Professor Barker explains.  

She said: ‘Surgery is a treatment of last resort for knee arthritis and should only be considered with severe osteoarthritis when other measures have failed to help such as weight loss management, exercises, physiotherapy, pain killers and after a minimum of 3 -6 months of non surgical treatment before referral.’ 

Managing knee pain

Knee pain can be caused by weak muscles and sometimes strengthening the muscles around the knee can help.  

‘Sometimes muscle weakness precedes knee pain; weak muscles lead to tendon pains around the knee’, says Professor Conaghan. 

He explains that as we age we lose muscle, this is especially the case in sedentary jobs. 

Plus, people who get knee pain also lose muscle quickly too. 

He said: ‘So, everyone needs thigh muscle strengthening. 

‘The main signs of weak thigh muscles are difficulty getting out of a deep chair or car without using your arms, difficulty getting out of the bath or a sensation of your knee “giving way”.’

But there are a few exercises that can target the right muscles.  

‘The good thing is that for most people, basic exercises can have a profound effect on improving knee pain and also in improving joint function,’ says Dr Darren Player, Lecturer in Musculoskeletal Bioengineering at University College London (UCL). 

Dr Player encourages strengthening and stability exercises, such as knee extensions, stair climbing, simple lying knee bends, static quad exercises and sit-to-stand exercises. 

He said: ‘Based on initial strength, symptoms and the underlying condition, it may be possible to perform more complex exercises, such as lunges which help with strengthening and stabilisation. 

‘Progress should be steady- working towards 8-10 repetitions for each exercise, repeated 3-4 times with sufficient rest.’

But these exercises should not cause acute pain, if they do Dr Player suggests reducing repetitions or sets and include more rest time. 

He added: ‘As with any form of exercise, there may be some pain felt in the days afterwards, but this is part of the natural regeneration process.’

For some people with very weak knees lighter exercises are needed.

Professor Conaghan said: ‘Many people who are very weak may find that walking multiple laps in a swimming pool is an easy way to build muscle. 

‘See a physiotherapist to give you one or two thigh muscle exercises to do everyday, such as straight raises when lying down. 

‘The key is to get into a habit of doing your muscle strengthening exercises and, as you get stronger, to move to more aerobic muscle strengthening exercises like exercise bikes or cross trainers.’

•  40 per cent of women reported a decline in their mental health due to joint pain

By Kate Pickles Health Editor

Updated: 19:36 EDT, 3 September 2023

Rugby legend calls for Matildas to complete revenge mission on England after the pain of the 2003 World Cup: ‘It still haunts me’

By Darren Walton For Australian Associated Press

Published: 02:38 EDT, 15 August 2023 | Updated: 02:38 EDT, 15 August 2023

Jack Grealish admits he’s ‘in a world of pain’ as bleary-eyed Man City star emerges worse for wear after epic four-day bender, with Treble winner set to join up with England

• Jack Grealish made the most of Manchester City’s historic Treble last season 
• The midfielder revelled in a four-day bender after the Champions League win
• However, Grealish is now facing the prospect of reporting for duty with England 

By Daniel Davis For Mailonline

Published: 14:47 EDT, 13 June 2023 | Updated: 14:48 EDT, 13 June 2023

Last month I experienced a dreadful pain on one side of my face – like an electric shock going from my upper lip to my hairline. It lasted a few seconds but stopped me in my tracks. I saw my GP who suggested it was trigeminal neuralgia, prescribed pregabalin and arranged an appointment with a neurologist. I’m frightened of the pain returning. Will it?

Trigeminal neuralgia is a sudden and severe facial pain. Attacks can last anywhere from seconds to a few minutes and can occur hundreds of times a day.

It’s related to problems with one of the trigeminal nerves, which run across either side of the face, branching from just in front of the ear, around the eyes and across the forehead and also the jaw. Usually just one is affected, so pain is felt on only one side of the face.

Trigeminal nerves transmit sensations of touch and pain, but they can become compressed – often by nearby blood vessels, for reasons that are not always clear – resulting in episodic pain.

The attacks can be triggered by activities that involve touching the face, eating and brushing teeth. But a slight breeze or air conditioning, or movement of the face or head, can also bring it on.

We’d usually only diagnose it once there has been consistent or recurrent pain, but a GP might choose to prescribe something as a pre-emptive measure.

The most commonly given drug for trigeminal neuralgia is carbamazepine, which works to dull nerve pain. Pregabalin is also a nerve-pain drug, but isn’t usually given in these cases.

Looking for causes is an important next step – dental problems, for instance, can be linked. Patients should expect a referral to a specialist pain clinic – with waiting lists as they are at the moment, making sure the appointment is made might involve being persistent with the GP. In some severe cases, surgery is required.

A few years ago I was started on statins as my cholesterol was very high – 7.7. My levels didn’t come down enough, so I was switched on to another statin but this seemed to trigger intense anxiety. A third type caused the same problem. I’m only able to tolerate a low dose of the original statin, but this isn’t controlling my cholesterol. I have a family history of heart attacks, so I’m wondering if I have other options?

Very high cholesterol combined with a family history of heart attacks is a risky situation to be in.

Bringing down the cholesterol level would reduce the risk of a heart attack or stroke. But other things will also be important, including treating diabetes or raised blood sugar and high blood pressure. Regular exercise and making sure you are a healthy weight – with a waist measurement of less than 37in for men and 31in for women – are key to this.

Statins are very common drugs but there are side effects for some people. Anxiety isn’t a typical one we hear, but if it is something you are suffering then doctors should offer alternatives. If only a lower dose of statins is tolerable, there is the option of adding another type of a cholesterol-lowering drug called ezetimibe. Together they may help control cholesterol without the side effects.

In many hospitals there are specialist lipid clinics that focus on people who have very high cholesterol that is difficult to treat, and it may be worth asking for a referral to one as they can offer a range of other drug treatments that can’t be initiated by a GP.

The charity Heart UK can offer advice (heartuk.org.uk).

My six-month-old grandson has an inflamed rash all over his body. Our doctor has prescribed an antihistamine, which only reduced the redness. He is unable to sleep, which means neither can Mum and Dad. Can you offer any advice?

The first thing I’d consider is eczema. This causes inflamed, dry and red skin with episodes flaring up and then subsiding.

It’s common in babies, and we have fairly standard treatment regimes that we would offer parents. A warning – sticking to these can be tiresome and boring. It certainly can help a great deal, but only if it is consistent.

The first step is avoiding all irritants, such as bath products and shampoos and things that may affect the skin, including fabric conditioner. Speak to pharmacists about a suitable soap substitute – usually a cream or an oil rubbed on the skin.

At least three or four times every day (often when changing a nappy) an emollient cream should be used – these are medically formulated moisturisers which hydrate and soften the skin. 

There are a number of options on chemists’ shelves and it may take some trial and error to find one that suits.

As well as this, when eczema is particularly flared-up, a few days of a mild steroid cream could be used in the worst areas. 

This worries some patients, but these are extremely safe and definitely a better option than leaving a baby in pain from the rash.

Antihistamines generally don’t help eczema.

It’s worth considering a cow’s milk protein allergy. This can cause a severe eczema-type issue on the skin as well as digestive issues, and often babies with very inflamed skin actually have this, not eczema.

Weather warnings aren’t so daft

I rolled my eyes when I read about the Government’s plan to introduce a new system of colour-coded warnings to tell us when the weather gets really hot or really cold.

I’m sure, like me, you thought: ‘Well, I can work that out for myself, thank you very much.’ But us Brits are not so good in the heat. I know this because every summer I see sunburnt kids and elderly people with heatstroke in my clinic. And every year thousands of people die from the heat in the UK. It’s a serious problem, particularly in over-65s. Health concerns are an issue in winter, too, when temperatures drop.

So I’ll be signing up to the emails. You can register via the Government’s website (gov.uk). The easiest thing to do is to Google ‘Weather-Health Alerting System’ and it should come up as the top hit.

What women’s health issues do YOU want tackled now? 

In August last year the Government launched its Women’s Health Strategy for England after spending a year gathering reports from women about their medical experiences.

There was a vast number of responses, with many telling stories of being ignored, dismissed and poorly treated. The Mail on Sunday is passionate about changing this – so we are assembling a Women’s Health Panel to tackle the biggest health problems facing 51 per cent of the population.

It will feature the UK’s foremost experts in a wide variety of medical specialities, from gynaecology and mental health to fitness and dermatology. Today, we have one question: What do YOU want us to talk about?

In the coming weeks, we’ll devote a whole edition of Health to answering in depth the most pressing issues you’re facing.

You can email me on DrEllie@mailonsunday.co.uk or write to me at: The Mail on Sunday, 9 Derry Street, London W8 5HY.

‘Calms my pain within MINUTES’: Shoppers swear by this £30 ‘life-changing’ CBD-infused balm for rapid relief from debilitating arthritis pain – and it’s on sale

By Emily Scrivener For Mailonline

Updated: 08:16 EDT, 1 June 2023

The Sackler family, once regarded as a beacon for philanthropic giving, got a major break in a bankruptcy settlement shielding them from criminal charges for their role in fueling a deadly opioid crisis that has killed more than 650,000 people.

OxyContin was the star of drug-maker Purdue Pharma’s portfolio, which proved a cash cow for the mega-elite Sacklers who at one point were worth $13 billion and used their fortune to fund whole museum wings, hospitals, and university departments.

Members of the Sackler family who served on Purdue’s board of directors helped to obscure the true addictiveness of the painkiller and rewarded prescribers for doling out a massive number of pills whether their patients needed them or not. 

Highly addictive narcotics like OxyContin have hooked millions of people who, when their prescriptions ran out, turned to cheaper heroin and eventually its even deadlier cousin fentanyl. 

A federal appeals court on Tuesday ruled that members of the family who served on the company board until about 2019 could be shielded from all current and future liability related to the harm done by Purdue’s trademark drug. 

The bankruptcy settlement announced this week would insulate the Sackler family, several members of whom served on Purdue’s Board of Directors until 2019, from thousands of lawsuits over the role they played in the opioid epidemic in exchange for about $6 billion.

The agreement, when finalized, would bring years of litigation and thousands of suits worth billions to a close and finally distribute about $750 million in reparations to victims’ families and survivors.

Over the years the Sackler family has enjoyed good press for their philanthropic contributions, with the family name affixed to whole wings of prestigious museums, universities, and art galleries in the US and the UK.

The Tate Modern in Britain has removed the Sackler name from certain exhibitions, as did the Louvre in Paris. In December 2021, the sprawling Metropolitan Museum of Art in New York announced that it would remove the family name from seven of its exhibition spaces. 

But many of the prominent cultural institutions are ditching their affiliation with the family and Purdue Pharma, whose legacy includes introducing a drug that helped drive a protracted overdose crisis that has killed more than 650,000 people since 1999.

Whole towns and neighborhoods have been decimated by the crisis. In Williamson, West Virginia, a state where more people have fatally overdosed than in any other in the US, out-of-state wholesalers had shipped nearly 21 million hydrocodone and oxycodone pills to two pharmacies just four blocks apart.

The tiny town of just 3,200 people was inundated with pills – more than 6,500 per resident.

Doctors were overly generous with the pills for patients just coming out of surgery, both major and minor, in part because Purdue Pharma rewarded prescribers the more pills they doled out. 

People recovering from a root canal or a broken bone were commonly prescribed strong painkillers to improve the recovery process.

Overprescribing was so pervasive that up to 92 percent of patients reported having leftover opioids after common operations. 

Purdue Pharma leadership had underplayed the drugs’ addictiveness for years, and insisted that its time-release formulations could not be abused. This was not true.

The deluge of pills in small towns and major cities represented the first wave of the crisis. But when people’s prescriptions ran out, many of them turned desperately to heroin sold illegally on the street.

Heroin is a semi-synthetic drug between two and five times more potent than morphine. Roughly 1.1 million Americans are hooked on it and over 9,000 people died from an overdose involving heroin in 2021.

Heroin-related deaths spiked 286 percent between 2002 and 2013. The vast majority of heroin users – about 80 percent – reported first misusing prescription pills.

The second wave of the crisis marked by an increase in heroin use ushered in a third, more deadly wave driven by the synthetic opioid fentanyl.

Fentanyl, which is cheap and often used as an adulterant in street drugs to boost the euphoric high, is 50 times more potent than heroin. An infinitesimal amount, barely enough to cover the surface of a penny, can prove fatal.

Roughly two-thirds of the fatal overdoses in 2022 involved fentanyl.

Drug traffickers commonly mix the synthetic opioid with other street drugs including heroin, cocaine, and methamphetamine, or press it into pills that resemble other prescription opioids. On the street, it is known as everything from ‘blues’ to China Girl, and Goodfellas.

The painkiller was first developed as an IV anesthetic in the mid-20th century.

By the 1990s, different iterations of the drug were introduced to the market, such as dermal patches and lollipops, giving people in extreme pain such as cancer patients going through chemotherapy a means of relief.

But in the early 2000s, the US Drug Enforcement Agency (DEA) was made aware of rampant overprescribing and, by the 2010s, the drug had flooded US streets.

Major cities have been devastated by the scourge of fentanyl. San Francisco has been acutely affected with a staggering 41 percent surge in the number of drug-related deaths in the first quarter of 2023 compared to the same time last year, largely due to fentanyl. 

The Californian coastal hub saw 200 people die due to overdoses between January and March, compared to 142 deaths in 2022. That amounts to one overdose death every 10 hours. 

Tests by the Drug Enforcement Administration show that four in ten pills sold in the US have at least 2mg of fentanyl — the equivalent of about five grains of salt — a dose that is considered potentially lethal.

The deluge of fentanyl in the US is primarily the result of criminal organizations in Mexico producing massive amounts of the drug using precursor chemicals shipped from China. According to the DEA criminal groups in Mexico are becoming increasingly advance, setting up secret laboratories and processing facilities.

So, who are the Sacklers really?  

The ascent of the Sackler family is a remarkable rags to riches story that starts with the unlikely rise of three brothers from Brooklyn: Arthur, Mortimer and Raymond, the sons of Jewish grocers who emigrated from Eastern Europe.

Within their lifetimes, they amassed an enormous $13 billion fortune (more than the Rockefellers or the Mellons) and began collecting art, wives and houses around the world. Their children and grandchildren enjoyed a life of luxury, attended the finest schools, and became fixtures on the glitzy society circuit.

Born in Brooklyn during the Great Depression, the brothers (who are now dead) went to medical school and became psychiatrists. They were especially fascinated by psychopharmacology as an alternative to other treatments like electroshock therapy for psychiatric disorders.

According to the New York Times, Raymond and Mortimer studied skin burns for the Atomic Energy Commission before they were fired for refusing to sign an oath promising to report colleagues having conversations that were considered ‘subversive.’

Arthur, the eldest, had a knack for marketing. He paid for his medical-school tuition by working at a small New York ad agency that specialized in the medical field. Possessing the unique skillset of a salesman, adman, and doctor made him a virtuoso in the business. Within a few years, Arthur bought the fledging agency and turned it into a powerhouse for pharmaceutical companies like Pfizer and Roche.

He revolutionized the industry by pioneering a new way of selling drugs that promoted the product to patients and doctors. More than anything, Arthur understood that physicians are heavily influenced by their peers, and thus crafted campaigns that directly appealed to medical personnel.

He got rich hawking Roche’s new tranquilizer, Valium, in the 1960s. One glossy for the pill depicted a woman surrounded by concerned doctors and family members because of her ‘psychic tension’, a 20th century term for what is now just considered stress. In part because of the success of Arthur’s campaign, Valium became the first drug in US history to top $100 million in sales.

During this time, he began to come under intense scrutiny for false advertising. One 1959 investigation conducted by The Saturday Review revealed that he had fabricated the names and identities of doctors who were used as references for the efficacy of a new Pfizer antibiotic.

His ad featured an assortment of doctors’ business cards next to the phrase: ‘More and more physicians find Sigmamycin the antibiotic therapy of choice.’ The only problem is that the names of the doctors and their telephone numbers did not exist.

Using Arthur’s ad money in 1952, the Sackler brothers bought Purdue Frederick – a little-known medicine company that mainly produced laxative and earwax remover out of the Greenwich Village. Raymond and Mortimer were co-chairmen while Arthur played a passive role.

Arthur Sackler died years before OxyContin hit the market. And states that have filed lawsuits against members of the family have not named his heirs. Arthur Sackler’s widow, Jillian Sackler, a major donor, has told institutions that her husband’s money did not come from OxyContin. 

Meanwhile, Raymond Sackler’s son Richard, who now lives in Florida, was an executive at Purdue when OxyContin launched in 1996 and later became CEO of the company. 

The drug did become a blockbuster, though generic opioids were prescribed far more often. 

Still, state and local governments that are suing the company assert that marketing by Purdue opened the door to wider use of prescription opioids.

Richard Sackler wrote in a 1999 email cited in court filings: ‘You won’t believe how committed I am to make OxyContin a huge success. It is almost that I dedicated my life to it.’

In a 2015 deposition, he tried to estimate how much the family had made from OxyContin. He said it was over $1 billion but less than $10 billion. In a video of the deposition that emerged in August, he was asked if he believed OxyContin was marketed too aggressively. He answered with a single word — ‘no’ — while barely glancing up from papers he was looking through.

Mortimer Sackler lived in London toward the end of his life. His widow, Theresa, who lives in England, and children Mortimer D.A. Sackler, Kathe Sackler and Ilene Sackler Lefcourt are all former board members and are named in lawsuits.

Mortimer D.A. Sackler and Kathe Sackler were also Purdue executives.

In legal filings, states have contended that the heirs of Mortimer and Raymond Sackler have accepted payments of at least $4 billion over the last dozen years. 

In the latest bankruptcy agreement, it was determined that the Sacklers who worked at Purdue withdrew roughly $11 billion from 2008 to 2017. 

More than half of that money was either invested in offshore companies owned by the family or deposited into trusts that could not be touched by bankrupcy. About $4.6 billion was used to pay pass-through taxes.

Arizona’s attorney general has asked the U.S. Supreme Court to force the family to return some money to Purdue so it could be fair game in lawsuits against the company. 

New York’s attorney general has requested financial records of entities connected to the family to try to trace the money. Her office said in a legal filing this month that it found $1 billion transferred to the family through Swiss banks and other secret accounts. 

The major exception to the Sackler family’s silence in recent years came when Richard Sackler’s son David and David’s wife, Joss, both in their 30s, both gave interviews for magazine profiles published earlier this year.

Joss Sackler has a doctorate in linguistics, serves as a rock climbing guide and has a fashion line. In a Town & Country interview, she expressed frustration with media attention on her connection to the Sacklers rather than her own work. More recently, she feuded about OxyContin with rock star Courtney Love, who said in an Instagram post this month directed at Joss Sackler, “Your. People. Killed. My. People.”

David Sackler, a Princeton University graduate who runs a family investment firm, made headlines last year when it was reported that he had paid $22.5 million in cash for a mansion in Los Angeles’ Bel Air neighborhood. He told Vanity Fair that the family has been vilified in part because family members have not told their story publicly.

‘We have not done a good job of talking about this,” he said. “That’s what I regret the most.’

Homeowners set to see interest rates rise for 12th time in 18 months – and have been warned they could jump as high as 5% by December

• Bank is expected to hike rates from 4.25% to 4.5% as it tries to curb inflation
• It will mean a 4.4 percentage point jump since December 2021 
• Marking the sharpest rise since 1989 

By Leah Montebello For The Daily Mail

Published: 16:51 EDT, 7 May 2023 | Updated: 16:58 EDT, 7 May 2023

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Analysts predict average household energy bills could fall to below £2,000 a year this summer after a slump in gas prices

By Luke Barr, Financial Mail On Sunday

Published: 16:52 EDT, 6 May 2023 | Updated: 16:52 EDT, 6 May 2023

Some links in this article may be affiliate links. If you click on them we may earn a small commission. That helps us fund This Is Money, and keep it free to use. We do not write articles to promote products. We do not allow any commercial relationship to affect our editorial independence.

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Paris Hilton was on Capitol Hill on Thursday to lobby members of Congress to support a bill designed to prevent sexual and physical abuse at schools, such as she endured.

The 42-year-old revealed in August 2020 that she had been abused at a ‘troubled teen’ facility in Utah, where she was sent for 11 months when she was 17.

Since then, the heiress and reality TV star has worked to improve scrutiny of schools, and prevent others from suffering like she did.

‘I’m doing everything I can in my power to fight for these children because these are children who come from families that can’t help and support them, and children from the juvenile justice system, foster care system. And they have no voice,’ she told Fox News on Thursday morning.

‘So I’m really just turning my pain into a purpose and using my platform to help make a difference and save children’s lives, because hundreds of children have died in the name of treatment in these places.’

Hilton is championing the Stop Institutional Child Abuse Act, which was introduced on Thursday by a bipartisan group of senators and representatives.

Democrat senator Jeff Merkley of Oregon and representative Ro Khanna of California backed the bill, besides Republican senators John Cornyn of Texas and Tommy Tuberville of Alabama, plus representative Buddy Carter of Georgia.

The bill seeks to create federal data collection and reporting standards for the ‘troubled teen’ industry and provide states with best practices to prevent abuse.

Hilton, speaking on the steps of the Capitol, described how she was subjected to horrific treatment at the school.

‘I witnessed and experienced sexual abuse from adult staff as well as endured verbal and emotional abuse daily. I was yelled at, dehumanized, silenced and stripped of any semblance of privacy,’ she said.

‘When I attempted to tell my parents about the abuse on the phone, staff would stop and immediately hang up the phone and punish me.

‘On top of this, you had no access to the outside doors, no sunlight, no fresh air. These were considered privileges.

‘What I went through will haunt me for the rest of my life.’

Hilton described being medically sedated against her will and forcibly restrained. She also said male staff members would watch her while she showered.

She previously described how she was sent there from New York as a teenage tearaway, and was subjected to emotional and physical abuse.

‘From the moment I woke up until I went to bed, it was all day screaming in my face, yelling at me, continuous torture,’ she said in 2020.

In an op ed in USA Today, published in 2020, she wrote that when she arrived at Provo Canyon School, she was forced to take off her clothes, squat and cough, and participate in a gynecological exam while male staffers watched.

She said she was told this was routine to check for contraband.

Hilton wrote that those invasive exams continued during her stay, with staffers pulling her from her bed in the middle of the night and taking her to an ‘exam room.’

‘Sleep-deprived and heavily medicated, I didn’t understand what was happening,’ she wrote.

‘I was forced to lie on a padded table, spread my legs and submit to gynecological exams. I remember crying while they held me down.’

Hilton wrote that she asked why this was happening, and was told to be quiet or she would be sent to solitary confinement.

She said she now realizes it was sexual abuse.

The school changed hands in 2000, and Universal Health Services, which now owns Provo Canyon School, repeatedly has declined to comment on what Hilton said happened to her, saying it didn’t own the facility during the time she said she was abused. 

Hilton was last on the Hill in 2021 pushing for a similar measure, the Accountability for Congregate Care Act.

Khanna and Merkley were also sponsors of that bill.

Khanna said he admired her commitment to enacting change, unlike other celebrities who ‘fly in, they do a press conference, you have some bill introduced and then they leave.’

Khanna added: ‘They came in three years ago and I remember talking to Paris’ mom… and they said ‘We actually want to get legislation done.’

‘And month after month with the organization they’ve been working to meet members of Congress, doing the work to actually get something done.’