Connect
Many questions about knee pain, shots, NSAID use, & scoliosis
Hello--I'm 68, an age when trying to solve one problem might cause another! I'm waiting for a new FM doctor, as my old one retired last fall and they haven't yet been able to replace him.
Right-knee pain for at least 15 years (with my weight always hanging around 200 lbs, at 5'6" but shrunken now to 5'3.5") Until recently, the bad episodes were fairly short-lived, so tolerable. I had to stop taking my longtime daily Aleve (NSAID) because of minor stomach bleeding, and am maxed out on daily Tylenol. Occasionally I've cheated and taken 1 or 2 Aleve when I have a really hard day or when my overall decades-long achiness (probably fibro) gets REALLY too bad.
(I did notice after a really hard last weekend--reunions, babysitting, not enough rest and sleep--that my knee ached horribly along with everything else--but after 2-3 nights of good sleep and extreme rest, the knee stopped hurting along with everywhere else!)
During that awful time, I started using diclofenac (topical NSAID) on my knees (the left one hurts too, but less), which is supposed to be easier on your stomach, but can it still cause bleeding--and how would I know if it was? (I only found out about it in the first place because of occult blood showing up in the yearly FIT (stool) test. The GI doc said after my EGD & colonoscopy that I didn't need to do those tests anymore.)
I want to get another cortisone shot in my knee (had one last fall) just before a VERY intense week coming up in August (house guests, very big family reunion, etc.), but I also remember the dire words of my scoliosis doc years ago: "DON'T GET OSTEOPOROSIS." I don't have it now, but I'm worried about steroids compromising my spine, which would be worse than anything! I've never had back pain, but now my lower back has started to hurt and I'm worried about it. (I should have STAYED 67!!--turning 68 opened a can of worms!)
Last fall I saw an ortho PA who said that based on my x-ray, I could get knee surgery (I presume replacement) whenever I was ready, but I chose to "kick the can down the road." Now I wish I'd done it, because now I have to wait til after the August stuff is over. Plus I will have to move my whole life (computer & projects, bed, clothes, etc.) downstairs where the bathroom and kitchen are, because I hear you can't do stairs for weeks. A huge disruption which will stress my knee even more.
The PA did get me an unloader brace, which saves my knee from slipping badly out of place when I'm out shopping or whatever, and it helps some with pain, but it's not really enough by itself.
In addition, I've have a slight case of MS, or something like it, since 1999. (It's not formally diagnosed, but I've never been referred to an actual MS specialist.) Even when the knee isn't hurting, I can no longer walk more than half a block without stopping, and fatigue is overwhelming if I do too much or don't get enough sleep. I should have tried for a real diagnosis long ago, because now a neurologist couldn't judge my walking distance anyway, what with the painful knee.
That's a lot of complaints and few real questions. But I'd VERY MUCH appreciate hearing your thoughts, knowledge, and experiences with any of these things. Eventually I'm sure I'm going to have to move over to the joint-replacement forum, but I'm not there yet.
Nancy
Like
Helpful
HugInterested in more discussions like this? Go to the Bones, Joints & Muscles Support Group.
Connect
It is SOOO important to have a doc you trust. When in any doubt--second opinion! In all my neurological forays, I've found that some docs pay attention (to what you actually tell them, as well as to the current state of their field) and others just don't. I had one who clearly wasn't paying attention even in medical school!
Best of luck to you,
Nancy
Hi Nancy,
Sorry, I could have been more clear. And yeah, if there is no pain I wouldn't get a cortisone shot.
And weirdly, if your knee hurts and you do get relief from a cortisone shot, you can delay any surgery. Again, bone-on-bone likely means a replacement is necessary, but put it off as long as other things are working.
With my shoulder, the first cortisone shot or two worked well and pain went away. Then the cortisone stopped working. Time for a replacement, again......
All the best to you.
Joe
Thank you for the kind words Nancy.
Yeah if the pain in your knee is off and on, I'd wait on surgery. What you describe may very well be a torn meniscus, meaning you're not completely bone on bone. And if you're doing stairs ok, well that is the ultimate test.
I have scoliosis too. In fact my lumbar spine is a disaster area. My surgeon has advised me to keep my core muscles strong, as they are literally holding my lumbar spine together and keeping me away from fusion. I was 6'1" at one point in my 20s. Then my back went to hell and now I'm pushing 5'10"!
All the best to you Nancy! Please reach out anytime you have a question.
Joe
Wow, Joe, THANKS for the encouragement AND the great info!
OK, this is something I didn't realize until reading your message...that on-and-off pain, and being able to do stairs, could mean it's not the bone-on-bone thing that is the biggest problem at this point. I actually WAS diagnosed with a torn meniscus 10 years ago, and maybe that's the reason the bad pain comes on all of a sudden. I did injure this (right) knee in 1990--fell off a recliner whose arm I was brilliantly standing on to hang a curtain. Thought I "broke" my knee but did not go to a doc, as I had no insurance then and I could still walk and move the knee--it was just horribly stiff for about a month. After that, I remember for a long time that inner side would painfully "shift," and in later years I started getting the painful shifts again. Every time it happened I'd say, "NOW I'm going to the doctor," but then it would stop and I wouldn't go--until 2015 when it shifted painfully and I could barely walk for days. That's when I got an MRI. Oops, I see the 2015 episode was the LEFT knee. (Well, I'm sure the right knee must have the same except worse. They take turns, apparently. I do remember getting an x-ray in about 2009 or 2010 and was told bone on bone, probably for the right knee.)
PROCEDURE: MRI Knee Lt WO Contrast
REASON FOR EXAM: Left knee pain. Effusion. Medial joint line tenderness. Crepitus.
TECHNIQUE: Proton density axial fat saturated, proton density sagittal, proton density
sagittal fat saturated, proton density coronal, proton density coronal fat saturated
images were obtained. A T2-weighted sequence was obtained aligned with the course of the
anterior cruciate ligament.
COMPARISON: None.
FINDINGS: Patellar articular surface shows grade III/IV chondromalacia involving the
medial patellar articular surface. There is a small knee joint effusion. Infrapatellar
tendon, the ACL and PCL are intact. Lateral meniscus is intact. Medial meniscus shows
radial truncation series 8 image 13, and an oblique horizontal tear through the posterior
horn of the medial meniscus with a dorsally located small parameniscal cyst. Medial knee
compartment shows grade II/III chondromalacia and lateral knee compartment shows grade II
chondromalacia. There is mild strain to the MCL and the LCL is intact.
IMPRESSION: Oblique tear and radial truncation type tear involving the posterior horn of
the medial meniscus with an associated mild MCL strain.
-------------
Well, maybe I should not plan on knee replacement this year, because maybe it really is just meniscus problems. But whatever it is, I have it in both knees for sure. I have to laugh because just now I found a 20-page file of my detailed knee history from 2006 to 2015--posts I had made on some message board and copied into a Word file. I can't believe it!! The common theme in my posts was always how these sudden painful shifts would happen and then fade away, and also that I had times where while trying to straighten or bend the (right) knee, I'd have to do it very slowly, in stages, because I could FEEL that it was going to shift if I didn't.
The fact is that I've only seen an ortho MD once, in 2015, who did the left-knee MRI and gave me a shot, and a PA once, last year, so I have not ever even discussed surgery with a surgeon. To be continued...
But THANK YOU, Joe, for reminding me of something I think I once knew but forgot...the pain problem really probably is just menisci.
Re scoliosis and a "disastrous" lumbar spine--OMG, who needs THAT as well as knee problems!! Sorry you have that hanging over you, too. Did you have scoliosis as a child, or did it start later--and is it progressing, do you know?
I have the S-curve (since adolescence), but the report of a recent lumbar MRI (which my FM doc wanted to prove his conviction that I had spinal stenosis to account for my very slow walking, but turns out I DON'T have stenosis) did not sound bad at all. I have never suffered from back pain (very lucky) but in recent months my lower back has at times gotten extremely tired, almost painfully so, which never happened before.
Ah, the joys of getting older & parts wearing out!!
Thank you again so much, and don't be surprised if I take you up on your offer to ask more questions!!
Best wishes & thanks,
Nancy
You are very welcome Nancy. And thanks for your kind words.
Before my TKRs, I had a partially torn meniscus in one knee. Some days it was fine, but if it moved the wrong way, my knee would lock up. Sometimes these tears resolve on their own. Other times, arthroscopic surgery is required to trim the torn meniscus.
I don't think I've had scoliosis since birth. I did "shrink" from 6'1" to 5'10". My spine surgeon told me my strong set of core muscles is holding my lumbar spine together. That's motivating.
And yeah, anytime you have a question, please just ask!
Joe
-
Like -
Helpful -
Hug
1 Reaction