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How is knee friction and pain controlled ?

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Orthopaedic Surgeon
Practicing since : 2000
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Hello There
I'd like to ask about the knee friction/pain.
My mom is 52 year old. She in good health and she does not have diabetes, rheumatism, high blood pressure or obesity but she suffers from knee pain and friction. She started to experience the pain 13 year age and the pain starts to increase with the yeays. Also, she is still capable of doing the normal daily activities and more but the pain is hard.

She has not experienced this pain in her youth so I guess it is because her age.

She uses medicines to reduce the pain which is
1.Celebrex, she uses this on daily basis
2. Dorofen, she starts to use this just these days

I'd like to know whether there a pain killer or a medicine for my mom because the pain is really hard these days.

Awaiting your advise
Posted Mon, 7 May 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Atul Wankhede 18 hours later
Hello,

Thanks for posting your query.

The age of your mom is unusual for severe arthritis and we're glad she has no co- morbidities like Hypertension, Diabetes, Obesity.

Also as you said she started experiencing this pain at the age of 13, so she suffered this knee ailment for almost 4 decades. Now that should ring an alarm in our minds.

She seems to have developed degenerative changes earlier than usual. I realize she has even started to hear sounds from the joint.

we can confirm the changes and grade the severity by doing an x-ray to begin with, and an MRI to further support the diagnosis.

Having done that we shall be in a position to comment on the appropriate line of treatment.

If you already have an x-ray done kindly oblige us by uploading the same on the query page.

You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

Meanwhile, the medications she's taking-celebrex is an anti-inflammatory drug containing celecoxib.

This she may take as long as her physician has advised.

Do not continue for long since its adverse effects are harmful.

The other one-dorofen contains drug used in cartilage regeneration in suspected cartilage deficient patients, which we have not established yet.

Nevertheless carry on with these for a while till we have sufficient evidence for a definitive treatment.

Ask her to avoid:

1. climbing/alighting staircase,

2. frequent bending of knee,

3. lifting heavy material and 4. excessive walking/running. she might benefit with hot fomentation, local ointments and knee braces/crepe bandage.

kindly get back to us with answers to following questions-

1. Is there a swelling on knee/knees,other joints?
2. Is the pain more prominent in morning?
3. Is there a history of trauma in past?
4. Is there a visible deformity?
5. How much can she bend her knee ?(to be measured from straight knee as 0-degree), and
6. Does her knee ever lock in a position?

Your feedback shall allow us to reach a diagnosis that we would confirm with the aforesaid investigations.

Awaiting your response.

Regards,
Above answer was peer-reviewed by
 
Follow-up: How is knee friction and pain controlled ? 2 hours later
Hello Doctor.

First thank you for your response.

I think I misspoke in determining my mom age. She does not have the pain when she was 13, she started to experience the pain 13 year ago ( when she 38 years old).

About the question:


1. Is there a swelling on knee/knees,other joints?
there is a small and rare swilling.
2. Is the pain more prominent in morning?
After she wakes up the pain is hard.
3. Is there a history of trauma in past?
no
4. Is there a visible deformity?
No

5. How much can she bend her knee ?(to be measured from straight knee as 0-degree), and
She can bend her knees as normal people ( 90 degree and more)

6. Does her knee ever lock in a position?

NO.


The pain existed all day long
 
 
Answered by Dr. Atul Wankhede 20 hours later
Hi,

Thanks again for writing back.

It is good to know that there was no preceding trauma, no major swelling / deformity / locking found and she can completely bend the joint.

It seems like she probably has primary arthritis. If the pain is prominent in morning 'Rheumatoid arthritis' needs to be rule out by "RA factor test".

in my opinion, we should move on to xray of her knee joint in following positions- AP in standing, LAT in supine and Skyline (merchant) view. This will allow us to know a fair view of the amount of damage
arthritis has caused. MRI if feasible is an alternative investigation and more definitive. You may get the tests done under the guidance of an orthopedic surgeon

Treatment options can be discussed based on the results of the test.

I wish you can keep me posted about the results of the test.

Wishing her a healthy life.

Regards

Above answer was peer-reviewed by
 
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