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What is the cause and treatment for severe knee pain and stiffness?

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General & Family Physician
Practicing since : 2010
Answered : 1109 Questions
Hello, I am a relatively fit 51 year old female with a history of meniscal tears when young and family history of osteoarthritis. I take supplements including multivitamin for over 50s, krill oil and chondroitin/msm/glucosomine. Recently I started walking fast 10km on roads, and at about the 7km mark a gradual onset of knee pain anteroinferiorly to my left knee which rapidly increased to extreme pain and difficulty walking. At the time I tried rotating my knee to see if that would help but nothing did. It took a week of rest for the knee to settle. I want to get out walking again. In addition, doing yoga, for the past 6 months can no longer sit back on my right knee (I am quite flexible), I feel there is a blockage posteriorly, and stiffness anteriorly with pain the more I try to sit back.
Posted Sun, 9 Mar 2014 in General Health
Answered by Dr. Manjeth Kumar G 1 hour later
Brief Answer: More suspicious of Rheumatoid arthritis. ESR, RA Detailed Answer: Hello, I have gone through your query and understand your concern. I have noted few findings are more towards Rheumatoid arthritis. 1. Raynauds disease is commonly associated with Autoimmune condition like Rheumatoid arthritis 2. Stiffness in joints is more and it even do not allow you to sit back. I further suspect more if you would have any Morning stiffness that lasting more than one hour, joint swelling and pain. Thus my first step is to rule out Rheumatoid arthritis by physical examination, x-Ray knee joints, Erythrocyte sedimentation rate (ESR), C- Reactive proteins, Rheumatoid factor (RA ) in blood. These are all the tests to identify Rheumatoid arthritis as well as helpful in rule out other diseases like Osteoarthritis. As Rheumatoid arthritis is a destructive joint disease, it is advisable to do investigation earlier and start treatment. Delaying treatment may lead further destruction and debilitation of joints. Hope this helps. Please write back for further queries. Wishing you good health.
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Follow-up: What is the cause and treatment for severe knee pain and stiffness? 36 minutes later
Thank you - I neglected to mention I am negative for all these tests - the Raynaud's is idiopathic as I mentioned....nil morning stiffness improving during the day... Would you please also address the first part of my question - ie. the symptoms that occurred during my walk - this occurred with my left knee. The right knee has the stiffness and pain on hyper flexion, I can passively flex with no problem but active flexing is an issue, ie. sitting back on my feet. I have slight increased swelling posterior to the right knee, but not palpable on slight flexion (considered Baker's Cyst), the swelling is more general, and absent on the left. Non-responsive to anti-inflammatories. Thank you
Answered by Dr. Manjeth Kumar G 16 hours later
Brief Answer: Osteoarthritis with Baker's Cyst. Rest, Ice, physi Detailed Answer: Hello, Thanks for your reply. From your query, i come to conclusion that you are suffering from Osteoarthritis of both knee. 1. As you had the history of Meniscal tear and also you are aging, that meniscus are degenerating and this both may lead to osteoarthritis. 2. As you suspected, Swelling in the back of left knee may be a Baker's cyst. Because it nothing but a collection of synovial fluid in knee joint behind the knee. It is more common in common with any form of arthritis. As you clearly explained that you have Idiopathic raynauds, thus I want to exclude the possible cause of the Rheumatoid arthritis which i mentioned in last reply. In Osteoarthritis, NSAIDS alone will not be helpful. You have to give rest to knee joints for some days and avoid activities like walking or other activities which aggravates your knee pain. Put ice on your knee for 20 to 30 minutes a few times a day to reduce inflammation and ease the pain. Get help from Physiotherapist and do physical therapy or certain exercises to help strengthen the muscles around the joint. Continue chondroitin/msm/glucosomine. If these measures are not found helpful, then steroid shots in knee joint or Injection of Hyaluronic acid into the knee joint will be helpful for you. Hope this helps. Please write back for further queries. Wishing you good health.
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