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Diabetic, suffering from chronic back pain, phantom pains in right foot and osteoarthritis. Getting worse. Should I be alarmed?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I am a type 1 diabetic, I suffer from chronic back pain from two vehicle accidents I was in over the last year, I suffer from diabetic neuropathy, I suffer from phantom pains in my right foot due to a lawn mowing accident that claimed all five of my toes, I also suffer from osteoarthritis in my knees and ankles which continues to get worse and worse at an alarming pace. It's almost to the point where I need help getting up if I kneel down. If am I am in a "catcher position" for anything my knees feel like they are going to bust through my skin and then painfully/violently crack many, many times on my way back up. They have gotten about 40% worse just over the last two years alone and show no signs of slowing down. I'm not sure what cause them to progress so fast. I can't stand for long periods of time nor walk for long periods of time or my legs start to give me a tremendous amount of painful problems. The only exercise I can do now is the elliptical since it doesn't put any harsh pressure on my legs. I can no longer run, or play basketball due to this and I am only 29 years old. I just married and have a seven year old step-son in which I would love to be able to do sports with. Any suggestions?
Posted Fri, 15 Nov 2013 in Back Pain
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer:
I understand your concerns.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

After going through your description, I felt your concern with regard to your health status.

Its very unusual and extremely rare to develop osteoarthritis in knees and ankle at your age of 29 years.

The conservative management guidelines for Osteoarthritis are as follows -

* PHYSICAL THERAPY : The mainstay of treatment in the early case is physical therapy, which should be directed at maintaining joint mobility and improving muscle strength.
Exercise can strengthen your muscles, which can help keep your joints more stable, and the stronger muscles help to absorb energy and protect the joint surface. Stick to gentle exercises, such as walking, biking or swimming.
Other measures, such as massage and the application of warmth, may reduce pain.
* LOAD REDUCTION : Protecting the joint from excessive load may slow down the rate of cartilage loss. It is also effective in relieving pain. The heavier you are, the more stress you put on your joints. Weight reduction for obese patients, wearing shock-absorbing shoes, avoiding activities like climbing stairs and using a walking stick are worthwhile.
* ANALGESIC MEDICATION : Simple over the counter medications like acetaminophen is sufficient in most cases. If this fails to control pain, a non-steroidal anti-inflammatory drug may be better.
* USE OF HEAT & COLD : Both heat and cold can relieve pain in your joint. Heat also relieves stiffness, and cold can relieve muscle spasms and pain.
* OVER THE COUNTER PAIN CREAMS : Local massaging with creams and gels may provide temporary relief from osteoarthritis pain. Some creams numb the pain by creating a hot or cool sensation. Other creams contain medications, such as aspirin-like compounds, that are absorbed into your skin.
Pain creams work best on joints that are close to the surface of your skin, such as your knees, Ankles and fingers.
* USING ASSISTING DEVICES : Assistive devices can make it easier to go about your day without stressing your painful joint. A cane may take weight off your knee or hip as you walk. Carry the cane in the hand opposite the leg that hurts.
* GLUCOSAMINE & CHONDROITIN SULFATE : Daily intake of Glucosamine & chondroitin supplements over a period of 3-4 months will help in reducing the arthritic pains and thereby decreases the necessity to take daily analgesic medications. Research suggests that vitamins C and D may help protect you against the progression of osteoarthritis.
* VISCOSUPPLEMENTATION: Hyaluronic acid injections given into the joint (especially large joints like knee joint) in prescribed dosages will give good short term pain relief in arthritic joints ranging from 1-2 years.

So, following the above measures will definitely make you feel better.

A few NATURAL PAIN RELIEVING methods and measures that may be useful for you.
- Release your inner endorphins : Endorphins are the body's natural pain relievers, and they can be as strong as many of the strongest pain relievers. The body produces endorphins during aerobic exercise. Infact any activity that gets your blood pumping for a sustained period will release pain relieving endorphins into your system.
- Eat cookies : Research shows that eating sweet foods like cookies, chocolate or ice cream, helps reduce the sensation of pain. Or just bake the cookies. Enjoying a smell that is both sweet and pleasant has been shown to reduce the perception of pain.
- Feel the heat :Applying some form of heat (a hot water bottle, electric heating pad) can go a long way in easing your pain. Benefits of heat are twofold: it increases the flow of healing oxygen and nutrients to the damaged area, and it suppresses pain signals being sent to your brain.
- Enjoy the outdoors :Researchers found that Vitamin D helps relieve pain by aiding in the absorption of calcium, which is needed for bone growth and repair. Other research shows vitamin D may directly help soothe pain. About 15 minutes of sun exposure on your face and hands a day is enough to get your daily dose of D.
- Meditate twice daily :Easy to learn and immediate results make this one of my favorite paths to natural pain relief. Meditation can also help reduce the depression, anxiety, stress and sleeping problems that often accompany chronic pain.
- Get enough restorative sleep :Getting enough sleep is critical to managing the pain and healing, so it’s important to employ a variety of sleep aids to help you get a healthy amount of sleep.
- Cool it with ice : Pain almost always comes with some level of inflammation, and ice is the best natural way to reduce it. Ice also helps by acting as a local anesthetic, and by slowing the nerve impulses, which in turn interrupts the pain-spasm reactions between the nerves in the affected area.

Hope all the above measures will put your mind and body at ease.


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