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Having back pain and knee after 5 months of delivery. Diagnosed as early stages of oesteo arthritis. Help?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
Hello doctor...
I recently delivered a girl baby in Sep 19th 2012 and it was c-section. I took complete rest for about 4 months, and started doing day to day activities in 5th month at home..I started to go for work from Feb 22 i.e exactly after completion of 5 months. After that i had slight back - ache during nights and it will be present 1,2 hours in the morning...after that it is not there...i thought this is because of bed adjustments(my bed is not equal in size, someups and downs are there), and sleeping with the baby, as baby is also moving continuously in the night. Just very recently about 1month back, my right knee got a catch while once i had to put my weight on right knee, after that it is giving continous tackling sound....i thought it is a catch and it will set automatically. After that when i sit in indian style , i am getting knee pain, and took support while getting up. only in this pose iam getting pain other poses pain is not there. As baby is there, from evening 6.45 to almost till 11 i shall be sitting down crosslegged. i am are making hte baby sleep on my lap and swing my thigh, so that she sleeps.pain is not reducing, so i consulted a doctor at office, then she gave me medicine to reduce pain for 3 days, then informed me that it is symptoms and early stage for oesteo arthritis...I WAS SHOCKEDDDDDDDDD.....i am just 28 years old, and how come such a big disease, i am not knowing how to manage.....she told it may be due to after pregnancy symptm or heridatry....asked me to take one x-ray...we have not gone till that stage...but please tell me is this knee pain is because of post pregnancy complication? or early stages of oesteo arthiritis? whether it can be cured? or life longi should suffer??? kindly let me know the reason for this pain??
my history : my weight is 73kg's height is 5'4. and i put on this weight recently post pregnancy. i stopped feeding.i had a miscarriage in 2011 august, as there is no heart beat found for the happened for 8 weeks. before pregnancy i was 62. and after miscarriage i put on to 68, i redecued by going to aerobics in 2011 to 62 kgs. so in generaly u can put me avg on 65 to 68 kgs. my mother is 58 years and she is having oesteo arthiritis.she is having it from 8 to 9 years and we are planning to go ahead for operation. Thanks XXXXXXX
Posted Sat, 24 Aug 2013 in Arthritis
Answered by Dr. K. Naga Ravi Prasad 55 minutes later
Hi Mrs. XXXXXXX thanks for writing to XXXXXXX

At the outset, I would like to assure you that your symptoms are NOT DUE TO OSTEOARTHRITIS but due to PATELLO FEMORAL ARTHRITIS.

Let me explain - OSTEOARTHRITIS of knee joint involves mainly the joint surfaces of FEMUR (thigh bone) and TIBIA (leg bone). This is commonly seen in ELDERLY age groups.
Whereas PATELLO FEMORAL PAIN or Anterior knee pain is commonly seen in YOUNG individuals who are physically active and involves the FEMUR (thigh bone) & the PATELLA (knee cap). This condition occurs due to "wear and tear" in the cartilage (a layer present on the joint surfaces of bones and provides smooth gliding while movement) of patella.

I think this condition has affected you because of the fact that you are sitting with hyperflexed position (wherein the femur & the patella will press against each other) as in sitting cross legged with baby in your lap.

The same thing happens while sitting in indian style toilet (hyperflexed knee joint causing severe compression of both femur & patella).

This condition is no way related to the pregnancy or delivery by C-section.

There is absolutely nothing to panic about this condition as this will respond well to medical management and you will be perfectly normal within 2-3 months of treatment.

Generally, Xrays will not show up this condition in the early stages.

The management of this condition involves -

* Reduce your body weight as excess load over the joints will always lead to early cartilage damage.
* Avoid "deep knee flexion" activities like Squatting (avoiding indian toilet and using Western type), Sitting cross legged & on the floor (both these positions will aggravate pain)
* Regular Physiotherapy for Quadriceps muscle (Strengthening this muscle will take off upto 60% of your knee pain). Actually you need to visit a physiotherapist for these quadriceps exercises. But I will explain you a simple at home exercise -
Sit on a table or an elevation with the foot not touching the ground > make a small tubular sand bag weighing around 3kg > Place or tie that sand bag at the level of the ankle > raise only the leg portion without lifting the thigh and hold it for atleast 10 seconds and lower the leg down > In this way raising the leg with the weight of sand bag, keeping it for few seconds and lowering it.
This can be done as many number of times as you can. But don't do it too vigorously from day 1 as you tend to get muscle pains in the thigh. So just keep on gradually increasing over a few days.
* MEDICINES - Simple analgesics like Paracetamol 500mg 2 or 3 times a day will supress your pain.
There are other good cartilage regenerating drugs but they are contraindicated (not to be given) in Lactating mothers.

Hope I have addressed all your issues. Happy to help for any more clarifications.

Above answer was peer-reviewed by
Follow-up: Having back pain and knee after 5 months of delivery. Diagnosed as early stages of oesteo arthritis. Help? 20 hours later
Thanks a lot for your soothing reply.I got confidence that i can be back to normal.Yes i do agree that i am really physically active thesse days, right from morning 7.30 to night 11.30, 12:00 .Working at home,office continuosly,with baby no proper sleep, iam very tired.

And few more questions,
is this also kind of arthiritis?
Will this can be cured only with exercises/physiotherapy or do i have to go to an orthopedic for consultation before going to phisotherapist?
Is this due to lack of calcium in my body, or my bone density is weak.any energy drinks you suggest for this, like women horlicks?
Will i be prone to oesteo arthiritis or rheumatic arthiritis in near future or future?if so after how many years i may have this problem. the answer will help me to take precaution and be very careful about my health.

Thanks a lot ..Hoping to see the reply...
Answered by Dr. K. Naga Ravi Prasad 5 hours later
Hi, thanks for getting back.

* Yes, this is also a form of arthritis (but is different from arthritis affecting elderly people, so nothing to panic)
* Physical therapy may cure this condition upto 70%. Drugs will also play a major role but the issue here is those drugs are not to be given in lactating mothers. Yeah, you have to consult an orthopedic surgeon for a clinical examination before attending physiotherapy
* No, Calcium or bone density have nothing to do with this condition. Sorry, I am not aware of any energy drinks that will influence the bone metabolism
* No, both Osteoarthritis(OA) & Rhematoid arthritis (RA) have different etiologies and there is no relation between your present condition and both OA & RA.
OA is a condition affecting elderly people and RA can affect any age groups & is of autoimmune origin.

Have a great day.
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