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Having severe pain in legs. Diagnosed with osteoarthritis, diabetic neuropathy and having Butrans pain patch. Treatment?

Jul 2013
User rating for this question
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I have severe pain if both of my legs which cause extreme discomfort and inability to do daily activities that I would enjoy otherwise. I was diagnosed with osteoarthritis and currently take Cymbalta and Lyrica along with Meloxicam just so I can carry on with my daily life. I also have on a Butrans pain patch and take tramadol for my back back which is severe as well. When the weather gets cold my pain gets to be absolutely unbearable at times and continues throughout the day. I have also been diagnosed with diabetic neuropathy but I don't know if that has anything to do with my pain in my legs. The pain is mainly in both of my knees/ankles/shins/calves. What can I do to get away from this especially being only 29 years old. I have a new family I am trying to take on and it gets to be extremely difficult especially attempting to keep up with the 7 year old. I exercise and stretch daily.
Posted Fri, 27 Sep 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer:
Management is by Conservative methods.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

It is very uncommon to see Osteoarthritic changes in the joints at your age.

The Conservative line of management of arthritic joints is 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.
It is not advisable to take any analgesic medication for a prolonged period of time as they may cause serious damage to the kidneys.

* 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 and fingers.

* 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.

Also, I suggest a few investigations like Serum calcium ,Vitamin D3 estimation , serum phosphorus to see if there is any deficiency. Treatment is to be given accordingly if there is any deficiency as all these are very important in maintaining the bone health.

Hope I have addressed your query. Happy to help further

Above answer was peer-reviewed by
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