Brief Answer:
Vicodin is addictive, other medications and treatments recommended first.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service,

I carrefully read your query and also the uploaded report.

You seem to have knee changes that are related to stress (physical stress on the knee).


There is a bone spur from the joint space and a boney prominence at the level of the tendine. The last one causes pressure on the tendon and thus pain with any movement that involves that tendon.
You can first use a combination of ibuprofen 600 mg and paracetamol 500 mg every 6-8 hours after food to help with pain. The Vicodin tablet is a combination of an opioid and paracetamol, used for severe pain when other treatments are not helping. It also should not be used for long time as it causes dependence.

I would also recommend you physiotherapy to help the muscle connected to that tendon to relax and stretch and the other muscles around to strengthen. This will help treat the pain

You should avoid running and similar activities as these may cause the stress on the knee. The physiotherapist will give you exercises to keep you active and that do not worsen your condition.

As for the relationship with the back pain, there may be such a relationship. Knee pain may cause back pain and vice versa as the joints function as a chain and a problem somewhere may bring a problem in the nearby structures. On the other hand, it is best to have your back checked as well to rule out primary conditions of the back.

To conclude:
- there may be a relationship between the knee and back pain but a check of the back is needed to verify this
- you may use ibuprofen and paracetamol as explained above to help with pain.
- seeing a physiotherapist is advisable so you can have exercises that will help with your knee pain. He will also be able to check your back as well and refer you if it is a need to have examinations or see another doctor.
- vicodin is addictive and may have many side effects. This is why it is best to try the above treatment first and the physiotherapy. Vicodin is rarely indicated for long-term use
- you may need to stop running and similar activities as they may worsen your symptoms
- in rare cases, if there are other symptoms such as skin rash, mouth lesions, fever, fatigue, etc, the doctor may need to consider examinations to rule out autoimmune conditions as well.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

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Brief Answer:
Vicodin is addictive, other medications and treatments recommended first.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service,

I carrefully read your query and also the uploaded report.

You seem to have knee changes that are related to stress (physical stress on the knee).


There is a bone spur from the joint space and a boney prominence at the level of the tendine. The last one causes pressure on the tendon and thus pain with any movement that involves that tendon.
You can first use a combination of ibuprofen 600 mg and paracetamol 500 mg every 6-8 hours after food to help with pain. The Vicodin tablet is a combination of an opioid and paracetamol, used for severe pain when other treatments are not helping. It also should not be used for long time as it causes dependence.

I would also recommend you physiotherapy to help the muscle connected to that tendon to relax and stretch and the other muscles around to strengthen. This will help treat the pain

You should avoid running and similar activities as these may cause the stress on the knee. The physiotherapist will give you exercises to keep you active and that do not worsen your condition.

As for the relationship with the back pain, there may be such a relationship. Knee pain may cause back pain and vice versa as the joints function as a chain and a problem somewhere may bring a problem in the nearby structures. On the other hand, it is best to have your back checked as well to rule out primary conditions of the back.

To conclude:
- there may be a relationship between the knee and back pain but a check of the back is needed to verify this
- you may use ibuprofen and paracetamol as explained above to help with pain.
- seeing a physiotherapist is advisable so you can have exercises that will help with your knee pain. He will also be able to check your back as well and refer you if it is a need to have examinations or see another doctor.
- vicodin is addictive and may have many side effects. This is why it is best to try the above treatment first and the physiotherapy. Vicodin is rarely indicated for long-term use
- you may need to stop running and similar activities as they may worsen your symptoms
- in rare cases, if there are other symptoms such as skin rash, mouth lesions, fever, fatigue, etc, the doctor may need to consider examinations to rule out autoimmune conditions as well.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
This is not a new thing and no repeat x-ray is needed at the moment, details below

Detailed Answer:
Hello and welcome back,

I am sorry you had this setback. I do not think you will need another x-ray. What might have happened is that the enthesophyte (the bony prominence at the tendon) is located at the knee cap, at the area where the tendons of the thigh muscles attach. So, kneeling has caused more pressure on the enthesophyte (which is the source of pain in your case).

You will need to give yourself some rest. You may continue with the local compresses (ice).
You can use the treatment I described above (ibuprofen and paracetamol) and only randomly you may use Vicodin if this treatment is not enough.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
This is not a new thing and no repeat x-ray is needed at the moment, details below

Detailed Answer:
Hello and welcome back,

I am sorry you had this setback. I do not think you will need another x-ray. What might have happened is that the enthesophyte (the bony prominence at the tendon) is located at the knee cap, at the area where the tendons of the thigh muscles attach. So, kneeling has caused more pressure on the enthesophyte (which is the source of pain in your case).

You will need to give yourself some rest. You may continue with the local compresses (ice).
You can use the treatment I described above (ibuprofen and paracetamol) and only randomly you may use Vicodin if this treatment is not enough.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

Now that the knee is so irritated it is best to avoid as much as you can activities that involve bending the knee. Of course, you should do your daily activities as much as the pain allows you. So, as for driving, I would not recommend to be for long times and also be sensitive to the pain, it is the pain that will tell you what you can do and how much you can do.

If you sit, I would advise you to keep your knee straight (straight leg elevated probably to help keep it straight), as bending the knee causes more stress on the enthesophyte.

You can use aspirin as it helps with pain and inflammation but it is very hard on the stomach. Please take it with food and if you get any stomach complaints or black stools you will need to stop it immediately and seek medical attention.
Ibuprofen also may hurt the stomach but this generally less pronounced compared to aspirin (thus, ibuprofen should be taken with food as well).

Very likely you will have pain tomorrow as well as, it is such a short time difference. Using ibuprofen or aspirin will relieve the pain but does not heal the cause.

Tylenol extra strength can be tried, sometimes it may be beneficial, especially if you combine it with aspirin or ibuprofen.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

Now that the knee is so irritated it is best to avoid as much as you can activities that involve bending the knee. Of course, you should do your daily activities as much as the pain allows you. So, as for driving, I would not recommend to be for long times and also be sensitive to the pain, it is the pain that will tell you what you can do and how much you can do.

If you sit, I would advise you to keep your knee straight (straight leg elevated probably to help keep it straight), as bending the knee causes more stress on the enthesophyte.

You can use aspirin as it helps with pain and inflammation but it is very hard on the stomach. Please take it with food and if you get any stomach complaints or black stools you will need to stop it immediately and seek medical attention.
Ibuprofen also may hurt the stomach but this generally less pronounced compared to aspirin (thus, ibuprofen should be taken with food as well).

Very likely you will have pain tomorrow as well as, it is such a short time difference. Using ibuprofen or aspirin will relieve the pain but does not heal the cause.

Tylenol extra strength can be tried, sometimes it may be beneficial, especially if you combine it with aspirin or ibuprofen.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
It is good you are going to rest

Detailed Answer:
Hello and welcome back,

I understand the guilt you may feel but as long as you plan to rest now and make sure to prevent this in the future, you should not worry.
It is my pleasure to be able to assist you.

I wish you good health and please feel free to contact me in case further medical assistance is needed.

Kind regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
It is good you are going to rest

Detailed Answer:
Hello and welcome back,

I understand the guilt you may feel but as long as you plan to rest now and make sure to prevent this in the future, you should not worry.
It is my pleasure to be able to assist you.

I wish you good health and please feel free to contact me in case further medical assistance is needed.

Kind regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
It is a pleasure

Detailed Answer:
Hello and welcome back,

It is a pleasure to assist you.

I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
It is a pleasure

Detailed Answer:
Hello and welcome back,

It is a pleasure to assist you.

I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

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