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Knee pain, done X-ray and MRI, taken Gabapentin and vitamin B12 injection, diagnosed as nerve pain. What should I do?

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Orthopaedic Surgeon
Practicing since : 1994
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I have sudden pain only at my right knee, without any injury or accident

First at all, My name is XXXXXXX, male, 27 years old, weight 62 kg, hight 172 cm, and I'm from Saudi Arabia.

I have sudden sharp pain at my right knee, it's start from two years ago till now, feels like a cutting muscle or electronic shocks, and it remains between 10 seconds to 2 minutes usually without doing any effort.

This pain is too sharp and make me screaming when it comes, the pain shock me randomly like when I rest or walk, sleep or wake up, take a shower or any time else.

Let me explain the positions of the pain: it could be start from right or left outside of the knee, and goes to inside the knee cap. Sometimes it starts from behind the thigh muscle, going to the knee cap. So whenever starts it will go to "inside" my knee cap.

I had visited many doctors, and I had made an x-rays and two MRIs to my knee and one for my spine, in addition to a blood analysis, and all of them were good without any problems!

Right now, the last doctor considered my problem as a "Nerve Pain, called Meralgia Paraesthetica", but he couldn't find the reason, or the source till now!

He have give me Neurontin "Gabapentin" 300 mg three times per a day "900mg daily", and B12 injection for one month every three days, but after two weeks with those medicines I still have this randomly sharp pain in my right knee!

BTW, this pain can disappear for two or four months, then back again and make my life so bad! and I dont had any injury or broken cap on it in the past

I have visiting some websites without any information about my issue, last one is here many people at this link have the same problem as mine but without any Solutions!

Please till me what should I do for this problem? I can't live with this pain any more!

You can find my last MRI report at attachment, there is a little mistake on it, it's for my right knee not left as the hospital written.

Thank you so much, and I hope to read your response soon

Posted Thu, 7 Jun 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 1 hour later
Thanks for posting your query.
I have seen the report attached with this query. At your young age, the intermittent sharp pain in the knee is more likely to be due to stress related minor capsular inflammation or a decrease in the joint lubricants.
Another cause to be considered is the neuropathic pain.
The mild inflammation of the knee mostly subsides by taking antiinflammatory agents and mild pain killers like ibuprofen on a regular basis. Opioid analgesics like Tramadol do not have any anti inflammatory effect. In some cases for acute problem muscle relaxants like thiocolchicoside are needed after consulting with your orthopaedician.
If still there is no relief then local steroids and oral lubricating agents like glucosamine sulfate and chondroitin are given. Injections - intra- articular are the last options to be considered if all the above measures fail.
In the meanwhile, for symptomatic relief:
1. Give enough rest to your knee- use a knee brace.
2. Take mild pain killers like acetaminophen or ibuprofen.
3. Stronger prescription NSAIDS with muscle relaxants may help if simple analgesics do not help.
4. Hot compresses to your knee will be useful pain relieving measure. You may apply a local analgesic gel on that area.
5. calf and hamstring stretches can be helpful under the guidance of a physiotherapist after the acute pain subsides completely.
6. Generally we recommended, rest, graded exercises, rest and graded exercises to let you know the right amount of time you can spend on exercise without injuring yourself.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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