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Suggest treatment for severe knee pain

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Posted on Thu, 16 Feb 2017
Question: Hi, This is XXXX. I am having right knee pain from last 4-5 months when i climb the stairs and some click sound also coming without any pain. from last few days am having pain in my back side of left knee if i sit for 20-30min. on the knees and stand suddenly. from last week am having pain and stiffness in left hand index finger when i walk freely. i consulted Ortho last week and he examined Rheumatoid factor which is 9 IU/mL, Blood Uric acid which is 7.1 mg/dl and calcium levels which is 8 mg/dl. He prescribed Aceclofenac, Zyloric (to reduce Uric acid levels) and calcium tablets. two days back i consulted Rheumotologist also and he checked my joints, reports and told we don't have any evidence for RA. He adviced to stop Aceclofenac, Zyloric asked to restrict Non-veg, Alcohol, Sweets and come after 3 weeks with Uric acid test, Vit-D levels test. i am following the same. but last mid-night and morning i got stiffness in my hand and it was there for some seconds. please let me know my condition and do i need to consult a doctor or need to wait upto 3 weeks? please help o this.


Thank you for your detailed answer.

I am not having inflammation or redness in the joints. i don't have pain in the all joints. am not having the continuous pain. i have pain in the knees and that was not started at a time in both the knees. first it was started in the right knee when i climb the stairs. after 3-4 months it was started in the left knee. i consulted Physiotherapist also and he told it is the condition called Patellofemoral pain syndrome. he suggested some exercises to strengthen the legs.

Now am having knee pains, pain and stiffness in the left hand index finger(which is present only when i walk freely, during any activity am not having pain), having back pain(since i need to sit for 8-10 hrs. daily in office i got this last year) and having stiffness in the hands for last 2 days with numbness in the mid-nights.

Can i wait for 3 weeks with these conditions or do i need to consult the doctor? can we diagnose the condition with the above information? please suggest me.

Thanks,
XXXX
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Answered by Dr. Aashish Raghu (44 minutes later)
Brief Answer:
Needs further work up

Detailed Answer:
Hi XXXXXXX

Thanks for the query

Rheumatoid arthritis can be confirmed by anti-CCP blood test. If it is positive then it means you have extremely high chance of having Rheumatoid arthritis.

In your case you seem to be having Gouty arthritis due to high uric acid. Do follow the advice given by your Rheumatologist as they are valid.

There can be other types of arthritis called Seronegative spondarthropathy which can cause joint stiffness and back pain too. This needs further investigation like ESR, CRP, ASLO, Anti-dsDNA etc. Ankylosing spondylitis may need to be ruled out.

This may need special medication called DMARDs such may need to be started. Do note if you get relief with cool or warm water soaks. Apply the temperature with such you get relief from stiffness.

You can continue to wait for 3 weeks because this could also be a self limiting condition. After 3 weeks we will be in a better position to confirm your condition if it exists.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu


Brief Answer:
Lifestyle disorder

Detailed Answer:
Don't sit for more than half an hour at a stretch. Do get up and extend your lower back. Walk around. Then come back to sit. Follow ergonomic protocol to avoid progression of the problem of further problems

You can wait for 3 weeks. Do perform Physiotherapy exercises as they will really help you. Perform Quadriceps strengthening, hamstring stretching exercises.
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Aashish Raghu

Orthopaedic Surgeon

Practicing since :2011

Answered : 5437 Questions

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Suggest treatment for severe knee pain

Brief Answer: Needs further work up Detailed Answer: Hi XXXXXXX Thanks for the query Rheumatoid arthritis can be confirmed by anti-CCP blood test. If it is positive then it means you have extremely high chance of having Rheumatoid arthritis. In your case you seem to be having Gouty arthritis due to high uric acid. Do follow the advice given by your Rheumatologist as they are valid. There can be other types of arthritis called Seronegative spondarthropathy which can cause joint stiffness and back pain too. This needs further investigation like ESR, CRP, ASLO, Anti-dsDNA etc. Ankylosing spondylitis may need to be ruled out. This may need special medication called DMARDs such may need to be started. Do note if you get relief with cool or warm water soaks. Apply the temperature with such you get relief from stiffness. You can continue to wait for 3 weeks because this could also be a self limiting condition. After 3 weeks we will be in a better position to confirm your condition if it exists. I hope I have answered your query. I will be available to answer your follow up queries. Regards, Dr. Aashish Raghu Brief Answer: Lifestyle disorder Detailed Answer: Don't sit for more than half an hour at a stretch. Do get up and extend your lower back. Walk around. Then come back to sit. Follow ergonomic protocol to avoid progression of the problem of further problems You can wait for 3 weeks. Do perform Physiotherapy exercises as they will really help you. Perform Quadriceps strengthening, hamstring stretching exercises.