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    Suggest treatment for severe knee pain

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Posted on Tue, 18 Jul 2017 in Pain Management
Question: what can I do to keep the pain down in my knees,I just had my 80 th. birthday XXXXXXX 9th.and had shots in them numerious times and do not want to have them operated on, due to other health problems. I am on LOTS of other meds, but would not mind trying anything that I can for the pain I also just had a stroke, 3 months ago and once in awhile have problems with my speech, I am on Coumadin 4mg. for the stroke. But what I need now is less pain in my knees I sing in church every sunday, and would like to be able to stand behind the pulpit to sing instead of the wheelchair I use. Would there maybe be a chance I could be referred by my Dr. which I see every 3 months or less depending on my conditions . To a pain center, for maybe the patches to put on my knees thank you . ????
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Answered by Dr. Matt Wachsman 23 minutes later
Brief Answer:
several modalities.

Detailed Answer:
First, the most dangerous by far is aspirin like drugs. They vastly increase the risk of dying from bleeding if on coumadin. They are generally considered too dangerous in this context.

Second most dangerous would probably be higher doses of narcotics. Besides the obvious, they also increase the risks of falls which have killed perhaps as many celebrities as drug overdoses (Leonard Cohen, XXXXXXX Burns, many many others).

The anti inflammatories in the shots by the time they get out of the knee get diluted so much they are entirely safe. Also, localized anti-inflammatory PATCHES would have some interaction with coumadin, but not a lot.

Nerve pills might have an effect but it is the knees not the nerves, so, lyrica, cymbalta, gabapentin, etc are UNLIKELY to work.

Amitryptiline is somewhat possible to work since it works directly on pain effects even though it is a nerve pill.

Then, physical modalities. Aquatic exercise (under some supervision) is quite good and quite safe and the only one likely to increase life span. Other physical therapies are safe and often effective.

Warmth might, XXXXXXX XXXXXXX might. They are also safe.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3724 Questions

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