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What Causes Pain In Patella Tendons?

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Posted on Sat, 15 Nov 2014
Question: Hello i have major pain in both my patella tendons. I have had this for over 10 year and the pain is getting worse.
I have had a open petella decompression on one knee but this only helped for a a few months while is was recovering and taking things easy.
one year on and the pain is worse than before and still getting worse and my other knee is in a worse state than the other when it was operated on.
i have been told that as it didn't work i shall not have any more surgury until the first operated knee shows signs of recovery and will be going back in a year (totalling 2 years since original surgury)
Is there anything i can do or have done as i can't struggle on like this i have had to quit my job as i can't drive properly and carryout my everyday tasks.
I also have a bad back and have done so for a good 5 years and recently been told i have 2 bulging discs in my lower back which cause me spasms.
I can't kneel down or bend my knee to squat due to the pain is so bad. I have to bend usind my back to pick thinks up for example which is not ideal.
i am on tramadol as gabapentine and some other drugs didn't releave the pain at all and 100mg of tramadol 4x per day is just touching the easing the pain slightly but not enough so will speak to my gp about increasing the dose.

Any help would be greatly appreciated as my gp just tell me to wait a year for my knees and has not said anything about my back.

Thank you
doctor
Answered by Dr. Mukesh Chugh (59 minutes later)
Brief Answer:
Cortisone and physiotherapy is helpful

Detailed Answer:
Hello
Thanks for posting
I have gone through your query and understand your concern. Since, you already had a surgery, and hence a second intervention has less chances of further improvement.
The only option left with us are-
Rest, Physiotherapy (knee specialist) along with Injection cortisone (both knee in one sitting).
As far as slip disc is concerned you may continue with Gabapentin or better would be the drug pregablin. To help you further please tell me-
1. Are you able to walk on your heels and toes?
2. Any numbness and tingling sensation in legs
Do not lose hope; I would try my best to help you further.
Take care

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Mukesh Chugh (12 minutes later)
i can go on my toes a little heals not so due to tight calfs due to so many years of bad walking. i have to tense my quads and knee to stop my knees from giving out as sonetine due to the pain they give out.
i do get tingling and in my feet and aroubd my lower legs upto my knees when standing. my physio left me with excersise to do but said i nolonger had to go back and see him as we had exhursted all his advise to try and stop the pain in my knees.
In total i have seen 5 physios in 4 years all caused me more pain when going to see them and symptoms didn't get any better.
i'm trying not to give up but after this length of time its really difficult as i also suffer from depression and am awaiting the results to a bone marrow biopsy due to low whitr blood cell, i am black so just hoping its just normal due to skin colour.

thank you
doctor
Answered by Dr. Mukesh Chugh (11 hours later)
Brief Answer:
Gait will improve once the patella tendon heals

Detailed Answer:
Hello
It’s good to see you.
I have gone through your reply carefully and have following suggestion for you-
1. For your spine problem, you may take drug pregablin along with methylcobalmine, tramadol and muscle relaxant drug like thiocolchicoside will help.
2. Patella tendinosis treatment through extra-corporeal shock wave therapy. This alternative therapy option, also administered by a doctor, relies on sound waves to relieve tendon pain.
3. Injection cortisone is a good alternative and other is a technique called Platelet-rich plasma (PRP). PRP involves injecting your own blood plasma into the tendon area to treat pain.
4. Patellar tendon strap- The strap puts pressure on the tendon and thereby redistributes load throughout the tendon. This takes stress off the injured parts of the tendon and thereby reduces pain. You still need to give your tendon time to heal.
5. Do stationary cycling without resistance.
Hope this helps.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh (29 minutes later)
Thank you for getting back to me.

The shockwave threapy was offer as an alternative to open surgury but as private i would have to pay for it and there was no results for long term outcome so i went for the most tried and tested option with the nhs.

My surgeon advised against having ain injection as it would cause my tendon to degenerate but the plasma injection sounds like an option to try.

I have a knee brace whuch supports around my knee but need even more support as it help incase my knee give out a little.
i have had the stationery cycling with no resistance for a whole the XXXXXXX i could do was about 10 mins. this left me unable to really move properly the next day which is whe.n one of my physios kind of gave up on the physio treatment as they didn't know what other things to try.
doctor
Answered by Dr. Mukesh Chugh (1 hour later)
Brief Answer:
Cycling exercises at week end with plasma therapy

Detailed Answer:
Hello
You are welcome.
I have gone through your reply carefully. Yes, tendon degeneration is a known complication of injection cortisone; to avoid this it should not be given in the tendon itself.
I would advice for-
1. Cycling exercises at weekend
2. Platelet rich plasma therapy.
I hope your queries are answered.
God bless you.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Mukesh Chugh

Orthopaedic Surgeon, Joint Replacement

Practicing since :1997

Answered : 1619 Questions

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What Causes Pain In Patella Tendons?

Brief Answer: Cortisone and physiotherapy is helpful Detailed Answer: Hello Thanks for posting I have gone through your query and understand your concern. Since, you already had a surgery, and hence a second intervention has less chances of further improvement. The only option left with us are- Rest, Physiotherapy (knee specialist) along with Injection cortisone (both knee in one sitting). As far as slip disc is concerned you may continue with Gabapentin or better would be the drug pregablin. To help you further please tell me- 1. Are you able to walk on your heels and toes? 2. Any numbness and tingling sensation in legs Do not lose hope; I would try my best to help you further. Take care