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Dr. Andrew Rynne

Family Physician

Exp 50 years

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hi, Ive been doing hydrotherapy for osteoarthritis in my hips

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Dr. Mahboob Ur Rahman

General & Family Physician

Practicing since :2012

Answered : 2000 Questions

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Posted on Sat, 26 Jan 2019 in Bones, Muscles and Joints
Question: hi, Ive been doing hydrotherapy for osteoarthritis in my hips and I have been having problems in my knees bending and pain going up and down stairs. xrays have shown everything in my knees is ok, but Im wondering I did a hydrotherapy session yesterday and my right knee is worse today. i have terrible pain bending down to the ground. is this normal? thanks and happy new year.
doctor
Answered by Dr. Mahboob Ur Rahman 2 hours later
Brief Answer:
See a rheumatologist

Detailed Answer:
Hi and Welcome to Ask A Doctor service.

Thanks you for using this app.
I have read your question and here is my advice.

In fact the problem in your knees do not seem to be related to hydrotherapy or its side effect . Though there may be some problem with hydrotherapy but those are mostly with the invasive methods. I don't understand we should blame this for your knee pain, rather to look for the cause of the knee pains.

Though the history is not sufficient to make a firm diagnosis of what may be the cause of your knee pain but the history of hip osteoarthritis, and the pain that is for long time , and pain that is worse with up stairs is suggestive that the pain maybe related to osteoarthritis of the knees.Specially if there is no significant stiffness (more then hour) in the said joints and if there are cracking sounds in joints with flexion and extension. X-ray is not very sensitive for picking up changes early in osteoarthritis, as it may be very much normal in early disease .So possibility of osteoarthritis in knee cannot be ruled out though it cannot be said for sure . So we just need to rule out any few other possible causes like if you have any trauma to knee , or if there is gross swelling in knee , or if you have stiffness of joints in morning (that is more then an hour) these symptoms would suggest other causes of joint pain like Rheumatoid arthritis etc.

One other possible cause is Gout (high uric acid ) that can cause acute joint pain . So checking uric acid level is not a bad idea.
Septic arthritis (infection of joint) is a serious condition that should always be rule out in any acute hot joint . This causes acute single joint pain , joint is very warn , very painful , and associated with fever . (your case does not seem like this)
So to finish , it cant be said for sure as what could be the cause, but likely osteoarthritis of knee.It's unlikely to be related to hydrotherapy. And a proper history , examination and few tests would be needed for diagnosis and better management.

Regarding treatment while pain may be helped by some OTC painkiller like ibuprofen, or paracetamol along with heat application but I suggest you should see a rheumatologist for proper assessment and management. Hydrotherapy only may not be sufficient as it only help the pain.

Good luck and happy new year .
Kind Regards
Dr Rahman
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Mahboob Ur Rahman 19 hours later
hi, thank you so much for your answer. i have had swelling in my knee after going up and down the stairs at my mums pool all day and it only went down after i rested it on the bed that night it does crack and click when i extend and bring my knee back it also feels like my knee buckles and out of 10 the pain when it feels like it buckles is about an 8 and this happens when i go to sit down or go down stairs. i hope that helps for further information should i ask for a knee scan? thank you again
doctor
Answered by Dr. Mahboob Ur Rahman 36 minutes later
Brief Answer:
Yes an MRI of the joint after proper assessment would be helpful

Detailed Answer:
Hi XXXXXXX .Thank you very much for writing back to us and providing the very necessary detalis .
Infact the pain and cracking would suggest osteoarthritis howe'ver if there is frequent buckling then we need to see it a little more .
No doubt , buckling may be caused by osteoarthritis and is a common cause .Your history is also suggestive .Howe'ver it's more likely if the joint has been aching for long like months to years , then the recent 8/10 pain may be caused by flare of OA .The nature of OA is that it have a good and bad times .But few thing more we should see

2. buckling and pain of knee joint may also be caused by damage to other structures of the joint.This includes meniscal tears ( small plates in joints ) , or tears of ligaments ( band that stablises joint ) or inflamation in membrane of joint ( plica syndrome ) .
Besides these buckling and pain may also be caused by "loose bodies " inside the joint .This small particle may be a brocken peace of cartilage , or bone , or calcium particles which floats in the joint and cause problems .
So to summarise it , one possibility is osteoarthritis but we need to see for the other possible cause .This would need detalied interview (specially if there is any hsotory of trauma ) and examination of the joint .And probably an MRI scan would be the best modality to know exactly the cause .Besides few blood tests like ESR , CRP , uric acid would also be helpful . So you may need to see an orthopaedic specialist who would first evaluate you and may ask for the MRI of the joint.

I am sorry to hear of the severe pain you have been suffering from lately .To help the pain at the moment I would suggest to give rest to the joint , ( avoid climbing and heavy exercise if possible) ,heat pad or ice packing , and some over the counter pain killer like ibuprofen or paracetamol. Application of knee brace may aslo help stablises the joint and reduce the pain.
Good luck , I wish you a speedy recovery to best of your health .
Please don't hesitate to ask if you have any further question or concerns.
Regards .
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Mahboob Ur Rahman 2 days later
thank you so much for my detailed answers. ill get some blood tests and an MRI and ask for a referal to an orthapedic specalist. thanks again! ill also grab some ibuprofen. can I take Ibuprofen amd and panadol together if the pain is bad again?
doctor
Answered by Dr. Mahboob Ur Rahman 19 minutes later
Brief Answer:
Yes you can take them .

Detailed Answer:
Hi , yes you can take them both if needed .We commonly prescribe them for moderate to severe severe pain.
Paracetamol is quite safe drug .You can take 1 gram four times a day .Similarly you can aslo take ibuprofen (if no history of kidney disease or peptic ulcer disease). You can take 400 mg to 800 mg few times a day for few days .Take ibuprofen after meals and if you have any stomach pain then you should take an antacids like lansoprzole once a day with ibuprofen .
Best luck .
Please feel free to write back to us if you have any question or concerns.
Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Mahboob Ur Rahman 1 hour later
thank you! i truly appreciate all your help :)
doctor
Answered by Dr. Mahboob Ur Rahman 52 minutes later
Brief Answer:
My pleasure

Detailed Answer:
This is a great pleasure for me if I could help you and I wish you a speedy recovery .
Above answer was peer-reviewed by : Dr. Nagamani Ng
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