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My knee keeps giving way. Advice welcome. Options
Naomi1
#1 Posted : Thursday, October 27, 2011 9:46:05 AM Quote
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I am quite newly diagnosed and have been on Methotrexate for 7 weeks. My 2nd course of oral prednisolone steroids ends today. My joint symptoms have returned as the steroids were reduced. I have a particular problem with my right knee as it keeps giving way. I will often be just standing doing something and suddenly I get a severe pain on the front and inside of the knee before the knee literally collapses under me. I can then limp with difficulty for a while before it settles down again. This has happened 5 times in the last week. The OT suggested a tubigrip bandage, which I am getting today. I will mention it to the nurse next week when she teaches me to do my injections. Does anyone have any suggestions about what to do. I'm not sure whether to use my stick (even though I don't really need it to walk now). I don't know whether to rest the joint or keep it moving. I want to keep working. Help! Also I am wondering if this symptom means I have already sustained damage to the knee.
Best wishes to everyone on the forum from Naomi.
LynW
#2 Posted : Thursday, October 27, 2011 10:19:10 AM Quote
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Hi Naomi

As one who has had knee problems ongoing for several years it doesn't sound good! As the knees swell due to inflammation caused by the RA it puts undue pressure on the soft tissues and joint lining. This in turn may cause the knee to malfunction. Often when you get the 'giving way' symptom it can be down to cartilage damage or a foreign body, perhaps a tiny fragment, an osteophyte, that has broken away and locks the joint occasionally. You may then have a period when you don't seem to have the symptom.

As knees are weight bearing it is important that it is rested, usually with the leg raised to help reduce fluid build up. Inflamed knees benefit from regular cold packs and the use of a knee splint (got mine from Boots). Tubigrip is normally only adequate for soft tissue injury and will provide only minimum support. Definitely worth using a stick or crutches for support when you are able to. Gentle movement is key to stop the knee from stiffening up.

If the problem persists it does need reporting to rheumatology who may in turn refer you to orthopoaedics for investigation. Alternatively, or in addition, you may be referred to physio ... they can offer some great exercises to strengthen the joint and surrounding tissues. At the moment I am on 12.5mg prednisolone to keep the knees in check, anything less and they just flare up again. Might be worth more steroid for you in the interim until it can be investigated.

Good luck Naomi Smile

Lyn x
My son, Ian, completed the BUPA Great North Run on 15th September running for the National Rheumatoid Arthritis Society (NRAS). You can read his story at http://www.justgiving.com/ianlukewilson

smith-j
#3 Posted : Thursday, October 27, 2011 7:34:04 PM Quote
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Naomi

I agree with everything Lyn has said. I had terrible trouble with my knee and eventually had to have a knee replacement. I used my walking stick before this and it really helped with my walking and more importantly my confidence.

I would definitely speak to you GP or rheumy team about physio. After my knee replacement I was given physio exercises to do over many months and it is amazing how much strength you can built up in muscles which are very weak to start with. Even after the op, my knee was still giving way but this was entirely due to the muscle being so weak after the operation. Now I have no problems.

All these symptoms which keep occurring with your RA can be very frightening but I promise it does get easier.

Take care

Jackie
xx
Naomi1
#4 Posted : Thursday, October 27, 2011 8:07:39 PM Quote
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I have been referred to physio by the OT. I just hope that the appointment comes soon as I am in real danger of not being able to work if this gets worse.
jenni_b
#5 Posted : Thursday, October 27, 2011 10:16:58 PM Quote
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You could ask for an ultra sound of the joint- they can pop some steroid in at the same time.

The ultra sound sees inside the joint in a detailed way.... or there is an MRI option of course.
how to be a velvet bulldoser
Lorna-A
#6 Posted : Thursday, October 27, 2011 11:52:14 PM Quote
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Hi Naomi,

Sorry to hear you now have this to contend with. Lyn's post is excellent she really knows her stuff about this awful disease. I do hope you get seen quickly.

Take care

Thinking about you Lorna x Smile
Naomi1
#7 Posted : Friday, October 28, 2011 1:41:51 PM Quote
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Thanks everyone for your kind replies.
Jenni, when you talk of 'popping a steroid injection in', please tell me how much this will hurt? I've heard steroid injections are really painful and the thought scares me. I need honesty here. I don't mind the thought of a bit of pain afterwards but it's the thought of pain as the needle is going in or when the liquid is pushed in makes me want to pass out with shock. I don't mean to be a baby here and I know many people are going through major operations and I'm sorry if I'm not being brave but I am needle phobic. I need to know the truth so that I can take action....e.g. use numbing cream or ask for some sedative to calm me down. I'm honestly worried that I will grab the needle out and possibly injure myself or the person administering. Please don't laugh...I'm not joking. I am scared (I did this before when they stuck a needle in my hand during childbirth) I know I'm probably going to have to face a steroid injection at some time so please help me to get prepared for it. X
julieporter123
#8 Posted : Friday, October 28, 2011 2:49:02 PM Quote
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Naomi
I've had a few steroid injections into my knees and the thought is worse than the reality.They do hurt but the pain is no where near as bad as you would think - and the benefits for me really outweigh the shortlived pain of the injections.I normally take some stronger pain killers an hour before hand but maybe discuss with your doctor about getting a mild sedative that you could take to relax you.My rhuemy normally injects local anaesethic at the same time so the pain afterwards is reduced.You will be lying down during the procedure so don't look!!! and make sure you rest for 48 hrs after to give them a good chance of working.
I'm having injections into elbows on 22nd Nov and i can't wait-they really do help
Hope this helps
Julie
Maria_R
#9 Posted : Saturday, November 05, 2011 10:18:51 PM Quote
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Hi Naomi

I have similar problems with my left knee. The rheumy said that that my quadriceps in my thigh were weakened as a result of the inflammation, so they need exercising to srengthen them.

Maria
Naomi1
#10 Posted : Sunday, November 06, 2011 10:20:13 AM Quote
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Maria_R wrote:
Hi Naomi

I have similar problems with my left knee. The rheumy said that that my quadriceps in my thigh were weakened as a result of the inflammation, so they need exercising to srengthen them.

Maria


Thanks Maria. I have been referred for physiotherapy as my OT says my muscles have weakened all over my body. Hopefully the physio will help the knee to stay put. I need it to be OK as I am trying to keep working and my job requires me to be quite physically active. Naomi x
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