Knee Problem

[Wrong Turn]

Knee problem.

Bot of my knees have felt weaker in recent months. I cannot walk down the stairs properly. I walk "gingerly" down the stairs.

When I go from standing to sitting in a chair I feel a small about of pain, and the knees feel weak.

My left knee has been getting stiff while sleeping at night, whether my leg is straight of bent.

It feels tight, throughout the day.

I have NOT twisted it, nor done any sports. Only walking.

One potential cause? I've had severe gout in this knee twice, and since my last gout attack in 2006, my left knee (and both knees have never been the same.)

(I have conquered gout. I haven't had an attack for 6 months because of dietary changes.)

What could be causing this?

I am 38 years old. If I'm having knee problems now, this could be a long road.

Thanks for any info, advice or help anyone can provide.

WT

Edited November 3, 2008 by Wrong Turn

[Captain Chaos]

I know a bit about knees having played rugby a lot as a kid and managing to snap my anterior cruciate in one knee as a result. Cry? Err yes, rather a lot...

However, it's difficult to make much comment without knowing a bit more about your problem. Is the the pain inside the joint or outside? Maybe you can be more specific. Will say that I had a problem with my patella tendon recently - doctor told me to buy a supplement containing 'glucosamine' which helps to strengthen and replenish ligaments and cartilage - after a couple of weeks it seems to be helping. Maybe you can try that.

If it's acute pain, you should definitely go see your doctor...

CC

[Cuban]

Bot of my knees have felt weaker in recent months. I cannot walk down the stairs properly. I walk "gingerly" down the stairs.

When I go from standing to sitting in a chair I feel a small about of pain, and the knees feel weak.

My left knee has been getting stiff while sleeping at night, whether my leg is straight of bent.

I have NOT twisted it, nor done any sports. Only walking.

Joints benifit from fish oils, are you getting any in your diet, take Omega 3 supplements.

Weak knees, not doing any sports? Are you within the 'correct' height vs weight band?

Knees suffer great stress carrying around the overweight, doing some light excerise to develop muscles around the knee would be time well spent. You mention walking - Thai sidewalk surfaces are good places to find uneven trip hazzards - is it possible that you have suffered a mild sprain while out walking?

Swimming is a good excerise that does not place physical stress on a these joints.

For pain relief try some Thai massage.

[FBN]

The stiffness at night may indicate an arthritic problem and degenerative knee lesions are typically more symptomatic when going down stairs.

Some blood tests (sedimentation rate and rumatoid factor) and and X-ray should give you an answer.

Joints need to mobilise as the cartilage has no real blood supply and is dependent on its nutrients from the synovial fluid in the joint. The "pumping" action when the joint is mobilised creates pressure gradients which allow for the synovial fluid to circulate properly.

This mobilisation must be NON-weight bearing for knees. Using a bicycle is better than jogging or a treadmill; the body weight is transferred to the saddle not the feet.

[Sheryl]

Agree with FBN, should see a doctor, preferrably a specialist in rheumatology. I recommend Dr. Virat at Bumrungrad, he'll make a thorough diagnosis and not jump to conclusions.

Dr. Virat Pinyopornpanit

Speciality: Medicine, General Medicine, Rheumatology (Arthritis)

Language: Spoken: English,Teo Chew,Thai

Qualifications: Medical School:

- M.D.Chiang Mai University, Thailand, 1988

Board Certifications:

- Diplomate of Thai Board of Internal Medicine, 1992

- Diplomate of American Board of Internal Medicine, 1996

- Diplomate of American Board of Rheumatology, 1999

Fellowships: Rheumatology, USA, 1999

Special Clinical Interests: Arthritis and Immunology

Day Time Location

Mon 09:00 - 18:00 NS 15B (Medical)

Tue 09:00 - 12:00 NS 15B (Medical)

Wed 09:00 - 18:00 NS 15B (Medical)

Thu 13:00 - 18:00 NS 15B (Medical)

Fri 09:00 - 18:00 NS 15B (Medical)

Sun 09:00 - 18:00 NS 15B (Medical)

[Wrong Turn]

Thanks to everyone with your replies and helps, and Sheryl thanks for the contact info.

In regards to a couple of questions above in posts:

1. Yes, I take fish oil regularly, every day.

2. I am about 40-45 lbs overweight.

3. The pain is in the "middle" of the joint, but also there is soreness (pain) on the inside of the knee.

I'll follow all of your advice and see a doctor about this in 2 days.

Thanks, again.

[jhc]

I used to have pain in both of my knees, the patellar tendon all my life until recently. I used to take 4 pills of Advil/Motrin about an hour before hard activity like racquetball/tennis just to lessen the pain and inflammation. Even went to doctor and got cortisone injections which did reduce the pain (i.e. less the need for Advil/Motrin) but it is a band-aid solution.

Then four years ago, I started to do Hindu Squats (learned from Matt Furey you ll find him in google) which I do about 60 to 100 almost everyday (my record was 680 in row and could have go on, but I stopped) and same time I started to eat low fat raw vegan diet (basically I just eat fruits in it's natural state and veggies too) which help me to lose about 45 lbs down to my ideal weight. Since then, my knees is like a new, far much better than even i was in teenager years. I have not took Advil/Motrin or any pills/drugs of any kind for past 4 years. I could play hard racquetball/squash all day and my knees are all fine.

So it must be both doing squats and eating healthy (fresh fruits/veggies in it's natural state, help me to lose weight) solved my knee problems for good.

For those who live in Thailand, eating fruits is not a problem Probably best and cheapest place to eat all kinds of fruits in season.

[Wrong Turn]

Thaks jhc,

I'll google Matt Furey for the Hindu squats.

Update:

It is....gout.

I found out myself.

I am frustrated because I had reduced meats almost completely. I reduced saturated fats. I take fish oil. And I drink at least 3.5 liters of water day, usually more.

I do drink beer almost every night. About 4-6 big bottles.

I walk everyday but I don't exercise right now (my fault) and I am overweight.

As I noted before I started taking Allopurinol that was given to me, but stopped because I hadn't had the liver and blood tests.

Tomorrow (my day off of work) I'm going to the doctor and will ask for the tests to start allopurinol.

Because of these gout attacks in the knee, I see potential knee problem in the future as I'm only 38.

This was the first gout attack for me in six months.

Thanks for all of the help.

Edited November 6, 2008 by Wrong Turn

[jhc]

If I am in your shoes, I would stop drinking beer, take no drugs at all, just eat fresh fruits/veggies in it's natural state, doing some hindu squats. I bet in 1 to 3 months, you will feel like a new man, even better than when you were 18 years old... What can hurt you if you just try for up to 3 months and see what your body tells you

Good Luck!

[Old Croc]

There's been several lengthy threads on gout in the past.

I suggest you use the search function and you will have access to every potential cure in the world.

[FBN]

Knee pain is not the most typical presentation of classic gout. Affects mostly the big toe first joint. Can involve the patellar tendon though as well. Have this confirmed by blood test and an X-ray of the knees.

The jhc story above is quite interesting and clearly shows the value of joint mobilisation to enhance the supply of proper nutrients to the cartilage.

Like he says, it won't hurt to try this for three months!! You are quite young and the chances are that any changes in the joints may not be irreversible at this point but you have to take action now..

[Old Croc]

I suffer gout and arthritis and am in need of a complete knee replacement.

My gout has always been confined to my feet, the knee problems stem from sport in my younger days and the arthritis.

Definatey do everything you can to fix it now, don't neglect like some, and end up as an old crock in later life.

[percy2]

I get gout in my big toe , metatarsals, ankles ,knees and even a little finger joint and a thumb joint.

I think an actual gout attack in the knee is the single most painful experience I've ever had.

I know exactly what you are talking about re tightness of the knee an an interior pain.

Gout also causes tendinitis which is what I think you are experiencing in your knee. (does your Achilles feel stiff in the morning? I walk around like an old man for the first 5 minutes out of bed)

I take allopurinol every day and drink lots of water , which has stopped me having a gout attack for about 6 months also.

Recently I have cut the booze down a lot (maybe 1 bottle / week down from a similar amount to you) and the tendinitis seems to be much better.

Cheers

[percy2]

To add to what FBN has been saying , I have also been doing a lot more exercise recently and the more I do (building day by day) the less effect it has on my knees.

Cheers

[jhc]

Agree with FBN that full range of knee motion via Hindu Squats along with better quality raw materials from fresh fruit/veggies certainly helped rebuild my knees making it stronger and free of any inflammation and pain.

Go to YouTube and search for "Hindu Squat" and you will find plenty of video giving you good example of how to do this exercise.

About eating fruits/veggies, try checking FoodNSport.com and FruitGod.com They might help motivate you to eat better. I learned from Doug Graham, he is amazing guy, he is 55 years old but he put any 20 something to shame in terms of fitness level. I am very good myself compare with average Joe Sixpack, but Doug kicked my butt from head to toe. Also you might want to check "durianrider" as he is one cool dude from Aussie telling us what simple living can do wonders for us.

[Wrong Turn]

Thanks for all of the replies.

I've read all of them and will heed your advice.

I just got back from the doctor and because of my chronic gout, which started in my early 30s, I am starting allopurinol when this latest attack fades away.

I'll start with 100 mg per day for a week, and if there are no problems, I'll take 300 mg per day.

I did not have a blood test. I have not scheduled a liver toxicity test, although I mentioned it, and was told it wasn't a big deal. Is this OK?

So....I'll start allopurinol soon.

Thanks, and I'll keep you posted.

Edited November 7, 2008 by Wrong Turn

[adamx]

You should NOT be having a beer every night if you have gout! Limiting your proteins is good but you should pretty much eliminate alcohol too. Also reduce weight. Stick to the elimination diet and you will be MUCH MUCH better. You are quite young and it will only get a lot worse as you get older if you don't take care of it now. Good luck.

[Sheryl]

I did not have a blood test. I have not scheduled a liver toxicity test, although I mentioned it, and was told it wasn't a big deal. Is this OK?

Before starting on a long-term medication with potential toxic effects you should have a baseline blood count (CBC) , liver enzymes (AST,ALT) and kidney function tests (creatnine and BUN). These are simple inexpensive tests and basic good practice.

Should then monitor same on a regular basis.

Any hospital or large clinic can do these tests.

I would also suggest a change of doctors to one who is more conscientious. The "mai ben rai" philosophy should not extend into medical practice. Sure, the majority of patients will do OK, but what if you are in the unlucky minority?

[barkingSane]

I am about the same age as you (OP) and have carried a knee injury for about 15 years (from cycling in a funny way). I was resigned to having it for ever but yoga seems to be curing it. My yoga teacher makes me sit between my heels then lie back. Hurts like mad but seems to be working.

Good luck.

[Wrong Turn]

I did not have a blood test. I have not scheduled a liver toxicity test, although I mentioned it, and was told it wasn't a big deal. Is this OK?

Before starting on a long-term medication with potential toxic effects you should have a baseline blood count (CBC) , liver enzymes (AST,ALT) and kidney function tests (creatnine and BUN). These are simple inexpensive tests and basic good practice.

Should then monitor same on a regular basis.

Any hospital or large clinic can do these tests.

I would also suggest a change of doctors to one who is more conscientious. The "mai ben rai" philosophy should not extend into medical practice. Sure, the majority of patients will do OK, but what if you are in the unlucky minority?

Thanks Sheryl,

This is an American doctor, and is also a surgeon.

He gave me the prescription for the Allopurinol and also noted that it is OTC (over the counter).

So...shucks! I should take these tests you mentioned. And then take a test later to make sure the medicine is not affecting my liver, etc.

Dang!!

Why didn't he do it right there??!!

[Denim]

My gf just had a case of water on the knee. Swelling around the knee cap and painful to walk or put weight on. Had to have it drained and go on a course of medication for a month to help repair the cartlage.

[CTM]

That's a lot of empty beer calories per day. You're getting almost your full days calories just from beer. It is no wonder your overweight.

I second the bodyweight exercises idea. Bodyweight exercises always just make me feel better. Joints, energy levels, mobility, everything. I would add in some direct joint mobility work also. Flexibility, mobility, muscle imbalances could be compounding your problems. Steve Maxwell has a good video called "Encyclopedia of Joint Mobility".

[Wrong Turn]

That's a lot of empty beer calories per day. You're getting almost your full days calories just from beer. It is no wonder your overweight.

I agree, CTM.

And I am responsible for this neglect, and I will do something to correct it. Tomorrow I'm doing an upper body weight training dumbell workout in the morning.

I have no choice. I have to do it.

I second the bodyweight exercises idea. Bodyweight exercises always just make me feel better. Joints, energy levels, mobility, everything. I would add in some direct joint mobility work also. Flexibility, mobility, muscle imbalances could be compounding your problems. Steve Maxwell has a good video called "Encyclopedia of Joint Mobility".

Thanks for the book tip. I'll check it out on Amazon.

[henryalleman]

Knee problem.

Bot of my knees have felt weaker in recent months. I cannot walk down the stairs properly. I walk "gingerly" down the stairs.

When I go from standing to sitting in a chair I feel a small about of pain, and the knees feel weak.

My left knee has been getting stiff while sleeping at night, whether my leg is straight of bent.

It feels tight, throughout the day.

I have NOT twisted it, nor done any sports. Only walking.

One potential cause? I've had severe gout in this knee twice, and since my last gout attack in 2006, my left knee (and both knees have never been the same.)

(I have conquered gout. I haven't had an attack for 6 months because of dietary changes.)

What could be causing this?

I am 38 years old. If I'm having knee problems now, this could be a long road.

Thanks for any info, advice or help anyone can provide.

WT

Probably its caused by arthritis

Had the same problems about the same age. Now 22 years later and after several operations I have since 3 years both knees replaced.

Some good advise

1- reduce your weight

2- stop to run or jogging, better drive bicycle ore home trainer. But if you do don't put force on your knees, you don't have to win any race.

3- at night put a pillow under your knees

4- don't sit too long

5- if pain put some ice on it

6-don't sit on your knees or sit or squat.

7- and the most important wait as long as possible to have an arthroscopic surgery

8- all alternative healing; pomades, injections or massages is simply bullocks, its only cost you money but its no help in any way what so so ever, tried it all. just put 15 or 20 minutes an ice pack and your pain will be gone

further information

http://www.niams.nih.gov/Health_Info/Knee_...ems/default.asp

[prk888]

Grape seed extract has worked for me for over 20 years for my knees (recommended by Dr. Christian Barnaard's nursing staff). Google the net for foods high in prutine - gout instigator - you'll be surprised how much delicious food should be avoided!

[qwertie]

The wrong FOODS cause 99% of problems both mental and physical. The right foods can heal them. This I know.

Daniel Reid (the tao of health, sex and longevity) says the retention of uric acid is the main cause of Gout and recommends carrot, beet and cucumber juice 10oz/3oz/2oz 2 pints daily taken at 6 intervals (buy a juicer and make your own).

Also lemon (lime?) juice taken 4-5 times between the above.

Raw spinach is good.

Avoid meat (you do) and refined starch and sugar, salt and preserved food.

If you are near Pattaya (and even if you are not) Google 'pattaya sports clinic' and see Nigel Kelsey. A most ordinary guy to meet - but gifted in massage and acupuncture. I am sure that he will amaze you with real results.

I'd be very happy to hear if the above helps you. Of course it goes without saying, keep off or severely limit ALL junk foods, inc fizzy colas, etc. Slow death in a glass. The beer would be better for you.

I'd also THROW AWAY the drugs you mention. NOT NECESSARY!!

[Sheryl]

I did not have a blood test. I have not scheduled a liver toxicity test, although I mentioned it, and was told it wasn't a big deal. Is this OK?

Before starting on a long-term medication with potential toxic effects you should have a baseline blood count (CBC) , liver enzymes (AST,ALT) and kidney function tests (creatnine and BUN). These are simple inexpensive tests and basic good practice.

Should then monitor same on a regular basis.

Any hospital or large clinic can do these tests.

I would also suggest a change of doctors to one who is more conscientious. The "mai ben rai" philosophy should not extend into medical practice. Sure, the majority of patients will do OK, but what if you are in the unlucky minority?

Thanks Sheryl,

This is an American doctor, and is also a surgeon.

He gave me the prescription for the Allopurinol and also noted that it is OTC (over the counter).

So...shucks! I should take these tests you mentioned. And then take a test later to make sure the medicine is not affecting my liver, etc.

Dang!!

Why didn't he do it right there??!!

The tests in question are standard for any physical check-up so if you have had a recent physical can use those results as the baseline. Still need to recheck it within a few months of starting therapy and then periodically thereafter.

AFAIK Allopurinol is still a prescription-only drug in the US. It is available OTC in Thailand but so are a LOT of other serious drugs....

Here is a link to a patient info handout on the drug:

http://www.medscape.com/druginfo/patientha...=patienthandout