Nick's Medial Plica Excision & Fat Pad 15 Months Post Op

Mr Green arranged for me to see Dr Kumar at the Pain Management Clinic at the BirminghamRoyalOrthopaedicHospital on Tuesday November 30th 2010 and had to wait for the appointment for over 4 months when I last saw Mr Green in July 2010. Before I saw Dr Kumar I saw one of the Nurses who asked me some questions about my right knee so Dr Kumar has an idea of the condition of my knee. When I saw Dr Kumar he did not really examine my right knee properly just asked me to roll up my trousers so he could take a good look at my right knee. I suppose he is not an OS and a pain Doctor so will not do a proper examination like Mr Green had done when I saw him in July.


He came to a conclusion that the pain I am experiencing is nerve pain and gave me some cream to try called Zacin cream (Capsaicin) that used for arthritic and nerve pain in the joints. Also he prescribed Lyrical (Pregabalin) that used for epilepsy and can all so be uses for nerve pain and would only take small dosages. It does have side effects and can cause fatigue and dizziness. I was reluctant to take Lyrical as I was worried about the side affects and how it could affect me when I am at work putting myself and others in danger if I feel spaced out at work that could lead to a serious accident. Also I was not happy to take medication all my life and wanted to find other ways to reduce the knee pain.


I looked at the BirminghamRoyalOrthopaedicHospital website and found they have a sports injury clinic which would be more suitable rather then going to the pain clinic. I would be able to see a sports physician called Dr Grahame Brown rather then seeing an OS who more likely to do surgery rather then trying conservative treatments. The clinic also has a team of physiotherapist under the guidance of Dr Brown and it also for people that have ongoing knee problems.


I booked an appointment with my GP to ask for a referral to see Dr Brown at the sports injury clinic and my GP was more then happy to refer me to Dr Brown as I told him that I was not happy about going to pain clinic and to take medication for epilepsy. I was still unable to run and still had pain and swelling at the bottom of my right knee.


Within 4 weeks I got a letter for my 1st appointment with Dr Brown on Wednesday January 5th 2011 in the evening after work. When I saw Dr Brown he asked me to strip down to my under wear so he could take a good look at my back and leg muscles. He asserted pressure on certain areas of the back muscles and right quads and on some parts of the muscles felt pain when he pressed against the muscles. He then asked me to sit upright the couch and asked me to move my right leg sideways and could not go all the way to the floor but I could do it with ease with my left leg.


He told me that I have tight and knotted muscles and would benefit having something called Intramuscular Stimulation (IMS) also known as dry needling used to treat myofascial pain, nerve pain. Dr Brown would find what is called trigger points in the muscles where the muscles are tight and knotted and by sticking needles into the trigger points it would relax the muscles and would feel less pain in the knee. IMS is a another form of acupuncture by under medical supervision under a qualified Doctor rather then seeing someone on a side street who may not be qualified to do acupuncture and may not know enough about Myofacial Pain as someone like Dr Brown does. I got a letter from the Hospital for my 1st IMS session within a few days of seeing Dr Brown on Wednesday 26th January 2011.


I got to the appointment on time and my Mum came with me as the information sheet about IMS that Dr Brown gave me say it a good idea to let someone else drive for you in case they are any side affects can make you feel sleepy. Dr Brown called me into to his treatment room and once again told me to strip to my underwear and lie face down onto the couch so he could stick some of the needles into my back muscles. Dr Brown stuck a few needles into my back muscles and told me it may hurt a lot and the pain may last for a few seconds or a few minutes. The pain lasted a few minutes and was fairly intense pain, the type of pain you feel if you have bad back pain that you find it hard to breath. That was the type of pain I felt and was made even worse when Dr Brown twisted the needles deeper into my back muscles. My skin went red which Dr Brown said is a good sign as it shows dry needling is working and that my muscles are very tight and knotted. I was told that the more pain you feel the better as it shows that the muscles are tight and knotted and benefiting from IMS sessions. After around 5 minutes he removed the needles from my back muscles.


I was then asked to lie on my back onto the couch with my back propped up and stuck some needles into my quad muscles in my right knee. I was bracing my self for some more intense pain but found the pain was not too bad at all and only lasted for a few seconds rather then minutes. Straight away felt could see it was working as I could now bend my knee sideways fully which I was unable to do before my IMS session. I could also squat with less pain and discomfort.


I went to the reception and arranged my 2nd IMS session on Wednesday 23rd February 2011 in the evening. I am really pleased that I managed to find someone like Dr Brown as in the UK sports physician are not very well known under the NHS. Dr Brown also works privately and has a lot of experience with back and knee pain. Can talk to him properly and listens to what you have got to say about my knee problems and can see he cares about his patients. He could see how much it means to me to be able to run once again. I would say he a fatherly figure and treats you like a human being as some Doctors are too serious and think they are almighty and do not have good verbal and communication skills with their patients while Dr Brown does.


After my 1st IMS session tried to see if I could start jogging once again and was thrilled to find that I could jog at a slow pace for the 1st time in over 3 years since I injured my right knee while jogging. I do however feel, pain at the bottom of my right knee when jogging slowly on the medial side and still have swelling at the bottom of the knee. I am certain it is scar tissue causing the pain and swelling as my knee was not as painful pre op as it is post op and still find it painful to squat. I cannot jog at a fast pace and cannot run yet so would not be able to compete in sporting activities and will see if IMS session will help or not and if it does not fix my right knee problems I am sure Dr Brown will try out another form of treatment or refer me to see an OS if he run out of options to try and sort out my right knee.


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