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Author Topic: Knee in severe pain, no explanation  (Read 19915 times)

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Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #30 on: November 15, 2010, 05:37:47 PM »
Still no word on the insurance. I might call later today, but I doubt that it will speed things up any.

I definitely felt a lot better when I was able to move around more, and it doesn't seem likely that the Lyme bacteria would relent simply because I was moving. So perhaps it is just an unfortunate constellation of symptoms. But I don't think my situation is going to be changing much any time soon. The last couple of days, other than the pains, I felt completely normal. No depression, no anxiety, nothing. I went to sleep, and woke up at some point in the middle of the night suddenly with what I can only describe as a mini panic attack. For some reason, my heart rate didn't increase, but I still got the tightness in the chest and sudden numbness in the extremities. They lasted about 10-15 seconds and repeated probably another 3 or 4 times before I was able to fall asleep again. I really think they are triggered by the pain in my knee. I've been trying to bear a little bit of weight on my knee while still using crutches, figuring that it is better for the joint than nothing. But my knee doesn't seem to tolerate it at all. I haven't had much in the way of sharp pains, but my knee now feels very irritated. That irritated feeling provokes a fear response for some reason. Now, whether I'm more vulnerable to that happening as a result of something else, or it is just the repeated blows of the last few months finally getting to me, I don't know. I'll probably raise the LD theory with a doctor when I get to that point, but this might be something I'll just have to manage for a while.

Offline kscope09

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Re: Knee in severe pain, no explanation
« Reply #31 on: November 15, 2010, 05:59:29 PM »
If you havnt had an mri scan then you must go and get one.  The longer you wait the more muscle you will loose and the worse the knee will get.  If you rest it too much and don't move around you are at risk of worse things than atrophy.  I'm tlaking about RSD and you really don't want RSD I can't stress that enough.  I've had scares about it before and from my research it is one of the worst things anyone could have wrong with them.  If youu rest too much you put yourself at risk.  So see a knee scpecialist and get an mri, do this before you have a scope.  If you are lucky a scope might not be necessary.

All the best.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #32 on: November 22, 2010, 12:34:57 AM »
Well, as if it couldn't get any worse, it looks like in my zeal to get that insurance application mailed out, I neglected something. They wanted a birth certificate! So now I have to wait even longer! Ahhhhhhhhhhh! What was finally a certainty, I thought, is up in the air again. I'm planning on hand delivering it tomorrow, but I'm sure they won't be in any rush to get it processed. Ack!

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #33 on: November 23, 2010, 01:53:45 AM »
I got a letter in the mail today that says that I am now covered by insurance! This is great news but I still need to take care of the birth certificate situation. Fortunately I can begin to make the appointments to get me where I need to go. Now the only concern is if I will be able to see the doctor that I want. We'll see.

Offline smillie

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Re: Knee in severe pain, no explanation
« Reply #34 on: November 23, 2010, 09:15:32 PM »
I've been catching up on your thread this afternoon. Congrats on getting your insurance! Hopefully you can get some resolution or at least a better understanding of your situation. A few posts back you were describing that panic feeling but not the full blown panic attack. I'm wondering if I can describe what you are talking about. I get a pain response that may be what you are talking about. It's almost like my throat and chest and stomach tighten up for just a bit like a contraction and I feel kind of quivery for a second as it releases. It's really hard to describe. It's definitely a response to pain and sometimes I don't even realize the level of pain that is there until I react to it. I know I'm describing it badly because it's really hard to describe. Does this sound anything like what you were feeling? I only mention it because I wanted to reassure you that it's just a pain response as far as I know and something I have experienced often. The best way I've found to deal with it is to lie as comfortably as possible, close my eyes, slow my breathing, and try to relax all of my muscles. It's a relaxation method I learned in child birth preparation and it really does help when dealing with pain and pain reactions. I do my best to just look like I'm asleep and enter a state of relaxation. It helps the pain subside and calms me down considerably.

Good luck and let us know what you find out!
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #35 on: December 05, 2010, 12:15:28 AM »
I have been under the impression that I was supposed to receive some sort of information pamphlet describing how I would go about the selection a qualified doctor under this insurance plan, and I still haven't received it. So I still haven't made an appointment. However, I'm fortunate that the problem finally seems to have calmed down. I've been walking, albeit quite slowly, for the last few days. My knees are still quite sore, but I haven't had any sharp pains, at least not yet. So I've been trying to strengthen some of my muscles since it felt like my leg was caving into the side when I first got off crutches, I was so weak! In any case, my situation is a good deal less urgent than it was a few weeks ago. Whatever could have caused that to happen, in the absence of some acute trauma (which there wasn't), I'll never know.

The plan now is to see how I respond to a gradual increase in activity over the next few weeks. Hopefully by then I can make an appointment to the doctor if I need to. I fully expect that I'll probably have to. It still feels like there is something catching underneath my knee cap. I obviously wouldn't care if it doesn't hurt at all, but given the last several months, it seems unlikely that it won't cause any further problems.

Offline marksalot

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Re: Knee in severe pain, no explanation
« Reply #36 on: December 05, 2010, 05:00:25 AM »
Just wanted to throw my story in here in case this helps.  I'm by no means recovered, but I have found a routine that I'm satisfied with so far.

Here's where I was at ~2 months ago: Knee pain when my leg is relaxed while sitting or lying down.  Mostly the medial side unless I'm in an odd position that puts pressure on the other side.  There was also pain and heat coming from below the kneecap (fat pad area) on some days.  Doing any exercise makes it feel "better" vaguely, but it also feels like I'm making it more sore at the same time.  So I go to two doctors who don't really have much advice other than to increase my activity with it.

So out of options, and lacking any sort of diagnosis or explanation, I really start trying to exercise.  I've just decided that this must just be one of those things that doctor's can't really explain.  Anything that makes it feel sore is OK, as long as it doesn't make it feel like there's catching/grinding/friction in the knee.  I'm doing inner/outer leg machines and leg curls at the gym.  (No extensions.)  Also found a recumbent exercise bike that seems OK.  (I still can't do most bikes because they don't feel good at all, but this specific one seems helpful.)  I'm still doing a lot of the physical therapy exercises, but I don't do any of them that don't make it feel good somehow, or that seem to be more painful than the others.  For all of these exercises, form seems to be important to whether it feels OK or not.  It's tough to nail down, but it generallly seems to help to keep my knees pointed out, feet slightly out, and try to emphasize using my outer leg muscles.  My hands are on my legs a lot to feel what my muscles are doing.  (Especially the outer quads and hamstrings.)

After about a month I start adding a squat machine in to my routine.  Low weight at first, and I adjust everything to make my knee bend as little as possible.  But this also seems to feel OK.  I'm glad I added this, because this seems to be the only thing I'm making progress at anymore.  This and the bike.  I still do the other exercises, but I'm not really increasing anything with anything else.  The pain wasn't too bad today during the day, but I still can't sleep with a straight leg.  And it still varies a lot from day to day.  But one thing that seems to help is to always exercise every day, no matter how sore it is.  (I do take one day off each week though.)

Oh, and at some point in this period I also decide to stop limping, stop using knee braces (unless it really hurts), and stop using anti-inflammatories.

Your condition could be completely different, and obviously I don't know that I'm even doing the right thing for myself yet.  (I won't know that until the pain goes away.) But maybe something here willl be helpful.
04/10: right kneecap catching and pain during a brief bike ride, start resting
05/10: red spot on inner knee, painful sleeping, GP recommends 6 wks rest and exercise
07/10: stretching helps pain, but exercise brings it back, GP recommends knee sleeve and PT

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #37 on: December 05, 2010, 07:23:53 AM »
Well, thanks for the suggestions but I have to say that I've just been flummoxed by my knees over the last couple of months. I've tried just about every combination of exercises imaginable and they haven't responded favorably. I'm going to make one last attempt over the next two or three weeks but then it's the cortisone shot/surgery route.

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #38 on: December 09, 2010, 02:50:10 AM »
Well, after a few good days my knee started acting up again and the familiar feeling of irritation and pain is returning. This time, figuring that prudence is the better part of valor, I'm going on crutches to preempt the agony that I was in last month. I guess my knee really never is going to improve without some sort of invasive treatment. There is a feeling of something popping or snapping in my knee in that location, so obviously something is horribly wrong there. Finding out what exactly will have to wait for a while because I never received all the information I required for my insurance. But when it's sorted out I'll be off to the doctor immediately.

The good news is that the psychological symptoms have almost completely subsided over the last couple of weeks. I'm certainly "stressed out", but it is a familiar stress and not severe anxiety or panic attacks. All of that was honestly a great deal more problematic for me than mere pain. So I'm faring better for now.

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #39 on: January 04, 2011, 09:53:18 PM »
I had finally gotten the insurance last week, but apparently the doctor was out for the holidays. So this week, I called to make an appointment.

I told the secretary my situation, and asked if it would be a problem if there was a specific doctor I wanted a referral to. I was told it will not be a problem. Amazingly, I got an appointment for Thursday! So, finally I'll see a doctor in a couple of days. If I can get that referral without any trouble, perhaps I'll be getting an MRI before the end of the month. At last, some unambiguously good news!  ;D

Offline smillie

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Re: Knee in severe pain, no explanation
« Reply #40 on: January 06, 2011, 03:28:02 PM »
I know it's not the case in other countries, but in the US you can actually expect to get appointments and procedures pretty quickly for the most part. I'm sure there are some doctors out there who are in high demand and take longer to get in to see, but for the most part, you can expect to get in within a week or so. I would guess they could get you on the MRI schedule very quickly if that is what you need. Just remember not to pin all of your hopes on an MRI. It doesn't always show that much. I'm glad you're on your way!
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #41 on: January 06, 2011, 07:40:27 PM »
What a difference another pair of eyes and ears can make. The new doctor today was completely different from my prior experiences. For the first time, I was given a comprehensive evaluation. Whereas the other doctors seemed pressed for time, and were trying to push me out the door, this doctor listened to everything I had to say, and went through a number of possibilities.

The highlights:

He thinks that it is likely that I have chondromalacia. However, when I asked why the pain would be so severe, he didn't really have an answer.

He looked at the alignment of my bones, and said that it does appear that I am knock-kneed. I asked if the misalignment meant that I would likely have to have some kind of derotational surgery, and he said that it is possible, but it is premature to think about that yet. He did say that the necessity of some kind of surgery is very likely.

I asked about the possibility of some other scans, like an MRI, and he said that he wants to review the X-rays first, but he actually had me schedule an appointment for tomorrow as well where we will further discuss my options.

I think I saw this week on the forum some discussion of the degree of the angle of rotation where a TTT or derotational osteotomy might be advisable. I would certainly want to make sure that I fit within the medical guidelines for that procedure before seriously considering it, and I would want to get a second opinion.

He actually said he is going to do some research at home for me! Quite amazing really. It will be interesting to see what he has to say tomorrow.

Offline Vickster

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Re: Knee in severe pain, no explanation
« Reply #42 on: January 06, 2011, 08:58:06 PM »
Good to hear that you are finally getting somewhere  :)

I too am slightly knock kneed (increased valgus alignment) and in addition to a nice ~1.5cm2 osteochondral defect on my WB lateral femoral condyle (caused by falling off a bike) filled with fibrocartilage, my latest scope (which was to assess suitability for a MACI) also discovered extensive grade 1-2 softening (so chondromalacia) on the lateral tibia in addition to the grade III on my patella that was tidied during my first scope 10 months earlier.  After the scope, the OS couched the possibility of an osteotomy to shift the weight to my 'pristine' medial compartment. 

No mention of derotational surgery, I don't think genu valgus is always accompanied by rotational issues (never been any mention in my case).  Will be discussing the next steps with the OS in a few weeks.  My understanding is that a TTT is more for when there is major patella / trochlea wear?  For knock knees and lateral wear a Distal Femoral Osteotomy and for medial wear an HTO.  The osteotomy section in the information hub on here is excellent - have a read :)

I have chronic discomfort, but wouldn't say the pain is unmanageable.  I can cycle ok, can use an XT, but any impact exercise, kneeling, squatting is not really possible.  I also get very stiff sitting for any length of time and find it uncomfortable to lie on that side.

Good luck with getting some answers.
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Vickster

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Re: Knee in severe pain, no explanation
« Reply #43 on: January 07, 2011, 10:40:00 PM »
How did you get on with the doc today?  Closer to a plan of action?  :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline knee always hurts

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Re: Knee in severe pain, no explanation
« Reply #44 on: January 07, 2011, 11:35:28 PM »
Thanks for asking, Vicks.  ;D

Yes, I actually gave a sheet to the doctor with the preferred specialist that I wanted to see, and he said, (Paraphrasing)"Mass General, Havard Medical School professor, I don't think you're going to do much better than that." He's actually calling the doctor to talk about my case and to schedule an appointment for me.

It's difficult to express how great this doctor is. He has all the virtues you would expect in a good doctor. He freely admits when he doesn't know something, listens to what you have to say, and evens wants to hear his patient's input. I think he actually learned something from me today. It was rather funny, he said that some of the things he was telling me might be a bit "old fashioned" since things change so quickly in the medical profession. He had told me yesterday that getting an osteotomy procedure would involve being in a cast for a significant amount of time. So I told him today that they actually have a new procedure that involves a plate that holds everything together rigidly, so that casts are unnecessary now. I think my other doctors would have blown a gasket in a that circumstance (Though I doubt the conversation would have ever gotten to that point), but he actually seemed happy to learn something new.

He said that his only interest is in helping his patient, so that he doesn't have any problem referring me to a specialist. He said that primary care doctors are a bit like "gatekeepers" who help to regulate the flow of traffic in the health care system. For routine things like diabetes management, or asthma, or many infectious diseases, they can take care of you, but in my circumstance, he that that I'm going to need specialized care. So it's on to the next step now. I'll post when I get an appointment date for the specialist.















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