Knee in severe pain, no explanation

[knee always hurts]

I'd suggest that everyone read Paul Ingraham's summary of brilliant new research discovering just why we're in so much pain. No, you won't feel any better after reading it, but it just might tickle your intellect. As it turns out, a lot of the pain we experience is completely pointless. But we already knew that, didn't we?

http://saveyourself.ca/articles/why-does-pain-hurt-so-much.php

It's time to stop blaming your poor, hapless knees. Awful little neutrophil @#$%!

[knee always hurts]

This is an interesting post from almost 8 years ago on the kneeguru:

http://www.kneeguru.co.uk/KNEEtalk/index.php?PHPSESSID=0ecdf8cda267180f48753e4a2cc9a86b&topic=3644.0

That fellow sounds like he had a strikingly similar snapping sensation (SSSS) to what I have, though I also have some snapping extending to underneath the patella. It's too bad that most people never post a follow up telling how they made out. I'm almost tempted to send off an e-mail to that address, but what's the chance that he'll still be using that one?

In light of the neutrophil driven vicious cycle afflicting my knee, and also SqshPlr8's successful cortisone shot, I'm starting to wonder if an injection could be beneficial for me. There is definitely some sort of tissue snapping in there, and if it could just calm down, and therefore slim down (And therefore calm down, and so on. Nice virtuous circle.) I might be able to break out of this cycle. I have had some mild success with the new PT program, as those tissues seem to snap a bit less, and I can basically walk without pain now, but I'm fearing that it may not ultimately be enough. I'm just getting tired of this continuous dull ache in my knee which has barely changed in 7 months now. I think it's worth continuing my current approach for another month or so, but if there is no change at all I'm hoping for another possibility. I wonder how probable a symptomatic lateral or suprapatellar plica would be in my case? I know these are rarely affected, but I'm at a loss for any other explanation.

Would it make any sense attempting to get a diagnosis for plica syndrome, or even just seeking out a cortisone shot for more general "anterior knee pain"? I know the literature on the use of these shots for AKP is rather sparse, and that cortisone shots can sometimes be harmful, but one shot seems unlikely to cause too much trouble and just might cure me. Is it worth a try?

[knee always hurts]

I got a call from the FDA trial today, and I answered some questions, and the fellow said that I probably qualify. I'm actually leaning against doing surgery right now, as a result of the preliminary success of the new PT program that I'm on, and that it's a randomized trial with a 50/50 chance that it'll be a microfracture rather than the new cartilage transplant procedure. The microfracture leads to fibrocartilage, which is not at all the same as the normal hyaline cartilage, and is also a contraindication for future cartilage transplantation, which is a rapidly developing field, if it fails (For example, ACI is 3x as likely to fail after microfracture). On the other hand, I was assured that at no point am I required to go through with the surgery itself, and it might be worth it just to get some scans done, and have another pair of eyes take a fresh look at my knees.

I've also been doing some research on anti-inflammatory gels, namely Voltaren, and it seems like it might provide some pain relief (sans those nasty gastrointestinal sides effects!) if nothing else. Does anyone have any thoughts as to how beneficial Voltaren might be for chondromalacia/PFPS? I'll call my doctor for a prescription this week if it makes any sense.

[smillie]

I posted to you in another thread, but I think Voltaren gel is definitely worth a try. You can't take NSAIDs with it--you have to do one or the other. But if they have been hurting your stomach, then this will be a definite relief.

[knee always hurts]

What you posted on the other thread sounds very much like my situation, so I think I'll give my doctor a call and see what he thinks. Combined with other measures, I think it will be helpful. If you read Paul Ingraham's recent summary of the new pain research, it's quite clear that joint inflammation is completely superfluous, without any benefit whatsoever and the probable cause of further harm. It's fascinating that the gel has the same warnings as the oral nsaids. I bet that it is just because all previous research on ibuprofen has been for oral meds, and without new research on the topical gel, they have to post the same warnings. When the new research is finally published, I bet we'll find that the gel is a far safer alternative.

Thanks for your helpful insights, smillie!

[smillie]

From what I've heard, the warnings etc. are the same as the oral meds because that is what is in it. They don't have anything specifically for the gel yet. But I can attest that I've tried oral and gel Voltaren. I can't take the oral, but the gel works just fine. I have no idea about the liver warnings, but it seems like that would be lessened too.

[knee always hurts]

That seems to make sense. I've really wanted to try some anti-inflammatory medications for the past few months, but have been dissuaded as a result of my stomach problems. This will hopefully take care of that.