Today I went to see another doctor (I like this medical insurance, all of these people to see me) - any way. This was an ortha, ortho - a Bone doctor (The other one was a sports bone doctor) And she played with my leg for a while, moving the joint through every possible movement getting it to clunk a few times.

She ended up suggesting cortisone shot into the knee.

I got it. I'm uncertain what to expect, how long does this last and just how does cortisone work when it comes to pain?

She wants to see me in a month. She said that she would prefer to not go the route of surgery and that I may have to get several shots. Is this normal?

Thanks and cheers

David

A cortisone shot may be recommended when more conservative measures – anti-inflammatory drugs and physical therapy – fail to relieve localized pain, usually in the joints or tendons. It can produce dramatic results and is believed to work by blocking the body’s natural inflammatory response. However, the effects are temporary and do nothing for the underlying cause. Pain relief from the shot begins within a few days and may last for a few days or up to a month, but unless you address the cause, it will recur.

Personally, I am opposed to coritisone (steroid) shots. They do nothing to fix the problem that you are having in the first place, they merely mask the underlying symptoms.

Cortisone shots work by decreasing the amount of inflamation in the area affected (in this case, your knee). Cortisone is not a pain killer, but what happens is that it reduces the amount of inflamation in the joint and, thereby, reduces the amount of pain. The length of time that the "benefits" of the injection varies per individual. They can last for several weeks up to 5 or 6 months. There are also cases where the results only last for a few days to a week (if this is the case, these injections aren't for you and getting another won't help much either).

I have had knee surgery 4 times (two full surgeries and 2 arthroscopic) for torn cartilage. I also have a torn ligament in one knee that I'm holding off on surgery of (it doesn't really hurt and doesn't cause me any problems, so I figure I'll wait till it does).
I will have surgery again when the time warrants, but I would not inject steroids (cortisone) into my joints as an alternative as they do not actually fix anything...

I'm curious David, what is the problem in your knee?

Thanks you two.

quote:

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I'm curious David, what is the problem in your knee?

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In 1996 I injured the meniscus. I held off until 1999 to get it "fixed" by that time it had folded over, forming a cyst.

In August of last year it started hurting again. It hurt below the knee cap, and on the left side and at times it felt like grinding glass. Of course this was during the time I had no medical coverage - so I babied it until I was able to get to doctor. During that time the pain has steadily grown worse and I started limping and the knee has started weakening a bit.

At the full physical I mentioned that (and several other things) and now I am seeing several specialists.

I have seen a sports medicine bone doctor who declared it to be patellar tendinitis with a touch of arthritis (From viewing an x-Ray).

Yesterday I saw a orthopedist who declared that it could be partially Patellar Tendinitis, but she moved it about and got it to "clunk" a few times, suggesting something mechanical is wrong.

The cortisone will be followed by PT - lots of icing - she wants to tend to the Patellar tendinitis - then go from there. I will return to her office in a month.

She did say that at the rate my arthritis is deforming the joint I will be looking at a total knee replacement in about ten years. She wants to put it off for as long as possible due to my "active" lifestyle.

She also said that I might have a bit of unevenness on what is left of the meniscus that is causing the clunk and some of the pain. She wants to hold off on MRI until the inflammation/swelling of the Tendon that goes from the knee cap to the shin bone goes back to "normal" we hope that the pain will stop when that happens. If not, then we start the next volley of interesting things to do.

IF there is need, then they will have be under the knife again, to scrape off (sand perhaps?) the rough spots away.

Other things on the list of tending:

Arthur Itis
Stop Smoking
work on the Hearing - My doctor is suggesting the insertion of tubes to assist drainage of the ears - there is a hope that more of my hearing will return. It is also hoped that when I quit smoking my sinuses will get under control.

Presently we are waiting for the gallon of blood they took from me nearly two weeks ago to finish up all of those tests He wanted to test nearly everything - from Liver Panel to HIV to electrolytes, Cholestrol too. The page he sent me to the phlembotomist (Vampires) was nearly 3/4 checked off for testing! If there is anything else wrong we will tend to that.

At 37 Years of age, having lived "hard" and "fast" for a good chunk of that I am surprised that I am still living - I think I have gotten very few consequences for my rebellious youth.

Cheers

David

David, your knee sounds a lot like mine. I'm taking a series of 5 shots, over a 5 week period in my knee now. As a matter of fact, I took one today and I have 1 more to go. Mine is different from the typical cortisone shot, I think. I'm taking Hyalgen and so far, it's really helping, and it's supposed to last at least a year. I had an arthroscopy 3 years ago to repair a meniscus tear. Good luck.

Those crazy shots feel weird, doesn't they?

Well actually mine hurt. Though she told me there would only be the pin prick, I think she entered too fast or there is just way too much tenderness down there. Each time she shot some deadener and move the needle deeper I felt a sharp pain.

Yesterday my knee swelled up, where the needle went in turned all deep, dark nasty purple. I bruise easily, so that may be the problem for that.

Maybe the additional pain was because I still stayed on my feet most of the morning at a job.

I ended up viewing a house yesterday after noon leaning heavily upon my cane.

Today it was as painful, stiff - very stiff. I have just finished icing it and have wrapped it - perhaps tomorrow or Sunday the pain will be gone and the cortisone will be working?

I'm spending time at home, on the couch, knee up, ice, The Tower Series to read (in the Past two days I have read the first two books). This weekend I will decline going to the parents to do their lawn.

I didn't know that there was something different than cortisone. Hylagen - I have to remember that.

I did discover that cortisone can damage ligaments and tendon connections in my WWW search on the subject. They tend to not want to use it often - so they might have a different treatment for a series of 5 like that.

I do know that more shots was one of the alternatives given to me. The doc did say there are therapies which tend to work to relieve the pain but do not attend to the damage. Relieving the pain means that I get more time to wear out the knee I have without too much discomfort. LOL

Cheers

David

David, my doctor told me to stay off my feet as much as possible on the day of the shot. He even told me not to do my aquatic exercises until the next day. I believe you made yours worse by staying on your feet on the job. My shots felt wierd but the pain was minimum. First, he rubbed on a deadener, than he gave me a small deadener in an injection, and then the Hyalgen injection. It made me slightly limp out to the car but once home and relaxed, I had no problem with it. I still can't relax before the injection. I just be a nervous wreck.

My Doc didn't say that, she told me that I should be up and about the next day - to take it easy that day.

And I did take it easy - I didn't carry all of that wood that day. I also didn't carry 90# bags of cement, I used the hand truck to move them about.

Actually yesterday was even more fun, I wrapped it in an ace bandage and went about business as usual - with a cane!

Good grief the pain is much worse than before the shot. Where the needle went in is a deep, dark purplish/black bruise - it is even bruised on the other side of the knee cap, almost as if she went all the way through, under the patella!

Ew.

Ice, Ice and More ice. Still aches.

If it doesn't get better by tomorrow I think I'll go in same day clinic and have them take a look see. I do not think this is right, bruise and pain.

David

I am so sorry David that you're having a hard time. That doesn't sound right to me and I think you should get it checked out. The worst thing that could happen is to get a blood clot from it. Were you sitting up or laying down when you got the shot? I was in a sitting position on the table/bed. My doctor said the needle goes in better in a sitting position. Keep me posted as to how your knee is doing.

David, steroid (crotisone) shots are not for everyone...sounds like they may not be for you.

You mention that they are doing this in lieu of surgery. Since it is not going to take care of the problem itself, why are you not considering surgery? I guess a better question would be...what did they find? You mentioned meniscus...is it a torn cartilage? I know you also mentioned arthritis. I have had arthritis in my knees since I was about 17...it bothers me little...but they did do the surgery to remove the cartilage which is what caused me pain and catching/clicking in the knee. Physical Therapy also helped in building up specific muscle areas surrounding the knee that took the pressure off the knee itself. While "going under the knife" isn't a great option, sometimes it's the best thing for you long-term.

Just 4 years ago I got the meniscus surgery.
I am still an active man - granted I no longer play tackle foot ball, or hard ball - but I am still active, on my feet doing things.

Not only that but the arthritis in the knee is very obvious on the X-ray. The doctors tend to agree that at this rate in about 10 years I will need to have the knee replaced.

IF we can keep from trimming the meniscus, or relying on surgery for a few years, I may be able to buy a few more years of use time.

Artificial Knees don't last long. It is really preferred to keep from using them until the patient is older and less active. A 20 year life span for the joint is expected.

At 37 that means I would see another surgery when I was 57, another one when I was 77. The longer we can put it off, the less change I will have to go through two knee replacements in future.

David