Sister has severe "wear and tear" in her knee -advice sought

Mat48

I have problems with my knee but unlike her I have RA and other stuff going on and I'm five years older than her too. She is 45 and is profoundly deaf and has been fast tracked to see a physio because of the extent of the wear and tear. So she sees the physio tomorrow with an interpreter. I said I'd ask here if anyone has questions they suggest she asks. She didn't realise that "wear and tear" means arthritis and is in so much pain with it. Why don't they call it arthritis in the letter? I was a bit baffled that the orthopedic report said that this extensive wear and tear in the patella region should not be the cause of her pain? If not the cause then what on earth is I wonder :?: :? :!:

Also I have wear and tear of my left knee now, under my kneecap, but was just told this by a physio at my recent rheumy appointment. Is this likely to be because of my RA and would they know by the region of the pain or should I have pushed to have this x-rayed I wonder? I don't live anywhere near my sister or I would have gone with her to this physio appointment but I'm at least very relieved that she's been fast tracked for this physiotherapy because of the severity.

Sorry never around these days but most of my problems are related to small fiber neuropathy just now - RA has only been lurking in the shadows 7 weeks since stopping all the meds with my rheumy's blessing!

stickywicket

My policy with physios is simply to do as suggested and ask to clarify anything I'm unsure of.

As for your own OA - who knows whether or not it'd have arrived independently of your RA. I know my OA was caused by there being no DMARDS on offer for my early RA years. By the time there was, the damage was done.

Mat48

Thanks SW. I suppose I feel extra protective about my sister as she's the youngster of the family with so much on her plate too re work and young family. I just said she should try to keep losing weight and do exactly as the physio advises re exercise. I also advised her to join this forum for advice and support but she probably wouldn't have time to join in much even if she joined.

Re RA - I do worry about being off all RA drugs but the sickness both ends and swelling up (face and lips) etc were too severe to keep going with these. He suggested I stay off and then if synovial swelling returns I will be able to try a Biologic and if it doesn't (and I rarely show swelling even when pain is at it's worst) I can try Leflunomide (4th DMARD) if I feel I need something sooner. He thinks my RA is a non-erosive slow burner so far so I'm quite optimistic but the morning stiffness is awful again just now and my ESR usually goes soaring up when I'm off DMARDs. As I've said the main problem is nerve related so I'm being referred to a neuro now and hopefully will find out cause and get treatment. GP wants me to try Pregabalin now but I'm happy to stick with Amitriptyline and NSAIDs for time being. But my husband says if I scream out in the night again he might secrete this Pregalabin into my cocoa regardless! XX

stickywicket

If your sister has a weight problem that might explain why the pain is so severe. According to Professor Philip Conaghan, Professor of Musculoskeletal Medicine at the University of Leeds and Medical Adviser to Arthritis Care. “while obesity is only one of the risk factors for OA it is a key factor in the severity of symptoms” http://www.arthritiscare.org.uk/NewsRoom/Latestnewsstories/z62G I hope she has a good appointment

barbara12

Hello Mat
Sorry your sister is having to go through this I was originally told wear and tear..then they started calling it OA I asked what was the difference nothing they said early days we call it w&t :?
I do hope your sister can get the help she needs,,of course losing weight would help , but she also needs the right exercises from a physio...it must be hard bringing up a young family , when in pain..I do wish her well..

Mat48

Thanks you are very kind as always Barbara. She had the physio this afternoon so I'm waiting to learn how it went. Mat x

Mat48

RE Weight problem SW - she doesn't really have a big weight problem - maybe a stone overweight for her age and height. But she realises that even quite overweight it's good to keep weight down as much as possible and she's dieting away now! She certainly isn't obese. PS I'll send her the link anyway as it will help her (and me) stay on track :roll: Many thanks. Mat x

stickywicket

Good. How did she get on with the physio?

Mat48

The physio just asked questions this time and said she would see her after work on Monday to start treatment. Apparently the GP has fast tracked her for this having seen the x-rays of her knee. I don't think she learned much from yesterday's appointment but just hopes she's a good physio. I suppose she will need an interpreter for the first few times so lots of organising. She works full time and has two young-ish children so she has a busy schedule but she says she's in agony presently and has to manually lift her leg out of the car. Sounds rather awful I must say but as a British Sign Language user it would be even worse if it was her hands or wrists.

I sent her the link and said we are in it together re weightloss as although I've a much smaller frame than her we are very alike and our BMI's are probably equally over the range relative to our sizes. Thanks for your advice and support. Mat x

stickywicket

Mat48 wrote:

she's in agony presently and has to manually lift her leg out of the car.

Oh gosh, I'd forgotten all about those days :roll: I've done the same with arms too. Not a lot of fun. I hope the physio helps. Same advice as for post joint replacements ie do as the physio says - don't skip bits (unless very scared it's doing something it shouldn't) and don't get over-enthusiastic. I hope it helps her.

Mat48

Yes me too - re remembering not even being able to get down the stairs or hold the steering wheel. But I'm keeping schtum about these memories as she's really very kind and sympathetic to all her friends and me always. Hopefully she's got a first class physio and losing weight and the specific exercises will mean she doesn't need a knee replacement any time soon.
Mat x