Flare up or deterioration

Hi

I have moderate hip and mild knee osteoarthritis. I have been struggling with this for about 6 months and have had to stop running. But for the last three months I have been walking a lot and swimming. However last week after swimming I had some inflammation near my hip and related pain in the knee and leg. This hasn’t really abated in the last 10 years, in spite of stretching and rolling and I now find that I have pain after walking a short distance. This seems like a sudden deterioration. Is this likely or could it be a flair up. I hadn’t experienced any flare ups before so I don’t know what to expect.

Thanks

Comments

  • Lilymary
    Lilymary Member Posts: 1,195

    Hi Nigel, joints can suddenly deteriorate, (mine did) sometimes triggered by an injury (as in my case) or possibly by a bout of simply “overdoing it”. I’d suggest resting it for a good while, ie no more high impact exercise, and easing back on the walking etc to let the inflammation settle. You might want to take anti inflammatories and a general pain killer (eg paracetamol) and see how it goes. If the pain continues, it may be worth asking your GP for a referral for X-ray, as it may be that the joint(s) has got to the stage that further treatment is required, eg steroid injection or referral for replacement.

    my osteoarthritis in my hip went from “a bit of a niggle” to finding I had very severe arthritis 3 weeks after a fall and being put straight on the list for hip replacement. When I went in for surgery in April this year the woman in the next room had a similar story, and the surgeons also said this can happen.

    Hopefully it’s just that you’ve overdone it, but if it persists, ask your GP for a reassessment

  • Lilymary
    Lilymary Member Posts: 1,195
    edited 2. Jul 2021, 22:08

    Oops! I hit “post” twice! Sorry,

  • NigelJ
    NigelJ Member Posts: 9

    Thank you for your comment and advice. I have a follow up appointment with my doctor in two weeks so I will check this and see if another scan is needed. Last one was in February and he was recommended exercise and strengthening at this stage. But sudden changes could alter that completely, as you note. Thank You

  • Lilymary
    Lilymary Member Posts: 1,195

    Hopefully in a few weeks time your pain will either have settled down, suggesting you just overdid it, or will remain similar suggesting further investigation needed. Sadly OA is a degenerative condition though. It can linger grumbling away in the background for years, as mine did, but at some stage it’s likely to need surgical intervention. That will mean adjustments in lifestyle I’m afraid, either to manage the pain or reduce the rate of wear, or to accommodate reduced mobility. If you ease back onto low impact exercise at this stage, you may find you can fend it off a bit longer.

    good luck with your GP, let us know how you get on.

  • NigelJ
    NigelJ Member Posts: 9

    Thanks. I used to run once or twice a week, only 5ks so nothing excessive. I had to give up at Christmas as my hip pain after running was getting worse over a 6 month period. Since then I have only been walking. Once a week I try to walk for an hour quick enough to get my heart rate up. Other days I just go for a walk around the block at normal waking pace. I am hoping this lower impact can be sustained as long as possible. But that is the challenge.

    I did manage a fast walk on Saturday, but I dropped the distance and the pace from my usual level. I still felt inflammation after about 40mins this time, whereas a few weeks ago I wouldn’t have any inflammation after the hour and could have continued. However I haven’t been too bad today for DOMS but I needed a rest from gentle walking round the park.

    I will carry on taking it easier until I see the Doctor in two weeks and hope it continues to ease off. I expect I won’t be recommended for surgery yet, as my Doctor seems keen to delay as long as possible (I am mid 50s) but if I think of the change over the last 12 months I am not so sure!

  • Lilymary
    Lilymary Member Posts: 1,195
    edited 4. Jul 2021, 21:17

    i know what you mean about scaling back exercise, reducing the length and speed of your walks. It can be tough accepting these adjustments. You may find shorter periods of swimming, or cycling, will be better ways to get some cardio exercise while keeping muscles toned and avoiding aggravating your knees or hip. Yoga and Pilates will also help you maintain mobility and muscle tone, while reducing wear and inflammation in your affected joints, which will hopefully keep you mobile for a good few years longer. It would be worth seeing a good physio to assess where you're at and come up with an exercise regime that works for you (if you can afford it, go privately, as the NHS list is miles long and only a limited number of sessions).

    Docs try to defer joint replacement surgery as long as possible as they only last 15-20 years and can only be replaced again once, with the second surgery being more complex. But they may be able to defer this with steroid injections, which can manage pain for months at a time for some if the degeneration isn’t too far gone.

    until then it’s about pain management, building muscles so they support the affected joints, maintaining mobility, and adjusting your exercise routine to reduce further wear to your joints. Hope this helps, and good luck with your GP. It would be worth aiming for X-ray to see what stage you are at (sorry, can’t remember if / when you had one, but if things are getting much worse, would be worth an up to date one as OA can deteriorate suddenly). My sister’s OA in her knees was so bad that she’d had both replaced by the time she was 60, so in extreme cases they can waive that principle.

  • Hi NigelJ,

    Thank you for posting on the helpline forum, I am sorry to hear how much you have been struggling recently.

    As Lilymary has said it could be that you may have been over doing it recently, we speak to a lot of people on the helpline where they find that they are feeling relatively pain free one day, so try to do too much in a short period of time and then only to find they suffer with the pain the next few days. With any form of arthritis, it is important to try and find that right balance between rest and exercise.

    Possibly speaking to you GP and request a medication review if you feel that the treatment isn’t helping, you can also ask about a referral to see a physiotherapist, this is an important part of treatment for most people with arthritis. It’s run by physiotherapists, who are part of a team of healthcare professionals who help you to resume or maintain an active and independent life both at home and work. They will also advise on structured stretching and strengthening exercises for your needs. 

    Also, if you enjoy going into a swimming pool, you could also enquire about Hydrotherapy, which is exercising in warm water. Hydrotherapy can help because the warmth of the water allows your muscles to relax and eases the pain in your joints, helping you to exercise. The water supports your weight, which helps to relieve pain and increase the range of movement of your joints. You will normally have hydrotherapy treatment within a hospital’s physiotherapy department. Usually, a physiotherapist with specialist training will show you how to do the exercises.


    Best wishes

    Chris

    Helpline Advisor

  • NigelJ
    NigelJ Member Posts: 9

    Thank you so much for sharing this information. I have a physio that I have been seeing for about a year. She helps with stretching and strengthening. For exercise she has just advised to not overdo it, try swimming and walk upright etc. I have eased back on my power waking recently which has helped and I will try swimming again next week. I also have a check in with my doctor, about 2 months after my PRP injections, so I may get some further advice then.

  • NigelJ
    NigelJ Member Posts: 9

    Hi. I saw my specialists this week. He thought the flare up was caused by overstraining. It has been a little better this week. He suggested I see him in 6 months time(earlier if necessary). He will probably give me an X ray then, which will be 12 months since the last one.

    Hopefully this plan will work out and I will be able to see if there has been any significant change over the last year.

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