Collateral Damage

jamieA

I've had an issue with my right foot for the last two years whereby it permanently feels like the after effects of an ankle sprain. It throbs and let's me know it's there 24/7 and recently I've experienced intermittent reduced mobility in it. I was referred to face to face physio by my nhsanywhere online physio a few months ago and saw one on Tuesday. He told me the issue with my right ankle is being caused by my left knee and the fact I walk with a limp because of the left knee. He has urged me to get a referral to orthopaedics as the last x-ray shows a considerable decrease in medial joint space and the rheumatologist last year said I need consider joint replacement. I'm not happy about the thought of a knee replacement but equally if it's going to cause further issues elsewhere I can't see an alternative. Meantime He's suggested building up my quadraceps muscles to take some of the strain off the knee as well as walking with a stick. So looks like I'm hitting the gym !

jonr

Hi JamieA,

I read your post with interest because I think your condition reflects mine in as much as the change in my own gait is having repurcussions on other parts of my body.

I was chatting with my Acupuncturist yesterday who sees a physio herself, she told me that it's probably better to use 2 walking poles rather than 1 stick to aid in alignment and equal weight distribution, so that might be worth looking into. In terms of building up the quads, walking is the obvious activity and the nice thing about Treadmills is apart from being sprung (so less impact on joints) you can also vary speed and incline. The gym I go to also has a set of motorised stairs, but that might be too hardcore! If you have enough mobility in your knees and ankles you could try going on a Spin or Static bike and that will defo build up those quads. If you've not used one before you can vary the resistance to suit your needs, I use this a lot when the weather's inclement and I can't get out on my bike, it's great cardio too.

Cheers,

Jon

jamieA

Hi @jonr

I joined the 12 week Nuffield Health Joint Pain programme in January - it ends next week. I'd recommend it to anyone - there's a woman of 84 on my course.

https://community.versusarthritis.org/discussion/59096/nuffield-health-joint-pain-wellbeing-programme#latest

Part of that is to teach you how to use the various equipment in their gym. You also get a further 12 weeks free membership and then a reduced rate membership if you want to continue. The person administering the course is also a personal trainer so I've asked her what she would recommend and the spin bike, recliner bike and a seated leg extension machine is what she suggested. I'm still waiting on my son to rebuild my bike for me - he's a cycle technician - so I use my wife's bike on a static cycle trainer at home.

I'm averaging 50-60 kms a week walking at present mainly with my dog. It never crossed my mind that my walking with a limp would cause other issues. The physio did say to keep walking - he reckoned I was walking more than he was - but to modify my gait by using a walking stick in my right hand. I have got 2 walking poles but never use them as one hand is usually occupied with the dog lead. I'd also feel a bit like Scott of the Antartic on my canal and river walks !

jonr

Fantastic JamieA, great you're able to walk such long distances and the advice is spot on. I apply a gel called FlexiSeq to my knees every day, it's clinically proven to lubricate the joints and it does seem to be working, less crunching and grinding too!

I have applied for the Nuffield Health course, I'm on the waiting list for the next one in my area (Oxford), thanks for the tip!

All the best,

jon

noddingtonpete

Hi

You might find the following of interest

https://www.versusarthritis.org/about-arthritis/complementary-and-alternative-treatments/types-of-complementary-treatments/flexiseq/

jonr

As a side note, Flexiseq Max (which is what's recommended for OA, sometimes called FlexiSeq OsteoArthritis), is eye-wateringly expensive at £18 for a 50mg tube. Applied twice-daily to both my knees it barely lasted 10 days and it's not available on prescription.

I found an online pharmacy called iPharm who sell the same tube for £9.31 so I order in bulk to achieve free delivery.

https://ipharm.co.uk/

noddingtonpete

It is available from many different outlets.

@jonr have you tried Capsaicin cream which is prescription only? More for pain relief but seems to work (for me, I use it on my hands)

https://www.versusarthritis.org/about-arthritis/complementary-and-alternative-treatments/types-of-complementary-treatments/capsaicin/

jonr

"@jonr have you tried Capsaicin cream which is prescription only? More for pain relief but seems to work (for me, I use it on my hands)"

Afraid I can't NoddingtonPete as my GP refuses to prescribe it for me. I have read up on it and by all accounts it takes a few weeks to travel to the brain with a 4x daily application. I managed to find it on sale on eBay but at nearly £20 for a 50mg tube it's going to require a remortgage because that'll be gone in less than a week.

Appreciate the tip though!

jamieA

https://community.versusarthritis.org/discussion/comment/706384#Comment_706384

Hi @jonr

You're not the first on here to say their GP has refused to prescribe capsaicin cream due to cost and I find that appalling. If you look it up on NICE it costs the NHS £17.71 for the lower strength and £14.58 for the higher strength (go figure that) for a 45gm tube. I find I only need apply it once a day in the morning and the trick I find with it is to then put my knee support or tubigrip on over it. That seems to cause it to retain the warmth and maybe increase the penetration into the joint. I noticed that effect first when I used it on my shoulder joint and then went for a walk with a backpack on. The straps of the backpack were tight against my shoulder and as the walk went on I felt my shoulders ease off a bit.

I posted here in Oct. 2021 about my use of capsaicin cream and the issue of it being unavailable in the UK for a time.

https://community.versusarthritis.org/discussion/55311/capsaicin-cream

I came across a DIY version using olive oil, coconut oil and cayenne pepper.

https://www.arthritis-health.com/video/video-reduce-arthritis-inflammation-homemade-cream

I used it - but increased the cayenne by 50% - and felt it helped. The downside was that the cayenne stains fabrics so tubigrips and supports looked awful and I didn't use it on my shoulders because of that.

The pain consultant also prescribed lidocaine patches and they help as well, particularly for my lower back - my right sacroiliac joint. They cost the NHS £75 for a 30 patch box - used 1 a day.

My biosimilar Amgevita costs the NHS £3550 a year and the one they were thinking of moving me onto cost £16000 a year. I also regularly get messages to say a missed NHS appointment costs £135. So in the scheme of things the capsaicin and lidocaine costs shouldn't be an issue - particularly if you need the pain relief.

Before I was put on these treatments I was on opiod painkillers - I'm sure that would have cost the NHS (and me) far more in the long term due to side effects.

Sorry for the rant!

jonr

Thanks JamieA, very informative and helpful so if that was a rant - please carry on!

I have another potential route for prescribing Capsaicin cream which is the doctor who administers my Steroid injections, she is a lot more sympathetic than my own GP and the 1st time I saw her she ran up a repeat prescription for Naproxen and Omeprazole for me which has helped a great deal. Thanks for the input on dosage, that's good to know.

I agree with you about the tubigrips - my daily routine involves the use of a deep tissue massaging gun then a layer of Flexiseq followed by Voltorol 12 hour gel, then Hemp cream and finally red Tiger Balm. After that lot I slip on tubigrips to not only protect my clothes but as you say, it seems to intensify the effect of everything. This routine is repeated in the evenings after a half hour sesh with a TENS machine. I'm still taking anti-inflammatories (prescribed and natural) but have cut down my Co-Codemol intake by 50% so I think I'm headed in the right direction. I've had 4 Acupuncture treatments and that is definitely improving tendon pain which is the worst part of my Arthritis.

Is this lot doing any good though? Well this time last year I could barely walk downstairs of a morning or get in and out of my car. Last weekend I walked up and down the highest mountain in south Wales so I guess the proof is in the pudding as they say.

I'd like to try Capsaicin based on your own results so if this doc won't prescribe I'll get some on eBay where there's a lot for sale.

Thanks again!

Jon