Knee osteoarthritis

[Jollj]

Hi all, after my diagnosis of osteoarthritis my consultant advised of referral to a pain clinic as has another medical professional after further assessment, my GP has only prescribed co-codamol , has anyone else heard of pain clinic and do I need to push my GP for referral.

[DorsetLady]

Yes, and yes...unless Consultant has referred you, but I doubt it!

[Jollj in reply to DorsetLady]

Thank you, the consultant was the chap who read my xrays, he wrote to my GP to recommend pain clinic and physio, GP gave me co-codamol I've had neither pain clinic nor physio.

[DorsetLady in reply to Jollj]

Well in that case you need to nudge GP into action!

Our local hospital has a pain clinic under the auspices of musculoskeletal clinic - not that I attended..,,was referred for replacement surgery.

[Jollj in reply to DorsetLady]

Many thanks, I appreciate its difficult given I have other health issues but my mobility is almost non existent both knees need replacing so any help is gratefully accepted.

[DorsetLady in reply to Jollj]

Sure it is…so grateful I had my replacement surgeries pre Covid - last one (shoulder) only just! Didn’t get to see surgeon at 6 week period or any physio. But at least pain free.

[MissKota in reply to Jollj]

Hi, I think you can actually self refer for physio now. Phone the physio department and tell them you have this diagnosis, they will take it from there.

Not sure about the pain clinic but I think it may be more along the lines of advice on lifestyle changes to help with the pain. It’s always worth giving that department a ring too if your GP is too slow.

Have you had an occupational health assessment from adult social services? They can help with small adaptations to your home and accessories to help with daily living. Again, you can self refer.

Sorry I can’t help more.

[Jollj in reply to MissKota]

Thank you, no I haven't had a thing only a report from the consultant from which my GP prescribed cocodamol, I will follow up on the physio etc, thanks again.

[piglette]

Where do you want to be referred to? I assume you have already been referred if you have a consultant?? I have never been to a Pain Clinic but have heard of people who have. My GP suggested physio.

[Jollj in reply to piglette]

The consultant who read my xrays was the first to recommend pain clinic along with physio of which I have had neither, all my GP recommended was co-codamol,then a telephone consultation with a nurse about the increased pain she also recommended pain clinic, I've not heard of them so wondered if anyone had and what to expect different than my GP.

[piglette in reply to Jollj]

I have had Platelet-rich plasma (PRP) therapy on just one knee. I have to have it done privately at the moment, which is pricey, but amazingly it seems to work for me.

[Hidden]

Hiya,Push for a referral. You don't say what grade of CoCodomol, I use 30/500 which is prescription grade. In terms of pain, it depends on how crippled you are. I was recommended a consultant by my friends/ family circle. My GP didn't rate any chance of getting this guy ....BUT ....I did. In effect I went from GP to Consultant in one hit and my wait was only 4 months - pre CoVid.

The point is and I'm assuming you have had XRays which show the damage to the knee caused by the OA - a pain clinic will only teach you to manage the pain. It will not cure the problem which can only be done by surgery.

It's a cop out by the medical healthcare professionals to take the heat off them during this CoVid stuff and to enable them to avoid the obvious. Meanwhile, you will suffer and assuming you have AF prolonged pain, controlled only by CoCodomol could well impact on your heart.

So go for it and hound these merciless sods until you get surgery. If they said Pain clinic now and gave you a date for surgery for say 3 months later that may well be different. They are just playing the god awful NHS system against you and your welfare. I always thought the mantra "do no harm" was relevant.

Good luck,

John

[Jollj in reply to Hidden]

Thank you, I have other health issues that currently rule out surgery, both knees require it but the pain is getting worse so mobility is drastically reduced.

[cherrytree16]

Hi. Your GP has to refer you to the pain clinic where they will assess the appropriate medication and if you require physio they will organise that as well.

[Jollj in reply to cherrytree16]

Thank you, that was rather what I was hoping for but I had never heard of pain clinic as such, I will speak again with my GP and ask the question directly, many thanks again.

[FattieBabs]

I had X-rays which showed problems with my knee and was referred by my GP for physio. The waiting list was 10 weeks to see a therapist but I am now in the system. However no offer of a consultants appt. Thinking of booking that privately. Feel rather let down

[Hidden]

I did the pain course (well, I think I have one more to do but it all closed down because of the covid) I found it interesting but it doesn't help in the case of OA. My knee is at the point of needing replaced so when it hurts it is because it is hurting, the pain clinic tries to deal with chronic pain and tells you that constant pain is really all in the head (cue eye raises to the ceiling) as pain is in response to something that is hurting and then that pain response get kind of stuck and keeps repeating.

They will probably explain it better but as I say I really don't think helps in the case of 'real' pain.

[Nightingales]

I have had good success at pain clinic with various X-ray guided steroid injections and radio nerve ablation of the SI joint. The problem is the waiting lists are horrendous. This is in the UK.

[katieoxo60]

It is quite usual to be referred Jollj to a pain management clinic . This can be done by your Gp , most clinics would stick with your GP or consultants preference for painkillers . Physio is being done via telephone , and a list of exercise which your GP can give you via a link to on line access or by printing a copy off for you . You can apply for Physio via online patient access i.e PC or internet telephone but this as to be paid for at time of booking. If you have had operation for the pain then Physio is face to face, during recovery period. I can tell you these things as I have experienced them due to joint problems for many years. Hope this info is useful to you, co codamol is a strong painkiller the only other ones are mainly morphine based or anti inflammatory like Gabapentin, or NSAIDS. Good luck with finding what is best for you, remember no one treatment alone works.

[Jollj in reply to katieoxo60]

Thank you very much for the info, very helpful, I need surgery but can't because of other conditions one of which also means no anti inflamms due to a massive bleed caused by declofenac, they were my go to help,since then nothing but pain and misery,cocodamol causes constipation so I have to restrict the amount, thats why I'm wondering what else the clinic may be able to offer.Thanks again

[Crazymama146 in reply to Jollj]

If you have constipation, you should be prescribed some gentle laxatives through your gp, or you could start with senna tablets that can be bought in supermarkets etc

[Batty1]

Maybe you could try knee braces.

[Jollj in reply to Batty1]

I've tried several different ones but none help, my physio consultant said he wasn't aware of any he could recommend, its just pot luck,some do, some don't.

[Batty1 in reply to Jollj]

Oh that just stinks !

[HeronNS in reply to Jollj]

I wasn't able to ue any of the expensive braces I was tried with. In the end I got a cheap elastic brace from a pharmacy, as mentioned in my other reply, and this stabilized my knee enough that I was able to walk more easily, and this had the effect of helping strengthen all those supporting muscles which are so important to keep knees working right. I also bought "urban poles" which are used a bit differently from Nordic poles, in that the handle has a ledge to enable you to offload the weight to your arm from either leg as you walk. This also helped with regaining strength. My physio also suggested I put a couple of books on the floor to practice going up stairs, which I had found impossible for a while. Slowly, slowly, and yet in retrospect quite quickly considering the basement level I had started at, I regained the ability to walk, to climb and descend steps. I've just started doing tai chi again (new year's resolution) and find I'm extraordinarily stiff compared with how I was about twenty months ago when I stopped the tai chi, but I will carry on and relearn the 24 movements again.

[Toffee-2017]

Hi I need my left and probably my right knee replacing, I have taken everything my gp could offer so was referred to pain management never seen face to face due to covid, but he can prescribe the strong stuff. You need to speak back with your gp and discuss your pain levels. Most days it’s a struggle to stand and walk. X

[BonnieMagic]

I had great experience of the pain clinic. It’s usually run by a combination of pain consultants (anaesthesists), physios and occupational therapists. I went on a seminar to manage my pain better which was incredibly helpful and empowering. Also prescribed medications and had several steroid injections into my spine which were a great help. Anyone with arthritis needs all the help we can get. Good luck and keep pushing.

[Telian]

Same as DL yes and yes. I’ve attended physio and musculoskeletal clinic - it’s a more sophisticated name for physio and eases the physio waiting lists. In my case they had no idea what was causing my arm pain - and it took that long to see them myself and GP solved it. Mine was soft tissue though not like you possibly requiring surgery. Worth doing a referral though while waiting as it shows your surgeon you’ve been through the system and hopefully can get you on the surgery waiting list as can be a long wait.Hubby has seen pain clinic for many years, as can’t have the back surgery required due to his weak heart, but all pain killing options were exhausted in the end. He now lives on morphine and three more analgesics. He was looking forward to having spinal injections but his cardiologist wouldn’t allow. It is worth a GP referral as they will look thoroughly at your situation and you can discuss options. Your GP might offer you physio first (we have a visiting physio at our surgery and was seen within two weeks) but discuss what YOU would like.

[HeronNS]

I have knee osteoarthritis which x-rays inform me is quite extensive. I injured both knees in separate accidents in 2020. It was so bad with one knee I was referred to an orthopod for possible knee replacement. However by then I had learned quite a lot about how to look after my knees and was beginning to improve. I was given his card and told I could contact him dirctly when I was ready for the replacement, no need for another referral. This was a little over a year ago. Since then I have improved so much I am walking normally and have no significant pain at all. Injuries healed.

How did I do it? First of all I changed my behaviour. Had been told by both doctors and physiotherapist that all my symptoms could be due to OA, but I knew I had some soft tissue damage and once I started to care for that the affected knee began to get better. I used a simple elastic brace from a pharmacy to stabilise the knee. I did exercises, both from my physio and from a book called Treat Your Own Knees (Johnson). I took care not to over exercise when I felt better (had been doing that when told it was only OA, as one does). I started using a non-medicated lubricant called Flexiseq (ordered via Amazon as I can't buy it in Canada, it's from the UK). Slowly but surely knees got better.

[Penpusher]

Hi Jollj,I have OA in my knees & shoulders, as well as several other conditions such as fibromyalgia that cause pain.

In March 2021 I was forced to change my GP and as part of the process decided to push for referrals to a pain clinic and dieticians too as I was losing hope of ever being pain-free again. The GP questioned my request so I was honest and told her the pain was so bad I was questioning whether it was worth going on as I no longer have any quality of life. She made the referrals for me.

I spoke initially to a psychotherapist a few weeks later as part of the pain clinic process and she asked me more about my situation. I made it clear I wasn't about to do anything stupid as my son is autistic and has no-one else around to support him. He needs me but that also means I need to manage my pain as I still work full time but have got worse whilst shielding.

So, as it turns out, the pain clinic course takes place over 12 weeks. Mine were actually two courses that started in September 2021. The first run by physios and other assorted clinicians- pain meds nurses etc. and the second 12 week course was a mental health-based pain clinic that started after the first course finished. There was some overlap in content but not that much. Each course was for 1.5-3 hours a week and they gave me as well as information mindfulness exercises, distraction therapies, the opportunity to tall to other people experiencing pain and professionals. More to the point they gave me hope. Previously I had put a lot of the responsibility for my wellbeing on medical staff. Now I feel more personally responsible and able to change my everyday situation. I can't cure myself but I can do something about my situation. I'd rather distract myself than take more pills (I'm on 30+ a day plus insulin and other daily injections).

Bottom line is I now have hope and feel like I'm doing things to help myself. Turns out I hate feeling helpless so I'd really encourage you to push for the referral. It's done me the world of good. Good luck!!

[Jollj in reply to Penpusher]

Wow, well done to you and thanks for sharing your experience, I have medical conditions that prevent surgery in both knees, the pain has got worse and its now difficult to stand and walk short distances due to said pain, I rely considerably only family to help which itself is very stressful, I get on well with my GP so will indeed push for a referral with hopefully a similar outcome to yours.

Again many thanks and good luck with continued better health.

[Kneesandtoes]

In other countries exercises are recommended. The Swedes for example have ‘arthritis school’. There is a lot on line. I used something called knee pain explained. When I looked for it now, it looked different, but may still be good. Bob and Brad have a whole series on YouTube. What really helped me in the end was going to a chiropractor. She diagnosed a torn meniscus and treated it. I found NHS physio of little help. It had been very good on a previous occasion, but had changed to ‘hands off’.The trouble with pain killers apart from effects on kidneys etc. is that you may do too much, when the pain is not telling you to stop. They also lower your body temperature. In my case warmth is key to staying pain free. Wearing wool rather than synthetic makes a big difference to me. I must stress that I do not feel the cold, but that warmth reduced the pain.

[Mikmax in reply to Kneesandtoes]

Interesting how you have used different strategies - I have also used Bob and Brad, after having a knee replacement I had dreadful tendinitis in my foot and their exercise suggestions were brilliant !

[Kneesandtoes in reply to Mikmax]

I think Bob and Brad have videos on stiff toe joints, which I must have a go at. My other strategy is diet. Almost thirty years ago I stopped using spreads, margarine and sunflower oil and changed to butter and olive oil. My painful swollen finger joints returned to normal. I avoid processed foods and I have been eating fermented vegetables for a few years. I have also increased vitamin D and tried to cut down on sugar. All with the aim of lowering inflammation. Nothing drastic but I think it all helps.

[Sikabum]

I recently had a big knee injury, after which it was very difficult for me to walk. I went to the doctor, had an operation, and was prescribed expensive treatment. Still, the insurance company refused to pay compensation. I didn't know what to do, as my finances were small. My friend advised me to contact claimsaction.co.uk/knee-inj... , who would be able to help me resolve this situation. I am now almost halfway through this course and am on the mend. Best of luck to everyone.

[HeronNS in reply to Sikabum]

This is an old thread. Maybe post your question, if you have one, in a new post so more people will see it?