Slowly, over just a few weeks, my left knee has become more and more painful on the inner side with stabbing pain from below the kneecap and tightening pain around the inside of the knee. (This has happened before and I ended up with bursitis). This has now forced me to rest it but it has also upset the lower back so now I have some degree of sciatica on the right side. There is nothing much in the way of swelling this time. I am following the Paleo/Ketogenic diet with very few distractions - just minimal over the holiday. The osteo advised me to keep walking which seems to have been the wrong thing to do. Does anyone have any advice? Yes, I expect there is arthritis and I also suspect the miniscus has degenerated - osteo also thinks the kneecap is not tracking properly - but so far he has not really been able to help. It will be 'wear and tear' doubtless.
I can no longer do the arch and flatten exercises (part of somatic exercise - Thomas Hanna) as the lower back hurts even more when I do and they are usually so relaxing. I can walk a short distance with the aid of a stick although I don't seem to be sleeping much.
I am due to reduce from 6mg to 5.5mg as I stayed at 6mg just over the Christmas period - however, now wondering if it is a good idea to reduce just now.
Again, any advice very welcome - just feel as though I am grinding to a standstill and I don't know where to get any help or useful advice.
Thanks and a happy New Year to you all.
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Miserere
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Thank you, PMRpro - I'm sure you are right - I'll stay at this dose for longer. Usually I am keen to reduce but I don't want to provoke another flare. Thank you for the links and yes, it could be tendinitis having looked at these - or wear on the meniscus. I rested it yesterday and for the first few minutes after I got up this morning it didn't hurt but then came back again, so I suspect more rest is needed. My osteo is a very active chap and doesn't really do 'rest' but there are times when it is needed.
Thanks again - just not sure what to do so think I will just rest it and gently exercise the muscles that support the knee without weight.
That's my next move - thank you! Yes, I am beginning to wonder ... he does a lot of climbing, fell running, marathons, cycling etc. Good for him - one day he may wear something out though.
He probably will - or fall off one of those mountains!!! And the fitter they are - the harder they fall All ours do silly things running or sliding up and down mountains. But they really are good at knowing when exercise might be better avoided and some hands on stuff be useful.
Definitely don't reduce while you sort out your sciatica and knee issue , you will be doomed to failure , have an unpleasant time off it , and possibly even have a flare and need to go up again anyway.
I have a heat or cold clay abdominal and back wrap by Dynamik ( they also do gel versions and types for knees etc.) It's invaluable for the sciatica and hip pain. I put it with mild compression at the upper hip level , were you would wear a sacroiliac belt , it warms and loosens the lower back area reducing the impingement on the nerve. You can wear it securely through the day doing activity or in bed.
Using a lower knee support or elasticated knee support for a few hours a day or on a walk could help you continue to do some light walking while keeping the knee in alignment , but don't wear it all the time as this can reduce the strength. Keep walks on flat surfaces and short , no more than ten minutes at a time in one session while recovering .While you aren't moving about keep your legs elevated in line with your hips on a chair or high stool.
Do some exercises by reduce how far you extend the areas when you feel that noticeable tightness , slowly pull back to the point you feel some stretch with absolutely no pain. Follow this for the back , hips and knees.
Wear good shoes that support the ankle as believe it or not poor foot support can add pressure through the knee joint and cause more inflammation.
Go for flexibility exercises rather than weight bearing ones whilst the knee is inflamed or misaligned and alternate days to rest the affected area well in between.
Try doing stretches on the bed or against the wall ( these can be done standing or on a chair or stool) to improve your sciatica , loosen the lower spine , and reduce the nerve impingement. Avoid exercise that have you bending your body forward or down beyond waist level as this annoys the sciatica and pulls the muscles too harshly at the inner knee ( so you only have your upper body at a maximum of 90 degrees to your legs ) and no upper body twists or arching movements.
Try using Nordic Walking Sticks on walks they improve posture , stability and reduce weight bearing in the knees whilst still allowing you to exercise as well as giving you a gentle workout of your arms and stomach.
Thanks so much, Blearyeyed!! What a lovely and informative response and I shall look up Dynamik - that could be very useful.
Yes, I am doing non weight-bearing exercises and will increase these gradually. As the knee begins to feel it can bear weight I shall take short walks with a support and then remove it. I have looked up a number of knee muscle support exercises and will take them gradually too as well as bringing in the exercise bike.
I agree - I need to do exercises against a wall or seated at present. Just disappointed that I can't do the flatten exercises that are a basic part of somatic relaxation. I can arch but flatten immediately hurts the sciatic nerve. These are exercises that usually make me so relaxed and lengthen the muscles and the back so easily. I shall keep the lower back straight for the time being until things ease a bit.
It really is a relief to hear from people on this forum as one can feel very alone with this. My grateful thanks again.
I tried all kinds of knee padding when I had problems as it was so uncomfortable to lie on my side in bed if my knees touched each other. In the end my best purchase, above all the gel knee cushions etc was a toddler pillow from Amazon. Just put it between your knees in bed. It makes a huge difference if you can get a good night's sleep.
Many thanks, Broseley - I am using a pillow at present but will have a look at these. At the moment it feels as though I shall be stuck like this forever. I'm sure that many people feel like this at the time. I shall try and contact the physiotherapy department next week - GP never any help.
Sorry to hear your tail of woe. I’ve been through a very similar time with my knee. I completely agree with Blearyeyed - great advice. That is the approach I took and, 3 months on I’m virtually pain free almost no swelling. The only additional thing I did was to use KT tape to take some of the pressure off the tight tendons. (There are YouTube videos on how to apply the tape). My physio also advised wearing supportive shoes, not my usual flip flops or crocs, and to add insoles to counteract my tendency to lean in as I walked, putting extra strain on the knee. Wishing you all the best.
Many thanks, Sukydee. I have had a quick look at KD tape - it looks interesting. I always wear well fitting shoes and house shoes (rather than slippers) as I have orthotics that I wear all the time and they are very supportive of the foot. I'm beginning to wonder if the tension that I feel from the pain and from other things is making it all worse as the back is joining in and sometimes the shoulders - all muscle tension. I feel if I could shake myself like a dog I might be able to shake it all away ... ah, well.
So glad to hear you are almost free of pain - that's great! Long may it stay that way.
Feeling thoroughly miserable this morning with stiffness and pain spread to lower back and upper legs etc. I decided to try an increase in pred. I increased from 6mg to 10mg - taking the dose about 3 hours ago. Guess what? I am able to walk, although the knee clicks and grinds, and the other pains are lifting. Why didn't I think it was related? I suppose because GPs always say shoulders and hips. I was also feeling very low and unable to sleep so will see how that goes over the next day or so.
I was feeling fine on 6mg and the downward slide only began a few weeks ago when I think about it which is why I queried decreasing to 5.5mg - because my shoulders were OK.
I think I shall stay at 10mg tomorrow and then drop back to 6.5mg. Perhaps the stress of Christmas approaching was a part of the problem. Also I didn't associate other symptoms with a flare - i.e. upset stomach, insomnia, irritability and a sinking mood. I really hate this blasted disease but will escape it one day. Sometimes, just sometimes, I wish I had never taken steroids and tried to battle through. Some have been able to do it.
An appointment with a nurse practitioner next week - I made this before I decided to try increasing Pred. I think I will ask for ESR and CRP test as they didn't test for inflammation last time - why not when the patient has PMR I don't know.
Thank you to everyone who has made such helpful suggestions - I shall certainly pursue some of them. What would we do without this support.
Being ill with something else can also cause a flare in PMR symptoms. If it were me, I would stick at 10mg for a bit longer - at least a week is the usual suggestion for this sort of flare before dropping back to the last dose where you were good.
"I wish I had never taken steroids and tried to battle through. Some have been able to do it"
There are precious few who have done it - it all depends on how long it lasts. I had had it for 5 years before I was offered pred, it wasn't diagnosed. I can still remember the relief 6 hours after taking that first dose of pred. By that time I was virtually housebound - without a car I couldn't go anywhere without excruciating pain. I kept mobile by going to an aquafit class every morning, the earlier it was the better a day I had. But I was stopped from driving for a time - incorrectly as it turned out. I discovered how dependent I was on the car - I was isolated and depressed. Along with a few others on the forum who have been messed about - delayed diagnosis for whatever reason, doctors who don't understand how best to manage PMR and allow flares - I now have a resistant form of PMR that needs more pred and where flares become harder and harder to get under control. There isn't a lot you can tell me about managing PMR without pred - but I can tell you, it is not a pleasant experience.
Thank you, PMRpro - and, again, for your good advice. Yes, it is easy to say 'if I had not ...' and sometimes, when feeling very low, those thoughts do come. The best thing I have ever done is to join this forum - I shall always be thankful for that. Your advice and that from others is so valuable.
Five years before being offered pred must have been so hard and I can understand the feeling of isolation you must have experienced. We hope to move from a small village into a town next year for that very reason - if one or both of us is unable to drive then life becomes very difficult.
Thank you - I will stay at 10mg in that case for the rest of the week and then drop back. Even over Christmas I have attended closely to diet and maintained weight so I can't think of anything else to do to support at this stage. I've made bone broth part of everyday nutrition and find it a very pleasant drink with which to end the day.
The knee pain is still there - just not quite so disabling - so perhaps that is a different issue. I feel I need to deal with stress in a much better way and that is something that I shall need to research and work on - it's all a learning process, isn't it ? Or it feels like it to me.
One thing I am keeping my fingers crossed for is a decent night's sleep - don't seem to have had one for weeks.
Thank you so much, again. I appreciate you sharing your knowledge more than you can understand.
It is difficult to sort out. My new rheumatologist backed my idea of finally getting a total knee replacement after many years of hobbling around with "bum" knees due to falls, tears, bone on bone, disintegrated cartilage, etc. Now five weeks after the TKR I have noticed most of the knee pain is gone (we shall see if all will be gone after a year). A good orthopedic surgeon/knee surgeon could hopefully give you good information. I used to use a knee brace, hiking sticks but last year I reached the end point where it was time for surgery. I hope they sort this out for you!
Good to hear from someone who has had a successful knee replacement - thank you for responding. Surgery is sometimes necessary, I know, but something I tend to try to avoid. I shall see how things go with the practice nurse. Long may your healing continue!
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All ours do silly things running or sliding up and down mountains. But they really are good at knowing when exercise might be better avoided and some hands on stuff be useful.
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