Osteoarthritis of the Knees

[sciencegirl]

Howdy peeps :basic45:

Does anyone here have osteoarthritis of the knees? What's your medicine protocol? Have you had knee replacements or are you expecting to have them replaced in the near future.

I have to have both knees replaced within five years. The left knee may be replaced sooner than that. They have me on 500 mg of Naproxen twice daily; which works pretty well; however, when it snows or rains; I know it the day before it happens. My knees are absolutely throbbing. Are there any creams in addition to Naproxen that are effect for the really bad days?

I'm feeling discouraged. Any insight is appreciated.

I just want to be able to do this again :basic44::basic44::basic44:

Thanks everyone who responds.:0012:

[Topaz]

This is why:

In 1999 I had a huge rt. knee problem. ( I stand all day at work).
It was so painful, actually going up more into the thigh and was swollen
twice its size.

The preliminary Xrays showed:
possible tumor/cyst inside and the ortho proudly said the left was 5 yrs behind and would be a mess then. I had an MRI which ruled out any tumor.

I have severe OA in many of my joints/and spine, confirmed by Xray.
So instead I was told, knee replacement soon, here is an injection and some
Vioxx.

I decided to do SAMe...instead. It had just come down in price back then in
1999 and I bought one box on sale at WalMart. Within days, I liked this choice.

It took about 2 yrs to start rebuilding my knee. Pain relief is faster, like within 2 wks. But actual improvement
takes longer.
SAMe has shown equal pain relief compared to NSAIDs like Naprosyn.
I now use 600mg daily first thing in the morning, and I have both knees, almost no pain anymore (except twinges) and have avoided the dreaded surgery.

NSAIDs in general are okay for brief things...but after 6wks they tend to suppress the other Cox-2 cytokines that our bodies make that enable healing.
So what happens is when patients use them LONG term, there is no improvement and in fact there can be deterioration.

SAMe actually restores functions over time.
Our bodies make it normally but with age this tends to decline.

It is now 2008 and I don't have any pain to speak of, my spine does not hurt, and the only thing is I get stiff when the weather changes. I don't need a replacement, and it appears that the "prediction" was not accurate.

We can do things to help ourselves. SAMe is not inexpensive and requires committment, but compared to the alternatives I think it is well worth it.
It helps with liver functions and also improves mood (and hence pain perception)

I use the brand name NatureMade since they brought this to U.S. and formulated a stable oral version of the injectable used in Europe since the mid-70's.

Here is a good link to read:
http://healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe33da65dd4&chunkiid=21460

http://www.umm.edu/altmed/articles/s-adenosylmethionine-000324.htm

The old high dose recommendations really are outdated. YOu can get response like I did for much less.
I started at 200mg a day for a month, then it seemed to wear off,
then I increased to 400mg each day in the morning, and it wore off in about a month, then I increased to 600mg...and that is where I stay..for years now.
If I reduce to 400/month I get flares about a month later.
So 600mg is my magic number.

I use buy one get one free, and Coupons from NatureMade for $7.00 that I earn by logging my points/purchase on their website.
Costco has 90 tablets for about $35.00...and that is as low as you will find it.
I joined there when they opened here years ago, just to save $$ on the SAMe. 3 months of purchases there pay my membership.
When I started back in 1999 SAMe was $1.35 a tablet a 200mg.
Now I pay about .30 a 200mg/tab with creative shopping.

There is nothing out there like it. And you have to have cartilage left, in order to see benefits. If you are bone on bone as shown on Xray...then you will have to skip this solution.

[PatC]

I suspect it's too late for me for SAMe.

I had knee pain for several years and the doctor I had at the time kept treating me for tendinitis. (He never took an x-ray.) Then in 2005 my insurance options were changed and I had to change doctors. On my first base lining appointment with my primary physician, she sent me to an orthopedics doctor for an evaluation and he ordered x-rays to be made prior to my visit with him.

On my first visit, he was sitting at his desk taking some info from me then he turned to his computer screen to look at the x-rays and was visibly startled. Both knees were bone-on-bone. He went through the usual stages for me saying that the usual penultimate stage of treatment was injections of Synvisc but that judging from my x-rays he had doubts that even that would give me any relief. However, he was willing to try it and my insurance would cover it.

Well, I did have the injections in both knees -- IIRC it was a series of three injections -- and I did have marked relief for probably six months. However, when the pain eventually returned I elected to go ahead with knee replacement. Although both my knees were in really bad shape and, according to the doctor the x-rays indicated my left was in marginally worse shape, it was the right that was giving the most pain. I was given the option of having both knees done at the same time, but I couldn't face that, so I had my right knee replaced in April 2005.

The doctor had warned me about the pain and he didn't lie. However, once I made the nurses understand I didn't ask for meds. unless I really needed them... the pain was manageable. I had a PT come to the house for a few weeks after I was out of the hospital... until I was up and around enough to continue the PT at a place in town. On my very last scheduled visit there, they were taking the measurements ... flex and straight... and the guy mashed down on my knee to try to get another degree and the pain was incredible. Of course they iced it down right away, but I still think something went wrong -- it doesn't show on xrays though -- because I've never been as well off as I was BEFORE that last visit.

I know I need to do something about the left knee. My limping is causing additional stress to my right hip and that CAN'T be good. I don't do badly when I use a cane to pick up some of the weight.... and speaking of weight, I'd be much better off if I could relieve knee stress by losing about 50 pounds.

I still need to have the other knee done but I keep finding excuses. It isn't the pain so much as I hate idea of being incapacitated for so long again.

I have never been prescribed Vioxx or Celebrex or anything other than the post-op pain meds then Naproxen, which I don't take daily.

[sciencegirl]

Thank you Topaz and Pat for your insightful posts. It is much appreciated. My left knee is close to bone to bone; and in about two years the right will be bone to bone. Very little cartilage left.

I will hold off my surgery for as long as possible; I do know that. Just trying to find a way to ge by with the Naproxen and the days I need something more.

:0012:

[NJ_Nurse]

I've had generalized osteoarthritis for about 25 years now and I wish I had the wherewithal to get several body parts replaced. lol Knees, hips, entire back, shoulders, you name it. The pain gets sooooo bad, sometimes I just cry.

Yet I cannot bring myself to do it....As a nurse I worked orthopedics and I've seen surgical intervention make a major difference for some patients, not for others.....

I've always been a believer in non-invasive treatment unless the issue is life threatening, or affects my quality of life to the point where I never have a good day.

So far the good days outnumber the bad. And all my parts work on some level. lol (except for that short term memory thing. That is getting soooo intermittent! lol)

[PatC]

Thank you Topaz and Pat for your insightful posts. It is much appreciated. My left knee is close to bone to bone; and in about two years the right will be bone to bone. Very little cartilage left.

I will hold off my surgery for as long as possible; I do know that. Just trying to find a way to ge by with the Naproxen and the days I need something more.

:0012:

You might want to check with your doctor. The Synvisc injections were VERY beneficial, and I understand they can be given more than once. Also, I heard the other day about a procedure that is less invasive than the total knee replacement. It sounded to me like they slipped something like artificial cartilage into the knee joint. I don't know what it's called.