My arthritic left knee hasn’t worked well for years, but until recently pain was intermittent and always associated with doing too much or doing something that might have been made less taxing if I had worn the brace the VA provided. For more than two months I frequently had difficulty rising from sitting because pain exceeded my tolerable threshold. Then, for no definable reason that problem disappeared to be replaced by near constant pain of variable levels.
Getting my primary care physicians to refer me to someone specializing in joints took time, but I won’t belabor the point or whine about my frustration. Recently, like three days ago (as I write this), I met with joint people.
There are four common approaches to knee pain of the arthritic sort, which mine is; replacement (partial or complete), living within ones pain tolerance and threshold, injection of hyaluronic acid (a joint lubricant) and injection of a corticosteroid. Wear and tear on the knee joint, whether ordinary or extreme, is part of aging and arthritis simply adds to the problem.
Replacement works if you can tolerate the rehabilitation period AND are wiling to work at range of movement and strength during thew rehab. I am still not ready to consider replacement because of the down-time during rehab. I don’t wanna be even more limited than I already am for even three weeks. Adding to that is the dramatic nature of replacement. I guess I see it like the difference between an engine rebuild when your MG-B’s engine sound a little out-of-sorts and adding a bottle of Motor Honey. Maybe the Motor Honey gains a few weeks or months. Just sayin’ how I reason it.
My pain tolerance for joint issues is pretty high, but when it gets to a point where you can’t do things while tolerating it, decisions have to be made. Lemme add here, that with my bum knee, in 2015 I piloted a tandem bike from Pittsburgh to DC, then north into central PA, covering 500+ miles. I like to do, but pain compromised my ability to do lots of things and not riding was the finale.
My primary care doc recommended that I get the knee lube (hyaluronic acid) because it had few potential issues. There’s some dispute about the efficacy of it. Sometimes it works and sometimes it doesn’t and how long if it does work is indefinite. The indefinite thing is true of a corticosteroid, too. Where there is a significant difference, it seems, is a corticosteroid’s potential to combat some of the physical issues in a bum knee, specifically swelling. If I was going to do anything, doing a corticosteroid seemed like a better first step.
I’ve never been a fan of needles of any size, but having one shoved into my knee joint carries a more dire mental image. I felt more “pain” meaning barely anything when I got the lidocaine than I did when the actual injection was done; painless and quick. Maybe it’s related in part to the number of knees they have injected; “some days we do 16 knees.” There are lots of old, bum knees wandering the halls of VA facilities.
I walked out of the facility without pain. I relaxed for the remainder of the day after getting home. The following day I helped a friend to install some edging and mulch. Later, I planted field peas and lima beans on my hands and knees and hauled a small cart load of mulch to the garden. If I’d had pain I could not have done a quarter of what I did. Did I overdo it? Not in my opinion. Part of me wants to get in as much as possible before that indefinite period becomes finite. I’ve ridden a mile and a half each day as a start toward regaining lung and heart.
I wear my brace for all but the least strenuous tasks around the house and carry it in a pannier when riding. I stay aware of hyper-extension, my knee’s mechanical issue. I cross my fingers.
So, here’s the point; I think the injection has been very helpful and what happens between now and when I see the orthopedist will be useful to us when we discuss what comes next. I’ll keep you posted.
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