Arthritis (knee joint)

[Wot2donow]

Hello all, pls I am hoping someone can help with this pls

Friend with serious knee joint arthritis pain (inflamed, can't walk properly) he's stopped work due to it.

1st medication given by NHS consultant didn't work at all, 2nd medication landed him in hospital with all the side effects on the box and even more horrible ones such as vomiting blood and none stop headaches which morphine wasn't helping and skin peeling like glove. This hospitalisation was in July 2022

He stopped the medication and the consultant saw him on the hospital bed and said he does not know what else to prescribe because none of the medications normally used for his condition did not work.

He also gets steroid injection sometimes when he sees the consultant (every 3 months) it helps but wears off after 2 to 3 weeks. He hasn't had the steroid injection in months. Now he is in terrible pain moaning and can't sleep.

He is waiting for a letter of appointment to see the consultant in November but

I am wondering what else can be done for him. I am sure there are ways to manage arthritis and wondering why the consultant is not prescribed that he gets the steriod injections every month to manage the pain (or is it dangerous to have steroid injections every month to control arthritis pain?)

Should he go private? If yes, pls which doctor or private consultant or clinic is best pls.

He is only taking Collagen joint supplement (see attached pictures) he's only started taking the supplement 2 weeks ago so still not sure if it's working or if it's going to work at all.

Suggestions, opinions and recommendations will be appreciated. Thanks a bunch xx

[AllLopsided]

Has he had any imaging? X-ray, CT, MRI? This should help determine how bad the arthritis is. Are there other problems as well?

There are meds he could have by injection.

He could have steroids or nsaids by mouth with something like omeprazole to protect his stomach. There are lots out there so he may not react badly to them all.

He could have opioid medication but I know the NHS isn't keen to give it.

A knee brace and/or crutches might help with pain when walking. As could an appointment with physio (private if necessary) to get targeted exercises to build specific muscles that will help protect the joint.

Is he a candidate for an arthroscopy (keyhole surgery to 'clean out' the joint - remove loose cartilage and/or bone spurs)?

Or if it's really bad (end stage/stage 4/bone on bone), he could be a candidate for knee replacement.

Very regular steroid injections are not necessarily a good idea as they can mess up the joint if he needs surgery down the line.

[GreenFingersWouldBeHandy]

Are there any other reasons why your friend isn’t helping to sort himself out? Having a dodgy knee doesn’t make him incapable.

[womblesofwimbledon5]

Steroid injections can only be given about 3 times a year, but there are steroid tablets that can be taken regularly for a certain period of time then tapered off. He could also take anti inflammatory tablets, muscle relaxants that may help him to sleep, gels and creams are available to rub on to help with pain, hot water bottle to help. If it’s inflammatory/rheumatoid arthritis there are monthly injections that you give yourself prescribed by a rheumatologist or infusions of the same type of drug. If I was him I’d definitely ring and speak to the gp or see him before the consultant appointment to see if anything can be given even in the short term like sleeping tablets. I hope he gets some help soon

[feindVicarInATutu]

I sympathise. Almost the week I turned 50 I started with knee and ankle swelling and pain - had an X-ray and diagnosed with osteoarthritis. It's incredibly frustrating as I've always been active . Now driving is a problem, let alone running. I've had the steroid injection but it didn't really work either and naproxen has nasty side effects. Your friend has my sympathies!

[MrsPerfect12]

I'm waiting for approval for an epi surf implant but that's private. I don't know full cost yet but roughly 6-8k - maybe look into this. I shouldn't need knee replacement if I have the implant. The my don't want to do TKR as I'm too young.
I'm classed as grade 4 after they cleared out my cartridge from a sporting injury.

[MrsPerfect12]

I forgot to ask what pain meds does he have?
I take remedeine forte and diclofenac that keeps the pain well managed.

[Mollymalone123]

I take diclofenac-which occasionally works but gives me terrible reflux even though I take omeprazole.by the sounds of it any nsaid is out if he has already had a bleed in stomach.
I’ve been in the waiting list for two new knees for 3 years-one us severe the other bone on bone.
i take slow release morphine and I try and walk the dogs a little every day.i now have bow legs and if I win the lottery the first thing I’ll do is go private.

the only thing that will work is to go private.

[Jellyshoeshurtmyfeet]

I have Ostenil injections privately through a physio and they're a miracle! I had the first round a year ago and am currently having another round. They last around a year. It's about £300 for the course. It depends on how severe the arthritis is but within weeks of having my injections I was walking without a limp or pain for the first time in years.

[dotty636]

CBD oil has cured my dog

[Coyoacan]

It might be worth seeing a reputable acupuncturist.

[Wot2donow]

@AllLopsided thanks a bunch
Yes, he's had several imaging done but I don't know what stage his arthritis is all I know is that he is stopped working, can't walk well, in pain, can't sleep, knee swollen & disfigured.
He was having steroid tablets & some other (I recall he was also having omiprazol tablets then) in when he 1st saw the consultant & it didn't work & it was changed to another medicine that landed him in hospital.
He uses crutches & knee brace etc

He is not a candidate for keyhole surgery (he's not mentioned that to me).

[Wot2donow]

@GreenFingersWouldBeHandy he was a capable but I am just helping a friend explore options available for him, get opinions & suggestions from people

[Wot2donow]

@womblesofwimbledon5 thanks
He takes only over the counter anti inflammatory tablets which he said does not help really & the creams/gel don't work too.

You said "If it’s inflammatory/rheumatoid arthritis there are monthly injections that you give yourself prescribed by a rheumatologist or infusions of the same type of drug."
I will tell him to ask the consultant about this monthly injections.
I will also tell him to call his GP & ask for something to help him sleep & strong painkiller for now at least until he sees the consultant.

[Wot2donow]

@feindVicarInATutu oh my so sorry you are also going through something similar. My friend is only 43 & I didn't know people under 60 could have very bad arthritis.


@sashh thanks, I will ask him to look into seeing an orthotist & he uses mostly heat & ice packs sometimes. He was seeing a physiotherapist early this year & was given targeted exercises. He's not tried TENNS & chamomile tea but will be Charing that suggestion for him to look into. Thanks

He is already under the care of NHS rheumatologist consultant.

@MrsPerfect12 thank you, I have never heard of epi surf implant but I will pass it on to him to look into. I am not sure if he's tried
remedeine forte and diclofenac.

@Coyoacan thank you, I will let him know to add acupuncture to the list of things to look into.


@Jellyshoeshurtmyfeet wow Ostenil injections sounds promising & I will also let him know & thanks for sharing that information.

@Mollymalone123 sorry about your situation & you are right that the only way forward might be to go private. I think it's better that way because it's taking too long under the nHS & it seems obvious that they don't wanna do much for him at all. Slow release morphine? How does one administer that?

@dotty636 thanks, I have heard about CBD oil & I am adding i

[Wot2donow]

@dotty636 thanks I will add CBD oil to the suggestion list to pass on to him.

[Coyoacan]

Actually, I have an elderly friend who is turning 91 this week, who had dreadful arthritis in her early forties. Her hands are still knarled. She went to a naturopath doctor and stopped the arthritis in its tracks. As I say, her hands are still knarled but she never complains of any pain or discomfort.

[Mollymalone123]

@Wot2donow is on prescription from gp but honestly now doesn’t really work that well and I will dvd up keep increasing the dose and eventually you have to taper off it which takes ages if u want minimal side effects

id give anything for new knees! I’m only 56

i am now considering a private prescription of medical cannabis via a private practice but it’s expensive as well.there was a post about it I think under chronic pain board.

[MissConductUS]

I have mild osteoarthritis in one of my knees. I started taking this supplement for other reasons, and it resolved the soreness in the knee. It has anti-inflammatory properties.

www.healthline.com/nutrition/berberine-powerful-supplement

[Remainiac]

Is it osteoarthritis or rheumatoid arthritis? It’s not clear from your posts. Treatment isn’t exactly the same for both.
I have moderate/ severe osteoarthritis in both knees, one worse than the other and full thickness loss of cartilage ie bone on bone. NSAIDS have stopped working for me, which isn’t unusual, as have the steroid injections. I’m doing Ostenil next.
I exercise hard to keep my leg, glute and core muscles strong and keep my weight down- losing even a little bit of weight, even if you don’t need to, makes a big difference to knees.
At the moment I’m taking a supplement of Glucosamine, Hyaluronic acid and Boswellia Serrata which is working quite well to reduce inflammation. Eventually that will stop being effective, as is the way with arthritis sadly. I’m 59.

[Remainiac]

You’ve just dismissed everything I’ve suggested that may be helpful based on lived experience in your keenness to score a point. Well done 👏🏻

[Remainiac]

That’s my very point - I don’t have superior knowledge, I’m sharing my experience but your point-scoring undermines that. You’re positing that there’s only the three-pronged high level approach in your post, where I, and other posters, are talking about actual interventions that we have found helpful.