Arthritis - diagnosis and treatment

[Rumbleinthecrumble]

I started having an issue in my right knee about 10 years ago, I wasn’t able to bend it properly, it felt like there was something at the back of the knee stopping it. I had stiffness and it felt sore. I went to see my GP who didn’t examine the knee, and just sent me for an X-ray at the local hospital. I was also told I could self-refer for physio which involved completing a questionnaire and waiting to hear back. Chased my GP up on the X-ray results and saw him again and was told it was inconclusive but might be arthritis, it would help to lose some weight (my BMI was 27) and I should chalk it up to old age (I was early 30s) and learn to deal with the fact that we’ll all get aches and pains.

The physio ‘appointment’ came through in the form of a phone call, I was asked some questions and told it could be a few things but sounded like a meniscus tear, I was emailed some exercises to do. Still no hands on examination!

Ended up seeing an osteopath and also a physio for their opinion alongside research which seemed to suggest it may be a Baker’s Cyst. Having osteopathy helped ease the stiffness and improve mobility, one evening I had awful pain, including a strange burning sensation down my calf which I think was it bursting. After that point the range of motion in bending my leg was improved but never returned completely.

Recently and suddenly I developed a pain in my left knee which felt very different to what I had experienced before - it was sore along the outside edge of my kneecap, this area was swollen and warm, hurt to walk on it, walking down stairs was agony. I have a baby that I need to carry up and down the stairs safely. Got an appointment with a GP (new surgery) who could not have been less interested. She put her hand on my knee and told me that as she could hear an audible crunching noise when I bend and straighten my knee then the issues were from wear and tear. I should take ibuprofen in tablet or gel form. When I asked did that mean it was not arthritis I was told “oh no, it is arthritis” and then packed off out the door.

I am not disputing the arthritis diagnosis although I was surprised by it as there is no family history and I’ve had the crunching noise in my knees for as long as I can remember (definitely since my late teens) and thought it was just a thing that some people have. I’m struggling with the fact I’m in pain and taking ibuprofen doesn’t help, and I’ve been given a diagnosis without any clear idea of what that means for the future. I am early 40s now so presumably this is just going to get worse?

I’m a little overweight - about 10lbs - after my pregnancy but am totally unable to exercise (even swimming is painful) and I’m worried now my other knee is affected I’ll be left with even less flexibility and mobility which causes issues with playing with my child - kneeling on the floor is impossible, I also can’t sit cross-legged, carrying up and down stairs is incredibly painful and this is a 9 month old.

For those people who have had an arthritis diagnosis - what would you advise works well for you in terms of pain relief, and also with regards keeping range of motion? Is this something I’ll have to live with daily or do people usually have flare ups that improve? Is there any way of treating this more thoroughly or is that only offered when things are much, much worse?

Thank you for reading!

Sorry to hear this. Do you happen to have psoriasis or have it in your family? I have psoriatic arthritis which is inflammation, rather than OA which is wear and tear. I say this because of the pain/red swelling which sounds like inflammation to me. Can you also ask your GP about naproxen which is a better NSAID, perhaps a referral to rheumatologist? Did the GP do a blood test for rheumatoid markers?
im only suggesting PsA as I get it and sounds similar, but it just sprung to mind
good luck

You need a rhumatology appointment.

Strangely I have psoriatic arthritis <waves to Chunky Bear>

I used to have Naproxen but as I am late 50s they have stopped prescribing it to me. I use tramadol for pain relief. I also have a TENS machine.

Basically if it is OA as already said it is wear and tear and it will only effect the joints that have worn.

If it is RA then it can effect every joint it is an autoimmune disease. Mine affects every joint and occasionally my eyes.

OA you want to keep movement in the joints and take pain killers.

RA means you may be prescribed 'disease modifying drugs'.

There are about 100 different different arthritis conditions.

You get a knee replacement OP when it gets really bad. Ask for x rays and a referral to the orthopaedic surgery They'll tell you if it is bad enough to require surgery

As @sashh says there are two kinds of arthritis.
Osteoarthritis which is wearing and tear. There's no treatment or cure other than physio, pain relief and eventually joint replacement.
Rheumatoid arthritis is diagnosed and treated by a rheumatologist. There are drugs which stop it's progress. It's considered the more serious but can be well controlled.
I have both.
Keeping movement and flexibility is important for both.

@chunkybear I do have psoriasis and hadn’t made the link, clearly neither had the GP. I wasn’t offered a blood test or any referral. It wasn’t even discussed, it felt like I was given a token diagnosis for something that felt serious and sent away with a suggestion to take ibuprofen.

I presume the only way it will be formally diagnosed is to go back to the GP and request further tests given the treatment is different for OA vs. PsA and RA.

Thank you everyone for your contributions.

I also have psoriatic arthritis and take DMARDs which when you get the right one are pretty amazing.

Just to say both my rheumo and GP have warned me on several occasions about ibuprofen and it's stronger siblings because they can cause damage to you if overused. I know it's difficult when you're in pain but try to be careful all thr same.

Also you should stress the psoriasis angle to get a proper diagnosis aa it's shameful you're getting fobbed off with some OTC painkillers and nothing else.

Given you have psoriasis, are not especially overweight and are very young for osteoarthritis to be so bad, AND one form of psoriatic arthritis typically affects large joints like the knee I'd be harassing my GP until I had a Rheumatology referral.

Another member of the psoriatic arthritis club here! I’m on fortnightly Yuflyma jabs and weekly methotrexate tablets. Together, they’re incredibly effective (for me,at least). When I was on methotrexate, the psoriasis and joint pain decreased dramatically but there was still a bit of stiffness here and there. Since being on the injections (originally Humeira but now the biosimilar Yuflyma, which works exactly the same way but is cheaper for the NHS), I have been completely symptom-free. No stiffness, no psoriasis. Definitely look at the psoriatic arthritis angle, there’s a lot that can be done about it nowadays.

I did this quick test, I answered enough to get my GP to refer me to rheumatology, I’d been diagnosed and was on my first set of DMARDS later that year.

with regard to the nails, the pots can sometimes be very hard to see, I have very thin nails anyway, but once you see them it’s something you’ll keep seeing - you can also get nails separating in places from the skin, and with regard to my fingers. I used to get very 👀😵‍💫 because sometimes it seemed like my fingers were changing shape, getting sore in random joints for sometimes a few days, other times a few hours, it was bizarre - turns out it was PsA
i am also on Yuflyma now too, after not doing so well on mtx or sulfasalazine
https://www.psoriasis.org/psoriatic-arthritis-screening-test/

@chunkybear did the mtx or sulphasalazine not work or was it side effects?

@isitmyturn - I took sulfasalazine for about 6 weeks, it gradually made me feel worse and had a bad affect on my MH, I had bloods done and a phone call to stop immediately as my liver enzymes were over double the max. I did however find that my pains had started to go!! Typical eh!
mtx didn’t work for me, I ended up with the worst flare up ever and it was making me foggy brained which I can’t have at work. Rheumy then prescribed Yuflyma - been 2.5 months and some good days! I also started Mounjaro which has seemingly helped too, albeit it may be biologic started kicking in as it was a month after starting