HELP MY KNEE-JERK REACTION TO PAIN
When rough surfaces of cartilage rub against each other there can be severe pain.
By Dr Rosemary Leonard
THREE years ago I had an arthroscopy on my left knee and in January this year, I had one on my right knee.
Both are still painful and it gets worse when it’s cold or when I walk for more than a few minutes.
My doctor has told me I have arthritis and at 54 I am too young, and it is not advanced enough, for me to have knee replacements. The pain is so bad it makes me cry and painkillers don’t work. Please give me some advice.
The most common type of arthritis that affects the knees is osteoarthritis. The cartilage cushions that protect the ends of the bones inside a joint become frayed and worn away.
This causes pain and inflammation, and, if the rough surfaces of cartilage rub against each other when the joint is
moved, there may be an unpleasant grating sensation.
Osteoarthritis tends mainly to affect weight bearing joints, especially the back, hips and knees and is more common in people who are overweight, or in those that do a lot of sports, as their joints have had to do more work and take more strain. However, it is rare among those under 60.
Occasionally it also occurs in younger people for no apparent reason and this is probably because there is a fault in the way the cartilage naturally repairs itself through life. Keyhole surgery – an arthroscopy – can be used to trim and wash away rough pieces of cartilage and is usually very helpful in relieving pain and stiffness.
Although replacing the knee joint can be a very successful operation, new joints have a limited lifespan.
In most people they last around 15 years and then can become loose. That means that if you have a new joint replacement now, the chances are you are going to need that replaced at some stage.
Second time, though, new joints can give a lot more problems. At your age it is better to try to follow your doctor’s advice and try other measures for easing your pain and stiffness. Top of the list is to get your weight into a healthy range.
You should also take as much exercise as your can, which will help you to lose weight and also strengthen the muscles that support your knees.
Swimming is excellent for people with arthritis, as the water provides support. Check with your doctor about the doses of painkillers that you are taking – do not be scared about taking the maximum dose of paracetamol (eight tablets a day) as it is not dangerous or addictive. Y
You could try a different type of painkiller, such as amitriptyline or gabapentin, which work by altering the way the pain message travels along nerves to the brain. You can get more information from the Arthritis Research Campaign
(0870 850 5000/www.arc.org.uk).
My right eye has been bloodshot six to eight times in the past four months. My doctor has checked my blood and blood pressure but I get the impression she thinks I’m wasting her time.
Surely something must be wrong? I am 58 and fairly fit, though I do suffer from regular headaches and attend a chiropractor for my neck and shoulders.
The most common cause of a bloodshot eye is inflammation of the conjunctiva, the clear membrane in the front
of the eye. This can be due to allergy, an infection, or trauma (for instance, from contact lenses). The eye looks red and sore and often waters as well. Another type of type of bloodshot eye is due to bleeding beneath the conjunctiva, caused by a burst blood vessel.
This causes a very dramatic bright red patch in one area of the eye and can look very alarming. In the vast majority of cases, this happens out of blue and there is no apparent cause. It’s more common in older people and it may occur after a bout of coughing.
Occasionally, it may be linked with high blood pressure and it is more likely to occur in people taking blood thinning drugs (such as aspirin or warfarin) and it has also been reported in those taking herbal remedies that can have the same effect, such as ginkgo biloba and garlic supplements.
In your case, it is unlikely to be linked directly with the problems you are having in your neck and shoulders but check with your doctor whether any medicines you are taking could be to blame.
Otherwise, don’t worry. The bleeding behaves like a bruise and goes from red, to purple and yellow, before eventually fading, which takes about two weeks. During this time no treatment is required, other than perhaps a pair of sunglasses if you are self-conscious about it.
If you have a health question for Dr Rosemary, please write to her in confidence at The Northern & Shell Building, 10 Lower Thames Street, London EC3R 6EN, or e-mail health@express.co.uk.
Her reply will appear in this column. She regrets that she cannot enter into personal correspondence and, due to the volume of letters, cannot reply to everyone.
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