What's Up With My Knees?

In My Humble Opinion (IMHO)
1

First of all, I’m seeing the doctor tomorrow, so no need to suggest it. This is just for funzies (and possibly to provide me some questions or relevant information for the appointment).

Basically, my knees are killing me. I first noticed it back in April; I’d occasionally have pain when while carrying my son (he weighs about 20 lbs). It was generally only if I had to bend down, or stand up from the floor, or sometimes when going down stairs. If I wasn’t carrying him, I was fine. So I started being really careful to stand up and get down carefully, by putting one foot behind me like in a runner’s stretch to distribute my weight, and supporting myself with a hand on furniture or something if possible. The real killer was sitting down with him to nurse; there’s just no way to get in and out of the chair without putting all our combined weight on my knees.

Then, the pain started getting worse, and more frequent. I began wearing knee braces whenever I would be spending the day with the kid. But it started to hurt even when I wasn’t carrying him. I began to wake up in the middle of the night with aching knees and have to reposition. Every morning, my knees felt stiffer and more painful. Now, I’m basically in constant pain. Just sitting here in my chair at work hurts. It hurts least when standing and walking on a level surface, but it’s always there.

It’s an aching, burning, sore pain, with sharp stabs when I do something to stress it. It seems to be located in the muscles and tendons just above my kneecaps, and directly behind them, or perhaps even in the kneecaps themselves. Whenever my knees are in one position for too long, they get stiff and very achy. They’re not at all sensitive to touch; massaging feels good, and when my legs are straight, I can move the kneecaps around with ease. As far as I can tell, there’s no swelling or anything like that.

Personally, I think I’ve just jacked them up by carrying the kid around too much, and they haven’t had time to heal. I can’t say for sure, since I’ve never had anything like this before, so I want to rule out actual disease. I’ve never been terribly athletic, but I’m not unhealthy, either. I eat pretty well, always take the stairs at work, do occasional yoga, and I’m a normal weight (5’9"/140).

If you’re not a doctor but play one on the SDMB, let’s hear your ideas. What’s up with my knees?

2

For you to be in pain with both knees at your young age is a serious problem. If just lifting an extra 20# from a chair is difficult, you have a serious problem. If you don’t do regular exercise and strength building, you have a serious problem. Am I making my point?

Chances are great that you have bilateral joint damage and early onset arthritis.

3

I am not a doctor, but when my son was about 8 months old, I started having horrible pain in my back, much like what you describe. It was very hard to pick up my baby from his crib. I saw my doctor and he said it was arthritis, he could feel the swelling at a few points along my spine. I was only 25. My doctor told me to take aspirin-- we know now that it’s not recommended for nursing mothers-- so I took it. The pain lasted for quite a few months, then started to wane, hard to remember when it stopped, but it eventually did. After a while it was gone entirely.

Years later, I had all sorts of tests related to a totally different matter, and there was no sign of any damage anywhere on my spine. Perhaps a doctor on this board will come along and solve the mystery for us.

Long story short: see your doctor, though I hope it’s just some kind of inflammation that’ll pass.

4

Just a wild-ass theory to throw out here, only speculative, please take with a grain of salt:

If you are the mother of a child that young, you were very recently teeming with hormones designed specifically to limber up your joints and ligaments and stuff. Could you have possibly hyperextended your knees, and they haven’t had a chance to heal? Hopefully, it’s something temporary!

5

Apologies for telling you to see your doctor, Heart of D. For some reason, even though I read your post carefully, the intro didn’t stick in my mind.
I hope everything goes well at the doctor’s today.

6

Hope all goes well. Knee problems suck. Hopefully it’s just some temporary strain, maybe as a result of carrying your kid around.

7

Some combination of tendon problems (google patello-femoral syndrome and pes anserinus tendinitis, both of which I was told I had), and arthritic damage.

My saga:

I had to give up biking at age 30ish because that killed my knees. I saw an orthopedist about it (he gave me the above terms) and spent a year doing physical therapy to try to strengthen all the supporting bits of the knee. Near constant pain, stairs were a hell of a challenge, etc.

I quit the PT… and the knees got better. Not “ride a bike” better, I was never able to get back to that, but the constant pain from the PT did stop. It was a wasted year (though I had great calf muscles during that year :D).

For the next 20 years, the knees would be mostly OK, though every now and then I’d have problems for a few days. About 2 years ago, they got bad (especially the left one). Saw another ortho, who talked about the options: PT, joint fluid injections, arthroscopy to try to clean up any meniscus tears, and possibly even ultimately knee replacement surgery. An MRI confirmed arthritic changes, no obvious meniscus tears, surgery not really indicated; try PT.

Well again, the PT made things hellishly worse, to the point where there were days where I could hardly walk. Not helped by the fact that I also had shoulder issues…on the side where I’d use the cane if I needed one! Only relief was a prescription NSAID.

I quit the PT, the knees improved a bit. I got joint fluid injected into the left one last summer (not as bad as I’d feared!!!) and it got quite a bit better. A year later, and I’m starting to feel some pain / catching again, so I may go back for another series.

A friend, just a few years older than I (so in her mid-50s) had both knees replaced last year and she says it’s the best thing she ever did. She’d been in constant pain for years, however, and surgery / injections provided short-term relief at best.

Anyway: You’ve got a young baby. That means you were pregnant. That does quite a number on the body’s connective tissue, both the hormones and the wonky weight distribution. It’d be a miracle if you didn’t have some aches and pains - and if you’ve got a pre-existing tendency to issues, that wouldn’t help.

You’re seeing a doc which is an excellent first step (or limp :D). S/he might suggest things like a stronger anti-inflammatory (even high-dose Advil didn’t help me, what did was diclofenac and it was WONDERFUL), an MRI, PT, and/or seeing an orthopedist who can help you get a handle on what’s happening.

Some medications may be out since of course you’re nursing (iirc Advil is OK, but I don;t know about the Voltaren; I had it as a combo with misoprostol to protect the stomach, and that is I think contraindicated for you). Icing the knees frequently might help and won’t do baby any harm. Put a pillow under your knees if you sleep on your back (I found I tended to tuck my right ankle under my left knee if the left knee was bugging me!). Maybe one of those hourglass-shaped pillows that goes between your legs, that might help when you’re sleeping on your side.

8

Does this sound about right?
http://en.m.wikipedia.org/wiki/Chondromalacia_patellae

9

I had something similar to that about 5 years ago. It helped a lot. Before getting shot up, I did some research…some people said it was very painful. Some people said it was painless. Apparently some people are better (more practiced) at giving these injects than others. I was seeing someone who does it a lot, and he was quite good. No pain at all.
-D/a

10

Heh - I was terrified. I’ve had injections of cortisone / anesthetic into various places on my feet and I’m surprised I haven’t bent the metal of the podiatry chair with my Death Grip Of Doom.

The ortho who did my knees numbed the area with a rapidly-evaporating spray of some kind of alcohol, then did the shot. It wasn’t pleasant, but not nearly as bad as I’d feared. Some pain but really nothing to write home about. More in the “discomfort” realm, really.

11

Welp, the doctor said that it could be tendinitis, but it sounds to him like it’s arthritis (or I suppose one of the other disorders suggested here; he’s just a GP, so I wouldn’t expect him to know exactly). After doing a little more reading about these issues, I’m inclined to agree, but we’ll see. He recommended we treat it as tendinitis for a few weeks and see how it goes. If it doesn’t get better, he’ll send me to an orthopedist.

So for now, I’m to 1) wear the braces all the time, 2) liberally apply rest and ice, 3) try strength-building, especially in the quads, and 4) take a really high dose of ibuprofen for a week. So far, I’m off to a terrible start. I rested and iced last night, and it just seemed to make them even stiffer, and I forgot the braces this morning. I’ll try to work on the quads this weekend, but I don’t have great heaping lumps of free time anymore. And I’m reluctant to take the ibuprofen just yet, since I’m still breastfeeding. The kid’s already had ibuprofen himself, for a fever, but I don’t know how much he’d be getting from me. He’s 10 months, though, and eating a lot of solids, so it’s no great tragedy if I have to pump and dump for a week and give him formula for that time.

But if this is not just a temporary deal, and it looks like it may not be, I’ll be really bummed.

Heh, no worries. I figured I’d still get a couple of those; I was just trying to stave off the onslaught.

12

Ibuprofen should be fine for you to take:

And if there’s something inflammatory going on, knocking it down fairly hard will give you very good relief and possibly shorten the course of whatever is going on.

13

Oh - and my post-c-section pain relief was Naproxen or another NSAID in that class, so the docs clearly weren’t worried :slight_smile: (Moon Unit got nothing but breastmilk, which I was pumping during that time for use when she was able to take food orally).

14

FWIW, all the times I’ve had tendon/ligament/cartilage issues in my knees, it’s taken six months or so to feel better. I spent a good portion of my college years taking huge amounts of ibuprofen and did plenty of icing. Like Mama Zappa, I found that the quad exercises and other physical therapy exacerbates the immediate issues. My knees hurt pretty much all the time from about ages 10 through 27. They started feeling pretty good once I became a couch potato. :slight_smile:

Good luck!

15

This is probably not the same thign as you have, but exercise did help for me –

A year or two ago my left knee started getting sore. It hurt in about the same location as you describe: kneecap area and upward. It felt sore, achy, tired (and did seem a bit swollen). I’d ice it, put it up, try to stay off it, and none of that helped. When I walked a couple of miles on it, though, although it would hurt like heck while I was doing it, the next day it would actually feel a bit better. My sister suggested it might just be weak (I also have a young child and had been far more sedentary than usual for a while) and I should just keep walking. I did, and the pain went away pretty quickly.

As I’ve said, this may well be something different based on what you’re saying, but if you haven’t tried that kind of moderate-but-persistent exercise yet, it might be worth a try. Good luck.

16

Is Lyme disease a possibility?

Says here that arthritic symptoms in the knees are common.

17

How old are you? Whats your gender? Do you have a family history of autoimmune diseases such as lupus or rheumatoid arthritis? Do you have a family history of gout? Have you ever experienced pain like this before in another joint? Are you sexually active (it matters)? With how many partners/do you use protection? Have you been sick recently in any way?

Repeat exactly how this began. Did it start in one knee and then spread to the other, or did it begin in both knees simultaneously? Has it ever spread to a different joint or has it just been sticking around in your knees? Do you remember any inciting trauma?

Describe the physical appearance of the joints. Is it swollen? Erythematous? Is there notable swelling or heat? Does it look inflamed? Is their audible crepitus when you move you knee? Is your range of motion affected? Do you feel any snags or bumps as you move your knees throughout its range of motion?

Describe the pain in more detail. Does passive movement hurt, or is only active movement painful? Is it better or worse in the mornings when you wake up? Does it improve or worsen throughout the day?

Honestly, it sounds like you might have rheumatoid arthritis. Sorry. Your doctor is likely to get an anti-CCP antibody, a rheumatoid factor titer, an erythrocyte sedimentation rate, a C reactive protein, a complete blood count, complete metabolic panel, maybe an anti nuclear antibody, and a plain x ray of your knees. He will probably get a joint aspirate to see whats going on.

A family practice doctor might do all this, but if they don’t then you should ask to be referred to a rheumatologist. They are the gurus of joint pain, autoimmune or not.

Also, its not lyme disease. Don’t even ask about it unless you have a history of outdoor exposure and known tick bite, found the tick to be gorged with blood, and then developed the hallmark erythema marginatum rash and had other symptoms as well. Your doctor will silently /roll eyes in his mind if you bring it up. And don’t ask for the test just to be sure. Its a shitty test.

18

I had knee pain that my doctor diagnosed as arthritis. It turned out to be inflammation caused by eating grains. Once I gave up grains and sugar, it took about a month for the pain to be completely gone.

19

Tell me about your shoes. After an injury when I was 13 I developed arthritis in my left knee (my pediatrician was convinced it was “growing pains” so I didn’t get an official diagnosis until it got worse when I was 21) and I’ve learned through hard experience that what you wear on your feet has a big impact on how your knee feels. Dress shoes are often hard on your knee(s). Sneakers are often better. It seems to be a matter of arch support and how that effects the alignment of your body from the hips down.

If you’re not wearing sneakers already, try buying a cheap pair of those “fitness” sneakers, the type that don’t look mishapen on the outside. The gains in toning are modest, but they are very well padded and there are reviews everywhere about them being more comfortable than their normal cousins. You can get them for $15-20 at K-Mart - and they feel about the same as the pair I paid more than twice as much for - and see if that makes you feel better.

20

Quick update:

For the past week, I’ve been wearing the braces every day, icing, and trying to avoid stressing my knees as much as possible. I also went ahead with the ibuprofen, since it only gets passed on in miniscule amounts (thanks for the links, Mama Zappa!). I also started sleeping with a body pillow between my knees. And elfkin477, I always wear either sneakers (Converse, though, so not ideal) or Clark’s flats. I think it’s all helped, but every morning, they’re stiff and achy again.

And… this morning, I also started having pretty severe pain in my hands, which I noticed when I picked up my kid. My feet are also a little achy, as are my elbows. In fact, I’ve been having pain in my elbows for a couple of weeks, too; I just didn’t think anything of it because it’s been really intermittent, not that severe, and goes away pretty quickly. Like my hands: they already feel considerably better now. But putting everything together, it’s really starting to look (albeit to my untrained eye) like rheumatoid arthritis.

So, I’m going to try to go back to the doctor this week, or perhaps he can refer me directly to an osteopath or rheumatologist. I’m still hoping this is something else, like stresses from the baby plus too much air conditioning, but I’m pretty concerned.

Boy, would it suck to have RA.

:mad:
:frowning: