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    Old 01-24-2010, 08:16 PM   #1
    Hopeful Wishes
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    Knee and Back pain...

    Hi all! I'm new here, and so happy to have found this forum! This is a pretty detailed account of what I have been going through since 2005- Any help would be greatly appreciated!

    February 2005- Fell off a horse. Knee went over the top fence board, and hung from rail. Swelling around knee, a locking feeling in knee cap and pain with activity. Over time pain increased along with swelling and frequency of pain.
    August 05- constant pain, always swollen

    October 2005- Ortho doctor #1- Physical Therapy and exercises with no relief. Exercises increased pain and swelling. Was on tramadol, anti-inflamatory and vicodin.

    November 2005- MRI and x-rays- both showed NOTHING

    December 21, 2005- Arthroscopic surgery, Doctor #1. Pretty much an exploratory basis- since scans were not showing anything, but there was an obvious problem. Constant swelling after surgery, all the way down to foot. Could not bend knee comfortably for 2+months after surgery. Was on crutches for almost 8 weeks after surgery. Surgery relieved pain for approximately 2months, and then pain was back, swelling never went down. According to Dr there was a small piece of tissue (he says I was born with it) that was "extra" he removed. Nothing else was found.

    2006- No relief. Ortho Dr #2. Physical therapy and massage therapy with exercises also tapped patella to the side- no relief, only made pain worse. Still constant swelling and a locking feeling in knee cap when trying to bend. Said knee cap was off centered, and noticed walking with right foot out to the side, had not paid any attention to it before hand so was not sure if it was normal or not. Huge amounts of scar tissue under both incisions.

    June 2006- Back pain started. Lower back, constant pain. No relief with ice or heat or pain medication. Tingly feeling down legs (almost as described with Restless Leg Syndrome) when lying down. Sharp shooting pains, in to legs like electrical shocks

    Late 2006- Saw family doctor, was referred back to Dr #2. Did x-rays, once again did physical therapy and massage therapy along with exercises. No relief. Pain was debilitating. Some days could not get out of the bed for the pain. Was put on amitriptyline 50mg every night, due to not sleeping from pain. Pain was not helped with pain medication, anti-inflammatory or nerve medications (Gabapentin 300mg- 2xs day) . Went 3 months, with no more than 2-3 hours of sleep a night

    January 2007- Still no relief in pain. Dr #2 had no idea what it was, and just suggested therapy. Pain continued to increase. Was not able to make it through a full day of school due to the severe pain.

    March 2007- Still no relief- was still doing therapy 3 times a week. Lost feeling in legs one day, walking up steps was very difficult and tiring, caused pain. Was still in constant pain. Every day life was put on hold.

    June 2007- Saw another dr, that is in practice with my GP. after no relief. Referred to Ortho Dr #3. Ordered MRI and full body scan with dye. Showed slight bulging disk, did not feel it was relevant. Sent to Physical Therapy again. Felt the pain was in my head.

    August 2007- no relief. Send to spine specialist at UVA- reviewed films from Ortho Dr #3. Did not see anything. Told me to continue physical therapy. Wanted to get another set of MRI’s and Full Body Scans. Did not follow up, as scans were only 2 months old!

    August 2007- Tried chiropractor- no relief. Only caused more pain after 3 weeks of going.

    September 2007 to Sept 2009- Back pain has continued. No relief. Painful when walking to classes or on feet all day. Same pains/symptoms as before. Muscle spasms.

    2006 to current- still constant knee pain. Some relief provided if wearing brace. Knee cap moves very freely L to R since surgery. Knee cap often locks in place if bending knee, have to physically move it back. Walking with R foot pointed out more so than was in the past. Cannot walk comfortably unless right foot is angled outwards. Always swollen- sometimes worse than others, but some swelling never goes down.

    Dec 2008- Knee pain started to increase along with back pain.

    January 2009- keep pain still increasing, along with swelling in leg/knee. Constant pain. Started wearing a knee brace, knee feels more stabilized with brace, than without, but not much relief in the pain. Pain started out as a 2, and by end of January was at 6. Swelling continued to increase.

    February 2009- pain and swelling continued to increase. family dr called me in tramadol (1Q 6h) and voltaren (BID) beginning of February. Had to take at least 2 tramadol a day, pain was still around 5-6. With tramadol pain was around a 4. Swelling did not decrease with voltaren (but stayed on it). Mid February, woke up at 5am, entire leg was swollen and a purple-y color. Knee had not been wrapped in 12hours, and I had been off of my feet for 9hours. Felt like my circulation had been cut off. Swelling went down in about 2-3hours with ice and elevation. Once I got up to go to class, entire leg began swelling again, and was still a purple-y color. The next morning, foot and leg had returned to normal color, and swelling was not AS severe but was still swollen. Swelling has continued, my knee, leg and foot are always swollen, it never goes down. (Still on voltaren)

    Mid February 2009- Pain and swelling still increasing, without tramadol pain is 7-8 with it, it is still a 5. Taking tramadol 3 times a day at this point. Shooting pains down to my foot, from my back, even when laying down. Foot will some times feel like it is asleep. The feeling asleep sensation and shooting pains, and swelling are present when knee brace is on or off, and during laying down or when on my feet. Used crutches for 4 days, since could not be off of my feet due to classes. Did not help swelling or pain. Not sleeping due to the pain. Pain is around a 9 most of the day. Took 1 vicodin to knock the edge off, pain still at a 6. Continued to take tramadol, 2 times a day after vicodin wore off. Next day pain was still at a 9. Took one Percocet, since I had to be on my feet all day due to classes, pain was still at a 5. Still on voltaren- no relief in swelling. Outwards angle of foot has increased since January.

    End February /Beginning of March- Taking (alternating) Percocet , vicodin, or tramadol, depending on what I have to do that day, and how much I will be on my feet. Still on voltaren. Only taking either 1 Percocet or 1 vicodin per day, rest of day I am using tramadol, if needed. Swelling is still increasing, or staying same. Swollen all the way down in to my foot. I walk to class at 9, sit from 9-9:50, walk to another class, sit from 10-10:50, and walk to another class and sit from 11-11:50, prop my foot up when I can, by the 11am class, I can feel my foot swelling. Pain is never less than a 5, no matter what pain medication I am on, with out medication it is an 8 or 9. Spent an entire day in the bed, with foot elevated, iced it 4x that day, with no relief in pain or swelling.

    March- Went to ortho #4- said there was nothing wrong with my knee; it was coming from my back. Sent me to Spine specialist- he suspected RSD and arthritis. Sent me to arthritis doctor, who put me on Lyrica 25mg, twice a day. Side effects were too severe. Switched me to zoloft 50mg, twice a day- had a reaction. Started to seek out another dr who was not so easily to prescribe medications, before looking at results. Was sent for another MRI- slight change in bugling disk- felt was irreverent. Also sent for CAT Scan of hips, everything was normal.

    April- Started seeing Ortho #5- Great referrals from friends. Looked at previous scans- believed there was an underlying issue with my knee, not showing up on scans. Also believed that RSD was a relevant possibility.

    July-Went in for a block in my spine to "diagnose"/treat rsd. Block put me in pain for 3 days, due to the tightness of my muscle when they went through it-- Relief in knee only lasted 6 days from block.

    August- Went back for another block- only lasted 3 days. Back to Ortho #5- Believed it was not RSD after the nerve blocks. Physical therapy/massage therapy for 4 weeks, if not improved wanted to do surgery.

    September- No improvement. Knee was locking to the point I was falling from the force of it locking up. Went to Ortho #5- Scheduled surgery for Sept 18th. He found a small tear in meniscus, and also a piece of Scar tissue wedge inbetween knee cap and calf bone. Removed both. Cleaned up excess scar tissue. No swelling after surgery; however lots of post surgery pain.

    October- Recovery going 100% full range of motion. (1st time I'd been able to touch by butt with my knee since 2005, also that I'd seen my knee cap, due to swelling)

    Still had some issues with locking- no where near as severe, just randomly. B/C i was not expecting it to, it would catch me off guard and it would forcefully pop. The pain is a 1-2 still hurts to stand on concrete (with good shoes on) or be on my feet for more than 5ish hours. Back pain is still there- constant. Muscles in my back are in knots, nothing will relieve them. In much less pain since my surgery but still not 100%... Especially for a 20 year old, that has a normal active healthy life.

    There is a huge history of arthritis and Fibromyalgia in my family. Grandmother has had both hips and both shoulders replaced. Grandmother and aunt both have been diagnosed with fibromyalgia. Mother at 50 yrs old, had hip replaced due to arthritis. Doctors have not seen any sign of arthritis but none have been able to give me a definite answer on fibromyalgia.
    Medications- (Past and Present)
    • Vicodin 5/500mg- back, knee and
    • Percocet 5/325mg-
    • Tramadol – back, knee
    • Ibp 800mg- knee
    • Valium 5mg- Back
    • Nabumetone- knee
    • Naproxen 500mg- Back/Knee
    • Sular- back
    • Diclofenac Sod 50mg- Knee/Back
    • Cyclobenazaprime 10mg- back
    • Gabapentin 300mg – back (600mgs 2xs day)
    • Tylenol
    • IBP
    • Advil
    • Aleve
    • Amitriptyline 50mg – sleep (due to pain)

    Medications (When Needed Only)
    • Percocet 5/325mg (PRN approximately 2T/week)
    • Vicodin 5/500mg (PRN 2T Q 4-6hrs- approximately 4T/week)
    • Tramadol (PRN 1T Q6hrs- approximately 2T/daily, no more than 3T/day)
    • IBP- (PRN 800mg-almost daily until Feb )
    I had weaned myself off of most pain medications, until February when pain started to increase with no relief. Up until then, I was only taking tramadol around 4 times a month, vicodin 2-3 times a month, and had not been using Percocet-had been u sing IBP almost daily. Have learned pain is part of my everyday life and only take when the pain is debilitating or extremely severe (This has been constant since Feb).
    • Sharp shooting pains
    • Tingly/Numbness in legs
    • Tingly in lower back
    • Pains rise in between shoulder blades in a shooting/electrical shock way
    • Spasms in lower back going in to hip/legs
    • Constant dull pain
    • Knots in muscles throughout back due to constant pain
    • Sensitivity to touch

    • Locking
    • Swelling
    • Grinding of knee cap
    • Mobility in knee cap
    • Right foot points at angle (has progressively gotten worse)
    • Worse over time
    • “Dislocation” of knee cap- only fixed by physically moving it back in to place.
    • Aches when cold
    • When sitting cross legged, if I go to bend to reach something, the bone behind knee, pops out, making impossible to straighten right leg. Takes about 15-20mins to be able to get bone back in place and full straighten leg.
    Large amounts of scar tissue under incisions from 1st surgery (2005)

    Any advice would be greatly appreciated.

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    Old 10-01-2010, 12:39 AM   #2
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    Re: Knee and Back pain...

    Hopeful Wishes-
    I can relate to your back pain. I also have severe low back pain that radiates down both of my legs and causes numbness and tingling. Some nights my legs ache so badly that I can not sleep (which is caused by my throbbing pain in my lower back). If you havent already, you should ask your dr. for the x-ray/mri/ctscan reports. A lot of dr.'s will tell you that your scans are normal when in actuality they show mild changes. My dr. explained this to me by stating that some mild arthritic and degenerative changes are normal therefore they dont tell you about it. At first I also was lead to believe that the pain was all in my head. Then I got my reports, did some research online for the terms I was unfamiliar with. Eventually I was sent to a pain specialist and believe it or not he was more help then any other dr. I had seen. Sometimes there are things that do not show up on the scans due to flares etc. (at least that is what I was told), he did a very thorougho exam then suggested steroid injections where they use a ct machine to get the exact spot of your pain. According to the dr. if the injections relieve the pain, in my case of the facet and si joints, then he knows for certain that his diagnosis is correct. At that point I was willing to try anything and thankfully they did help. Also, if you lead an active life, you may want to talk to your dr. about doing away with the many different pain meds you are on and giving you one long lasting pain med. I currently take 15mg of oxycontin and can take it up to 3x per day if needed. I also have 10mg. oxycodone (fast acting) that I am able to take for the breakthru pain. I have found that if I am proactive with my pain meds, I can ususally get by with taking one 15mg oxycontin at night (I also take valium at night) and one 10mg oxycodone in the morning when i get up. This combo usually lasts me all day and I have several other pain issues besides the back problems including fibromyalgia. I have been on the same dose of meds for 2 years now and it makes life much more functional. Sorry I dont have better advice for you. But I would consider getting the actual scan report and possibly seeing a pain management dr that specializes in back problems. Take care! Hope things get better for you!

    Old 10-04-2010, 06:45 AM   #3
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    Re: Knee and Back pain...

    For one thing, you are on way too much Tylenol. I agree with foxgirl74, try a pain specialist. Sincerely, searchin

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