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  • Knee Bursitis, ankle instability, and Scoliosis

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    Old 09-23-2013, 07:31 PM   #1
    wnorm
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    Knee Bursitis, ankle instability, and Scoliosis

    I am a 60 year-old woman with untreated idiopathic adolescent scoliosis, curvature ~45 degrees. The left leg is 3/4 inch longer than the other and has a pes planus foot. The right leg is curved and has a pes cavus foot, and that foot is ~2 sizes smaller than the other because of the high arch. The right ankle has a double maleolar bone and is unstable. I have been having joint problems for years. The last 7 years my right knee has been geeting more and more painful. The bursitis is excruciating. I haven't been out of the house for over a week and can't sleep for more than ~ 4 hours/night (last 2 months) because of the pain. I can't take NSAIds any more because I have collagenous colitis and am in the midst of a major colitis flare with severe pain and G.I. symptoms etc. R.I.C.E. is not helping enough. I have all my shoes corrected so the right shoe has ~1/2 inch external elevation. Originally correcting my shoes years ago greatly helped my right knee pain. Now it doesn't seem to want to heal if I wear the elevation. I only seem to be able tto walk properly in the house if I'm barefoot. My rheumatologist says he is out of tricks. I had a cortisone shot 11 days ago and a shot of Hyaluronic acid ~ 6 weeks ago. THat didn't help at all. Even if my knee heals somewhat after a few weeks of being a couch potato because of my structural problems, the knee is going to flare up again. I'm really at a loss as to what to do. I'm living in Quebec and have to wait many months to see my orthopedic surgeon. Any thoughts ? I've heard that shortening the longer leg (barbaric procedure) can sometimes help.

     
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    Old 09-23-2013, 08:00 PM   #2
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    Cool Re: Knee Bursitis, ankle instability, and Scoliosis

    Quote:
    Originally Posted by wnorm View Post
    The last 7 years my right knee has been geeting more and more painful. The bursitis is excruciating. I haven't been out of the house for over a week and can't sleep for more than ~ 4 hours/night (last 2 months) because of the pain. .... Originally correcting my shoes years ago greatly helped my right knee pain. Now it doesn't seem to want to heal if I wear the elevation. I only seem to be able tto walk properly in the house if I'm barefoot.
    - have you tried protecting your knee by strengthening your 'quads' (your upper thigh muscles)?

    - when sleeping, have you been trying a 'knee protective' posture of having a pillow or two under the knees while on your back, and between your knees while on your side?

    - does walking properly in the house barefoot not aggravate your knees? If so, would that or the equivalent be an option for walking outside your house?

    - editted to add: does walking with your knees slightly bent (i.e. your legs not hyperextended and straight) less painful for your knees especially when walking downhill?

    sf

    Last edited by SoundsFamiliar; 09-23-2013 at 08:03 PM. Reason: the usual

     
    Old 09-24-2013, 07:41 AM   #3
    wnorm
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    Re: Knee Bursitis, ankle instability, and Scoliosis

    Thank-you for your response:
    answers:
    1) Yes. I do exercises to strengthen quads
    2)I do the whole pillow bit.
    3)It probably aggravates the osteoarthritis but it makes the bursitis less painful for now.I try with shoes, without, with elevation , without, with knee brace and/or ankle brace and without... You name it. I've tried it.
    4)not really. It's difficult to say. I get a bit of relief when I stretch my hamstrings.
    I'm trying to wear my knee brace right now, and my bursitis is burning from the pressure.

     
    Old 09-24-2013, 08:20 AM   #4
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    Cool Re: Knee Bursitis, ankle instability, and Scoliosis

    I suppose 'cold packs' are being tried, to help reduce the swelling/pain?

    Unless your doctor disapproves (and you should check with your doctor first), another pain relief approach consists of using a herbal salve that 'numbs' the nerves (from the 'hot pepper' family, the active ingredient is capsaicin) that some people find helpful. That said, pain is our body's signal not to be ignored or eliminated imo (we rely heavily on pain to modify how we use our bodies to minimize damage).

    Knee braces can be very fussy to fit properly (I've one I use infrequently, a family member received it from our healthcare unit and didn't want it back after she passed) that has a few add-on stabilizers), so I'm wondering if possibly a different model would be helpful. Mine (google: pavis new edge patella stabilizer) is quite adjustable. Perhaps a change in type of knee brace could be of modest help.

    Just being able to switch to an alternate style knee brace might be helpful (different pressure points, giving some relief to the contact areas).

    sf

    editted to add: Pain is not good. Keeping 'ahead of the pain' helps our bodies heal. In your shoes, I'd be relying heavily on avoiding walking (eg. using an electric sidewalk scooter might be viable in your neighbourhood).

    Last edited by SoundsFamiliar; 09-24-2013 at 08:25 AM.

     
    Old 09-25-2013, 06:52 PM   #5
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    Re: Knee Bursitis, ankle instability, and Scoliosis

    Thank-you.I've tried everything you've mentioned.I'm not going out. Today I had to go out to visit my mother for her birthday. She is 94 and has severe Alzheimers. I feel worse now. I had to see her and also pay the caregiver. I had no choice. A scooter is not an option. Actually it hurts a lot when I sit. Bending the knee is painful.
    I just got the written report of the xray. It said " no effusion. Normal alignment with mild medial and patellar OA. Small bony infact or enchondroma of the distal femoral shaft." 4 years ago. the xray report said" minimum joint space loss at medial compartment. Mild osteophyte formation. No fracture or effusion. Somewhat mottle zone of sclerosis at distal femoral shaft, likely small bony infact".
    Now that doesn't sound so terrible to me. The knee articulates well according to the rheumatologist. However I can barely walk. I wonder if the osteonecrotic bone at the distal femoral shaft has to be removed? What do you think?

     
    Old 09-25-2013, 08:21 PM   #6
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    Cool Re: Knee Bursitis, ankle instability, and Scoliosis

    I think, that is way beyond my understanding. My approach, hopeless though it sounds and likely would be in practice except perhaps over a period of years, would be to focus on an extremely healthy diet (avoiding poor choices and eating lots of 'protective' foods such as green veggies, green tea, along with anti-inflammatory types of foods such as garlic, cinnamon, etc.) and actively try to keep my mental/emotional state level.

    I suspect that you're about at the point where in desperation you'll need to consult a surgeon or two for what surgical options are available. The last resort I suppose would be 'knee replacement' (no guarantees as always with serious surgical approaches of that character). There should be a better outlook with knee replacement surgery if you're a nonsmoker and have an otherwise reasonably healthy body.

    If (a pretty big if) your NSAID sensitivity dies down, and even if it does, returning to NSAIDs might be seen as 'high risk' to your digestive system not recovering again and that could become a bigger issue, you may find (if this has not already been tried) the 'salve' approach better than the oral route for anti-inflammatories (your system still gets anti-inflammatories which will impact your digestion if you're predisposed that way, but because the salve is applied as a transdermal gel directly to the affected area (typically containing 10% diclofenac), the effect is perhaps twice as potent as the oral route so you can get about the same effect with perhaps half the impact on your digestive system).

    Some people find that when pain is unmanageable and out of control, rather than trying to 'escape' / ignore the pain, they can somehow 'embrace' it, accept it as a part of themselves and (with no small amount of luck I suspect), they find that is a way to cope with it while having less wearing impact on them.

    sf

    edittd to add: "bending the knee is painful", there are accessories for wheelchairs & scooters to 'prop' the problem leg up so it need not be bent while sitting

    editted further to add: "ankle instability" -- I think that might prove aggravating for your knee; perhaps there is boot-like footwear that would stabilize the ankle

    Last edited by SoundsFamiliar; 09-25-2013 at 08:36 PM.

     
    Old 09-25-2013, 08:45 PM   #7
    wnorm
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    Re: Knee Bursitis, ankle instability, and Scoliosis

    Thanks again. I really have tried everything except surgery. I try to eat as healthy as I can, but it's difficult with colitis. I also am not in the best shape. I have obstructive sleep apnea (borderline extreme). I had surgery for uterine cancer in April. I really can't tolerate nsaids at all anymore

     
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