Knee pain advice - Home remedies/Medication?

General
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Hi All,

I’ve had PsA for a few years now, I am 31 years old. I have bad psrioious on the scalp and tried a lot of different things. I have come to accept that I will never get rid of it. My issue is the knee pain. Thankfully I don’t have issues other then my knees right now but I don’t know how to manage the pain. I was on sulfazane but found out I was allergic. I did methotra and it didn’t really work for me … I was on Naproxen 1 pill a day and it helped but was told I had to stop taking it because my blood pressure got high.
Other medicines suggested are stronger and could impact being pregnant. I am not pregnant now but want to be in the next year or so.

I am curious to what other people do to manage this pain. The morning stiffness, the standing up after sitting to long, not being able to bend my knees or walk right is awful. I need help.

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Hi Emma,

Movement, physical therapy, exercise, ice, and heat.

Personally, I find if my joint is visibly swollen and red, ice is often helpful, whereas if it just feels stiff, then it seems that heat works better - but everyone is different so you’ll have to experiment - some advocate alternating the two! This is just first aid though - not real management or prevention.

Movement, physical therapy, and exercise (as much as you can reasonably do), are critical - think of them more as management of the issue. It took me a while to accept it, but sitting too long - really is sitting too long. So the trick to this bit is to really pay attention to how long is too long, and do as much as you can to get up and move before it happens.

But above all, do regular PT, or exercise of sort. Remember, you are 31, and this is a marathon - not a sprint, you have a lot of years yet to run (pun intended). I have always found exercise and PT hard - not because I don’t like them, but because often it feels like one step forward and two back. So my ‘exercise goal’ is just showing up :joy:

When I first started, 1 month, 2 months, even 6 months, it seemed there was no change. But 3 years later I woke up one day and realized I had gone from being tired and so sore I was overwhelmed after a 1km flat walk (I had some big issues that caused at lot of muscle degeneration at onset, age 36), to, on a normal day, being able to hike hills for 5km.

Now, as long as I’m not in a flare, I can meander slowly in the bush for the whole day, covering around 8-10km. I’ll be sore and stiff the next day, but more like a slightly exaggerated version of “I went too hard at the gym” than “oh my god I can’t move” that PsA can invoke.

So to my final point. the DMARDs are the prevention part.

I can understand your concerns. I was very lucky, in many ways, my onset was soon after I had my daughter, rather than before. I have read a small amount about this (papers directed at the Rhuematologist), and my understanding is that the aim is to get the patient stable before they try to get pregnant, then remove anything toxic during the “trying” and pregnancy period, and have a plan for what to do after birth (as many experience flares post birth).

You might already have such a plan with your Rheumy, but if you don’t, it is worth opening the discussion to see if you can make that plan, because at the end of the day, if you can be as successful as possible with the prevention part, you’ll get to enjoy your little one even more :grinning:

Unfortunately I know all too well the last place you need to be with a little one relying on you is in a flare, not knowing what medication will work.

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I found the walking helped keep my joints moving better. I mean my knee, hip, and feet hurt no matter what so why not give them a little exercise instead of sitting around being in pain. I also found that by taking 2000 IU of fish oil every day helped with the pain enough to stop my naproxen. Honestly I didn’t think fish oil would work but one day I forgot to take my naproxen and I had the same amount of pain as I did when I took it.

Lastly, I’ll just tell you that PsA does get in the way of life sometimes. You have to know how your body reacts to things and take it into consideration when you plan stuff. If your knees are hot to the touch then its time to sit with ice packs. Don’t push yourself too hard on flare up days.

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Thank you guys, means a lot to know I am not alone because sometimes it feels that way or that I am the weird on or lazy one who can’t walk.

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Do you need a knee replacement? Sometimes OA comes into play with PsA.
My rheumy explained it to me this way…OA is like fleas and PsA is like ticks. WEll, you have both and it has destroyed your knee. So…I got a new one.
Before I gave into surgery, I got pretty good traction from kenalog injections and lots of Tiger Balm.

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You might also look into your shoes and inserts just to make the moving around part easier. My recent flare caused some significant foot pain and I ended up at the podiatrist. The inserts i ended up getting really helped me be able to be on my feet. I’m not sure how much they’ll help knees but it might be worth asking your doc about.

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I have one knee that hurts bad most of the time because it has been operated on three times. My PSA is bilateral. Some days my knee will barely hold me up and I have to use a cane.

Ice helps, but the best thing I have for it is my hot tub. Some one recommended buying a hot tub and I did. I spend a lot of time it for the aches and pains and sore muscles.

I talked to my doc about the knee hurting very bad and asked him if I should stay off of it when it hurts and he said push through it and use if I could. Can’t win.

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What I will tell you is that the biggest SCAM out there is knee surgery (other than when it finally does need replaced) There is absolutely no evidence it does anything except line the pockets of the ortho who charges you 3 grand for less than 20 minutes with a scope. Believe it or not pushing throught it seems to help the long term problem the best.

For short term relief You may want to try a topical NSAID (voltaren is one) the best are compounded (and cheapest) I had one made with Tiger balm and Diclofenac that was amazing. It took almost 2 years of PT and treatment, but today my knee is perfect. Hot tub ice bracing splints what ever it takes. Just not roto-rooter…

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I’ve had 6 surgeries on my “bad” knee, and found my best tool in keeping pain/mobility is a stationary bike. It’s been my best friend for the last 4-5 yrs. My situation is a bit odd. The first 2 surgeries were NOT necessary (just like tntlamb mentioned :frowning: ), but I was “young and dumb.” Now I know the first situation was likely my first ever PsA flare 20 yrs ago.The 3rd/4th surgeries were necessary because of OA that developed from previous surgeries, and likely inflammation from PsA. The Dr filled some tiny articular cartilage holes that were growing rather quickly. Unfortunately, my knee DID get to the point of almost needing a replacement because the undiagnosed PsA was eating away the cartilage at an alarming rate. I was only 43 though and a great candidate for ACI (Autologous Condrocyte Implantation). Since then, and because of chronic issues with severe scarring, I’ve learned all sorts of ways to help deal with limited mobility, swelling, and pain. My physical therapist has been a Godsend. I’ve also just learned my own body finally, and what doesn/doesn’t work for me. :slight_smile: I can actually bike A LOT more than I can walk because walking/standing increases my swelling quickly. Biking just makes me feel less brittle and helps a lot with stairs. I use a compression sleeve whenever I shop or am on my feet for long periods (which for me is anything over 2 hours a day). I was told to concentrate on strength training of my quads to put off the knee replacement, and also to ice it 3-4X a day. On days I forget or get busy, I pay for not icing. In the winter I take a hot bath at least every other day to improve flexibility. Now I do long bending stretches/hold to keep my scar tissue flexible so I don’t lose the mobility that it took a year to gain after the last surgery. I take a daily anti-inflammatory because swelling continues to be a problem, just not as bad as before. I also get a set of 3 hyaluronic acid injections every 6-8 months and will do so until the joint is replaced. Long term data doesn’t support their use/efficacy, but in my case, the idea is to try anything to put off a replacement until I’m 50, plus I do get some benefit from them. Lastly, I still doubt my DMARD is working to halt my PsA. I’m in contact with my Rheumatologist this week to ask about something stronger, as other joints have joined the “swollen club” too.

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