Knee Pain

Knee pain is new to me,this is one place I don’t usually suffer from,but since Saturday my knee has been aching,I can’t pin point where the pain is. It feels stiff & when I walk it feels swollen yet I can’t really tell if its swollen. Other than my usual daily Celebrex & my heat pad I’ve not really tried much else.
I guess my question is what does PsA feel like in the knee,or could it be osteo? Thanks for any input.

Hi Lindseylou, I get knee pain as well but haven't yet had any x-rays or had them examined by my rheumy. Initially it was fairly generalised aches but as it has got worse it has become more focused and sometimes very sharp pain although the location varies from day to day. And they are definitely very stiff in the mornings.

When I walk the pain is usually on the inside of the knees ... where they would touch if I had my legs together, at rest it is lower and throbbing, sometimes I get pain and swelling of the Hoffa's pad (the fat pad below and to the outside of the knee cap) which I figure may also involve the bursa around it. If I knelt, which I almost never do, I feel as if there is something in my knee, so this may well be swelling.

I've printed off a couple of diagrams of the knee anatomy from the internet and have been putting crosses and some notes on different areas each time they start to hurt so that I've got something to show my rheumy at my next visit 'cos my knees are definitely on my agenda!

For me, cold works best when they really hurt, especially around the Hoffa's pad .... so again this makes me think it may be bursitis as well as whatever else is going on.

Thank you for your replies. I realized after I posted when I got up that the inside of my knee felt like it was burning bit didn’t feel hot to touch on the outside. My doc appointment is next week so I guess I’ll wait until then.

My knees have been problematic for years. Definitely PsA related due to swelling and heat. But so far, so good, and there is minimal damage on x-ray.

Definitely worth it to get it checked out though, as there may well be something that you can do to improve the current situation.

The “osteo or PsA” question is an interesting one. I had knee aches and stiffness for years, and some dramatic “knee-vents” like sudden swelling, pain, and a feeling of warmth. This was all written off as osteo. Both knees were replaced. It was after that that my feet started giving me grief and I was diagnosed with PsA. The rheumy said “I’d put my money on your knees having been PsA as well”. Then my hips went, and the radiology report said it was OA. That seemed counter-intuitive to me, and I even argued about it with my GP. Her line was “You can have both OA and PsA, you know. You worry too much.” It was my surgeon who suspected that what the radiologist had said was “OA” on the x-rays, was, in fact PsA. And when I had the hip replaced, what they found was clearly PsA damage.

So who knows whether it’s mechanical damage (OA) or inflammatory (PsA)? What I will say is that if I were a doc and I had a patient with PsA, and there were new joint symptoms, I’d be assuming it was PsA. But I’m not a doc. Nor do I play one on the internet. :wink:

You might do some documentation, as others have recommended, before your next appt. I take measurements with a sewing tape of the inflamed joint and then the non-inflamed one. Now, I have baseline measurements of each… I never know what will go nuts next! Anyway, it tells me if I have something going on that is not be immediately visible. I keep notes of where it hurts, how I make it worse vs better, and what it limits as far as mobility.

I have noticed that when my knees are swollen that ice works better than heat, and I’m a heat girl for sure.

Get it looked at. Until then RICE (rest, ice, compression, elevation). Maybe that will help until you can get the pros on it.

Yes, there’s an interplay between OA and PsA – one sets the other off. But if the doc assumes that it is “just” OA, nothing other than palliative measures are required. If, on the other hand, the assumption is that the joint damage is PsA, more drastic measures would be in order, to prevent further possible damage and damage to other joints. I wish someone, somewhere along in the 20 year process, had erred on the side of caution with me.
It’s a tricky business, this.

It’s still no better,don’t get me wrong,I can walk on it but its uncomfortable but it’s not getting worse either. I guess it must be swollen because there isn’t as many wrinkles in it like the other knee haha! Just doing chores & resting it in between,see doc a week today.

My knees. My poor, damaged, swollen and miserable knees. You know..the ones with the shards of glass that stab into my soft tissues every time I take a step. sigh. Take it from a person who has been fighting knee pain for well more than 50% my your doctor.

When I was 16, I cracked both of my kneecaps right across the center of the knee (laterally). Falling down a flight of stairs and landing on your knees is a really bad idea. I don't recommend it. I supposedly recovered, though the last time I had xrays taken (about 3 years ago) the xray tech winced and said, "how do you walk on those??" I guess I've developed a little bone spur problem over the years (I'm 45 now). Not to mention the complete lack of a fluid sac under either kneecap. That is OA, right? NOT. I mean, yes, it is OA, of course...but the bursa in my knee is now approximately 4x its normal size- and that is relatively recent. I swear I'm carrying around a softball in that thing from the looks of it! My Rheumy took one look at it, grabbed a really large syringe filled with some kind of steroid and popped it into the middle of the swelling. Then the P.A. asked if we should "drain" it, but the Rheumy said, "that isn't fluid, that is the actual bursa." Youch!

Since I have developed PsA, it appears that my immune system sits back, gleefully anticipating when the next injury will happen so it can swarm in and create massive flareups of inflammation, pain, and ugliness. Obviously I have PsA involvement in places where I don't have injuries (at least I don't think I do...maybe too many tequilas back in the days when I could drink?) I think at this point the chicken/egg discussion is moot for me. I know that wherever I get injured, no matter how seemingly insignificant, I WILL have PsA involvement. I also know that I have PsA involvement in places that I don't recall ever getting injured. As for what to do to relieve said pain? Let me know when you figure it out. But in the meantime, call your doctor. Knees are really important and not something you want to "wait and see" only get 2 of them - at least until you get to be of an age where the doc will consider replacing them. At 45, my doc still isn't willing to do so. Good luck!

Before you assume the pain is FROM your knees, PLEASE, have your back checked. My husband had his right knee replaced several years ago on the advice of his osteo. Has had nothing but problems since. Why? Because the original issue wasn't his knee, it was in his lower back. After talking to a lot of spine guys, they see this all the time because people assume that knee pain means knee issue. It doesn't always. Sometimes you just need to be taught how to move, lift and stretch differently as you age in order to compensate for the differences in your body from age and disease. Checking it out can't hurt.

What an interesting story, Scottie Mom. A knee replacement (and its recovery) is a big deal, and to think that the problem was elsewhere! Nasty.

I get the same knee pain, burning on the inside. My left knee is worse then the right and this is new to me as I haven't had any problem with my knees until last spring (my first flare in my knee) and now it seems to be one of the spots I have daily manageable pain.

Lindseylou said:

Thank you for your replies. I realized after I posted when I got up that the inside of my knee felt like it was burning bit didn't feel hot to touch on the outside. My doc appointment is next week so I guess I'll wait until then.

It feels like I have a weight inside it & a tight band all around it!

Both of my knees grind badly for years of working on a ship and running many miles. I've never had x-rays but I know the cartilage is shot. They sound horrible, but have never had pain like what I'm experiencing now. They both feel swollen and the tendon on the inside left knee is usually sore. Now with any walking, standing, moving I get a deep burning ache. I also get the same burning in my hands(fingers) , feet, and shoulders and hips.

Lindseylou said:

It feels like I have a weight inside it & a tight band all around it!

I found out yesterday that its just a little fluid & some inflammation,she’s hoping that yesterday’s Orencia infusion will take care of it. Fingers crossed!