cortizone shots for knee osteoarthritis

Hi Godey, sorry that no one posted sooner but sometimes some of the threads get lost if there not in the main RA topc. 

Well, once you have degenerative OA and the cartledge is gone there's not much you can do.  I'm having my first knee replaced on July 16th and the other knee replaced 6-8 weeks later.  I've had cortisone shots and Synvisc injections to both of my knees several times and I've run out of options.  Have you talked to you ortho about Synvisc inj.  It's like shooting WD40 into the joints.  For me it worked well for a year but since I'm bone on bone there's not much can be done but knee replacements.  Ask about Synvisc.  I understand not being able to exercise and diet.  I've just lost 25 lbs. and my goal is another 35 lbs.  I know I have to get the weight off my joints.  I plan on golfing 3 months after I have my second surgery.  Keep us posted on how you're doing and talk to your doc about Synvisc.  Lindy.

  Hi, I'm new to the group, too, but I did want to respond to the guy looking at total knee replacement, asking for encouragement and possible alternate treatment options until he's gets a little older.   Poor baby, you do need encouragement….Osteoarthritis sure ain't for “sissies”!   It usually occurs in people who where always very active.  I think that’s the most “painful” thing about it.   My background: I am 62, a retired R.N., and I developed OA symptoms in my right hand when I was about 38-39.   I remember my first HMO family practice doc told me, "You have to expect this sort of thing at your age."      (She herself looked about 12, and I might've slapped her, but my hand hurt too much!)  The only treatment I ever received from any of my doctors for the pain, swelling, stiffness, and "locking" of my right CMC joint (wrist-thumb joint) was one NSAID after another.  They didn’t help and the OA just progressed until I was forced to have CMC Joint Replacement plus thumb PIP joint fusion about 5-6 years ago.  (There are a lot of nerves in hands, so recovery is not fun!)    About 4 years ago I had a reaction from a flu shot which resulted in the injection site becoming very red, accompanied by fever and pain/swelling in all my joints at the same time.  After a 5-day Medrol Dose Pak, everything immediately went back to normal EXCEPT for my right knee.  I had an x-ray and was told it was advanced OA.  I was surprised because I'd never had any symptoms in my right knee before then.      

In my opinion, most family practice and internal medicine doctors use treatment routines they learned by rote in medical school -- without even thinking about what they're doing.  I told my family doctor that years of taking NSAID had never helped my hand before I had surgery, and now the pain in my knee was seriously affecting my ability to work.  As a devoted “pill pusher”, he told me to try Vioxx, a new NSAID, for 6 months.  At first it was helpful, but that didn't last.  It did, however, cause severe side effects involving my stomach/esophagus, and I was also breaking out in giant hives because I'd became so sensitized to NSAIDs.  So I quit taking it. (Good thing--it was later  taken off the market for causing hearts attacks, etc.)   When I returned to my doctor, my right knee was very swollen, very red, very hot to the touch, and extremely painful.   He examined me, muttered a few "tsks", then he sent me to Physical Therapy!  I couldn't believe it.  My knee was so painful I couldn't even get through the initial assessment!  So I went back to my doctor and insisted he refer me to an orthopaedic surgeon.  He did, but was reluctant, saying I must "want" surgery!  (Excuse me, but orthopaedic surgeons actually do more treatments than just surgery!)  The Ortho I saw discussed several options with me, and told me also I'd probably be looking at surgery in not too many years.   Since joint replacements don't last forever, I wanted to wait as long as I could before haveing surgery.  (The surgery works longest for people who are less active--usually older people.)  One option was a series of Synvisc injections.  They are intended to act as a "cushion" in the joint where the cartilage has been destroyed.  FYI: Some people have good improvement; some don't. People allergic to EGGS shouldn't take them.  I'm not allergic to eggs, but since my problem starting with an allergic reaction to "something" in a flu shot,  it was not a good option for me.  My best option was steroid injections. (For one thing injections don't hurt the stomach!)  The steroid injections directly into the knee joint were not very painful.  He did it right in the exam room and it was over in a few minutes.   After a few days I was able to return to Physical Therapy and complete the prescribed course.  FYI:  The steroid injections aren't recommended more often than every 6 months.  They didn't completely eliminate my pain, but they did help a lot.  I could no longer take NSAIDs and I could not function using pain meds.  However, I managed with a COMBINED TREATMENT PLAN consisting of the direct steroid injections every 6 months, a home exercise program (learned at Physical Therapy), and a combination of ice/ heat/ rest for pain and swelling (applications also learned at P.T.), as well as a "positive attitude" and distracting myself mentally, rather than focusing on the pain  (techniques I'd learned in Hand Therapy post op), I was able to continue working until I could get on social security.  (Nursing can frequently get very “physical”!)  My OA is end stage now.  I use a cane to walk outside my home—takes away from some of the “weight bearing” on my right knee.  (Unlike “Dr. House” on TV—use the cane in the hand opposite the affected leg!)   Personally, I just love using the "disability" sign in my car--I hate to walk across big parking lots!  The most important thing is to keep moving to the best of your ability—USE IT or LOSE IT!  I found a pretty good set of DVD’s at a book shop with exercises for people with arthritis.  There are things out there—find them.  Also find a well-reputed Physical Therapy facility -- Ask your Ortho.  A good therapist has "magical" things to teach you for a home program!  (After you learn what you can do safely, then maybe you can return to your gym!) Gaining weight is a problem.  While I was still active, I was a small woman who could eat like a longshoreman and never gain weight.  Well, those days are gone!  One of my biggest pitfalls is being married to an Italian who is a gormet cook.  I need to lose weight because I'll be scheduling total knee replacement surgery for sometime this winter.  From what I've heard, Weightwatchers works pretty well.  It will take dicipline on my part...and possibly hurting my husband's feelings by saying “no” to his delicious food.        However, I just bought a book of Weightwatcher recipes for him—now he’s all enthused to try them out!   Don’t bury yourself in self-pity....you got a bad break, true; but you're not dead!  Changes are a part of life—we just have to change with them.  Eleanor Roosevelt once said, “When something absolutely must be done, one usually finds a way of doing it!” 

You may have to “reinvent” yourself a bit, but you’ll find your way.   

    (Big hugs!)