Joint Pain..swelling..

[maxNcathy]

Can you share anything that has worked for you or others to help deal with joint pain..swelling?

The joints in my big toe are acting up.

But more urgent is related to a friend who may not go hiking this year because of pain in his knee and swelling behind the knee.
I really want him to come hiking with our little group on March 19th on the AT.
He is 68 yrs of age and very fit otherwise.

Any advice most welcome

[Barbarosa]

I have had very good results from Celebrex (200mg capsules, prescription). I just take it when on hiking trips, not all the time.

I have also started Glucosamine/Chondroitin on a daily basis. My joints feel more cushy, but it may be placebo effect.

[jlb2012]

joints in big toe - get your uric acid levels checked - may be gout related - if so there are a couple of prescription drugs that can be used to lower uric acid levels

pain in knee plus swelling behind knee - no good ideas other than to try a neoprene knee brace - probably should have a doc take a look at it also

[FanaticFringer]

This stuff has worked wonders for my knee. Don't believe the naysayers who say it is dangerous yet will take numerous OTC products that have very known side effects. www.whiteblaze.net/forum/showthread.php?t=26255&highlight=DMSO
I have recently been using DMSO from a company that uses a precise amount of honey in their formula. It has eliminated side effects such as redness, itching, and skin flaking that I experienced while using the straight 70% formulas or formulas with added aloe. I tried adding honey to these other formulas but saw no improvement in the side effects.
My last post on that thread suggests taking anti-oxidants with this compound
which you should be taking anyway.

www.dmso.bz/pages/2/index.htm

[mrburns]

For the knee... Rest, Ice, Compress Elevate for the next 2-3 weeks, then buy the support brace I mention below and slowly start up activities again... with luck, he might be ready for your march trip.

(If your friends knee is visually swollen and it's been like that a week with no improvement... definitly go see the Doc despite my other comments)

Here's the reason for my RICE/brace recommendation and some other thoughts....

I have pain in the front inside area of my left knee, and pain along back interior tendon that connects to my knee... not sure of the medical terms for all that... It's been hurting over a year now. Everybody said "go see a Dr." but I've seen the doc for other kinds of over-use and impact injuries and the answer is always (RICE) "Rest, Ice, Compress, Elevate"... so I don't bother any more with the Doc.

Maybe my injury is similar to your friends, but either way here's some ideas....

Definitely RICE... don't leave the ice on more than 15 minutes at a time, and give at least 10-15 minutes between ice sessions. This should be good for your toe as well.

I used to wear one of those $30 braces with the metal supports along each side (Walgreens or any pharmacy store)... that was a significant help for me when the pain was consistant, couldn't do much without it on. Now it's just intermittant, so I don't do anything for it... I just try to stay off it when it hurts, mostly after running... While running increases the pain, hiking with a pack seems to help, so your friend might experiment a bit with cross-training activities (after giving it a rest for a couple weeks).

It's been recommended to me that for any knee pain I should get supportive inserts for my shoes. Even though there seems to be good medical evidence for the relationship between foot supports and less stress on the rest of the leg joints... It always seems like a big marketing scam when I make any kind of inquiry at the shoe store... Plus, I"d probably need to buy a new pair of shoes 1/2 size bigger than my current ones to make room for the insert.

If your friend's pain is bad then I'd suggest some shoe inserts, maybe even custom ones... I think the custom fit inserts are about $100 (non custom are around $30).
I have not bought any, but I'm coming around to the point that I might buy a pair next time I need to buy a new pair of shoes.

[Phlashlite]

I tried the expensive inserts and found the spenco backpacker to be far superior. Also the CHAPOTE(sp) knee brace is super. I used Alleve found it better than Vit I, also the GLU/CHO combo. We were out for about a month of our hike and the knee and leg pain came back after we restarted our pains went away. Also treking poles help relieve some knee and back pain. The lighter weight hikers seemed to help. I think I heard taking a pound off your feet is like taking 3 off your back. Maybe someone could correct that last sentence. Toes are more of a problem once you get your feet and legs going.

[mudhead]

I have had big toe issues in one toe due to old shoes, too much bend=pain.

New shoes clears it up after some tender time.

Back of knee might be a bursitis issue. If I had a flare of that again, I would start aspirin regardless of pain or lack of.

I am not a doc, and one might be helpful.

[gldwings1]

The cure depends on the cause. Is your pain due to gout, arthritis, injury? If it is gout, nothing will work but gout medications which treat your uric acid reuptake in the joints. If it is arthritis or injury, Non Steroidal Anti-inflammatories, Celebrex, Motrin, Alleve, Naprosyn, Mobic and others will work. That being said, if this is a chronic problem, you need to see your MD to ensure this is not something more nefarious. Also some NSAIDs, Celebrex, Mobic and a few others were on the FDA's "bad" list a couple of yrs ago. They were not removed from the shelves indefinitely so they may have decided that the meds are ok. I am not even sure of all of the side effects that the FDA claims they caused. Can cause GI upset, Peptic Ulcer Disease (PUD), chronic abuse can lead to liver dysfunction, but used as directed, these meds are great at treating the inflammation which may be causing the pain.

[micromega]

First thought is to consult a doctor/orthopedist. Discuss your concerns and explore your options with the doctor, thats really the best thing to do. Of course, the doc is probably going to tell you all the things you got for free up above...

Aside from all the things already mentioned, perhaps your friend with the knee problem can explore stretching and conditioning of muscles in the leg. Imbalances and weaknesses of the thigh and calf can cause knee pain.

You don't say if your friend is active, if he isn't then slowly building up a mileage base could help. Sudden changes in mileage can cause or exacerbate problems.

The only other thing I can think of that may help is to choose the area you hike wisely. As I'm sure you know, some hikes just aren't knee-friendly.

[Auntie Mame]

You have my sympathies! I have had r. toe joint pain for about 2 years, it comes and goes, but is worsening, not getting better. Saw a foot and ankle Doc who x-rayed and found arthritis and virtually no cartilege there. They made me a carbon fiber plate that has a rocker-shape built in, which can go under the insole of right shoe/boot. It is the flexing that hurts, so the more stable the sole, the better.
I use Aleve when its crucial to be on my feet. I also use a silicone toe separator, a little thing shaped like an elongated spool, and it helps align that fore foot.
Now I am looking for the right footwear for long distance hiking, as I am set to head out at the end of this month. Keens have wide toe boxes, and regular hiking boots have nice stiff soles, so who knows. Keep us posted.:confused:

[Wise Old Owl]

My doc perscribes Etodolac 500Mg to lubricate the knees and other joints. Unfurtunatly, due to other meds it tears up my stomach. I prefer a quality Glucosamine & Chondroiten, and a small amount of sugar in my diet. Some sugar is necessary in any diet as that is what the body needs to create the lubrication of the joints.

[Appalachian Tater]

The cure depends on the cause. Is your pain due to gout, arthritis, injury? If it is gout, nothing will work but gout medications which treat your uric acid reuptake in the joints. If it is arthritis or injury, Non Steroidal Anti-inflammatories, Celebrex, Motrin, Alleve, Naprosyn, Mobic and others will work. That being said, if this is a chronic problem, you need to see your MD to ensure this is not something more nefarious. Also some NSAIDs, Celebrex, Mobic and a few others were on the FDA's "bad" list a couple of yrs ago. They were not removed from the shelves indefinitely so they may have decided that the meds are ok. I am not even sure of all of the side effects that the FDA claims they caused. Can cause GI upset, Peptic Ulcer Disease (PUD), chronic abuse can lead to liver dysfunction, but used as directed, these meds are great at treating the inflammation which may be causing the pain.

What gldwings1 said.

[geckobunny]

I'm definitely not a doctor. But I have plenty of experience of hiking along with joint pain.

I also found a way to ease the pain...without costly medication. My secret...avoid these things completely:dairy, salt, sugar, refined flour, animal products

what do I eat? lots of fruits and veggies, beans, nuts, rice. Not only do my joints not ache, but I feel better all over in general. And I have the satisfaction of knowing that I'm eating real food...things I can pronounce. Amazingly enough, I find that a lot of stuff is quite packable, and tastes a lot better than anything that could come out of a cardboard box. I know it sounds strange, but it totally works for me...keeps me out of the doctor's office and on the trail. Not to mention that I and my kids are hardly ever sick.

but don't take my word for it. check it out for yourself.
www.drfuhrman.com His book, Eat to Live, totally gave me my life back.

[Tilly]

I had a horrible flare up of tendonitis/knee pain a few years ago that debilitated me so bad I could barely walk (due to knees that don't track properly.) After doing a few months of PT, which helped tremendously, I do the following in regards to backpacking:
-Work out with weights. Do squats, lunges, step-ups, etc., if you can without causing any pain, in order to strengthen the joint.
-Take an NSAID every 12 hours 1 day BEFORE you start hiking.
-Wear a knee brace regardless of wheather it hurts, or not.
-Use hiking poles, and go reasonably lightweight.
Of course, I had to quit the weights because I have carpal tunnel so bad that I can't pick anything up over like 1#, but that's another story.
Good luck!

[mudhead]

Some sugar is necessary in any diet as that is what the body needs to create the lubrication of the joints.

Jackfreakinpot!~

Grease me up!

[maxNcathy]

Thank You all very much for the ideas you have given so far.

[Shade]

See a Podiatrist. Your foot alignment can be corrected to fix the toe pain which will make you walk straighter and fix your knee pain. The drugs will just mask the ailment.

[margo]

This stuff has worked wonders for my knee. Don't believe the naysayers who say it is dangerous yet will take numerous OTC products that have very known side effects. www.whiteblaze.net/forum/showthread.php?t=26255&highlight=DMSO (http://www.whiteblaze.net/forum/showthread.php?t=26255&highlight=DMSO)
I have recently been using DMSO from a company that uses a precise amount of honey in their formula. It has eliminated side effects such as redness, itching, and skin flaking that I experienced while using the straight 70% formulas or formulas with added aloe. I tried adding honey to these other formulas but saw no improvement in the side effects.
My last post on that thread suggests taking anti-oxidants with this compound
which you should be taking anyway.

www.dmso.bz/pages/2/index.htm (http://www.dmso.bz/pages/2/index.htm)

I tried dmso on my tennis elbow and at first was getting a little relief but the burning and itching was a nuicence.

Then I got pycnogenol, or french maritime pine bark extract. I swear that stuff cured or greatly reduced my tendonitis.

The arthritis is another story. I don't think the glucosamine does anything for me but I'm afraid not to take it. I've also tried microlactin and other natural products. At one point I took vioxx but of course it got taken off the market.

I've tried to stay in shape and take care of myself my whole life, except for a few short discretions, but my joints ache anyway. I just had a torn meniscus and arthritis scraped in one knee and it's much improved but there is still this ache. It's sucks when you get older and can't do things like you used to do. It's like simple things are more challenging than they ought to be. I went for a day hike when I thought my knee was totally on the mend but when I had to pee I found it nearly impossible to squat! :mad: Getting in and out of the tent was a challenge too, I flopped around like a decked mackrel till I could pull myself up.

I can do those things a little better now but I think a lot of these aches are permanant. That's why all of a sudden I am planning more hikes than I have been, I might get too old someday, sooner than I think.

[Dogwood]

I've been a competitive tennis and basketball player, runner, and hiker most of my life. While not a doctor I can tell U for certain that 1500 mg. Glucosamine, 1200 mg Chondroitin, and MSM(upto 8000 mg per day, most people see positive results with much less, most start off with 1000 mg per day) have definitely improved my joints. These supplements were not a magic bullet for me; I used them in conjunction with other treatments and life style changes. And, I didn't see significant results overnight. U can find these three supplements together in one product such as FlexAMin and Osteo Flex. I don't think most western trained MD's are going to know of, least recommend these over-the-counter supplements. They tend to only know of prescription drugs from big pharmaceutical companies. I also take 400 mg SaMe and 60 mg Hyaluronic Acid(cushions the joints, its the HA that "pops" when U crack your knuckles when its forced out of your joints) per day which help my joints. These supplements are all available over the counter and have much fewer(if any) side affects of many of the prescribed drugs. I highly recommend U look into them.

U can get many of the benefits Of DMSO by taking MSM because I believe DMSO breaks down into MSM once inside the body. DMSO is a solvent that comes in medical and industrial grades. DMSO got a bad rap mainly because some people were using the industrial grade for medical purposes.

From a nutritional stand pt. U can also decrease or eliminate foods or activities that create a pro inflammatory(stuff that causes inflammation that can add to or be the causes(s) of joint pain) response in your body. Smoking, alcohol, foods causing or containing high phosphorous levels(some meats(interesting enough is that diets high in meat also tend to produce copious amts. of Uric Acid in the body, most carbonated sodas) and strong acids(like coffee, one of the little discussed side affects of coffee are those that are created by the strong acids in it) are some things that promote inflammation in the body and may have a hand in osteoporosis.

As already mentioned, it makes good sense to explore the use of trekking poles, proper shoes and possibly orthotics, and lightening your load.

What ever U decide, seek to alleviate the cause rather than simply treat the symptoms !!! I commend U for taking a pro active approach to your health!

[mkmangold]

Limbrel is a new anti-inflammatory medication that is made from plant flavinoids. In my case, if I don't take it, I feel worse.
Flector is a brand new medication that is a topically applied NSAID patch that gets the medication to the site without significant side-effects systemically.
I get quality DMSO from vet suppy stores.
Dogwood: the statement "I don't think most western trained MD's are going to know of, least recommend these over-the-counter supplements. They tend to only know of prescription drugs from big pharmaceutical companies" is ignorant at best.

[Dogwood]

Most MD's trained here in the US have received 10, that's ten hrs., or less medical instruction on proper nutrition(that includes instruction on vitamins and supplements combined!). Alternative and Eastern treatments and therapies are often frowned upon and not given equal merit with western medicine philosophy. The use of vitamins, herbs, and supplements, no matter where they originate from, are simply not given the same emphasis as prescription drugs here in the US. When faced with the two options of prescribing a prescription drug or vitamins/supplements/herbs western doctors tend to prescribe the prescription drugs. Western MD's are, too often, ignorant of the potential benefits of vitamins, supplements and herbs.

[FanaticFringer]

Most MD's trained here in the US have received 10, that's ten hrs., or less medical instruction on proper nutrition(that includes instruction on vitamins and supplements combined!). Alternative and Eastern treatments and therapies are often frowned upon and not given equal merit with western medicine philosophy. The use of vitamins, herbs, and supplements, no matter where they originate from, are simply not given the same emphasis as prescription drugs here in the US. When faced with the two options of prescribing a prescription drug or vitamins/supplements/herbs western doctors tend to prescribe the prescription drugs. Western MD's are, too often, ignorant of the potential benefits of vitamins, supplements and herbs.

Many doctors are aware of the benefits and studies show many take supplements themselves. It's all about the big $$$$$$ as to why they don't recommend supplements often.

[Dogwood]

Certainly, prescription drugs have their place in medicine, but they are sometimes overprescribed(think antibiotics) and prescribed when less intrusive and costly alternatives exist.

[Dogwood]

Many doctors are aware of the benefits and studies show many take supplements themselves. It's all about the big $$$$$$ as to why they don't recommend supplements often.

If this is true what a sad state of affairs western medicine is in!

[mkmangold]

That's still too many generalizations to be true. "10 hours" may or may not be true, it wasn't for me, and what do you base this on? Most of what an MD does is through hands-on experience. Therefore: clinics in med school, residency, and CME post-grad. Does it occur to anyone that MD's learn AFTER formal education?
As for the comparison with antibiotics: I have had 1000's of patients come to me begging for antibiotics for their viral infections. I have had dozen of complaints to the hospital systems because I refused to give them the medicines they want. How fair or true is that? And that is DESPITE extensive patient education.

[c.coyle]

What works for my knee arthritis: Ibuprofen. 600 mg 4 times a day when it really gets bad. 400 mg 4 times a day for "normal" pain. Reduces my pain 80-90%.

I started glucosamine/chondroitin, 1500/1200 mg per day, about a month ago on the advice of my orthopedist, who says it works for about 50% of people who try it. Too early to say if it's working for me.

[Think Spring]

In my view, your friend should be professionally evaluated by a sport's medicine physican. This 67 year old, former high school and college athlete, retired coach...etc....had similar presentations in my right knee. A tear in the medial maniscus, a Baker's cyst from an old injury, and some bursitis presented the same discomfort and has been treated by a GREAT sport's med. doc. Glucosamine and Chondroitin supplements daily, along with five Supartz injections will have me back on March 9. Hike on...!:sun

[maxNcathy]

In my view, your friend should be professionally evaluated by a sport's medicine physican. This 67 year old, former high school and college athlete, retired coach...etc....had similar presentations in my right knee. A tear in the medial maniscus, a Baker's cyst from an old injury, and some bursitis presented the same discomfort and has been treated by a GREAT sport's med. doc. Glucosamine and Chondroitin supplements daily, along with five Supartz injections will have me back on March 9. Hike on...!:sun

I will relay advice given above to him today.
Thanks.

[Catnip]

After seeing all these replies, I hope your friend goes to a doctor. There are all sorts of things that could be wrong, hopefully something easily treatable.

That said, I may as well throw in my contribution :) . I have arthritis in one knee and stepped wrong last summer resulting in pain and swelling that made me limp. It wasn't better even after RICE and ibuprofen for a couple days. Got a steroid shot from an orthopedic doctor and 36 hours later I was as good as new! It saved a 9-day camping trip with my boys that started 48 hours after the shot. (Be aware that the symptoms will often be worse the first 24 hours after a steroid shot into a joint).

[Dogwood]

Of course, physicians continually increase their knowledge throughout the course of their careers, which makes it possible for one doctor to be more informed in a particular area than another doctor(after formal education a doctor can choose as to what additional information he/she wishes to be informed about), but my pt. remains: during formal western medical training a greater emphasis is placed on educating about and prescribing prescription drugs rather than examining the potential benefits of vitamins/supplements/herbs and prescribing them. This creates a bias towards prescribing prescription drugs! This bias may last throughout a physician's career. I assume U are a western medicine trained MD. It is not my intention to play doctor or step on your toes, but ask yourself: when U first read maxNcathy's post were U inclined to first prescribe prescription drugs or to examine the possibility of prescibing alternative forms of treatment not taught to U in med school? Did U even consider alternative forms of treatment not taught to U during your formal western medical training? Hopefully, U are knowledgable of and consider the potential benefits, and possible side effects, of other forms of treatment not originally taught to U during med school. When armed with this knowledge and used in conjunction with your formal western medical training don't U think that it makes U a better physician?

[Dogwood]

That's still too many generalizations to be true. "10 hours" may or may not be true, it wasn't for me, and what do you base this on? Most of what an MD does is through hands-on experience. Therefore: clinics in med school, residency, and CME post-grad. Does it occur to anyone that MD's learn AFTER formal education?
As for the comparison with antibiotics: I have had 1000's of patients come to me begging for antibiotics for their viral infections. I have had dozen of complaints to the hospital systems because I refused to give them the medicines they want. How fair or true is that? And that is DESPITE extensive patient education.

Indeed, it may not be fair, true it probably is, but don't U have a duty, indeed an obligation, to fulfill the Hypocratic oath U took, to provide the best health care U know of to your patient, to inform them that the celebrity or actor they saw promoting that little purple pill on TV or in a magazine may not be right for them, and even if so informing them results in complaints to the hospital system? I can sympathize with your predicament. Sometimes your hands-on well thought out treatment plan conflicts with what patients assume is right for them, which is sometimes based on what has been marketed to them by drug companies. It begs the question: who is best able to decide what is the appropriate course of treatment? Ideally, shouldn't it be a well informed physician in conjunction with the patient?

[Mother's Finest]

Assuming that there is no history of gout, and this is not the issue, there is some reason your joints are not functioning correctly.

Many times, flexion of the first ray is compromised by a pronated foot. In laymans terms, a flat foot. If your feet tend to collapse, this could be part of the problem. The goal is to raise the medial arch, thus lowering the head of the first metatarsal and allowing for maximum freedom of range of motion for the great toe.

Again, assuming that your feet are flexible and collapsing, a properly crafted orthotic could help you.

also, nutritional supplements can help you re-build the damaged cartilidge.....

peace
mf

[maxNcathy]

Thanks mf i will check into gout.

[horicon]

Joint swelling????? I'm not a doctor but take 2 advil, stay off your knees and feet.

[maxNcathy]

Joint swelling????? I'm not a doctor but take 2 advil, stay off your knees and feet.

May I call you in the morning?