Knee Pain

[amberhfreeman]

I have been running on and off for about 3 years, but very regularly for the last year. I struggle with pretty bad joint pain in my knees, ankles, and hips from running, and also wrist pain regularly also. I have resigned that I will just have this pain and need to manage it with ibuprofen.  In the last three months I have however been  having a new more severe pain in my left knee. It hurts pretty much constantly, but worse during physical activity, and hurts like a bruise when pushed on. I decided to see my pcp to get some answers because the left knee has really been holding me back and too painful to ignore. He moved my leg a bit by bending it and said I needed to be tested for RA and get an x-ray done. He did say the tendons seemed tight but though arthritis was a more likely cause. Autoimmune diseases run in my mothers family as well as MD. Well he sent me the lab results today and a note that all looked normal to him, and he recommended ibuprofen as needed. So I feel like I have no more answers than I had before. Would like some insight if anyone has some. Labs are below.

ESR (SEDIMENTATION RATE) 0 - 20 mm/Hr 12
WBC 4.5 - 11.0 10E3 4.7
RBC 3.80 - 5.10 10E6 4.67
HEMOGLOBIN 11.7 - 15.5 g/dL 13.8
HEMATOCRIT 35.0 - 45.0 % 42.2
MCV 81 - 101 fL 90
MCH 27 - 34 pG 30
MCHC 32.0 - 36.0 g/dL 32.7
RDW CV 11 - 16 CV 12.9
PLATELETS 150 - 450 10E3 261
MPV 8.6 - 11.7 fl 11.3
NEUTROPHIL 36 - 78 % 54
LYMPHOCYTES 24 - 44 % 38
MONOCYTES 0 - 8 % 6
EOSINOPHILS 0 - 6 % 1
BASOPHILS 0 - 1 % 0
NEUTROPHIL ABSOLUTE 1500 - 7800 # 2560
RHEUMATOID FACTOR 0.00 - 13.99 IU/mL LT 10.00
ANA SCREEN Negative
SODIUM 130 - 145 mmol/L 140
POTASSIUM 3.5 - 5.0 mmol/L 4.3
CHLORIDE 96 - 108 mmol/L 104
CO2 22 - 32 mmol/L 26
ANION GAP 4 - 18 10
BUN 3 - 18 mg/dL 8
CREATININE 0.50 - 1.30 mg/dL 0.70
GLUCOSE 70 - 99 mg/dL 81
GFR   GT 60
GFR, AFRICAN AMERICAN   GT 60
TOTAL PROTEIN 5.9 - 7.6 gm/dL 7.7
ALBUMIN 3.2 - 4.6 gm/dL 3.8
CALCIUM 8.8 - 10.5 mg/dl 9.4
BILIRUBIN TOTAL 0.0 - 1.1 mg/dL 0.3
ALKALINE PHOSPHATASE 0 - 136 U/L 98
AST 0 - 37 U/L 13
ALT 12 - 78 U/L 24
HEMOLYSIS None None
ICTERUS None None
LIPEMIA None None

[jemma116]

Although your blood results came back normal, does not mean that you do not have a problem.  But confirms that you do not have RA.

Did you ever get an x-ray done of your hips, knees and ankles?
It may be that you do have tendon and soft tissue problems; other problems may be bone degeneration as in osteoarthritis.

Stop doing the running whilst you are unwell so as not to cause further damage.  Are you wearing the correct footwear to support your feet?  Wearing incorrect footwear can cause problems.  Gentle exercises so as not to get stiff would be a good idea and a physiotherapist would tell you what exercises and the amount you need to do.

If you do decide to take anti-inflammatory drugs, be aware that they can cause stomach problems, so take the medication with or after food if the doctor has not prescribed a medication to protect your stomach.

If the condition is acute then you will need to rest the legs and elevate them to allow them to heal.  Tendon and soft tissue problems can take a very long time to heal and you may find that applying a cold compress may help to reduce the inflammation and pain.  If you do have degenerative bone problems, you will need to learn how to manage this and to gentle exercises so as not to stiffen up.  (exercises in the pool and swimming are good).  You may find over the counter pain relief like paracetamol may help to take the edge off your pain.

With your wrist pain, do you do any type of repetitive work, this could be a manual job or working at a keyboard and computer?  If so, your wrist pain may be due to inflammation of the tendons and soft tissues due to overuse.  You would experience pins and needles if it was carpal tunnel syndrome.  Take frequent breaks from any repetitive work and get wrist supports to allow the wrists to heal.  Wearing a bandage around the hand and wrist will also help to provide support until you get the correct wrist support splints.  If you do ignore your wrist problems, it will get worse to the point that you will not be able to use your hands at all.  So do take care.

Wishing you a speeding recovery.

[Dr. Kokil Mathur]

Hi!
I am sorry to hear about your medical problems. Since your blood tests are normal and so is probably X-ray, you need to get a MRI of knee joint to look for ligament or meniscal tears and injuries, patella displacement etc. It may also be a pinched nerve or a muscle injury. So and EMG/NCV may help in diagnosis. Please discuss these aspects with your doctor. Also, find out if physiotherapy will help relieve the pain. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.