Degenerative Knee Arthritis and Medication Challenges

Degenerative knee osteoarthritis and issues related to pharmacological treatment?

Hello, Doctor.
In recent years, every time I get out of bed, my bare feet feel like they are being compressed and painful as soon as they touch the ground.
However, the pain disappears after I take a few steps.
Occasionally, my knees also make noise.
I have visited orthopedic specialists over the past 2 to 5 years, but they only prescribed painkillers, which have not provided any significant relief, or the pain returns after just a few days.
Recently, about half a month ago, I went to an orthopedic clinic that seemed to be very busy.
However, it was strange that almost every patient was required to pay out of pocket for injections, which consisted of two large injections and one small injection.
There was a large bag of discarded syringes under the table, and each injection cost 100 NT dollars, totaling 300 NT dollars for three injections, all out of pocket.
I observed that many patients were unknowingly accepting these injections, which made me suspect that this clinic might be engaging in profit-driven practices in collusion with pharmaceutical companies.
I reluctantly participated in the injections, but I have deep doubts because they mentioned that the injections were optional.
How is this considered a medical practice? The injections I received included one with ginkgo biloba, another labeled as Glucal-Black inj.
u/Chitonin, and another said to be collagen.

Could you please advise if these injections have any therapeutic effects? Personally, I have received several injections and have not felt any significant benefits.
From my understanding, injections are rarely used in orthopedic treatments unless it involves hyaluronic acid.
My knowledge is limited, so I hope I am not being too presumptuous in asking you, Doctor.
I look forward to your clarification on this matter.

Lai, 60~69 year old female. Ask Date: 2010/01/27

Dr. Shi Qiming reply Orthopedics

In response to your symptoms, it appears that you are experiencing plantar fascia inflammation.
This occurs when the arch of the foot flattens upon the initial step, leading to stretching and pain in the plantar fascia.
Generally, injection treatments are not necessary.
Regarding your question about the efficacy of injections, the effects of local injections are limited and temporary, and they are typically not recommended, especially for out-of-pocket expenses, which should be avoided.

Reply Date: 2010/01/27

More Info

Degenerative knee arthritis, also known as osteoarthritis, is a common condition that affects many individuals, particularly as they age. It is characterized by the wear and tear of cartilage in the knee joint, leading to pain, stiffness, and decreased mobility. Your description of experiencing pain upon standing after sleep, which subsides after walking, is a classic symptom of this condition. The popping or cracking sounds from the knee can also be associated with the degeneration of cartilage and changes in the joint structure.

In terms of treatment, it is essential to approach degenerative knee arthritis with a comprehensive plan that includes both medication and physical therapy. The medications typically prescribed for osteoarthritis include non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief, as well as topical analgesics. However, as you mentioned, these medications may not always provide lasting relief, and their effectiveness can vary from person to person.

Regarding the injections you received at the clinic, it is crucial to understand the types of treatments available for knee arthritis. Commonly used injections include corticosteroids, which can help reduce inflammation and provide temporary pain relief, and hyaluronic acid injections, which aim to lubricate the joint and improve mobility. However, the efficacy of these injections can vary, and not all patients experience significant benefits.
The injections you mentioned, such as "Glucal-Black" and collagen, are less conventional and may not have strong scientific backing for their effectiveness in treating knee arthritis. While some patients report subjective improvements, it is essential to approach such treatments with caution, especially if they are not supported by robust clinical evidence. The concern you raised about the clinic's practices and the potential for profit-driven motives is valid; it is always advisable to seek treatment from reputable healthcare providers who prioritize patient care over profit.

If you feel that the treatments you have received so far have not been effective, it may be beneficial to seek a second opinion from another orthopedic specialist or a rheumatologist. They can provide a thorough evaluation of your condition and discuss alternative treatment options, including physical therapy, lifestyle modifications, and possibly more advanced interventions if necessary.

Physical therapy is often a critical component of managing knee arthritis. A physical therapist can design a personalized exercise program to strengthen the muscles around the knee, improve flexibility, and enhance overall function. This approach can help alleviate pain and improve mobility over time. Additionally, weight management is crucial, as excess weight can place additional stress on the knee joints, exacerbating symptoms.

In summary, managing degenerative knee arthritis involves a multifaceted approach that includes appropriate medication, physical therapy, and lifestyle modifications. If current treatments are not providing relief, do not hesitate to seek further evaluation and explore other options. Your health and well-being are paramount, and finding a treatment plan that works for you is essential for improving your quality of life.

Similar Q&A

Understanding Cartilage Degeneration: Treatment Options and Care Tips

Hello Doctor: My mother has recently been experiencing swelling and pain in her knee joint, and after an examination by an orthopedic specialist, she was diagnosed with cartilage degeneration. Is there any medication available for cartilage degeneration, and what should she pay a...

Dr. Xie Tianjie reply Orthopedics
Knee joint degeneration includes aging or inflammatory phenomena of the cartilage, ligaments, and subchondral bone. Common symptoms include knee pain, swelling, and feelings of weakness or pain when going up and down stairs. The recommended approach to care is to reduce the burde...

Understanding Early-Onset Osteoarthritis: Causes, Symptoms, and Management

Hello Dr. Yang: I have several questions and would appreciate your prompt response. Thank you! I am 37 years old, 160 cm tall, and weigh 63 kg (this is my first online consultation). Earlier this year (around February), I started experiencing mild soreness in my knees (including ...

Dr. Yang Zhengfan reply Orthopedics
Dear Annie, You have quite a few questions, and I will address the key points as follows: 1. The causes of arthritis were previously attributed to overexertion, but it is now recognized that individual physiological factors are also closely related. 2. Arthritis cannot be c...

Struggling with Knee Pain: Seeking Solutions for Weakness and Discomfort

I have been experiencing knee pain in both legs for two years. I have consulted many doctors (orthopedics, rehabilitation, rheumatology, and neurology) at major hospitals. Some doctors indicated that I have patellar malalignment, while others said it is not severe. Rheumatology t...

Dr. Shi Guozheng reply Orthopedics
It could be a spinal issue compressing the nerves, leading to weakness in both knees. Typically, if it were degenerative arthritis of the knee, there would usually be pain and some degenerative changes in the knee joint. Medication treatment can also provide improvement. If sympt...

Managing Knee Degeneration in Elderly Patients: Alternatives to Surgery

Hello, doctor. My grandmother is 83 years old and suffers from Parkinson's disease and severe knee degeneration. She has been regularly visiting the clinic and taking medications prescribed by both orthopedic and neurology specialists. Previously, she received hyaluronic aci...

Dr. Shi Guozheng reply Orthopedics
1. You may need to consult with doctors from other specialties. 2. You can try platelet-rich plasma (PRP) therapy, but if your overall health is good, you might consider undergoing surgery.