DQOTD: When to See Doctor, Pain Level?

[Midpack]

I’m battling a knee injury, over two months now - and it’s clear it’s just not going away. Comes and goes, ranging from occasionally “barely able to walk” (two episodes) to walking with pain (2 on a scale of 10), and it never goes to zero pain. Is it easier for an ortho to diagnose/treat when I’m nearly unable to walk OR on a “good day” - or does it not make any difference? Unfortunately I’m able to deliver myself in either state, and I’m desperate to improve…

 

[audreyh1]

I’d be seeing a doctor.

I’d probably discuss with my PCP about who to see first.

 

[Bamaman]

After having a wife under pain management for the past 20+ years, I've seen her pain progress year by year. Pain is something to listen to. When you're miserable, it's time to do something about it.

I would suggest you contact your primary care physician and figure out who the premier orthopedic surgeon is in your area specializing in knees. Often, it's the same guy that handles the universities' athletic programs.

Get a referral to get his opinion on where your knee is presently at.

My wife had a knee replacement three years ago, and she's done well with it. Unfortunately she needs the other knee replaced.

 

[Aerides]

I’m battling a knee injury, over two months now - and it’s clear it’s just not going away. Comes and goes, ranging from occasionally “barely able to walk” (two episodes) to walking with pain (2 on a scale of 10), and it never goes to zero pain. Is it easier for an ortho to diagnose/treat when I’m nearly unable to walk OR on a “good day” - or does it not make any difference? Unfortunately I’m able to deliver myself in either state, and I’m desperate to improve…

Makes no difference when you go, so call and make an appointment now. A good ortho will diagnose via symptoms and an xray, which anyone decent one will do on site at the start of your appointment. An MRI will probably be prescribed if the xray doesn't show the obvious culprit, or even if it does, if surgery is a likely remedy. Some injuries they can diagnose via certain movements or twists right there in the office.

The good news is you probably haven't made it worse waiting, but it's better to take action sooner than later because you'll end up favoring, and over taxing, your "good" knee in the interim.

I would suggest you contact your primary care physician and figure out who the premier orthopedic surgeon is in your area specializing in knees. Often, it's the same guy that handles the universities' athletic programs. Get a referral to get his opinion on where your knee is presently at.

if your plan doesn't require referrals, google is helpful to start as well, and will mean you get to the right doctor quicker. I did that, without asking my PCP, and ended up with a great ortho doc a mile from my house within few days.

 

[6miths]

I think if I had a 'knee injury' as in a discrete traumatic event and the pain did not resolve within say a week, or worsened with time or became 'barely able to walk' then I would be seeing a doctor immediately. And I never go to the doctor. OTH at 60, I know that my knees are going to hurt after playing hockey or hiking 10 miles over hill and dale or spending a day in the yard and I wouldn't think of seeing a doctor for that.

 

[RunningBum]

Does it ever feel like you knee locks up? It so, that along with the occasional pain could be a meniscus tear. As I understand it sometimes it pinches and really hurts, other times it's more or less in the right place and not so bad. Pretty easy fix to trim the meniscus. I think it is confirmed with an MRI so I wouldn't worry about the timing of your initial visit, and the MRI should show it whether you're in pain or not. I'm not a medical person so take this for what it's worth. Maybe most of your cartilage is gone and sometimes you are bone on bone, and maybe a candidate for knee replacement.

If your primary care physician is good you could start there, or just go to an orthopedist if you have a way to know a good one. For me, there's a sports medicine doc that's really good so I start there for such things. He's good at diagnosing and also making good referrals.

 

[Midpack]

I think if I had a 'knee injury' as in a discrete traumatic event and the pain did not resolve within say a week, or worsened with time or became 'barely able to walk' then I would be seeing a doctor immediately. And I never go to the doctor. OTH at 60, I know that my knees are going to hurt after playing hockey or hiking 10 miles over hill and dale or spending a day in the yard and I wouldn't think of seeing a doctor for that.

There was no incident, no fall, no impact, no discrete trauma. I just woke up one morning barely able to walk.

It was a day after I’d walked/played 18 holes of golf, about 8-9 miles walking (for the day). I’d been walking 8-9 miles/day twice a week, and 4-5 miles the other 4-5 days of the week regularly for months without issue. Golf swing may be compounding the miles on the knee, since one knee is perfectly fine - presumably both knees have the same mileage so it can’t be miles alone? .

However, I’d recently adding running to my daily walks, run a block, walk a block for 2-4 miles for about a month preceding the first really bad morning. Didn’t notice any injury or pain the night before, but I probably shouldn’t have tried to run at all at 67 yo. Too soon old, too late smart…

 

[braumeister]

Makes no difference when you go, so call and make an appointment now. A good ortho will diagnose via symptoms and an xray, which anyone decent one will do on site at the start of your appointment. An MRI will probably be prescribed if the xray doesn't show the obvious culprit, or even if it does, if surgery is a likely remedy. Some injuries they can diagnose via certain movements or twists right there in the office.

The good news is you probably haven't made it worse waiting, but it's better to take action sooner than later because you'll end up favoring, and over taxing, your "good" knee in the interim.

This is exactly what I was going to write. A quick X-ray may be enough, but if there is any ambiguity an MRI will resolve it.

Knee surgery is incredibly good these days; DW has had a couple of them. Only takes about 15 minutes in most cases.

 

[Midpack]

Does it ever feel like you knee locks up? It so, that along with the occasional pain could be a meniscus tear. As I understand it sometimes it pinches and really hurts, other times it's more or less in the right place and not so bad. Pretty easy fix to trim the meniscus. I think it is confirmed with an MRI so I wouldn't worry about the timing of your initial visit, and the MRI should show it whether you're in pain or not. I'm not a medical person so take this for what it's worth. Maybe most of your cartilage is gone and sometimes you are bone on bone, and maybe a candidate for knee replacement.

If your primary care physician is good you could start there, or just go to an orthopedist if you have a way to know a good one. For me, there's a sports medicine doc that's really good so I start there for such things. He's good at diagnosing and also making good referrals.

It doesn’t lock up, but I have a reduced range of motion in the suspect knee along with the chronic minor ache. Can’t bend it as much as the other knee, it’s a little harder to put my right shoe on. And I get acute pain if if I try to (hyper) straighten the leg or twist the knee. The knee feels weaker, more fragile.

I already got a referral from my PCP for a good sports medicine ortho, I’ll probably make an appt with him next week based on what I’m reading on this thread.

 

[6miths]

Ah then it's a tougher call but I still think that two months with no significant improvement and 'barely able to walk' pain would get me in. You may only get advice about things you have already tried but if you have already tried them then it's off to the next level. And 67 with a lot of miles is getting into that range where a 'fix' might be needed. Sounds like significant pain, not resolving and having a substantial impact on your life - criteria to get it checked out. Sorry for your pain.

 

[Nick12]

I'd be at the doctor. If it is a knee replacement it is a long process to include recovery.

 

[Ronstar]

.... I already got a referral from my PCP for a good sports medicine ortho, I’ll probably make an appt with him next week based on what I’m reading on this thread.

Good idea. 2 months with no noticeable improvement. Sounds to me like it's more than a simple strain or sprain.

 

[harllee]

Midpack I would go to the sports ortho as soon as I could get an appointment. There may be something simple that can help you like a shot of cortisone or Euflexxa, Do you wear a knee brace? That my help until you can get into the doctor. If down the line you need a knee replacement DH just had it done at Duke and all went great. He had a great surgeon that does 5 knee replacements day (has done 1000s), PM me if you need his info.

 

[Midpack]

Ah then it's a tougher call but I still think that two months with no significant improvement and 'barely able to walk' pain would get me in. You may only get advice about things you have already tried but if you have already tried them then it's off to the next level. And 67 with a lot of miles is getting into that range where a 'fix' might be needed. Sounds like significant pain, not resolving and having a substantial impact on your life - criteria to get it checked out. Sorry for your pain.

It’s much improved as I tried to note “Comes and goes, ranging from occasionally “barely able to walk” (two episodes) to walking with pain (2 on a scale of 10), and it never goes to zero pain.” But it just won’t go away…

 

[Aerides]

There was no incident, no fall, no impact, no discrete trauma. I just woke up one morning barely able to walk.

This is kinda what happened with me and my meniscus tear. I traced it back to almost slipping in the shower, but twisting and not slipping, as that was the only thing that made sense in hindsight, but in the moment there was no pain, no feeling of oh bugger that's gonna hurt. Just a bit of soreness started creeping in at night a few days later. Went like that for weeks.

Then soreness after runs...Then soreness after nothing...etc. etc...then major almost-can't-walk-pain after a run a month or so after the pain started, and that's what sent me to the ortho because it was getting worse, not better.

My initial visit was an xray, an exam, and a cortisone shot. Gave me time to plan for surgery which was absolutely NBD.

 

[FIREd]

When pain starts to impact my quality of life, I go see a doctor.

 

[Blue531]

Since I don't believe that allopathic doctors have all the answers to pain and chronic pain, I personally would exhaust the internet for information concerning natural cures to my problem. There are many functional medicine doctors and naturopathic doctors with you tube channels now and they provide great information. Deficiencies in vitamins and nutrients can make it harder for us to heal. The question I would ask myself is am I giving my body what it needs to heal itself? Am I low in magnesium (almost all of us are), low in vitamin d, etc. Sometimes, we still have pain where an injury occurred because the body is tearing it down to rebuild. No, I'm not a doctor, but I stayed in a Holiday Inn once. Magnesium oil which is applied to the skin (transdermal) could be of help rubbed into the knees several times a day. I've had success with it since I have suffered with fibromyalgia and my pain has been significantly reduced. Anyway, magnesium oil and vitamin d is what I would try along with a healthier diet for oxidative stress.

 

[mystang52]

Good move seeing a sports ortho. I'd suggest you do some advance planning for the likely prescription for P.T. Start researching now for a good PT near you, IMO it would be better yet if the PT has sports expertise. Whether you consider yourself an athlete or not, from my own experience sports MD's/PT's are more practical in getting your injury better vs the standard protocol.
FWIW, my anecdotal experience is that the leg press exercise is invaluable in improving your knee. Just be certain you start at very low resistance lest you make it worse.

 

[Midpack]

Good move seeing a sports ortho. I'd suggest you do some advance planning for the likely prescription for P.T. Start researching now for a good PT near you, IMO it would be better yet if the PT has sports expertise. Whether you consider yourself an athlete or not, from my own experience sports MD's/PT's are more practical in getting your injury better vs the standard protocol.
FWIW, my anecdotal experience is that the leg press exercise is invaluable in improving your knee. Just be certain you start at very low resistance lest you make it worse.

Fortunately a neighbor is a good PT, she and her husband are young, very active/athletic - so I know where I’m going if PT is the recommendation. Thanks.

 

[bolt]

I do not want to marginalize your particular pain levels circumstances Midpack. I certainly do not.

I'd advise researching a Dr.John Bergmans(online) advocacies unless your in Hunington Beach, SCalif. USA.
Then I'd both visit him & also research his insights.
His backround is compelling.

Pain, pain is personal. Some call someone elses injury/death their own emotional pain.
Sounds nonsensically self-interested to me.

Good luck & Best wishes......

 

[aja8888]

When I tore my meniscus a few years ago, I didn't know I did any damage although I recall the incident (fell, landed on knee first). The next day it was clear I did something wrong. An MRI diagnosed it and ortho surgery fixed it. I'm good as new now.

Now I have arthritis in that knee, but it still is in working order.

 

[old medic]

Get to the Doc....

 

[harley]

I trust doctors to deal with injuries/physical pain a lot more than I do with internal stuff. And pain is my Kryptonite. Especially enduring pain. Get thee to a physician!

 

[Midpack]

I have an appt for the 16th, first available so he must be good?

 

[harley]

Hopefully. However, I just tried to make an eye doctor appt and they are currently scheduling for Nov. But I'm out in the country with fewer choices, so hopefully your person being booked up is a good sign.