Pain Management/Knees


I am 55, overweight but not obese.
Three years ago, playing soccer with my kids, I injured both knees. The right one was a strained MCL, the left I tore the meniscus.
Doctor said exrays looked OK, nothing but a bit of calcium buildup (normal) time and tylenol.
By this spring they had not improved, both stiff, the left still painfull, and the right would actually give out.
A physiotherapist was able to improve the stiffness, thats it.In frustration I saw a accupuncturist. After ten treatments, he was able to resolve the pain in both, and pretty much 'fix' the ligament issue.
The one with the torn meniscus will not let me walk for more than 20 minutes without becoming painfull. This pain lasts for a full day, then completely goes away.
More accupuncture treatments did not help, he said to stop walking/playing golf. No can do, I need the exercise!
Question 1: Is this now arthritis?
Question 2: Would seeing a chiropractor or other type of therapy help?

There is no way to determine what the physical state of the joint is without another x-ray.  However, I have to completely disagree with the acupuncture specialist because stopping movement is the quickest way to lose range of motion.  Knees are delicate - especially as we age and the joint has more play and less synovial fluid.

There are several things that might help - the first one you know already and don't do - lose weight - don't worry I am not judging - I am in my 40's have bad knees and listen to my doctor harp on me about the same thing.  It is true though - less weight on your knees = less problems with your knees.

Aside from that I have three tips for you that will help.

1) Synvisc - synvisc is a synthetic synovial fluid that is injected directly into the knee space - YOU WILL NOT BELIEVE HOW WELL THIS WORKS.  I wore a full knee brace - with metal joint side reinforcements for lateral movement on both knees everyday for a couple of YEARS before I went to the orthopedist and he did synvisc injections.  It felt like I brand new knees.  It typically lasts about 6 months before new injections are needed.  NOTE*** Do not make the mistake of thinking you actually DO have new knees.  They felt so great I went for a run the next day (before the other shots were administered - back then is was 3 shots over 3 weeks now it is 1 shot) and then I had knee pain.  Let the drug fill the joint and spread out and then do LOW IMACT exercise.  

2) Low impact exercise.  The walking is ok but it is higher impact on the joint that other exercises.  Lower impact exercises will exercise the joint and your cardiovascular system without banging on your knees.  Swimming is excellent.  Bike riding is even better.  Bike riding works the knee from all points in the range of motion with much less impact.  I would recommend you change walking to bike riding or swimming.  Continue golfing - your life has to be worth living to make you keep taking care of yourself.  When people give up on their passions they tend to give up on themselves.

3) Glucosamine and Condroitin.  Take it - a total of about 1600 units of glucosamine in divided doses (half in the morning and half in the evening) Don't worry if the otc supplement you find is a little stronger or weaker it will be just as effective.  NOTE*** You must take this for 6 weeks daily before you see or feel the benefits.  The tv commercials that are trying to push liquid glucosamine as a "next day" remedy are bunk.

Glad to hear from you as you work through the knee issues and experiment with treatments.

Hope that helps - Joshua

Lastly, yes I think I can recommend a chiropractor.  Mine had to actually change the way my feet fall because one leg was falling shorter than the other due to alignment.  It did take stress off my knee so at the very least it is worth the consultation.


Pain Management

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Dr. Joshua P. Cappuccilli


I will be able to answer most questions regarding pain management with medications, physical manipulation and trigger point injections.


My current pharmacy practice is specialized to manage challenging patients with chronic pain. I work closely with a number of physicians in the surrounding area to ensure safe and effective pain management while working to minimize the potential from drug abuse, drug addiction and drug diversion. My practice is approximately 40% chronic pain patients on long term therapy.

BA from the University of South Florida 1998 PharmD from the University of Florida College of Pharmacy 2008 AphA certified in Medication Therapy Management

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