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Posted 9/16/2012 8:44 PM (GMT 0)
Hi everyone,

I normally post on the Crohn's forum. I am 53 years old and I have had Crohn's disease for around six years. Since last spring, I started to have joint pain in my hips and knee. My GI recommended that I make sure to keep moving because being sedentary will make things worse. I took his advice and was walking daily. In August, my right knee was becoming progressively more painful, but I kept walking, thinking that might help. During the last week of August, I helped move my daughter in to college..she is living on the third floor of a house. I didn't carry a lot of heavy stuff, but just the walking up and down the stairs caused my knee to be in severe pain and it swelled to twice the size of the other knee. I iced it all the way home (4 hour trip) and went to see my internist the next day. He didn't even examine it....didn't even touch it! He gave me Celebrex samples, which I cannot take due to my Crohn's, and told me to call him in a week if it still hurt. So I called back and he referred me to an orthopedic surgeon, and I couldn't get in for three weeks. I have an appointment next week. I suspect arthritis since I didn't have an injury.

While I am waiting for my appointment, I still don't know if I should be resting my knee, or trying to keep walking? The pain is terrible at night, and it is still significantly more swollen than my other knee. Also, any suggestions for what I should be asking the doctor will be greatly appreciated. This severe pain is all new to me, and my internist gave me no direction as to what to do. Thanks.
Posted 9/17/2012 12:10 AM (GMT 0)
Rest it and keep icing it. If the swellling and pain decrease you can try gentle low-impact exercise, or just rest it until your appointment. I know it's a difficult step to take, but using a cane in the hand on the side opposite the sore knee can take a lot of the load off that knee also.

The ortho will certainly take x-rays and may want an MRI. I know those of us with IBD are told not to take NSAIDS, but to be blunt we sometimes have to compromise. I was put on Mobic by my rheumatologist because he's had less bleeding problems with it than with some of the other NSAIDS> I've been taking NSAIDS daily since before I was diagnosed with UC. Simply put, I can either take one and MAYBE have some bleeding, or I can not take it and be absolutely sure I won't be walking within a couple of days. As with a lot of things we encounter, we have to weigh things and make our own decisions.

I hope you're able to get relief from the pain and get your mobility restored soon; it's really crummy to be stuck in a chair or bed.
Posted 9/17/2012 12:27 AM (GMT 0)
Thanks Judy2,
I tried taking one Celebrex pill and I didn't feel well. In addition to my Crohn's I have bad GERD, and I had terrible heartburn. It could have been a coincidence, but I have a history of bleeding ulcers in my small intestine, and I'd sure hate to go back there again! It seems like even short walks are causing a LOT of swelling, so I think I'll take your advice and just ice it and take it easy until I can get to the doc. Will x-rays or an MRI tell me what type of arthritis I have? or that I have arthritis for sure? Thanks for your help!
Posted 9/17/2012 2:08 AM (GMT 0)
Usually the damage seen on x-rays is pretty characteristic and somewhat different for osteo and RA or other inflammatory diseases. Sometimes blood tests are used to differentiate the inflammatory processes, although for those of us with other inflammatory diseases things like the CRP aren't as helpful.

With your stomach history, you probably shouldn't risk NSAIDS. I do find that Tylenol Arthritis helps me quite a bit also. It will take longer to be effective than an NSAID, so during acute flares you're usually better off to just take it every 8 hours so the pain doesn't have a chance to get ahead of it.

Have you been on Prednisone at all for your Crohn's? That can definitely cause some ugly joint problems also.
Posted 9/17/2012 2:30 AM (GMT 0)
I had a really tough year with my Crohn's from last August-March. I was on Prednisone for awhile, had c.difficile, a partial obstruction....long story with lots of illness, but I finally turned the corner and my GI symptoms are doing really well right now. So it's really disappointing to now be struggling with my knee...my body is so strange!!! I haven't been on Pred since last winter, so the timing seems weird.
Posted 9/17/2012 5:26 AM (GMT 0)
I'm sure you know that steroid use can cause osteoporosis. What most of us don't realize until too late is that it can also cause bone death - osteonecrosis (also called avascular necrosis.) The blood supply to the bone is cut off, causing the bone to begin to die and areas of necrosis develop. The long bones of the body are usually involved at the ends where they articulate with another bone - the hips, knees, shoulders being the most frequent. Be sure to mention your history of steroid use to the orthopedist so he can rule this out. It is extremely painful and progressive unless treated. I'll be hoping you don't have that.
Posted 9/17/2012 12:19 PM (GMT 0)
Thanks...I hope not, but I will definitely mention it. Thanks for all your help!
Posted 9/17/2012 12:58 PM (GMT 0)
You're more than welcome. Please let us know how things are going for you.
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