Your questions on joint care and joint pain have been answered by the consultants from Spire Healthcare

janeainsworth

I have pain in my right hip & knee, worse after exercise. Sometimes my right hip twangs as if something goes out of place & back again.
What is concerning me though is that for the last few months, if I’ve been sitting for some time, when I get up for a few seconds I can’t actually move because I can’t put weight on my right hip.
Eventually I can ‘get going’ & after a few steps I can walk properly.

What could be causing this? At the moment I’m trying to strengthen the muscles in my leg with resistance bands, use diclofenac gel, & take glucosamine tablets.

Can you recommend anything else I should or shouldn’t be doing? I don’t want to give up walking, cycling and tennis. So far I have resisted my husbands instructions to see my GP. Is it time to give in?

Thank you.

Hi @janeainsworth, thank you for your question.

Arthritis can often present in different ways. Patients can feel catching and also suffer from something we describe as start up pain, where the joint feels stiff and loosens off after a few steps. It is great that you have started muscle strengthening and non-steroidal anti-inflammatory gels can often help. I would stay as active as possible but avoid any activities that act as triggers. I think it may be worth seeing your GP to get an x-ray and have a clinical assessment to be sure that this is osteoarthritis.

- Stephen

Lorraine1602

I have had both hips replaced. Now my knees are becoming very painful. Can you recommend anything to relieve pain so that I can perhaps at least delay having knee replacements?

Hi @Lorraine1602, great question.

The decision to replace a joint is made when the pain is no longer manageable with symptomatic control. Painkillers do help. Other non-surgical pre-joint replacement interventions can be reducing your body weight if this is an issue, improving muscle strength around the knee and also using a knee brace which can take some of the pressure off the knee. Injections of local anaesthetic and steroid can also help manage the painful symptoms before heading towards a knee replacement.

Unfortunately, there are as yet no proven therapies to restore the cartilage in the knee that has been damaged by osteoarthritis. Research is under way to look at new treatments as part of randomised control trials, although these are not available as routine patient treatments at the present time.

- Stephen

CV2020

My partner gets painful hips in bed every night. This happens every night and really disturbs his sleep. He doesn’t want to take painkillers if possible. Any suggestions please?

Hi @CV2020, thanks for your question.

Night pain is a classic sign of arthritis, it is a constant dull ache like tooth ache in the hip or knee. I would suggest that if painkillers are not working then it may be time to see an orthopaedic surgeon after a review by your GP. Keeping active, and keeping the weight down can help reduce symptoms but they are unlikely to go away completely.

- Stephen

kathcake

Is it normal for my joints to click everytime I get up?

Thanks @kathcake. Joint clicking and popping can be normal. It may be caused by the ligaments or bubbles in the synovial fluid.

There are also other mechanical reasons for a joint to click, such as damage to the internal structures or loose bodies within the joint. If the clicking and popping is not painful and is not causing discomfort then it can be considered normal. If it is associated with pain or if the joint is not able to go through its full range of movement and is locked, then this should be investigated.

- Stephen

5together

I’ve been told I need TKR for severe arthritis in one knee, which had to be grafted, pinned and plated following an accident 25 years ago. I do have some pain from the joint, but it is mostly manageable and I only take painkillers during particularly severe attacks. I have been putting off surgery because pain isn’t a driver for surgery, although my range of movement has been steadily declining. Am I doing more harm than good by waiting or if I can manage longer should I? I’m in my mid 50s and otherwise fit and well.

Dear @5together, it sounds like you have been doing well in the last 25 years since your accident.

Trauma to a joint can often lead to the development of arthritis many years later. The range of movement of a joint before a joint replacement can often affect the range of movement after a joint replacement and trying to delay it for as long as you are able to do is often a sensible option. This discussion needs to be had between you and your treating surgeon.

- Stephen

MichD

I have arthritis in my neck and knees and facet spondylosis in my back. I can't take anti-inflammatories because of my asthma and past stomach ulcers, are there any alternatives that I could use safely or supplements?

Hi @MichD, thanks for the question.

There are a number of different types and class of painkillers. There are some newer painkillers which avoid the side effects with asthma or stomach ulcers. Different painkillers tend to work for different people and I would recommend speaking to your GP about the latest painkillers available to help with the pain associated with spondylosis.

- Stephen

Megaladon

How can I prevent pain in my knee joints after exercising? Recently now that we're allowed to socialise again I've been doing lots more activities than usual and I'm beginning to feel pain in my knees. It's concerning me because I don't want this to become something that ends up getting bad and preventing me from doing things. What can I do to stop the pain and prevent anything happening to them which will stop me from being active? Thank you

Hi @Megaladon, many thanks for your question.

Activities that avoid causing and triggering knee pain are best for patients with knee arthritis. This includes swimming and cycling as they are non-weight bearing activities. You can also focus on strengthening the muscles that protect the knee such as the quads and this can be really beneficial. Finally, avoid certain activities that can trigger the arthritic pain, such as walking on uneven ground or cobbled surfaces.

- Stephen

Hi everyone. Thanks for posting your questions on this thread. We'll be answering a selection of these over the next hour or so. We hope that the answers are helpful to you!

- Stephen, Chris and Gerard