Osteoarthritis

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JD2020
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Re: Osteoarthritis

Post by JD2020 »

They took my blood and put it in the spinner to get some component of blood. Everyone was impressed by how much of that component I had.

Then they injected the stuff into the capsule of the toe joint. (I think that was how they described it.) But no one had told me how painful it would be. omg. Seriously, super painful. But only for a short period of time, until I tried to put weight on my foot to go home. omg again. My daughter went to find a wheelchair, because I am that big of a baby, and I was convinced that I would not be able to put weight on that foot for a week.

I felt better the next morning.

It took a long time before I knew if the injection had worked. At the follow up appointment, I said I thought my toe was getting better, but I wasn't sure if I was just imagining it. But now I am sure.
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Tincup
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Re: Osteoarthritis

Post by Tincup »

roxanne wrote: Very interesting JD2020. Can you explain the procedure and what you went thru with the injection? I was told about it, but I figured injections don't work. Did the pain immediately go away or did you have to wait for weeks to feel better?
When Theresa had her stem cell procedure, in the pre-op meeting, after Theresa's procedure was discussed, I asked the doc what he could do for my shoulder. I'd not had it imaged, but the doc said I likely had a torn labrum. It was from a skiing impact injury several years before. My issue wasn't pain, but the tissue was "catching" on surrounding bone, most likely. The doc suggested PRP, which I did. It is a 8 or more week (don't recall exactly) healing procedure. After about 4 weeks, I thought it was making a difference, but wasn't really sure. Then I came across a shoulder protocol that involved daily dead hanging by your hands/arms. This actually creates physical space in the joint and it worked very well, so I can't really comment on the success of the injection as the hanging works so well.

I can say that Theresa's stem cell procedure also included PRP as part of the injection. As she mentioned it was partially successful. It is certainly a financial risk on the probability of success. I know some people where PRP has worked really well and some not at all.
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Davidmoshe8833
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Re: Osteoarthritis

Post by Davidmoshe8833 »

roxanne wrote:For Tincup and TheresaB
I am trying to start the Plant Paradox Diet. I have been suffering for a year and a half with OA of the knee. I was a runner and now I can hardly walk. I would like your help in starting to get rid of lectins and hopefully have some resolution. I tried injections of Hyaluronic Acid and had a Steroid one without any relief. I'm doing physical therapy but no relief. I had an MRI which showed degenerative OA with Tendinopathy. So my last resort is to go lectin free. Without going into a rabbit hole can you recommend a way to start I do Intermittent Fasting 16-8 most days with some days 18-6. Also, I can't lose more weight. I'm at 106 lbs at 5.6. Whatever you can recommend will be appreciated. To make things worse money is an issue. I'm E3/4 and struggling with the issues of blood sugar regulation, cholesterol, and I'm always tweaking. Thanks in advance for your responses.

Roxanne
Hey Roxanne,

I'm a physical therapist, I work primarily in orthopedics, and do geriatric based home care several days per week, I'm pretty familiar with OA. Most of the time, PT should be able to help quite a bit. For those who have severe OA, they are sometimes able to manage with a mixture of the proper exercises/stretches, manual therapy, and other medical interventions such as synvisc injections.

Tendinopathy is tricky- I'm assuming we are talking about patellar tendinopathy here? When the tendinopathy is chronic, the interesting part is that they've found over the years that there is little to no inflammation found in the tendon. You get what's now referred to as tendonosis- where the collagen get's worn down, the thickness of the tendon tends to increase, increased angiogenesis etc. The mechanism of pain in tendonosis is not still clear, however eccentric exercises have been shown to be one of the best ways to improve tendon health and potentially reverse the tendonosis.

Regarding nutrition and diet, everyone is very different- I've observed that my patients with diabetes, other chronic conditions, as well as Alzheimers- everything hurts. The PT is more slow going and less beneficial with them. If you haven't experimented with elimination diet - particularly gluten, looking at your omega-3 ratios etc could all be beneficial. Additionally, there have been a number of studies that are beginning to show that curcumin works well for pain, including arthritic pain ( links below). While trying to dig up these articles, I also stumbled across some evidence for collagen supplementation as well.



Collagen:
https://pubmed.ncbi.nlm.nih.gov/30368550/

Curcumin:

https://pubmed.ncbi.nlm.nih.gov/27703331/

https://pubmed.ncbi.nlm.nih.gov/30975196/. curcumin vs diclofenac for knee OA

https://pubmed.ncbi.nlm.nih.gov/27533649/.

https://pubmed.ncbi.nlm.nih.gov/30772789/
roxanne
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Re: Osteoarthritis

Post by roxanne »

JD2020 wrote:They took my blood and put it in the spinner to get some component of blood. Everyone was impressed by how much of that component I had.

Then they injected the stuff into the capsule of the toe joint. (I think that was how they described it.) But no one had told me how painful it would be. omg. Seriously, super painful. But only for a short period of time, until I tried to put weight on my foot to go home. omg again. My daughter went to find a wheelchair, because I am that big of a baby, and I was convinced that I would not be able to put weight on that foot for a week.

I felt better the next morning.

It took a long time before I knew if the injection had worked. At the follow up appointment, I said I thought my toe was getting better, but I wasn't sure if I was just imagining it. But now I am sure.
Thanks JD2020. I looked into it and I was told I probably would need a series of injections if the first one does not work, and the cost is around 2000 per injection. Pretty expensive. I will look around more, this sounds as it might be workth it.

Again, thank you,

Roxanne
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Re: Osteoarthritis

Post by roxanne »

Tincup wrote:
roxanne wrote:
When Theresa had her stem cell procedure, in the pre-op meeting, after Theresa's procedure was discussed, I asked the doc what he could do for my shoulder. I'd not had it imaged, but the doc said I likely had a torn labrum. It was from a skiing impact injury several years before. My issue wasn't pain, but the tissue was "catching" on surrounding bone, most likely. The doc suggested PRP, which I did. It is a 8 or more week (don't recall exactly) healing procedure. After about 4 weeks, I thought it was making a difference, but wasn't really sure. Then I came across a shoulder protocol that involved daily dead hanging by your hands/arms. This actually creates physical space in the joint and it worked very well, so I can't really comment on the success of the injection as the hanging works so well.

I can say that Theresa's stem cell procedure also included PRP as part of the injection. As she mentioned it was partially successful. It is certainly a financial risk on the probability of success. I know some people where PRP has worked really well and some not at all.
Hi Tincup:
I was told the price was around $2000.00 per injection and I might need more than one. It's pretty expensive but I will look around, maybe find a Dr. that can give me a more definitve answer and maybe a better price. If it worked I wouldn't mind having one, but a 50% chance is not that good, especially with my experience with the other injections that did nothing for me.

Thanks,

Roxanne
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Re: Osteoarthritis

Post by roxanne »

Davidmoshe8833 wrote:
Hey Roxanne,

I'm a physical therapist, I work primarily in orthopedics, and do geriatric based home care several days per week, I'm pretty familiar with OA. Most of the time, PT should be able to help quite a bit. For those who have severe OA, they are sometimes able to manage with a mixture of the proper exercises/stretches, manual therapy, and other medical interventions such as synvisc injections.

Tendinopathy is tricky- I'm assuming we are talking about patellar tendinopathy here? When the tendinopathy is chronic, the interesting part is that they've found over the years that there is little to no inflammation found in the tendon. You get what's now referred to as tendonosis- where the collagen get's worn down, the thickness of the tendon tends to increase, increased angiogenesis etc. The mechanism of pain in tendonosis is not still clear, however eccentric exercises have been shown to be one of the best ways to improve tendon health and potentially reverse the tendonosis.

Regarding nutrition and diet, everyone is very different- I've observed that my patients with diabetes, other chronic conditions, as well as Alzheimers- everything hurts. The PT is more slow going and less beneficial with them. If you haven't experimented with elimination diet - particularly gluten, looking at your omega-3 ratios etc could all be beneficial. Additionally, there have been a number of studies that are beginning to show that curcumin works well for pain, including arthritic pain ( links below). While trying to dig up these articles, I also stumbled across some evidence for collagen supplementation as well.



Collagen:
https://pubmed.ncbi.nlm.nih.gov/30368550/

Curcumin:

https://pubmed.ncbi.nlm.nih.gov/27703331/

https://pubmed.ncbi.nlm.nih.gov/30975196/. curcumin vs diclofenac for knee OA

https://pubmed.ncbi.nlm.nih.gov/27533649/.

https://pubmed.ncbi.nlm.nih.gov/30772789/[/quote]

Davidmoshe8833

Thanks for your response. I am going to physical therapy and doing some exercises but I do not know if they are eccentric. I will ask him on my next visit. The tendinopathy is in the Quadriceps and Patellar tendons. No tears, but degenerative problems with the meniscus and chondromalacia patella. As a Functional Medicine Health Coach, I have done the elimination diet and tried all the strategies you mentioned, except for the Collagen supplementation. I used to run 7 to 8 miles a day without a problem, but one day out of the blue I started feeling pain.

I had 5 hyaluronic acid injections and did nothing. Are these the synvisc injections you mentioned?

Also I will ask the therapist about manual therapy. Do you think taping the knee will also help? Maybe if I suggest to him what you mentioned I can start feeling better. I have to admit that at least now I'm not limping as much which is great. A ny other suggestion will be greatly appreciated.

Roxanne
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Re: Osteoarthritis

Post by Davidmoshe8833 »

roxanne wrote: Fri Dec 03, 2021 7:28 pm

Davidmoshe8833

Thanks for your response. I am going to physical therapy and doing some exercises but I do not know if they are eccentric. I will ask him on my next visit. The tendinopathy is in the Quadriceps and Patellar tendons. No tears, but degenerative problems with the meniscus and chondromalacia patella. As a Functional Medicine Health Coach, I have done the elimination diet and tried all the strategies you mentioned, except for the Collagen supplementation. I used to run 7 to 8 miles a day without a problem, but one day out of the blue I started feeling pain.

I had 5 hyaluronic acid injections and did nothing. Are these the synvisc injections you mentioned?

Also I will ask the therapist about manual therapy. Do you think taping the knee will also help? Maybe if I suggest to him what you mentioned I can start feeling better. I have to admit that at least now I'm not limping as much which is great. A ny other suggestion will be greatly appreciated.

Roxanne

Roxanne,

Taping ( kinesio tape) can sometimes be effective in the short term to help offload the tendon- not a ton of evidence behind it as far as I know, but I do use it and it helps give a little relief temporarily. The eccentrics are important, and even more important than that is usually strengthening your gluteals and core. When the hips and core are weak, the quads become more dominant when you move.

Manual therapy that I find to be useful, mobilizing the patella, gently distracting the tibial-femoral joint into flexion/ext, massage to the pes anserine musculature, popliteal fossa musculature, and tibialis posterior.

Also, there is some evidence for incorporating medial arch support ( over the counter works) to help with knee pain, but its benefit is also thought to be more short term (4-6 weeks) - which isn't nothing, sometimes you need to get over that hump and let things calm down.


All in all, discuss this with your PT- they are in charge of your POC, they should be familiar with most of this- just like mental health therapy, PT is often a process. Our diagnosis (unlike in medicine) is dynamic and often movement based, and therefore is subject to change as your movement changes. Sometimes the therapist doesn't have time to pay attention and reassess due to a heavy schedule etc... do you work one-on-one with your therapist? If not, consider trying to find someone who will give you their undivided attention for at least a 30 minute session. Unfortunately many out patient facilities double book, and book every 15-30 minutes due to low insurance reimbursement rates. 1-1 clinics are harder to find, but they still do exist, not all of them are out of pocket ( I work for one and know of a few others here in NYC).

Happy to help you figure this out more if need be, keep me posted,



- David
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Re: Osteoarthritis

Post by roxanne »

Hi David:

Thanks so much for your thorough response. I'm having my PT tonight and will talk to the therapist. He does not do what you told me, but I will gently suggest it to him. I am in Brooklyn but money is tight if I don't go with Insurance, so hopefully he can help.

I will keep you posted.

Roxanne
JD2020
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Re: Osteoarthritis

Post by JD2020 »

roxanne wrote: Tue Nov 30, 2021 11:14 am
JD2020 wrote:
roxanne wrote:I have been suffering for a year and a half with OA of the knee.


Roxanne
I have OA in the toe. The doc gave me surgical options. I asked if I could try a PRP injection. He said sure. He said he doesn't recommend it first because he feels guilty doing so since it is not covered by insurance and he said seems to be effective only 50% of the time. I was willing to gamble $1000 to avoid surgery. 1 1/2 years later, it is like I have a different toe. I don't know if this is an option for knees.



Very interesting JD2020. Can you explain the procedure and what you went thru with the injection? I was told about it, but I figured injections don't work. Did the pain immediately go away or did you have to wait for weeks to feel better?

Thanks in advance.

Roxanne
Hi Roxanne, sorry for the delay in responding. I was on vacation and offline.

They drew blood, put it in a machine, separated out some component of the blood, and injected that into the toe. They referred to it as the joint capsule or something like that. Sharply, surprisingly painful. By the next morning I was fine, but I really could not put any weight on my foot that afternoon. I had a follow up appointment 6 weeks later. As expected, I didn't really know if the toe was feeling better or if that was me wishing it better. It was quite a while later that I was sure it was better. Not stiff, not achy. We hiked a lot this week, and my toe did not bother me.
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Re: Osteoarthritis

Post by roxanne »

Hi JD: No worries at all. Thanks for responding. I have been asking around about the injectons and they do them on knees, but apparently it might take more than one and the price is quite steep. I will probably be seeing David, an Apoe4 member, he's a physical therapist and he's also in NYC. We'll discuss that too. I'm so glad your toe did not bother you while hiking. That is such good news!!!!

Roxanne.
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