Question
My mother is 79 yrs old and has been suffering from osteoarthritis for a number of years. Her hands are knubby but what gives her excruciating pain these days are both of her knees. Her legs have become severely bowed, and knees are swollen. She says her feet are often numb and very cold all the time. She can only go up steps by crawling on hands AND feet like a toddler learning to climb steps. She takes the Glucosamine combination, occasional Advil, Vit. E and multivitamin, Namenda (because of ministrokes she’s suffered) and 81 mg. of aspirin. (she recently started antidepressant–Lexopro, and has been on cholesterol reducing Lescol as well as 50 mg. of Trazadone.) In the past she tried Celebrex but did not see any relief from it. I know there is no cure for her great pain, but what is the best route to pain relief? Cortisone injections and viscosupplementation have been mentioned by her internist, as well as surgery. She is squeamish about surgery. I would really appreciate it if you could tell me if we should try cortisone or the viscosupp. treatments. Also, we live in College Park, MD area. Where can I take her to see experts. We can come to Hopkins but would prefer Metro-DC area.
Answer
It is difficult to say without seeing your mother. Possibilities include cortisone injections, non-steroidal anti-inflammatories, viscosupplementation (Hylagan, synvisc)., physical therapy and low doses of analgesics. Knee replacement, as you mentioned is also a possibility. I would strongly suggest that you see a rheumatologist to sort thorugh some of these possibilities. Your local Arthritis Foundation or the American College of Rheumatology website can give you a list of board certifed rheumatologists in your area.
