The People's Perspective on Medicine

Doctor Wants Alternative Treatment for Sore Knees

Sore knees make it hard to exercise. Heck, they make it hard to get around, period! What can you do if surgery or stem cell injections don't work?
Surgical operation for knee arthroscopy micro surgery in hospital operating theater emergency room of traumatology and orthopedics.

Have you ever had sore knees? It makes it hard to climb stairs. Even walking can be a challenge when your knees hurt. Most people take NSAIDs (nonsteroidal anti-inflammatory drugs) like celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Advil, Motrin, etc), naproxen (Aleve, Naprosyn) or meloxicam (Mobic). Such medications come with a lot of side effects. You can learn more about the dark side of NSAIDs at this link.  Others, like this doctor, have gone way beyond NSAIDs with limited success.

Other Treatments for Sore Knees:

Q. I am a physician, but traditional medicine has let me down. Knee surgery has not helped my sore knees. Neither have stem cell injections.

I have tried oral supplements without much success. Any suggestions?

A. Have you considered a topical NSAID such as diclofenac gel for your sore knees? It should be less likely to cause systemic side effects than oral drugs like ibuprofen or naproxen.

There is a surprising amount of controversy surrounding topical NSAIDs. The FDA requires a scary warning about drugs like Voltaren Gel. Here is our take on this complex issue:

Stories from Readers:

Richard in Washington shared this story:

“I was prescribed Voltaren Gel for knee and back pain some years ago. The stuff was magic but at $50 per tube I only used it when I absolutely needed it. On a trip to Canada I discovered it was available over the counter for $17 a tube. I buy a couple of tubes every trip.”

Maggie in Alabama has a similar story:

“I was prescribed Voltaren gel for arthritis in my feet. Didn’t expect much, but got pain relief within minutes. Unfortunately, my co-pay was $42.00, which kind of pissed me off.

“I researched Voltaren, and saw it was available over the counter in Canada, so I had a friend get me several tubes at a time. I’ve been on SSD for a decade, but Voltaren has allowed me to work part-time. It works so well, for me anyway, that there’s no reason for it not to be OTC, except that pharmaceutical companies like the money.”

We do think people should consult their health care professionals before using topical NSAIDs. Some individuals are so sensitive to such drugs that even topical formulations cause them stomach upset or high blood pressure.

Other Options for Sore Knees:

Even though you have not had success with supplements, have you tried turmeric (curcumin), ashwagandha, boswellia, ginger, MSM, SAMe, tart cherry juice or pineapple (bromelain)? We recognize that as a physician you will want some scientific support for such alternative approaches. You will find it and more details in our eGuide, Alternatives for Arthritis. Look in the Health Guide section of www.PeoplesPharmacy.com.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
Alternatives for Arthritis
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This eGuide describes nondrug alternatives for arthritis with the latest scientific studies to document anti-inflammatory activity. This comprehensive online guide (too long to print) adds the science behind ancient healing traditions.

Alternatives for Arthritis
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My husband had severe knee pain; the doctor said he would need a knee replacement. Out of desperation, I bought Copperfit knee braces. What could we lose at that point? They worked a miracle. He wore them every day for a few months and then as needed. He rarely needs them now. I don’t know why they work but they do. I also bought a pair for me since occasionally my knees would ache. I put them on when I will be doing strenuous activity and whenever my knees ache, and the next day I have no knee pain.

I take turmeric and collagen and bone broths for inflammation. Last year my knee cap was pulling to outside, and meniscus issues after physical therapy were not working. I finally saw chiropractor, and he fixed it in one adjustment with the spring-loaded tool he uses. Pain gone instantly.

I went to a pain management specialist last Dec. ’18 and he did a nerve block on my knee. I had instant relief. This is mid-June, and I still have no pain. It is wonderful, and it has eliminated the need for knee surgery.

I’ve had knee problems for decades. When I was 65, a severe problem occurred, and surgery was recommended. But after doing some research, instead of surgery I opted for physical therapy to strengthen the supporting muscles to help both of my knees. I continue to do some of the exercises daily and my knees are doing very well without surgery or injections. I turn 70 in two months, and my knees are doing very well.

“Sore knees” is a vague category, but I believe the answer is not a drug but a muscle: the quadriceps, the big muscle on the front of your thigh that connects hip to knee. About ten years ago I damaged my right knee but chose not to have surgery. A physical therapist showed me a simple exercise that she said would keep me out of pain if I would do it regularly. I am not a disciplined person, but I do that exercise as well as careful stretching. In time the meniscus deteriorated to the point that the knee is “bone on bone,” but I am still a happy hiker, swimmer, and walker. If you keep your quads both stretched and active, in my experience the knees will be fine. Ask a physical therapist!

I have read and tried many of the remedies mentioned. The use of arnica was helpful in acute, but not so in chronic soreness. Good shoes are always a worthwhile consideration, and the results will be immediate. I have personally found MSM and Glucose Sulfate ineffective after 9 months of personal trial. Correct taping has helped me and my patients in acute cases. The two most effective and lasting approaches I have used have been acupuncture with the use of moxabustion for 8x over two months and losing 20% of my body weight I am 270lbs.

My radiologist told me my knees were a lost cause and I needed two knee replacements. I thanked him for his opinion, stated losing weight and using acupuncture (and qi gong). I must add that as a 40 year practitioner of Tai Chi Chuan, I have found it has made my knee problems worse without strict care in playing the form. Presently I have not lost 20% yet, but working on it and I am free of knee pain.

I have been crippled by RH Arthritis in the past. It was worst in my knees. I have treated it successfully with diet and homeopathy so I am fully-functioning and pain-free 30 years later. Anti-inflammatory diet with all intolerances removed, coupled with daily walking and homeopathy were what worked for me.

As a woman who has successfully avoided bilateral knee replacement since it was first recommended in my early 40s (1995), I’ve had plenty of knee pain experience.

What’s helped me:
* supportive footwear with frequent replacement when heels have 1/8th inch of wear
* prescription orthotics
* elevate knees for 2 hrs. each evening (zero gravity chair) to facilitate fluid drainage & decrease Baker’s cysts
* walking several times per day (2 – 5 mi. total)
* avoidance of uneven surfaces
* low-nightshade diet
* supplements: SAMe, EPA fish oil, cetyl myristoleate
* Ketoprofen topical gel (compound Rx; used on racehorses).

I no longer tolerate oral NSAIDs.

I think understanding the cause of one’s knee pain helps one address contributory factors. These will vary from person to person. I hope you will be successful in finding ways to ease your pain.

Thank you, and I agree. Please explain Prolotherapy.

No one so far has mentioned weight loss. If every pound lost (with physician approval of course), is 3 to 4 pounds of stress less on your knees so a 10 pound weight loss may reduce 40 pounds stress off your knees.

I started having arthritis pain in my knees about 10 years ago. My doctor prescribed Voltaren gel, but after reading potential side effects, I didn’t want to use it. My doc assured me that those were limited to the oral medication so I started using the gel. Even though I used less than directed, I got excellent relief. Then, three weeks down the line, I suddenly developed major edema in the ankle on the leg I’d been treating, and that evening my blood pressure zoomed up to 220/110. I ended up in the ER being monitored for about six hours until my BP was down to a more normal range.

Recently, I developed statin myopathy after a big dose increase and had to stop statins completely. It took about three months to recover and, to my surprise, all of my arthritis pains disappeared too. I had had one knee replaced and was well on the way to needing surgery on the other. It is pain-free now. Unfortunately I will have to try statins again because of high cholesterol.

My sore knees (and hip) turned out to be the result of not stretching the large leg muscles. When these contract they put significant pressure on the joints as well as the nerves in this area. I went from almost having a knee and hip replacement to no pain at all after going to physical therapy. Hyaluronic acid also helped to lubricate the joints, and now I’m pain free. Keep in mind that if you have bone on bone PT won’t help this much so that is a different story.

I have been taking a combination of turmeric and curcumin for years with much success (do a Google search on products). When I run out, I notice!

For my bad knee [bone on bone], I take 1000 mg/ x2 a day of Turmeric, plus 25 mg/ x 2 a day of Celery Seed Extract [85% 3nB].

In addition, I purchased a pair of “Hoka One-One” tennis shoes. They are “unbelievable. They actually force you to walk heel to toe, like you’re supposed to and helped correct my pronation of my foot. That along with some Quad exercises from ‘Youtube’ to strengthen my thigh muscles, and
I’m actually walking like I should: pain free.

In addition, I suspect it also helped my lower back ‘Fascet” joints to relieve the pain I had been having there.

It’s wonderful to be pain free.

The doc tried stem cell injections for knee pain that did not work. I attended a “seminar” that was actually a slick sales presentation given with a free buffet for all attendees. It reminded me of a time share pitch I saw in the 80s and that alone saved me from getting sucked in. On line research showed many non-MD practitioners making claims.

How did stem cell treatments go wild like this? Did the FDA lose their grip? Are any stem cell offerings legit? I’d love to get your take on this phenomenon.

Please note that diclofenac is not the generic name for Naproxen. One of the brand names for diclofenac is Voltaren, as stated later in the article. Naproxen is the generic name for Naprosyn, Naprelan, Aleve, and Anaprox.

I would like Peoples Pharmacy to look into Prolozone injections into knees.

Check your diet! The pain may be caused by an unsuspected allergy to food or drink that you have been using. In my experience, just eliminate a single item for a time and see if the pain disappears–keep doing this until you find the culprit (or culprits).

I went to my doctor for a painful knee last year, and she sent me to physical therapy after doing some testing and finding arthritis in the knee. The PT really worked. Basically I was strengthening the thigh muscles and hip muscles which support the knee, and I was very faithful in doing the prescribed exercises at home. Of course, the success of PT will depend on what’s going on with your knees, but this was a striking success for me.

I would refer people to the People’s Pharmacy show on Prolotherapy. There is no industrial push for this as no company can make much money on Dextrose and water injections. Fibroblasts on skin and in joints grow well along planes of sugar as cells without blood supply get shed. Dr Knutson and the Prolotherapy people are onto something sweet.

I’m writing from British Columbia, Canada, to comment on the Voltaren question. I have a recently purchased 100 gram (3.5 oz) tube of Voltaren Emulgel (1.16%) that probably cost $20 Canadian and a 50 gram (1.75 oz) drug store bottle of diclofenac cream (10%) that cost around $30 Canadian in 2015. Perhaps it is the concentration of diclofenac that is the difference.

Recently I was told I have a Baker’s cyst behind the knee, which I was told is the result of knee arthritis and synovial fluid draining off my knee. To me, this explains why my knees have felt like there is no cushioning in my knee joints and I’m having more difficulty in walking and doing stairs. Is there any way to restore the fluid??

I’ve recently had very good outcomes using arnica gel on my knees and thumb joints 2–3 times a day. It works just as well for me as Voltaren gel. I first bought it in a health food store, but have since found a larger tube (same brand; twice as large) online for the same price. It is not sticky or gooey, I use less than the Voltaren, and it easily washes off my hands. I just rub it in until it’s dry to the touch. I saw one comment about knee injections helping, but they only work if you still have cartilage left in your knees. They will not work for bone-on-bone pain or after knee replacement.

I was on vacation in Toronto Canada a couple of years ago and was amazed to find extra-strength Volatan, an over the counter product for only $12. USD. What an eye-opener.

Years ago I had HYALURONIC ACID injections, and it worked wonders.

Also I made a point of strength training with squats and deadlifts. My knees are now pain free.

Regarding the sore knees, I had the same problem but refuse to take NSAIDS or pain pills. I have gone to a chiropractor once a month for many years and mentioned the problem. Now each time I go, I get my knees adjusted by the chiropractor! Sounds crazy but it has made a huge difference for me and helped my knees quite a bit.

What about stem cell injections ? I am very surprised at People’s Pharmacy’s silence on an explosion of full page adds offering stem cell therapy as a solution to many health problems .

Acupuncture and Chinese Medicine. They work most of the time
Qigong

To manage mild to severe osteoarthritis in both knees, I have tried oral and topical NASIDs, turmeric, ginger, MSM, SAMe and tart cherry juice. While trying to avoid surgery because of sensitivity and reactions to metals and plastics, both used in prosthetics for knees, I also avoid overuse by keeping stairs and steep areas (going up or down) to a minimum. I discovered physical therapy exercises expressly to build support for the knees and CBD ointment to be my go-to solutions. I have had too many friends who were on cloud 9 after injections and surgeries to be let down when the solutions eventually fail. They return to more pain and much less money!

Here’s what I’ve done for my own sore knees, and these help a lot:

1) I bought new running shoes that prevent me from pronating. Amazingly helpful!

2) I used kinesio tape to decrease knee tendinitis that was caused by my previous running shoes whose soles had worn down, causing me to pronate.

3) I went to a podiatrist who referred me to a physical therapy group, and I learned some achilles tendon (and other) stretches from the physical therapist.

4) I take oral glucose-amine sulfate with MSM.

5) I take oral bromelain/papain that is anti-inflammatory.

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