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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31609
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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CBC information WBC is 7.7, platelets 219 anc 6.2 gran%80.1

Customer Question

Customer: CBC information WBC is 7.7, platelets 219 anc 6.2 gran%80.1 i have been having some knee pain all other are normal
JA: Thanks. Can you give me any more details about your issue?
Customer: knee pain x 2 weeks. i have a history of anemia
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Submitted: 11 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 11 months ago.

Hello,

I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

Your investigations are normal and do not indicate any specific diagnosis for the knee pain. You may need a x-ray and MRI to ascertain the cause of pain in knee. You may also need blood work for autoimmune panel and gout. Following measures would be helpful in the knee pain, meanwhile;

1) Knee care in the activities of daily living. Few simple self-care measures can be remarkably effective in ending pain cycle.

a) Avoid prolonged standing or walking or sitting with joint in a single position.

b) whenever you sit, keep the knee stretched and fold them intermittently.

c) Squatting, sitting cross legged should not be done.

d) Avoid climbing stairs.

e) Avoid sitting legs unsupported or hanging.

f) Reduce weight if over weight/obese.

2) Rest: Taking a break from your normal activities reduces repetitive strain on your knee, gives the time to heal and helps prevent further damage.

3) Anti-inflammatory medications

4) Physical therapy; the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Ideal is supervised physical therapy. Stretching exercises are also part of the physical therapy regime.

5) Orthotics and bracing.

The most common causes of anemia are;

1) iron deficiency (with or without blood loss),

2) chronic disease/inflammation

3) chronic kidney disease

4) deficiencies of folate or vitamin B-12,

5) diseases of the bone marrow

6) hypothyroidism, hypersplenism, and hemolytic anemia

So investigations entail (if not already done);

1) Complete blood count (CBC)

2) Peripheral blood film

3) Vitamin B-12

4) Folate

5) Reticulocyte count

6) LDH

7) Thyroid-stimulating hormone

8) Serum creatinine and estimated glomerular filtration rate

9) Serum ferritin

10) Serum iron

11) Total iron-binding capacity

So these investigations need to be done for the exact assessment and long term management.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 11 months ago.

Apart from the analgesic; following would help you for the knee pain, meanwhile;

1) Physical therapy; this is the mainstay of the management of the knee pain. Stretching exercises, strengthening exercises, mild weight bearing exercises, swimming on the week-ends etc would be helpful.

2) Deep electrotherapy; this entails going to physical therapy center and take care of specific issues which are more painful.

3) Glucosamine and chondroitin supplements

4) Diacerin too can be tried which suppose to regenerate the cartilage, if this is its damage due to injury or age.

5) Local analgesic sprays

6) Acupuncture

7) Consideration of hyaluronic acid injection in the joint. Some physician may inject steroid too for the pain relief.

8) Warm shower in morning would open up the joints.

9) Capsaicin (Zostrix, ArthriCare) is an irritant derived from chili peppers that provide relief by depleting a chemical that transmits pain from nerve endings. Various strengths are available without prescription. (It causes a burning sensation thus one has to be careful while applying and should wear a disposable plastic glove). This is used only in moderate to severe chronic pain.

10) Acupuncture; most popular forms of alternative or complementary medicine, particularly for pain relief.

11) Analgesic patches too are available for the pain relief.

These are the exercise resources for the knee. You can pick the exercises which suits you;

http://bigkneepain.com/knee-exercises.html

http://www.pamf.org/sports/king/kneerehab.html

If overweight is an issue; long term is achieved by weight reduction. High impact exercises should be avoided; like kneeling and bending. These supplements help in rebuild the cartilage;

1) Omega-3 fatty acids, such as fish oil,
2) SAMe (s-adenosyl-L-methionine), 600 mg daily.
3) Glucosamine/chondroitin, 1,500 mg daily.
4) Bromelain, 250 mg twice a day.

Following homeopathic remedies are suppose to help;

1) Bryonia
2) Graphites

Following herbs are suppose to be good;

1) Ginger
2) Cat's claw
3) Willow bark
4) Turmeric
5) Devil's claw.

You may get an MRI to assess the exact cause of pain, if not yet done.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 11 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.

Expert:  Dr. Arun Phophalia replied 11 months ago.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 11 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.

Expert:  Dr. Arun Phophalia replied 11 months ago.

Hope you are doing good.

Let me know if you have any follow up questions.

Regards,

Expert:  Dr. Arun Phophalia replied 11 months ago.

Merry Christmas and a very Happy New Year 2016.

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