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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5071
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I am 57 years old and have arthritis in both ankles. One I

Customer Question

I am 57 years old and have arthritis in both ankles. One I broke playing squash in my younger days and the other a couple of years ago. My problem is they ache and cramp at night often waking me up. Plus the old break burns. I also have it in my hands and finger which ache and get pin and needles. I work standing on my feet during the day. I've also had a knee replacement on the same leg as bad ankle and a spinal fusion. I am trying very hard to lose weight. Have lost 7 kg but need to lose another 12 kg. do you think the diet shakes work and any other suggestions for my cramps as they almost feel crippling.
Submitted: 28 days ago.
Category: Neurology
Expert:  Dr. Bob replied 28 days ago.

Diet shakes can work if they supress your appetite, but they are not a good long term solution. You should see a nutritionist and get on a low calorie diet. You should also exercise more, which is probably very hard for you given your arthritis. The best exercise in a situation like this is swimming, as our weight in the water is only about 1/5 of what it is on dry land, allowing one to exercise more with less pain and wear and tear on the joints and back. As for the cramps, you should check in with your GP to make sure it is not related to a vitamin or electrolyte deficiency. You should also work with a physical therapist on a home program of twice daily stretching that will reduce the frequency and severity of your cramps. In addition, you can ask your GP about muscle relaxers which reduce cramping and help people sleep at night.

Customer: replied 28 days ago.
The scariest part for me is my dad suffers the same problem and can barely stand for long and his tried all the gimmicks went to naturopath and has never had weight issues however was a heavy smoker and drinker. I have never smoked , did drink in my younger days and I used to walk twice a day most days kind of an addiction for an hour each session. I'm not a good swimmer but am willing to try. I have mentioned to my gp the cramping and burning and asked if it could be nerve damage. He said could be and told me to take panadol 3 times a day.
Expert:  Dr. Bob replied 28 days ago.

That's acetaminophen (tylenol) which may help with pain but does nothing for cramping or inflammation. For these you would need a muscle relaxer (eg. flexeril, baclofen) or an antiinflammatory (eg. ibuprofen, naproxyn). If your joints are really bad, I would recommend that in addition to seeing a physical therapist, that you also see a rheumatologist. These are the doctors who specialize in diagnosing and treating diseases of the joints.

Customer: replied 28 days ago.
I'm a bit scared to take ibuprofen as I have a hiatus hernia and take nexium he did tell me to take voltaren and double the nexium dose. Do I need a referral to see physical therapist and rheumatologist? Maybe my dad should try them he is very grumpy and just lays around seems depressed to me.
Expert:  Dr. Bob replied 28 days ago.

Yes. You could benefit from both referrals. Your dad as well.

Customer: replied 27 days ago.
Thank you excellent advice
Expert:  Dr. Bob replied 26 days ago.

You're welcome. Hope all works out for the best for you.

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