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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35768
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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About 6 months ago my left knee swelled up and was very

Resolved Question:

About 6 months ago my left knee swelled up and was very painful. I bought a therauptic brace and wore it for about 2 weeks and the swelling left but the pain has stayed. It has now went up into my left hip and the front of my leg around to my groin area. I have trouble going up stairs and walking any length of time. The pain wakes me up at night and the only way I can sleep is on my back without a lot of pain. I have 2 heart valves that have to be replaced and I was wondering if maybe that is part of the problem.
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 8 years ago.


What are the treatment and investigations done for your pain?

Dr. Arun

Customer: replied 8 years ago.
I went to my family Doctor when my knee swelled and he is the one who told me to wear the brace and to make an appoointment to have an MRI but I don't know who to go to to have it done.
Expert:  Dr. Arun Phophalia replied 8 years ago.


You need to contact an orthopedic surgeon for evaluation and investigations. This is likely related to osteoarthritis, though a family history of Lupus does warrants blood work specifically for it. This does not look related to rheumatic disease. The pain extending up to the thigh and groin is due to abnormal weight bearing to protect from pain and thus other muscles and joints in lower limb have been affected. The conservative therapy of the osteoarthritis knee is following:

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.

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.

6) Glucosamine and chondroitin orally for about 1-2 years and a trial of diacerin for three months.

7) Hyaluronic acid injections in knee.

8) Local analgesic sprays and ointments to your skin may help relieve the pain and stiffness of osteoarthritis.

9) Deep Electrotherapy by physical therapist. Please see these resources for the exercises (you can pick which suits you best);

Please feel free for your follow up questions.

Dr. Arun

Customer: replied 8 years ago.
What kind of anti-inflamatory medice and what can I do to ease the pain at night
Expert:  Dr. Arun Phophalia replied 8 years ago.


For the night pain, ideally you should take some narcotic analgesics. But you would need prescription for it. Diclofenac sodium is one of the best anti-inflammatory, but again it is not over the counter. A night pain is an indication of the total hip replacement, so getting an MRI and an orthopedic consultation is further course of action. Warm moist compresses before going to bed and then application of an analgesic patch should ease the pain.

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Dr. Arun

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