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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10341
Experience:  14 years experience in the field of Family Practice
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I'm assuming this isn't 'free' medical advice. I'm suffering

Customer Question

Customer: Hello.. I'm assuming this isn't 'free' medical advice.
JA: Thanks. Can you give me any more details about your issue?
Customer: I'm suffering from chronic R knee pain. It was involved in an accident several years ago...In the last few years I've suffered from moderate/severe pain in the right knee. I I've had several X-rays, MRI's, CATs. with nothing structural showing; however, it's bee drained multiple times and I I've seen mult ortho guys show can't decide on Gout, Pseudo Gout or other so my MD just continued with the Norco 5..He passed away. My new MD is not willing to do so. How do I approach this to keep from pain and avoid a gap in therapy?
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Submitted: 1 year ago.
Category: Medical
Expert:  Anthony Bray, MD replied 1 year ago.


I think best if you may establish with an orthopedic specialist for the knee pain. Ongoing follow up to determine cause if possible is in your best interest. Ortho would probably continue you on pain regimen (Norco or similar)

You may benefit from an anti-inflammatory ( Aleve over the counter 2 tablets twice a day with food for example ) Rx options may be considered ---Lodine / Voltaren/Celebrex

Topical application such as Aspercream may help...

Check your blood for uric acid level should help differentiate if gout is serious consideration of cause...

Osteoarthritis is most common... Status of cartilage in joint would be helpful to guide treatment..possible that measures such as steroid injectioon to knee or Synvisc or similar may be helpful

I hope that this information is helpful for you.Let me know if you have further questions or concerns.I will be happy to get back with you.If my answers have been helpful and to your satisfaction then please remember to leave positive feedback Thank you and best regards,

Anthony Bray MD

Customer: replied 1 year ago.
The two Ortho specialists have drained and administered injections (not certain what meds) to mitigate pain/recurrence. They don't thing Gout is the driver. At the end of the day, they're not receptive to long-term pain management.I've an aggressive leadership position with a Fortune 10 company requiring travel throughout the US at short notice. This is a significant at-risk situation, personally and professionally. Insurance, out-of pocket costs aren't any issue- I need to identify a solution.
Thanks you.
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

You may benefit to seek to consult a pain management specialist for help with the chronic pain. I understand your situation. Many doctors feel under much pressure to avoid prescribing narcotic pain meds for longer than a couple of weeks ( much pressure and scrutiny by DEA on that issue ) This is not to say that you don't NEED pain relief but it is recognized that the climate these days makes the pain control issue more complex. It is more standard of care these days to have specialist such as ortho WORK WITH pain management specialist when opioid meds such as Norco are needed.

A pain management specialist could handle the more potent aspects of pain relief for you but you may see an ortho for other aspects of follow up care of your knee joint....

Other measures that should be helpful >>>

NSAID such as Iodine / Voltaren / Celebrex

Supplement >>chondroitin sulfate and glucosamine 1200/1500mg/day

Topical to knee such as Aspercream

Physical therapy .....

I hope that this is helpful for you. Let me know if you have further questions. I will be happy to get back with you

Best Regards,

Anthony Bray MD