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Knee/leg pain 2nd time around

AnonymousUserAAnonymousUser Posts: 49,662
Hello all- 2nd time posting here . My original post about 10 months ago concerned pain primarily in my left knee (with slight trunk pain also). I have had 2 disc surgeries- L4-5 - the most recent 30 months ago and also 2 knee surgeries on that knee area (ACL and microfracture 6-8 years back)..Am active (cycle,spinning class etc) and have generally been pain free post surgeries. Age 54
Last October/November I started having severe knee area leg pain but no other issues. Went to my doctors and they were concerned given the history and did an MRI which was negative. Prescribed dose pack and PT which seemed to work- pain subsided. Well, it has returned-exact same pain as last time -does not respond much to OTC pain meds and is worse the more that I am up weight bearing. I actually went cycling a few days ago and did fine but hurt badly after.I don't appear to have any objective defecits- can walk on my toes and heels etc and no bladder function problems etc.

Has anyone had or heard of this type situation ? Perhaps this is just something that will happen from time to time and go away after a few weeks. Hope so. I hate to go see the docs again with this . Thanks in advance for any ideas. James


  • If you have no other symptoms, is it more likely that it is some sort of structural problem with the knee itself?

    It would be unusual to have knee pain caused by a lumbar spinal nerve, and to have no other locations of pain in other parts of the leg, hip or foot. Perhaps it is an arthritic condition or scar tissue from the two knee surgeries...maybe even gout?

    Does it help to ice it after activity?

    You can run a search for dermatome map or chart to see which nerve roots cover the knee (front of knee is mainly L4, while the back of the knee is covered by S1 and S2.)

    By dose pack, I assume you are referring to a Medral pack, which is a steroid. Your knee would probably respond to that regardless of the cause of your pain, as it would help inflammation of the soft tissue of the knee, and also would help the areas of the spine that might be inflamed...so you cannot really rule anything in or out based on the fact that the medicine helped somewhat.
  • Gwennie 17- thanks for the reply. It is indeed unusual but essentially the same pain I had prior to disc surgery. I never presented with typical L4-L5 pain. Actually went to my knee doc (ortho) and he suspected disc after ruling out any additional knee issues. I did PT, injections , pain meds for about 6 months before finally having the surgery which brought immediate relief. Reading elsewhere on this site I saw someone commented on the irritating fluid released from annular tears- maybe something like that which could explain why Medrol dose pack had some impact last time. Have been having mostly 7-8 type pain past few days- appt with ortho tomorrow. Thanks again- I will keep you posted. James
  • If you had discectomies, it is possible you have reherniated the same disc. Years ago they used to remove the whole disc, which kept the number of reherniations down!! But it left patients with a "bone on bone" situation which was equally painful. Now they remove the portion of the disc that is bulging or spilling out, leaving other parts of the disc behind. (to cause more trouble at a later time??)

    I'll be interested to hear what you learn at your appointment!! Please let us know.
  • Gwennie- Mayo in Florida . I saw ortho doc last week - he is fairly well convinced not knee structural issues- although there are some. To test, he gave me cortisone injection in the knee joint- has had zero effect. NS appt in 2 weeks. Good level of pain when I am weight bearing and getting a little depressed just thinking about what might be ahead.
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