I'm 30 years and recently i have been diagnosed with OA in my knees

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hi... recently had gone to rheumatologist for knee pain ... he diagnosed me with OA in my knees i'm really depressed and worried as i think im young to get diagnosed with OA though no one has it in my family and i have never injured my knes... but i had high uric acid lvel 8.3.. so i think my OA is due to uric acid level.. though after medication its under control.. but m really worried about my OA progression and m afraid i'll b able to work normally with my job in future... cos my profession demands lot of physical activity..

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  • Posted

    I was going to ask the same as Susan has. I was told I had OA in my knees and hands about 10 years ago but it wasn't OA at all as there is no evidence of it now. Joint pain due to uric acid isn't usually OA, it's gout

    I'd be asking for a second opinion if there isn't real evidence of OA that you have been shown. The rheumy who told me I had it just examined my knees and bent them a bit "I can feel it" she said. 

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  • Posted

    my dr. diagnosed my OA with the help of Xray. and for uric acid he asked for a blood test..
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    • Posted

      Then as Eileen says - take it with a pinch of salt.

      Nowadays OA is diagnosed in over 45 year olds without even getting xrays. If you feel pain in your joints then if they rule out other causes such as RA then it's deemed to be OA.

      When you're younger more investigations are required. But still I wouldn't take the OA diagnosis as gospel as all it really means is that you have sore joints that can't be explained by anything else.

      It's not normal to have degenerative changes in joints at your age but it can happen. Provided that wear doesn't continue it's not the end of the world. But you need to find out WHY your knee joints are wearing. That's important.

      My personal guess (massive big guess because I know nothing about you) is movement impairment. What is your posture like? Do your feet point out when you stand walk? Try digging your fingers into your quads - outside edge, just above the knee. Poke about quite hard in there. Do you feel any sore, tender spots in the muscle? If so, massage them as hard as you can tollerate - it will hurt. Just put pressure on the sore bit and hold for 10 - 20 seconds. Then do the same in your calf muscle - behind and below your knee - again, outside edge of the muscle. Treat any sore spots you find there.

      Did you find sore spots, did massaging them ease off symptoms at all? This is all clues that you need to look for.

      As well as taking Eileen's advise and saying  you're not happy to accept an OA diagnosis (for which there is no cure) without first ruling out all other causes - including soft tissue causes. OA is a cop out diganosis. A way of getting rid of a tricky problem.

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    • Posted

      Reason they don't use xrays any more for over 45's is that xray evidence of dengerative changes is meaningless. Most people have it after 45 but with zero symptoms. It's not normal at 30 but it happens. In itself not that big a deal.
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    • Posted

      hi susan thanx for concern and ur advice... susan is it possible to avoid knee surgery and lead a normal working life till i get retire from my job @ 60yrs because my jobI(im govt employee) is only source of income for me and im also going to get married soon... so whever i think of future and read bout OA progression it scares me... and i feel dipression i have not talked about my OA with my fiance as m afraid how will she react to it .....
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    • Posted

      This is what makes me so angry about an OA diagnois. They hand them out like sweeties without regards for the damage it does. It becomes a self-fulfilling prophecy for many.

      There are never guarantees, but honestly - an OA diagnosis means nothing. When you really look into it you discover that it's NOT really a diagnosis but more a description of symptoms. Sore joints. That's all it tells you - well, you already knew you had sore joints - that's why you went to the doctor. He has let you know that you also have joint wear so that's a heads up - it's important to get to the bottom of this so you can stop your joints wearing further. But it doesn't mean you're not going to be able to work or that you'll need surgery.

      Very many people diagnosed with OA just ignore the diagnosis. Do nothing, carry on as normal and never have any further problem. I have a 55 year ultradistance running friend that was told he had severe OA in his knees at about 50 years old. He stopped running as advised but after a year he was miserable. He went back to running and hasn't had any further issues with his knees. He races up and down mountains, does 5k in 20 minutes, has cycled around Europe, runs races of 100km at a time - and does well. He's actually very competetive for his age. He says he can still sense something isn't quite right with his knees but he never has pain or other problems.

      Other people - like me - have to find the root cause of their problem and work hard to put things right. Just pushing through didn't work for me.  But I'm now 100% cured and symptom free. My problem was muscle imbalances.

      Some people go on to have severe pain and wrecked lives. You have to wonder how much is down to the doctors putting such depressing notions in their heads! But it can't be ignored - some do have serious problems. There is absolutely no reason to think you'll be one of them and you have every reason to fight hard to make sure you're taken seriously and that you're given answers.

      There is no reason for you to think the worst. I wouldn't recommend just ignoring. At your age I'd be looking for the root cause. Have you been to a physical therapist? They aren't brilliant at sorting these things out, but if you explain the situation and say you want to identify any movement impairments or postural problems that might put strain on your knees they may be able to help. Don't get conned into forking out a small fortune for lengthly treatments though (been there, done that!). And DON'T give up if they too say it's OA - they're all trained the same way unfortunately and all make the same mistakes.

      I'm not alowed to post links here, but go to my profile and you'll find a link to my website where I share my story and lots of self-help information.

      Do what I advise re checking for trigger points. You'll find out more about trigger points on my website. This costs nothing and could eliminate your symptoms completely.

      Don't be depressed. There is every reason to hope for a full resolution - you may have to put in a bit of hard work to get it, but WAY too soon to think the worst.

       

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    • Posted

      hey susan thank u so much for ur support and advice to me .... ur reply has really motivated and inspired me .... now i feel more energetic and also very eager to find out the exact cause of my knee pain... once again thank u very much... 

      sincerely roopesh

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    • Posted

      Thanks Susan - pretty much what i'd have added to my first post!

      You can provide links if you use a pm - click on the envelope below the person's avatar on their post.

      I saw a superb podiatrist - on the NHS but she was exceptional who identified a postural reason for pain. As Susan says - knee pain can often come from knock-knees, back problems, pelvis being out of alignment but you will rarely find a UK orthopod or rheumatologist who will mention any of that, it is taken far more seriously in mainland Europe. 

      Investigate options such as osteopathy and Bowen therapy - but not for weeks and weeks without end as many chiropractors will try to convince you is needed, If Bowen hasn't improved the situation after 3 sessions it won't.

      But a prognosis over 20 or 30 years isn't possible for anyone - and there is a LOT you can do to help in the longterm. It is now accepted that exercise helps - it isn't to be avoided but it does help if any postural problems leaving you lop-sided have been sorted.

      Good luck!

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  • Posted

    Hello Roopesh

    We all get health issues sooner or later but we have to get on with life, right ?

    About the uric acid, it's in red meat, red wine, chocolate, seafood, spinach and some other foods. Controlling your diet will help, uric acid is the cause of gout.

    I had gout 15 years ago but not anymore. 

    Alpine

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    • Posted

      thanx alpine.. for ur concern and advices.. it will be of great help to me...

      u controlled ur gout by avoiding foods with uric acid?? or r ualso taking medicines...

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    • Posted

      I took medication at first and soon learned what foods to avoid. The problem has not returned for several years. It began in 2000 with severe knee pain, a GP told me it was O/A but never carried out any tests. Another doctor was correct in identifying gout.

      Alpine

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    • Posted

      This is posted as a reply to alpine so it will appear just here - it is directed at roopesh too.

      Can I just point out that it isn't uric acid as such in the food - uric acid is the waste product from substances called purines, present in some foods and all your own cells. It is foods with lots of purines you should avoid altogether and those with moderate amounts should be kept in moderation. Meat as such is not the biggest offender.

      The Gout Society has an excellent article about managing diet to reduce flares of gout and this is just a small extract:

      "High purine foods include: (avoid)

      •Offal - liver and kidneys, heart and sweetbreads

      •Game - pheasant, rabbit, venison

      •Oily fish - anchovies, herring, mackerel, sardines, sprats, whitebait, trout

      •Seafood - especially mussels, crab, shrimps and other shellfish, fish roe, caviar

      •Meat and Yeast Extracts - Marmite, Bovril, commercial gravy as well as beer

      Moderate purine foods (eat in moderation)

      •Meat - beef, lamb chicken, pork

      •Poultry - chicken and duck

      •Dried peas, beans and legumes - baked beans, kidney beans, soya beans and peas etc.

      •Mushrooms and mycoprotein (Quorn™)

      •Some vegetables - asparagus, cauliflower, spinach

      Wholegrains - bran, oatbran,wholemeal bread

      Low purine foods

      •Dairy - milk, cheese, yoghurt, butter

      •Eggs

      •Bread and cereals - (except wholegrain)

      •Pasta and noodles

      •Fruit and vegetables (see moderate purine list)

      How much protein do you need?

      Generally you need about 1g of protein per kg of body weight (70kg man only requires 70g of protein daily), unless you are on a protein restricted diet e.g., some people with kidney disease may need to restrict their intake.  

      Here are some examples of protein content of food:  

      •100g (3.5oz) chicken breast contains 22g protein

      •100g cod fillet contains 21g protein

      •Large egg contains 6g

      •30g (1oz) hard cheese contains 8g protein

      •30g cottage cheese contains 14g protein

      •30g almonds contain 5g protein

      Protein is very important part of your diet, it used for growth and repair, as well as an energy source. Not only that, but eating sufficient protein improves satiety (how full you feel) as well as blood sugar control.

      However, as its important to use high purine/moderate protein foods with caution, then you are best to combine both animal and vegetarian sources of protein. Studies have shown that vegetarian diets that are high in purines (e.g. from lentils etc.) are much less likely to lead to gout.

      In addition, red meat is a very good source of iron and is easily absorbed by the body. Other foods such as eggs and pulses contain iron, but in a form that the body finds hard to absorb. However, the absorption of iron can be improved if you also eat vitamin C - rich foods in the same meal e.g., add green and red peppers to scrambled eggs.

      Some people find that certain foods such as strawberries, oranges, tomatoes and nuts will trigger their gout even though they are not high in purines. Although there is no clear evidence to suggest why this happens, it is probably best to avoid them if you have had this experience."

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  • Posted

    Hello Eileen

    Must confess I never heard of purines but I looked up uric acid many years ago and found a list of foods to avoid. From then on I have been gout free. 

    Alpine

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    • Posted

      Absolutely not disputing that - just adding the details of why.

      But there are things that are more important to avoid than just red meat - which is fine in small amounts and an important source of portein and iron.

      The western diet includes far too much meat but meat per se is OK. Go for a steak in the US and it will be about 4 times what you need/should eat if you are prone to gout. There is no real reason to avoid a nice bit of steak, lamb or pork as long as it is a sensible sized piece (less than 4oz). 

      And beer is far worse for the gout sufferer than wine!

      " In one of the largest studies of its kind a group of leading American researchers has for 12 years charted the effect of alcohol consumption on gout among 47,000 people.

      The results - Beer: Contains the most purines and is the greatest offender. As few as two to four beers per week increase the risk of gout by 25 percent. Those drinking two or more per day increase their risk by a whopping 200 per cent.

      Spirits: Those consuming as little as one drink per month are at increased risk of a gout attack. Those who drink daily increase their risk by 6 per cent.

      Wine: The clear winner when it comes to the drink of choice for gout sufferers. Though wine also contains purines, the study concludes it has no measurable effect on the instances of gout."

      And another comforter: while "candy" chocolate is bad for gout, real dark chocolate isn't and even helps in a gout attack:

      "Very simply, cacao contains flavonoids, powerful antioxidants that fight the symptoms of gout lowering blood pressure and cholesterol levels and as these antioxidants improve blood circulation, they in turn increase the amount of uric acid levels that is dissolved in your bloodstream being finally processed properly and out of your urine and into your toilet bowl. Raw cacao prevents inflammation due to its interaction with leukotrienes providing relief from a gout attack working the same way NSAIDs do whereby the flavonoids and polyphenols work together and act as COX2 inhibitors decreasing pain in your joints. Cacao’s antioxidant properties help keep your body functioning at its optimal best and that also includes the proper functioning of your kidneys which is so important for the gout sufferer in preventing future gout attacks."

      Of course, individual people will have their own personal triggers and it may be that wine or chocolate do it for you. But otherwise, no need to omit them altogether. Moderation in all things!

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