 Poster: A snowHead
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@skimottaret,
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use Voltoral gel on the knees, I use the double strength 12 hour stuff and it works much better than the standard gel.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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@simonopt,
I do, and have done for nearly 20 years, but my knee flexion is nevertheless more limited than it used to be.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Q for the Pharmacists. Can one use the above mentioned gel if on prescribed Meloxicam?
I'm on prescribed Meloxicam, but only take it when doing prolonged exercise, as on a recent ski holiday. I stopped taking it as soon as the skiing had finished, which on reflection has turned out to be a painful mistake. Should have stayed on it for another week.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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I make a tomato ketchup of my own because I do not like any salt or sugar added to it.
1 tin of tomatoes 400g
1 teaspoon of tumeric
20g of raw ginger
10g of raw garlic
black pepper
a splash of olive oil
maybe some chillis if I want it spicy
Put it in a smoothie maker, and pour it into a bowl and put it in the fridge.
It makes a good pizza topper, sauce for pasta, and I also use it uncooked with chips made in an air fryer. (sometimes I mix in a spoon of mayonaise which makes it taste creamier when eaten as ketchup with chips)
This contains no salt, or added sugar (if you do not add mayonnaise) and is a natural anti-inflammatory sauce. (apart from the tomatoes)
I do not know if it works or not as I do not tend to get much inflammation, but it fits in with my low salt low sugar diet. Watch out with the garlic, as eaten raw it can create wind!
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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@Bigtipper, Are you suggesting this as a knee rub? 
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You'll need to Register first of course.
You'll need to Register first of course.
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@Frosty the Snowman, I'm lucky, I often ski with a qualified pharmacist, so I can ask her questions on the hoof, so to speak. The other week in Gressoney, when my injured knee was starting to hurt a bit by about noon, although I'd applied 12 hour Voltarol gel at about 7.30am, she told me it was safe to take a couple of Ibuprofen, as not that much of the gel actually gets absorbed.
Sorry, that wasn't quite an answer to your question, which was about Meloxicam (of which I hadn't heard) not Ibuprofen.
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@Frosty the Snowman, if you added chillis it might be quite good if used in this way
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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A retired medic friend of mine, who is a musculo-skeletal specialist, swears by a jollop called Flexiseq for her sore knees. But she readily admits it may be the placebo effect at work!
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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The thing is, sometimes fitness is no longer an option. My knee gave out overnight when I felt fitter and stronger than I had for years.
For the next four years I could barely walk properly let alone run, cycle or squat. I had an arthroscopy to clean it up but it didn't stop it swelling or the pain on pressure. Maximum dosage diclofenac made little difference either. I still skied every year but with ever decreasing fitness levels.
Three years ago, it swelled to the point that I had a baker's cyst that ruptured and went down the inside of my calf muscle. A 7x2cm lump of synovial fluid that took weeks to dissipate and meant I could no longer get a boot on.
That summer I had 3 x PRP injections 8 weeks apart. I now hear the crepitis in my knee but rarely feel it. It can be a little sore after hard exercise but it responds positively. Instead of getting worse with more exercise, it gets stronger. I actually think that skiing improves it. I don't take anti inflammatories anymore and it doesn't swell up any more than my good knee i.e.minimally.
Apart from stem cell treatment (which is even harder to find) PRP is both the cutting edge and the last resort. It worked for me. YMMV.
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I had 3 x PRP injections 8 weeks apart
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Interesting hadn't heard of that before. Have heard of stem cell therapy but was advised by physios not to go with it due to age and rehab making the cure not balanced by the treatment...
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You know it makes sense.
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@skimottaret, no idea why they would tell you that. The American specialist who treated me in Qatar is licensed for both in the USA but only PRP in Qatar so that's what I had. I would have had stem cell if it had been available.
They're complementary treatments though. Stem cell should repair things whereas PRP changes the immune system response to the injury. It's a natural chemical reaction rather than a physical one. It's still not well known in the UK but I discussed it with Jonathan Bell on another thread and he is also using it, with success.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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@Raceplate, When I looked at it a few years ago the process involved drilling into the underside of the kneecap to create "wells" for the injections. Things may have moved on a bit. Thanks for sharing
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Poster: A snowHead
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@Raceplate, very interesting.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| skimottaret wrote: |
| @Raceplate, When I looked at it a few years ago the process involved drilling into the underside of the kneecap to create "wells" for the injections. Things may have moved on a bit. Thanks for sharing |
That's a different procedure. The theory behind that was that drilling small holes into the articular cartilage would stimulate inflammation and promote bone growth (articular cartilage) in the worn away areas, thus removing the arthritic pain. I met someone once who had this done and she told me it was a complete disaster. Her knee was far more painful after the procedure than before. I'm not surprised. The basic issue with a knee is that there is almost no blood circulation in the centre of it. That's why damaged bits rarely repair themselves. So drilling holes in a place with no circulation just makes it weaker.
What PRP injections do is to put high quality blood cells into a place that normally has no circulation and therefore it reacts to it, positively. It is a chemical reaction, not physical so it doesn't repair anything, officially. However, there are plenty of people who anecdotally tell you their knee is "better" following PRP. I haven't had mine checked recently but I'm pretty sure that my "very loose" ACL in that knee is no longer very loose. IMO, that can only be down to the PRP injections.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@Frosty the Snowman, IIRC, Meloxicam is an NSAID (Cox 1 & 2 inhibitor) anti-inflammatory. Official advice would therefore presumably be not to add in others - so that would include Diclofenac or Ibuprofen gels but not Tiger Balm, Ralgex, Deep Heat etc - not least because of increases of potential or actual side effects or overdose-type effects. Gastric irritation would be the most obvious, but not likely to be over-relevant if using a topical preparation. But there could be other issues. Read the medication leaflet and check with your GP.
But since it is usually prescribed for arthritis and the like, if you are not getting satisfactory pain relief then perhaps a chat with the GP or physio is worth it anyway?
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Taking an oral dose of ibuprofen (up to the max recommended dose of 1200mg per day) on top of a topical NSAID is highly unlikely to cause any short term issues - systemic exposure of a tropical prep is much lower than via the oral dose, and post-op it's common to be prescribed up to 2x the normal oral dose of ibuprofen (I.e. 2400 mg per day) which would give much higher overall exposure. Longer term, even normal doses of NSAIDs are associated with gastrointestinal side effects, hence the omeprazole mentioned somewhere earlier in the thread.
As always, get your doctor or pharmacist's advice on pain relief if you plan on doing anything outside the norm or have persistent pain - don't rely on internet expertise. 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Inhurt ny back a few years ago and when I eventually went to my Swiss “GP” and confessed to self medicating with Ibuprofen he asked “how much” and upon the response of 600mg x 4 he queried whether I was a homeopath....
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You'll need to Register first of course.
You'll need to Register first of course.
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@Frosty the Snowman, it is fine to use Ibuprofen or voltarol or any other topical NSAID while you are taking Meloxicam. The effect of the gel is very localised, and there is virtually no systemic absorption.
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@Hells Bells, Thank you. Much appreciated.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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I am now 70 and just back from 3 weeks skiing with just the odd day off. No ibuprofen or anything similar.
I exercise beforehand by swimming and put up with the grumbles from my creaky old knees when I am in the resort.
Pain is your bodies way of saying that something is wrong. I listen to such messages. Ignoring them or covering them up is not good IMHO.
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But that's not really how pain works:
- DOMS is not a symptom of something being "wrong", or that you should change what you're doing. It's simply a side effect of unaccustomed exercise.
- The pain you get from a burn is to tell you to move away from the cause. The pain you get *after* the burn is a side effect of the damage you did.
Each to their own, of course.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@On the rocks,
Ibuprofen is a drug that can be very useful but its worth bearing in mind a few things.
It is a particularly useful drug in orthopaedics.
If a joint is inflamed through injury or arthritis it can help reduce pain and stiffness in the joint but it works best in a mild to moderately affected joint, in other words some injuries and worn out joints are beyond being helped by this drug.
Some people seem to get a good response to ibuprofen whereas others don't , and may respond better to another of so called non steroidal anti inflammatory drugs (NSAID's) . Ibuprofen has the advantage of being available without prescription. Having said that the others aren't necessarily "stronger".
All NSAID's have some risk- as do all medications. Certain people should be very careful with NSAID's - they are known to be particularly troublesome in those with diabetes, history of bleeding from the stomach and those on medications like blood pressure tablets or anticoagulants. Hence why a pharmacist tends to question you - do check with them to see if you are at a higher risk.
Finally to answer your question.
Some people tolerate theses medications well and remain on them for prolonged periods but this should be at your doctor's recommendation.
I often talk to my patients about strategic use of NSAID's as part of an overall package of managing an arthritic knee.
For those who manage to stay reasonably fit but find skiing etc stirs up the knee i suggest that they experiment whether taking one before, one after or just for 24 hrs/ two days etc works. For them to learn what is the minimum number of tablets they can get away with and still participate in their sports. I also recommend that they pay attention to the total load they put on their knee for example : if skiing for 3 hrs a day whilst taking day three off ( because that's when you are most fatigued) allows you to to ski all week then that's what you should do. If you go for it on day one and ski 5 hours but can't "contain " the problem for the rest of the week your strategy has been wrong. Adding in icing, compression is fine. Watch the conditions : rutted ice is going to load the knee terribly whereas soft groomed snow is less likely to do so.
At the end of the day it comes down to using your common sense but setting out with a clear strategy and testing it. Ibuprofen can be a useful part of that strategy if you apply it in a considered way.
Jonathan Bell
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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@Jonathan Bell, Fab post.
I am taking on board all of it.
After 6 yr gap due to hip and knee issues I got myself a new hip, got fitter, lost weight, trained hard and went hammer and tongs at it for 6 days, fuelled by drugs, alcohol, adrenaline, excitement, peer pressure, happiness etc etc.
The hip was perfection, but the other hip and knee have given me a terrible 2 weeks, just settling down now.
I know that I will have to adopt your strategies above. Thanks for sharing.
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@Jonathan Bell, Fab post.
I am taking on board all of it.
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+1. Thank you - again!
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You know it makes sense.
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@Frosty the Snowman,
Glad that helps. I think welll see more treatments come on stream that can help delay surgery. I’ve been getting some good results with PRP for arthritic knees. I was quite a skeptic for along time but the evidence for it working just seemed to become more convincing. I haven’t any experience of using it in the hip though.
I’m watching the MSc ( stem cell) space but although some interesting studies I’m not yet totally convinced - I think we need some more trials that prove it’s worth and I have some reservations about how consistent the product is.
Jonathan Bell
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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@Jonathan Bell and other posters, thanks everybody. Based on the comments I won’t pre load but will start taking ibuprofens if the knees start to niggle until end of the Ski trip, more or less what I’ve done previously
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