Spondylitis Association of America Forums General Discussion General Message Board for Ankylosing Spondylitis and Related Diseases Knee stiffness! Heat? Cold? Other ideas?

I was dx last year w/Undifferentiated Spondy. Horrible pain and stiffness in ankles and achilles, fingers wouldn't move one morning after waking up, knee stiffness. HLA-B27-negative. Negative for everything, really, my rheumy diagnosed me based on my ankle enthesitis alone. Couple prednisone courses and max dose of Sulfasalazine later, which cleared up ankles and fingers (mostly), I started Enbrel in December because my knees were so bad.

My knees are still so unbelievably stiff most days that I wonder if the Enbrel is working. Rheumy seems to think it is, and I have had three spells of good days, each of which lasted no more than a week, but were fabulous and reassuring and made me hopeful.

Has anyone found that ice versus heat helps super-stiff joints, knees? Any topical remedies that help? I've tried most everything, and make myself get up and move. I feel best when I'm exercising (i.e. biking) but it's a chore some days just to walk TO the bike to get on it.

I know I can't expect to feel 100% all the time, and I see a lot of folks who feel their treatments are working but still deal with stiffness. Like perhaps this is indeed the best I'm going to feel and just have to deal with it?

Anyway, first-time posting after lurking for months. I'm far from a worst-case scenario here, I realize, but sure would love to find some relief for these stiff knees

Thanks for listening.
Lynn

I use Aspercreme for toes and joints. I also used long acting Acetaminophen for pain. Sometimes Aleve helps the severe pain. Hot tubs help too.

Warm is in general much better than cold as it will increase your blood flow. In those times when you don't have pain stretch.

Be sure that you don't have any problems with medications and/or speak to your doctor prior to starting any new medication.

Have you ever had joint injections? I find them very helpful, and give relief often for several months.
I think if you use heat it should be followed by cold to take the inflammation down.

You may have some OA in your knees in addition to the AS. Have you had x-rays of your knees recently? If you do have both, the Enbrel is not going to help the OA, only the AS.

I have both spondy and OA in my knees. My rheumy says my OA is secondary to, and brought on by, the spondy. Ice has never helped my knees. I use the hot tub at the senior center where I do my water aerobics, and that helps some.

A lot of people get relief from Voltaren gel. I tried it but had to stop because of side effects (terrible tinnitus), so I can't vouch for it personally. But it's worth trying if you haven't already.

Welcome to the group.

Thanks for the responses. A bit more history - I've got some OA in my right knee and a meniscus tear in my left. I've been waiting to get my knee scoped, as the ortho docs I've seen have wanted to see what the Enbrel does first. I'm sure that flares in my knees make it seem worse than it is.

I've tried some (likely expired) Voltaren gel, but am on oral Diclofenac, which is the same thing, so they don't advise combing the two. It didn't do much. I use OTC stuff - Blue Emu, Tiger Balm, etc., just to feel like I'm doing something for myself.

I've had a long history of cortisone injections in both knees. For about 10 years I had inexplicable pain in various joints, but primarily my knees (above the knee, not the actual joint like gets stiff these days w/the spondy) but was never diagnosed w/anything. Didn't really meet the criteria for spondy until my ankles acted up a couple years ago. The injections were miraculous - worked every time to where I literally felt 100% until they wore off - sometimes many months. Most shots were in my knees but I had a couple in my ankles that didn't last.

Both my rheumy and ortho docs wonder about the long-term effects of the injections in my knees, but no way to know much. My left knee (with the meniscus tear) is much worse than my right lately, but I had far more injections in my right knee than my left (I also have significantly more OA in my right than my left, so who knows).

When the spondy subsides (rare though it is), neither the tear nor the OA really bothers me. I think the mechanical issues plus the spondy combined make it worse than either separately.

I've also had an injection in my right knee of euflexxa, this lubricating stuff. Seemed to work. It's been a year and a half and haven't needed a follow-up/booster shot.

All this to say I think ice seems to help the pain from the meniscus tear, but the stiffness just gets overwhelming and I've not yet figured out anything to do for it. Going to try another short (16-day) prednisone taper next flare-up to see what that does, but that's not a long-term solution for me.

Thanks for listening everybody
Lynn