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Featured Knee Pain Questions & Answers

My knee has been really bothering me, and I've been taking several ibuprofen every day. My daughter said these can cause other health problems. Is that just for the prescription strength? Do I need to worry about over-the-counter medications?

Dr. DiNubile's response:
Your daughter is very wise to alert you about the potential health problems associated with over the counter (OTC) medications. Just because something is OTC does not mean that it is not without danger. Non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen) are a prime example of this. The ones that are sold OTC are basically the same that you can get via prescription, only at a lower strength. If you are taking these continuously, you may be exposing yourself to health risks associated with these medications. They can be effective in the management of osteoarthritis, but in recent years, we as physicians have become more conservative with their use, especially longer term. Some individuals are more predisposed to problems with NSAIDs than others, and these problems can include gastrointestinal issues such as bleeding, problems with liver and kidney function and even cardiac issues. Most individuals tolerate NSAIDs just fine when taken properly, but everyone should be aware of the potential problems that can arise. If you need to take OTC medications like ibuprofen or other NSAIDs more than a few weeks at a time, even if you seem to tolerate them, you should bring this up with your physician or consider seeing an orthopedic specialist.

More Featured Questions

I had my injection of Synvisc-One a couple of weeks ago. When can I start exercising?

Dr. DiNubile: Exercise is essential not only for maintaining health but also in the management of osteoarthritis. I applaud your interest in getting back into exercise and encourage it. With my patients, I believe that the relief they got with treatments like Synvisc-One was only the first step in getting them better. Once they start to feel relief, I think it is essential that they get back into a proper exercise program. With my patients, I usually ask them to take at least two days off after the injection and then monitor their response. If they start to feel better, then within a week I can let them start some easy lower impact exercise like walking, stationary cycling or water based exercise. I also instruct them on simple exercises to maintain strength and mobility around their arthritic knee. This helps keep them out of trouble with exercise. It is sometimes a challenge to find the right exercise routines that are tolerable for those with osteoarthritis. One mistake is to give up exercise completely and adopt a more sedentary lifestyle. In the short-term you might feel a little better sitting around doing nothing, but long term, your overall health and functional abilities will deteriorate. I would urge you to talk to your doctor, or physical therapist, about what type of exercises are best for you and when you can ramp up that program.



PLEASE NOTE: The views presented herein are solely those of Dr. DiNubile, Orthopaedic Surgeon. Sanofi does not endorse Dr. DiNubile or his book, FrameWork. Dr. DiNubile is a paid advisor for Sanofi. Be sure to consult with your own doctor before starting any exercise program or health regimen.

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Dr. DiNubile is an Orthopaedic Surgeon specializing in Sports Medicine in private practice in Havertown, Pennsylvania, and is a Clinical Assistant Professor of the Department of Orthopaedic Surgery at the Hospital of the University of Pennsylvania. Dr. DiNubile has been chosen in "Best Doctors in America" as well as "Guide to America's Top Surgeons."

He is the author of the bestselling book, Framework—Your 7 Step Program for Healthy Muscles, Bones & Joints (Rodale) and is Executive Producer and host of the award winning national PBS television special, Your Body's FrameWork.

Indication

Synvisc-One® (hylan G-F 20) is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics, e.g., acetaminophen.

Important Safety Information for Synvisc-One

Before trying Synvisc-One, tell your doctor if you have had an allergic reaction, such as swelling of the face, tongue or throat, respiratory difficulty, rash, itching or hives to SYNVISC or any hyaluronan-based products. Should not be used in patients with an infected knee joint, skin disease or infection around the area where the injection will be given, or circulatory problems in the legs.

Synvisc-One is only for injection into the knee, performed by a doctor or other qualified health care professional. Synvisc-One has not been tested to show pain relief in joints other than the knee. Tell your doctor if you are allergic to products from birds – such as feathers, eggs or poultry – or if your leg is swollen or infected.

Synvisc-One has not been tested in children (≤21years old), pregnant women or women who are nursing. You should tell your doctor if you think you are pregnant or if you are nursing a child.

Talk to your doctor before resuming strenuous weight-bearing activities after treatment.

The side effects sometimes seen after Synvisc-One include (<2% each): pain, swelling, heat, redness, and/or fluid build-up in or around the knee. Tell your doctor if you experience any side effects after treatment with Synvisc-One.

View the Complete Prescribing Information for Synvisc-One (PDF)

Indication

SYNVISC® (hylan G-F 20) is used to relieve knee pain due to osteoarthritis (OA). It is for patients who do not get enough relief from simple painkillers such as acetaminophen, or from exercise and physical therapy.

Important Safety Information for SYNVISC

Before trying SYNVISC, tell your doctor if you have had an allergic reaction, such as swelling of the face, tongue or throat, respiratory difficulty, rash, itching or hives to SYNVISC or any hyaluronan-based products. Should not be used in patients with an infected knee joint, skin disease or infection around the area where the injection will be given, or circulatory problems in the legs.

SYNVISC is only for injection into the knee, performed by a doctor or other qualified health care professional. SYNVISC has not been tested to show pain relief in joints other than the knee. Tell your doctor if you are allergic to products from birds - such as feathers, eggs or poultry - or if your leg is swollen or infected.

SYNVISC has not been tested in children (≤21years old), pregnant women or women who are nursing. You should tell your doctor if you think you are pregnant or if you are nursing a child. Talk to your doctor before resuming strenuous weight-bearing activities after treatment.

The side effects sometimes seen after SYNVISC include pain, swelling, heat, redness, and/or fluid buildup in or around the knee. These reactions were generally mild and did not last long, but in rare occasions these side effects were more severe. The most commonly occurring adverse events outside of the injected knee were rash, fever, nausea, and headache.

View the Complete Prescribing Information for SYNVISC (PDF)

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Important Safety Information: SYNVISC and Synvisc-One are contraindicated in patients with known hypersensitivity to hyaluronan products or patients with infections in or around the target knee.