Question to general practitioner Maarten: Tear in the meniscus 

Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.

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Dear Martin,

I am 77 with all blood test readings within stated limits and all organs working well for my age except I have an easy sour stomach with reflux.

Since yesterday I just got up from the sofa with a sudden and severe pain in the left knee which has now become swollen. Everything points to a tear (or something) in the meniscus (I had this 20 years ago in the other knee so I know what I'm talking about).
Through YouTube I have seen some videos of the physiotherapists “Bob and Brad” but for now the pain is so severe that I can't do even their most moderate exercises, except spinning on the stationary bike without setting any resistance.

My question concerns the Diclofenac EG Retard 100 mg that I still have and that will soon expire (prescribed to my wife when we were in Belgium).

When I read the long leaflet, one has to be very careful with this type of medication and I wonder whether Diclonefac only reduces the pain without affecting the healing process.

If yes then I would rather not swallow this and then create other problems.

What do you think?

Regards,

F.

******

Dear F,

The first thing to do is to reduce inflammation. Diclofenac is an anti-inflammatory, but one with many side effects. It's a product that shouldn't be sold. That's why I would get Naproxen 300 mg (soproxen) from the pharmacy. 2-3 tablets per day after meals. Also as stomach protector Omeprazole 20 mg before breakfast.

If you get a fever, go to the doctor immediately.

Also treat with ice or ice-cold compresses. Whether it really is the meniscus, research will have to show. there may also be (pseudo) gout.

Physiotherapy is indeed indicated for a meniscus problem.

Yours faithfully,

Dr. Maarten

Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).