OpenHealth Q&A

Experiencing Persistent Discomfort in Left Knee: Guidance Needed

I am a 36-year-old male currently under treatment with Skyrizi for psoriatic arthritis and psoriasis, and I regularly use meloxicam and acetaminophen as needed—typically every day. I am on several other medications that I suspect are unrelated to my current issue, but I can provide a complete list if required. I have been on these medications for over a year without any recent additions. Several months ago, I began to experience intermittent pain in my left knee, particularly in the area around the kneecap. This discomfort is not constant; instead, it tends to fluctuate. It generally recedes after a day or two of rest, but flares up with exercise or prolonged bending or extension of my leg. I've struggled to determine a neutral leg position that wouldn't induce pain. The discomfort can vary from barely noticeable to a moderate burning feeling that occasionally disrupts my sleep. As a college instructor, I often find myself standing and moving around for hours at a time a couple of days each week during the fall and spring semesters. I wouldn't classify myself as a serious athlete; my main form of exercise is taking walks, usually lasting about an hour. Occasionally, I walk briskly to elevate my heart rate, but I don't engage in more strenuous activities. Recently, I've reduced my walking significantly due to this knee pain and other life circumstances that have occupied my time. While meloxicam manages some residual symptoms of my psoriatic arthritis and alleviates various minor aches, including this knee pain, I am unsure of the effectiveness of acetaminophen in this instance. I'm not looking for a diagnosis or medical counsel through Reddit. I initially believed rest might alleviate my issue, but since that hasn't been the case—or perhaps it just requires more time—I'm considering visiting a doctor in person. My main concern is identifying the appropriate type of specialist to consult. Navigating the healthcare system here in the U.S. can be daunting for me; I often feel overwhelmed and anxious, making it hard to communicate with healthcare providers. This has resulted in several negative experiences, leading me to prefer tolerating mild to moderate pain rather than dealing with medical appointments. To complicate matters, I currently lack a primary care physician. I attempted to find a new one last year, but it didn't go well, and I've been reluctant to return. I do have a rheumatologist for my psoriatic arthritis, and I'm in the process of transitioning to a new dermatologist since my previous one left the practice this spring. My rheumatologist is, for now, my only reliable point of contact within the healthcare system. Should I search for primary care doctors covered under my insurance and arbitrarily select one to discuss my knee problems? Would it be more prudent to reach out to my rheumatologist, who I trust, and ask for a referral, even knowing that it’s outside her specialty? Or should I book an appointment directly with a specialist, such as an orthopedist? If I do see a specialist, will they be equipped to address my concerns, or might they merely advise physical therapy as a first step?

Answers (1)

6/17/2025, 4:40:53 PM

OpenHealth AI

Based on your description, you are experiencing persistent discomfort in your left knee while managing psoriatic arthritis. Given the fluctuating nature of the pain, which worsens with activity and doesn’t improve with rest, it's important to understand your options for addressing this issue effectively.

Summary of Main Points:

1. The knee pain you're experiencing may be related to your psoriatic arthritis and warrants attention.
2. You have multiple options for consulting a healthcare provider - a primary care physician, your rheumatologist, or an orthopedic specialist.
3. It’s crucial to seek a specialist who can evaluate your knee issues and potentially recommend personalized treatment or therapy.

Explanation:

Your intermittent knee pain might stem from various factors, including inflammation associated with psoriatic arthritis, patellofemoral pain syndrome (pain around the kneecap), or even issues related to your existing medications. Since rest hasn't significantly helped and the discomfort impacts your daily activities, seeking professional help makes sense.

Next Steps:

1. Consult Your Rheumatologist: Given your history with psoriatic arthritis and your trusting relationship with your rheumatologist, this is a good first step. Explain your knee symptoms in detail and ask if she thinks a referral to an orthopedic specialist is warranted or if she can provide insights or treatments herself.

2. Consider Primary Care or Orthopedics if Needed: If you're open to it and feel comfortable finding a new primary care doctor, this could be beneficial for comprehensive care. Alternatively, if you prefer, directly booking an appointment with an orthopedic specialist could be helpful since they focus on musculoskeletal issues and might provide immediate relief strategies, including physical therapy recommendations.

3. Prepare for Appointments: When you do visit a specialist, prepare a summary of your knee issues, including activities that aggravate your pain, what seems to ease it, and any treatments you've tried. This can streamline communication and ensure your concerns are addressed effectively.

4. Follow-Up Care: Depending on the feedback from your specialist, explore recommended treatments, be it physical therapy, modifications in activity, or medication adjustments.

5. Emotional Support: Navigating healthcare can be overwhelming. It might be helpful to bring a friend or family member to appointments for support, or even consider speaking with a therapist about your healthcare interactions if you find them particularly anxiety-inducing.

Taking these steps can help you address your knee discomfort while also reinstating your confidence in managing your health.