No more NASIDs for me - What now?
#51
Senior Member
I've been a fairly serious bicyclist for over 50-years but have had seven knee surgeries (three on the left and four on the right) during that time. I can ride 60 or more miles at a decent pace with little knee pain and ride at least 8-hours a week. My normal post ride drug regimen was 1400 mg of Ibuprofen and a double IPA pint of beer followed by another 1400 mg Ibuprofen an hour before bed. I seldom had trouble sleeping due to knee soreness.
BUT - I recently experienced more than three consecutive days of excruciating abdominal pain- the worst I've ever experience in my long and eventful life. After two ER visits and many painful and intrusive tests I was diagnosed with a Cecal Ulcer caused by Ibuprofen abuse. I've been told that I have to stop using any NASIDs of any kind.
My research show that folks over 65 (I'm 69) have a 10x higher incidence of Cecal Ulcers if they have a long history of Ibuprofen abuse. Complete avoidance of NASIDs in those cases almost always result in a complete healing of the ulcer.
I've not had any NASID in the last two weeks and my ulcer is almost pain free. But, my knees are killing me and I have a get deal of difficulty sleeping at night. My knees just ache and ache and I cannot find a way to make them comfortable. The pain is not sharp or intense but is constant and significant. I've cut my riding back to 15 - 20 miles of low intensity flat land riding four times a week but it does not seem to diminish the discomfort.
My GP and Gastroenterologist offer no good suggestions for a reasonable pain management drug to take after riding that does not have nasty side effects.
Does anyone here have any experience with a non-Nasid / non-Opioid pain management drug for long term night time knee and leg pain?
My orthopedic surgeon really wants to replace both my knees but I am not there yet.
BUT - I recently experienced more than three consecutive days of excruciating abdominal pain- the worst I've ever experience in my long and eventful life. After two ER visits and many painful and intrusive tests I was diagnosed with a Cecal Ulcer caused by Ibuprofen abuse. I've been told that I have to stop using any NASIDs of any kind.
My research show that folks over 65 (I'm 69) have a 10x higher incidence of Cecal Ulcers if they have a long history of Ibuprofen abuse. Complete avoidance of NASIDs in those cases almost always result in a complete healing of the ulcer.
I've not had any NASID in the last two weeks and my ulcer is almost pain free. But, my knees are killing me and I have a get deal of difficulty sleeping at night. My knees just ache and ache and I cannot find a way to make them comfortable. The pain is not sharp or intense but is constant and significant. I've cut my riding back to 15 - 20 miles of low intensity flat land riding four times a week but it does not seem to diminish the discomfort.
My GP and Gastroenterologist offer no good suggestions for a reasonable pain management drug to take after riding that does not have nasty side effects.
Does anyone here have any experience with a non-Nasid / non-Opioid pain management drug for long term night time knee and leg pain?
My orthopedic surgeon really wants to replace both my knees but I am not there yet.
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#52
Senior Member
Join Date: May 2016
Location: Weschester NY
Posts: 187
Bikes: 2013 Specialized S-Works Roubaix, 1980 Colnago, Litespeed Ocoee
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I know a bunch of you have suggested to "just go for the knee replacements". I share a similar reluctance to go for knee replacement, but I'm not quite as bad off as our OP. I have pretty arthritic knees, the left being really bad with bone-on-bone, and that one has had two arthroscopies. While this has forced me to give up sports like tennis, and running, (I never much liked running anyway,) I can still cycle, swim and ski. But there are multiple reasons for my reluctance fro knee replacement, but the biggest one for me is that I can still do much of what I want, and I only have modest occasional pain. I can live with that. Getting dragged on extensive shopping expeditions by my wife or daughter are about the worst things I do to cause knee pain.
As far as cycling, I have changed my style of riding. I will not stand up to pedal anymore. For comfort, and prostate reasons, I have switched from a road bike to a hardtail mountain bike with 1-1/8" high pressure road tires. An air over oil fork, a suspension seatpost, and a Selle Man saddle make this a very comfortable ride on my somewhat bumpy local bike paths. But with a 26 tooth front chainring, and a 32 tooth rear, it also gives me the gearing where I can climb 10%+ grades without standing. For me, the key to avoiding knee pain is to keep the pressure I apply to the pedals quite low, and keep my cadence in a 75-90rpm range. If that means my speed drops dramatically on steep uphills, I'm OK with that.
So my recommendation to the OP is to get yourself a bike with mountain/style gearing, and learn to ride with less pressure on the pedals.
As far as cycling, I have changed my style of riding. I will not stand up to pedal anymore. For comfort, and prostate reasons, I have switched from a road bike to a hardtail mountain bike with 1-1/8" high pressure road tires. An air over oil fork, a suspension seatpost, and a Selle Man saddle make this a very comfortable ride on my somewhat bumpy local bike paths. But with a 26 tooth front chainring, and a 32 tooth rear, it also gives me the gearing where I can climb 10%+ grades without standing. For me, the key to avoiding knee pain is to keep the pressure I apply to the pedals quite low, and keep my cadence in a 75-90rpm range. If that means my speed drops dramatically on steep uphills, I'm OK with that.
So my recommendation to the OP is to get yourself a bike with mountain/style gearing, and learn to ride with less pressure on the pedals.