# Pseudogout?



## EJ (Aug 29, 2005)

Yeah, I never heard of it either before my knee became the size of a grapefruit.
Got a cortisone shot which cleared it up in 48 hrs but after 5 weeks symptoms have returned. 
I was hoping someone here has experience and could tell me what works to treat a flare-up and anything to help prevent another one?
My big $ Ortho has been less than helpful. 
Thanks!


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## burtronix (Jun 5, 2006)

What differentiates pseudo from the real thing? I had what appeared to be gout in my big toe a few years ago. I don't drink, but had OD'd on beef & pork for several days. Then got dehydrated on a ride.

Prescription anti-inflammatory & changed diet took care of it. I'm completely off red meat. Tart cherries (or juice) are supposed to help.


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## Boomchakabowwow (Sep 8, 2015)

never heard of pseudogout.

regular gout, i am familiar intimately with. 

i gave up on my doc and had her refer me to a rheumatologist. it was game on..he explained it to me. i am now on meds and have been gout free for about 6 years. i had it on my right toe and left knee at the same time when i cried "uncle".

i got off of the meat heavy diet as well.


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## Crankout (Jun 16, 2010)

Are you sure it's not pseudo goat?


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## Boomchakabowwow (Sep 8, 2015)

damn..could have waited till i swallowed my coffee.. hahah


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## EJ (Aug 29, 2005)

burtronix said:


> What differentiates pseudo from the real thing?


The difference is the type of crystals in the joint that cause the inflammation. 
The medical term for pseudogout is calcium pyrophosphate deposition disease or CPPD.

"regular" gout is caused by deposits of monosodium urate monohydrate crystals.

My docs told me not much is known about CPPD as far as what causes it or how to prevent it. Mine doesn't seem to respond well to the NSAIDs. I did find an epsom salt soak helped get the swelling down.


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## jeffscott (May 10, 2006)

GT_guy said:


> The difference is the type of crystals in the joint that cause the inflammation.
> The medical term for pseudogout is calcium pyrophosphate deposition disease or CPPD.
> 
> "regular" gout is caused by deposits of monosodium urate monohydrate crystals.
> ...


Well I know about gout...

Rest Ice Compression Elevation....plus Vitamin I. To help cure a flare.

Cut Back on food and drink that cause dehydration.....

Increase water consumption.

I found some analysis of both pseudo gout and gout....large amounts of aerobic exercise increase the amount and severity of flares for both...

I drink water till my pee is light straw and no darker....and that is one hell of a lot of water.


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## likeaboss (Jan 1, 2012)

Because of a separate medical issue I am predisposed to Gout. I had a minor flare a couple weeks ago and have increased my H2O intake and cut down on red meat. I also have started taking Gouch every morning. So far so good.


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## vikb (Sep 7, 2008)

Unless you've had a needle in your inflamed body part and the fluid examined under a microscope you really don't know if you have gout or one of the other acute arthritis conditions with similar symptoms. A blood test for elevated uric acid levels is not the smoking gun or a definitive diagnosis.

I've had numerous gout [or psuedo gout] attacks over the years. They suck. A lot. The frequency is not enough to pursue any drastic treatments..at least not yet. I assume it will get worse.

I have not noticed any correlation with eating red meat or alcohol. Ice, rest and high strength NSAIDs do it for me. The folks I work for let me ride my MTB at work when I have an attack as we have 3 different shops I have to move between in a large area. I can pedal without pain when I can barely walk 20'.


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## Boomchakabowwow (Sep 8, 2015)

vikb said:


> Unless you've had a needle in your inflamed body part and the fluid examined under a microscope you really don't know if you have gout or one of the other acute arthritis conditions with similar symptoms. A blood test for elevated uric acid levels is not the smoking gun or a definitive diagnosis.
> 
> I've had numerous gout [or psuedo gout] attacks over the years. They suck. A lot. The frequency is not enough to pursue any drastic treatments..at least not yet. I assume it will get worse.
> 
> I have not noticed any correlation with eating red meat or alcohol. Ice, rest and high strength NSAIDs do it for me. The folks I work for let me ride my MTB at work when I have an attack as we have 3 different shops I have to move between in a large area. I can pedal without pain when I can barely walk 20'.


just so you know, i was told by my doc that the flare up that causes all that pain is just a symptom of gout. you have gout even without the flareup. damage to your joints can be happening silent and painfree.

i'm on Allupurinol now. i dont think i have had an attack for 5 years. we played with the dosage just to get my uric levels below 5. strategy is to hover it there and i should be pain free. a gout sufferer gets flare up usually in the 6 range. non gout sufferer can have uric levels way higher than that and never have a flare up or joint damage.


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## vikb (Sep 7, 2008)

Boomchakabowwow said:


> just so you know, i was told by my doc that the flare up that causes all that pain is just a symptom of gout. you have gout even without the flareup. damage to your joints can be happening silent and painfree.


I have never heard or read that anywhere. If you have any medical reference with that info send it my way I'd like to read it.

What I have been told by doctors, my GF who is a RN and read myself is the damage occurs during the inflammation cycles when the uric acid crystals are present and not simply due to the fact you may have higher than typical uric acid levels. I don't see what the mechanism of the "silent damage" would be, but I'm happy to learn more if there is evidence of this happening.


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## Boomchakabowwow (Sep 8, 2015)

just what my doc said. my rheumatologist. he said we have gout way before our first attack..i think he said 10 years. 

i asked a lot of questions. Dr J retired or i would email him.


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## Boomchakabowwow (Sep 8, 2015)

he also said most general practitioners dont know crap about gout. mine over prescribed and my liver sent out an SOS.


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## Crankout (Jun 16, 2010)

I've always thought of gout as a disease begotten to the less-exercised and of poor diet crowd.


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## vikb (Sep 7, 2008)

Boomchakabowwow said:


> just what my doc said. my rheumatologist. he said we have gout way before our first attack..i think he said 10 years.
> 
> i asked a lot of questions. Dr J retired or i would email him.


I can't find a single reference to this ^^^ in any medical literature. So I am skeptical. But I definitely agree each gout attack causes damage so if you have them frequently doing something about them is smart not just for the short term pain relief, but also for the long term situation.


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## jeffscott (May 10, 2006)

Crankout said:


> I've always thought of gout as a disease begotten to the less
> 
> Nope you get it when you are dehydrated as well....and that comes with lots of aerobics if you arnt careful


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## jeffscott (May 10, 2006)

vikb said:


> I can't find a single reference to this ^^^ in any medical literature. So I am skeptical. But I definitely agree each gout attack causes damage so if you have them frequently doing something about them is smart not just for the short term pain relief, but also for the long term situation.


It makes sense to me...

What happens first is your urate levels begin to rise (for whatever reason)...then at some particular level the crystals begin to develop in your joints....and you could easily get kidney stones...

I had kidney stones but I was really luck cause they came out before they got big enough to hurt....(doc saw them on an ultrasound and next time they were gone)...

This all happened maybe 2 or 3 years before the first gout flare...

So now I take the pills and hydrate better they say it can take 3 plus months for the crystals to clear from the joints...

I will eventually get the urate levels down, and then taper the pills...


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## Boomchakabowwow (Sep 8, 2015)

vikb said:


> I can't find a single reference to this ^^^ in any medical literature. So I am skeptical. But I definitely agree each gout attack causes damage so if you have them frequently doing something about them is smart not just for the short term pain relief, but also for the long term situation.


i'm not a doc, and i cant search med docs for crap. i'm only passing on what Dr Jameson told me. either way, the pain sucks. i had it in my knee and opposite toe at the same time. i feel for those that live with constant pain..that bit almost crushed me.


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## LeonD (Dec 26, 2003)

Love my general Doc but for gout, go see a rheumatologist. That's what they deal with.


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## InertiaMan (Apr 16, 2004)

OK, 19 posts in, and we've got 17 posts about "regular" gout and none (other than the OP's original question and explanation) about pseudogout. I was recently diagnosed with pseudogout, so would be interested to hear from others that are managing w/ _*pseudogout*_.

Despite the helpful intent, comments about normal gout aren't really relevant to the thread topic. As the OP tried to explain, although the symptoms can be similar and they both involve crystal formation, the origins of the two are totally different. Urea is a direct causal factor in normal gout, and there are a variety of diet and medication treatments that can reduce urea to treat the problem. In contrast, pseudogout, or CPDD, generally has no diet or medication treatment (other than symptomatic relief via NSAIDS or corticosteroids).

One of my frustrations, other than the knee pain, is that I can't seem to identify any consistent context for "flare-ups." I rode 35 days on the Baja Divide and the symptoms were manageable. Then I'll go do a 90 minute local ride, and for some reason my knee will ache for two days. So I get apprehensive if I'm considering a big commitment like the AZT750.

Seems like problems just keep accumulating since passing 50. I'm a bit afraid that this may be the proverbial "beginning of the end" of my cycling days, but I'm hoping it eases off, or at least doesn't worsen. My doc says that there is no statistical pattern of increasing crystal deposits / symptoms; some folks get better, some stay the same, some get worse and they don't know why. Hopefully I'll find myself among the former.


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## jeffscott (May 10, 2006)

InertiaMan said:


> normal gout aren't really relevant to the thread topic. As the OP tried to explain, although the symptoms can be similar and they both involve crystal formation
> 
> One of my frustrations, other than the knee pain, is that I can't seem to identify any consistent context for "flare-ups." I rode 35 days on the Baja Divide and the symptoms were manageable. Then I'll go do a 90 minute local ride, and for some reason my knee will ache for two days. So I get apprehensive if I'm considering a big commitment like the AZT750.


dehydration is very bad for crystal build-up

Mineral imbalances. The risk of pseudogout is higher for people who have excessive calcium or iron in their blood or too little magnesium. (Mayo Clinic)

Colchicine (Colcrys). Low-dose pills of this gout drug are also effective for pseudogout. If you have frequent episodes of pseudogout, your doctor may recommend that you take colchicine daily as a preventive measure. (Mayo Clinic)

Seems there are some similarities

Apply all the gout fixes....doesn't hurt

drink lots of water


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## InertiaMan (Apr 16, 2004)

jeffscott said:


> dehydration is very bad for crystal build-up


Literally no medical evidence that dehydration contributes to pseudogout occurring (although _severe _dehydration apparently can contribute to arthritic "attacks" among people with pseudogout). May sound intuitive to you, but no medical evidence to support your claim. Unless you consider sources like watercures.org to be medical evidence (I don't).



jeffscott said:


> Mineral imbalances. The risk of pseudogout is higher for people who have excessive calcium or iron in their blood or too little magnesium. (Mayo Clinic)
> r


Yay, you can search google. Yes those are risk factors, but for the vast majority that have normal mineral levels (me among them) this is irrelevant, and for the minority w/ those imbalances, correcting them doesn't cure the pseudogout.



jeffscott said:


> Colchicine (Colcrys). Low-dose pills of this gout drug are also effective for pseudogout. If you have frequent episodes of pseudogout, your doctor may recommend that you take colchicine daily as a preventive measure. (Mayo Clinic)


May be effective for _*symptomatic relief*_, but has no proven influence on crystal deposition. So essentially another tool in the quiver like naproxym/Aleve, cortisone, etc.



jeffscott said:


> Seems there are some similarities


Similarities, yes. They are both crystal deposits. NSAIDS can provide symptomatic relief. So what. CPPD has no treatment to reverse/resolve the crystal formation or prevent future crystal formation, whereas gout often has VERY effective dietary and medication solutions that reduce uric acid, which can reverse crystal formation and eliminate future gout. So very dis-similar in the critical area of treatment/resolution/living-with the issue.



jeffscott said:


> Apply all the gout fixes....doesn't hurt


Sleeping under a pyramid won't hurt either.



jeffscott said:


> drink lots of water


Again, no medical evidence this benefits pseudogout.

Science knows exactly what causes the crystal formation in gout. Uric acid is a direct causal factor, and uric acid levels can be directly targeted with diet and drugs, often completely eliminating the crystal formations and associated symptoms. This is GREAT for gout sufferers . . . many of them can effectively be "cured".

Science does not know what causes the calcium pyrophosphate formation in pseudogout. CPPD has no such treatments to reduce or reverse or eliminate future crystal formation. Hence my perspective that discussion of gout treatments is not particularly useful in understanding/coping w/ pseudogout.


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## jeffscott (May 10, 2006)

InertiaMan said:


> Literally no medical evidence that dehydration contributes to pseudogout occurring (although _severe _dehydration apparently can contribute to arthritic "attacks" among people with pseudogout). May sound intuitive to you, but no medical evidence to support your claim. Unless you consider sources like watercures.org to be medical evidence (I don't).
> 
> Yay, you can search google. Yes those are risk factors, but for the vast majority that have normal mineral levels (me among them) this is irrelevant, and for the minority w/ those imbalances, correcting them doesn't cure the pseudogout.
> 
> ...


Yeah so keep not drinking enough.....don't relate symptoms and flares to hydration

you should probably quit riding.....

Oh and mayo clinic says colchine same drug as for gout....

but hey

just give up


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## InertiaMan (Apr 16, 2004)

jeffscott said:


> Yeah so keep not drinking enough.....don't relate symptoms and flares to hydration
> 
> you should probably quit riding.....
> 
> ...


Who said I'm not drinking enough? Who said my flares correlated with (de)hydration? Neither is true. I'm suffering from pseudogout. You're suffering from pseudo-science.

Mayo does say colchicine is used for both gout and pseudogout, but apparently you missed the first sentence of that page: _"There's no cure for pseudogout."_ Colchicine is mentioned along with NSAIDS and steroids _to treat the symptoms_, not the cause.

The OP was soliciting insight from folks with direct experience w/ pseudogout, as am I. Speculative comments from people that aren't even suffering from it is not useful. I'm simply trying to focus this thread on discussions of direct experience. If you told me "I have pseudogout, and colchicine moderated my symptoms enough to take less Aleve" that's useful. Telling me "colchicine is prescribed for both gout and pseudogout so therefore the two disorders are equivalent" is both wrong and useless.

Give up? I've got >300 hours on the bike since January with Tour Divide and CTR to come . . . what have you got? F&^K you.


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## gt2brew (Mar 23, 2006)

I'm 55 and was diagnosed by a GP as having Gout but my wife, a pharmacy tech, said my diet and lifestyle didn't fit that diagnosis. So I went to a Podiatrist and the x-rays proved that I didn't have Gout, but rather arthritis in the big toe joint due to a long toe. Over the years I've had "Gout like" flare-ups and even a swollen knee (from overly tight hamstrings causing the patella to be pulled out of alignment) and I'm forced to get a steroid to ease the swelling and pain. For the last few years I would feel my feet ache after a ride and I would worry about a flare-up, but the flare-ups occur randomly. This past winter I tried flat pedals due to freezing conditions, and noticed less pain. After some research and advice from a friend I tried flats from http://pedalinginnovations.com/ and after 2 months I can feel the difference. These pedals re-position your feet so there is less pressure on the toes and ankles and spreads the "load" to the entire foot. Perhaps you are experiencing similar flare-ups....hope this helps.


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## InertiaMan (Apr 16, 2004)

gt2brew said:


> After some research and advice from a friend I tried flats from http://pedalinginnovations.com/ and after 2 months I can feel the difference.


Hah! Coincidentally I just did my first ride in 15 years on flats last night, so very timely comments. Those long pedals from Pedaling Innovations look interesting, thanks for pointing them out. I'm surprised they didn't mention Joe Friel and Steve Hogg, two widely known cycling coaches who have been advocating mid-arch cleat positions in road biking for years. 
I have a chronic but moderate pain under the ball of my left foot, unrelated to the pseudogout as far as I know, which I'm hoping will diminish w/ use of flats. But my initial motivation was to learn better riding technique and to get my body accustomed to flats so that I can use them on long bikepacking trips. Maybe I'll check out the PI pedals.


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## gt2brew (Mar 23, 2006)

The pain in the ball of your foot sounds familiar. Have you had a podiatrist x-ray it? The arthritis in my feet (yeah, I'm lucky enough to have it in both) coupled with my flat foot and plantar fasciitis makes it a real problem to keep up with. New foot position has been remarkable, as well as the epsom salt soaks.....good luck


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## InertiaMan (Apr 16, 2004)

gt2brew said:


> The pain in the ball of your foot sounds familiar. Have you had a podiatrist x-ray it?


X-ray taken, podiatrist appointment is next week. Curious what imaging shows and/or what doc says.


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## EJ (Aug 29, 2005)

OP here - here's what I've learned /observed since my post in Nov.
Since I wasn't responding to the NSAIDS, my Dr gave me an Rx for low dose steroids. If I feel symptoms coming on (usually starts as stiffness in my ankle/knee) I take a couple of them and it knocks it right out before it becomes a full-blown outbreak. I've done this 2 or 3 times since Nov.

I do think that hydration plays a part. I've starting keeping a bottle of water on my desk at work. I also think alcohol plays a part in bringing it on, as does stress. 
I've also started taking Turmeric supplements. Not sure if it really helps but right after I ran out, I felt the symptoms coming on so I started taking it again.

Since I now have a way to treat an outbreak before it gets started I think it's certainly manageable. If I start having to take the Rx every week, that would be cause for concern.


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## gt2brew (Mar 23, 2006)

I can attest to stress being a factor, I'm in denial about alcohol though. You may want to add Alfalfa to your supplement regimen....

Alfalfa aids in pain and stiff joints from swollen knees and swelling of ankles and feet. Alfalfa is a natural diuretic and helps regulate the body's acid/alkaline balance. Recognized for centuries for its healing properties, alfalfa contains eight digestive enzymes, calcium, phosphorus, iron, magnesium, chlorophyll, bioflavonoids, trace minerals and vitamins.

The alfalfa plant is also popularly used as an alternative natural source in homeopathic medicines worldwide. Today, alfalfa is suggested for treating gout and gouty arthritis, most other arthritis types, kidney and bladder problems, colon problems, anemia, asthma, diabetes, ulcers, stomach ailments, prostate conditions, gas pains, hiatal hernia and water retention. Alfalfa Supplements â€" An Arthritis Remedy without Drug Side Effects

You may have better luck with Circumin if n-saids were no help, but you are already taking Turmeric so you should be careful there.


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## walshb (May 21, 2019)

GT_guy said:


> I was hoping someone here has experience and could tell me what works to treat a flare-up and anything to help prevent another one?
> My big $ Ortho has been less than helpful.
> Thanks!


I was diagnosed a few years ago, with Pseudogout in both knees, confirmed by X-rays. The doctor showed me the crystalline deposits. As "luck" would have it, I had also broken 2 ribs during a fall around that time. Researching what to do for broken ribs, led me to what I am convinced may be a cure for Pseudogout. I ordered some Cissus Quadrangularis from Amazon, which is supposed to help fractured bones heal faster. A few days after taking only half the recommended dosage, my knees quit bothering me. I took the CQ for about 2 years, then began slacking off to see if my knee problem would return. It hasn't, so far. I don't even take the CQ any more, it's probably been about a year now since I quit taking it. 
I'm hoping that someone else will try this and let us all know if it helps for their Pseudogout. You can buy it from Amazon. It's a natural product made from a grape vine. It's also very cheap. The brand name that I have used is Absonutrix but there are many others. Read the reviews, do some research, and give it a try if you are still looking for a possible (and natural) solution. 
I hope it helps someone else like it has helped me.


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## InertiaMan (Apr 16, 2004)

Way to go @walshb !! You solved a complex medical problem in your first ever post! Amazing!


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## walshb (May 21, 2019)

InertiaMan said:


> Way to go @walshb !! You solved a complex medical problem in your first ever post! Amazing!


I accidentally "solved" it. Lol
If it helps even one person, it was worth posting it here.


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## bsieb (Aug 23, 2003)

Taking tumeric (curcumin) for my arthritic knuckles... the water on my knee has cleared up. I can now kneel without discomfort, had not been able to do that for several years. No allergy symptoms for two years now either, nice perk.


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## rdsmith3 (Oct 5, 2014)

vikb said:


> ...
> I have not noticed any correlation with eating red meat or alcohol. ...


Same here. I get gout occasionally in the joint behind by right big toe. I like red meat and red wine. Also beer. I find no correlation between consumption of those and gout episodes. It's very strange but just something to accept as I get older.


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## EJ (Aug 29, 2005)

walshb said:


> I accidentally "solved" it. Lol
> If it helps even one person, it was worth posting it here.


@walshb - I hope you are legit and not just shilling some supplement. I'm going to give it a try. I'll post back after a month of use.


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## Nat (Dec 30, 2003)

GT_guy said:


> @walshb - I hope you are legit and not just shilling some supplement. I'm going to give it a try. I'll post back after a month of use.


His first ever post was to a two year old dormant thread and has nothing to do with mountain biking... I'm going to go ahead and call shill.

His profile page says he doesn't even have a bike.


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## EJ (Aug 29, 2005)

Nat said:


> His first ever post was to a two year old dormant thread and has nothing to do with mountain biking... I'm going to go ahead and call shill.
> 
> His profile page says he doesn't even have a bike.


Yeah, my thoughts as well. He made almost the same post 2 yrs ago on a guitar forum.

There does seem to be some data on this out there and my knees are still bothering me so I'll gamble the $20 and see what happens.


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## seeking cppd cure (11 mo ago)

Yesterday at 11:52 AM  
 
 

 
   
 
 Add bookmark 
 
  #40  
 
 


I am 70 years old. RA hit me at 50. The pain was constant. My legs, feet, ankles, knees, hands, wrists all in pain. Because of the pain, I sat on my butt for 17 years, until retired, so my leg muscles did not support me very well. I had developed severe knots of pain in my left leg. I got Mad at the pain, pressed hard against the knot until it finally relented. Then I discovered the bubbles in my left leg. But my right leg did not display the same way. So reasoned that the bubbles should not be in my left leg and I started to crush them. I went to bed that night and for the first time in 17 years, my left leg laid in bed, CALM, no pain. Amazing. The bubbles and crystals attach to the tendons for their energy(parasite?). Scrape them off of the tendons. The bubbles and crystals are more interested in the tendons, than the bone.
To crush the bubbles and crystals, I use the top of my fingernail to push down and away on the crepitus and pop the bubbles. try not to dig in with end of the finger. The skin will suffer, work on another areas until it heals. You might use a spoon. The bubbles are arthritis. I think the bubbles are parasites, because, when you pop the bubbles more push in behind it, to replace the bubbles, I just popped. I call my work with my fingers 'scrapping'. I can scrape in one same area for a full minute before I pop all of the bubbles in that vicinity.
The crystals are just the excrement of the bubbles. If you crush the crystals, they will be absorbed by your body and flushed out through the poop shoot. AND THE PAIN GOES AWAY!
I first starting scrapping about three years ago, it has been a continual process. The muscle redevelopment takes a long time. I can walk again and am riding a bike 8 miles a day.
My rheumatologist does not understand what I am doing, but I can walk again, so it is a good thing.


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