Managing Knee Pain, Fatigue, and GERD

Question: There are no physicians who specialize in PPS near my home. I believe I had non-paralytic polio in 1952. I started having symptoms of PPS in 1993. I have full body pain and suffer from extreme fatigue. Testing by a neurologist in 2024 showed mild evidence of having had polio. I have worked with my primary doctor since 1994 to treat the pain with various medications, which have almost eliminated the body pain. Other symptoms are increasing, such as throat irritation and GERD. Exercise seems to make my fatigue worse. Weakness has also been increasing.

The orthopedist diagnosed me with osteoarthritis. He has thus far given me two steroid injections which have provided me with some relief. I’ve treated myself with Asian knee patches. I don’t like the steroids in my body, so two weeks ago I had a prolotherapy injection. If the knee pain is caused by PPS, how should it be treated? Is there an indication as to how much longer I could live this way?

Answer from Marny Eulberg, MD: You are not alone in being in parts of the country with very few healthcare professionals who have expertise in helping people deal with possible polio-related symptoms or trying to figure out which symptoms may be polio-related and which could be from other conditions such as osteoarthritis or related to. If the neurologist did an EMG (electromyogram) that showed evidence of nerve damage from polio, then you did not have “non-paralytic polio,” even though the paralysis may have been so slight that is did not show up on routine inspection/exam. Your GERD could be causing the throat irritation, or it could be due to allergies and several other non-polio-related conditions. GERD is quite common in people as they mature, including the majority with GERD who never had polio.

As for your question about how much longer you could live this way—if you are asking about life expectancy, unless polio survivors have severe breathing problems or severe swallowing problems, they can expect to live as long as their peers who never had polio. Post-polio syndrome is a slowly progressive condition and since the neurologist in 2024 felt you had “only mild evidence of polio,” I would expect that any polio-related symptoms will either not get much worse or if they progress, it will be slowly. It seems that your knee pain is due to the wear-and-tear arthritis. It could be indirectly related to polio if you had long-term muscle imbalance in your legs or some deformity that was caused by your childhood polio.

Additional remarks from Daniel Ryan, MD: I would agree with Dr. Eulberg’s assessment. Regarding your knee, I would like to add that treatment options you have already tried—cortisone injections and prolotherapy—are reasonable approaches. Other possibilities include physical therapy, knee bracing for added support, and if appropriate, viscosupplementation (hyaluronic acid) injections. If the osteoarthritis is very advanced, symptoms are significantly limiting your function, and you are medically cleared, a total knee replacement could be considered in the future.

Post-Polio Health (Vol. 42, No. 1, Winter 2026)