Knee Pain Service
Knee pain is a common symptom that affects people of all age groups. It may result from:
- Injury (strained ligament or torn cartilage)
- Rheumatoid arthritis
Minor knee pain responds well to rest and anti-inflammatories. Additionally, physical therapy and knee braces also can help to alleviate knee pain.
In more severe cases, however, you may require steroid injection, PRP, hyaluronan replacement, surgical knee repair or knee replacement.
Location and severity will depend on the cause of the knee pain. Additional signs and symptoms that may occur with knee pain are:
- Swelling and stiffness
- Redness and warm to the touch
- A sensation of weakness or instability
- Popping, clicking or crunching noises
- The inability to fully extend or flex the knee
Call your doctor if you:
- Are unable bear weight on your knee or feel as if your knee giving out (unstable)
- Have a lot of swelling in the knee
- Are unable to fully extend or flex your knee
- See a deformity on the knee, or on the upper or lower leg
- If you have a fever in addition to pain, redness and swelling
- Have severe knee pain that is present after trauma
Knee pain can be due to trauma, mechanical problems, arthritis and other issues.
Trauma to the knee can affect the bones, cartilage, ligaments and the sacs filled with fluid that surround it (bursae). Some common knee injuries are:
Anterior cruciate ligament (ACL) injury. This is a tear of the anterior cruciate ligament (ACL), one of four ligaments that connect the shinbone to the thighbone. An ACL injury is particularly common in people who play sports in which there is a lot of sudden change of direction such as basketball or football (soccer).
Fractures. The bones of the knee, including the patella (kneecap), can be broken during car accidents or falls. Those with osteoporosis can sometimes sustain a knee fracture simply by stepping improperly because the bones are weaker due to the reduced density.
Torn meniscus. The meniscus is a tough rubbery cartilage that functions as a shock absorber between your thighbone and shinbone. If you suddenly twist your knee while bearing weight on it, it can tear.
Knee bursitis. Some knee injuries can lead to inflammation in the bursae, the sacs of fluid that cushion the outside of your knee so tendons and ligaments can glide smoothly over it.
Patellar tendinitis. Tendons are thick, fibrous tissues that attach muscles to bones. When they get irritated and inflamed, that is known as a “tendintis”. Runners, cyclists, and those involved in jumping activities may develop inflammation in the patellar tendon (kneecap), which connects the large quadriceps muscle at the front of the thigh to the top of the shinbone (tibia).
Some examples of mechanical problems that can cause knee pain include:
Loose body. Sometimes a piece of bone or cartilage can break off and float around in the joint space due to injury or degeneration. This may not lead to any problems unless the loose body impairs knee joint movement. In this case the effect is likened to a piece of wood stuck in a door hinge.
Iliotibial band (IT band) syndrome. The iliotibial band is a tough band of tissue that connects the outside of your hip to the outside of your knee. At times it can become so tight that it grinds against the outer part of your femur (thigh bone). Long distance runners and cyclists are very susceptible to iliotibial band syndrome owing to the type of repetitive movements they engage in.
Kneecap dislocation. This occurs when the triangular bone (patella) that is located at the front of your knee slips to the outside of your knee and quickly slips back into position. In some cases, the kneecap may stay displaced and you'll be able to see that it is out of place.
Foot or hip joint pain. If you develop foot or hip pain for whatever reason, you may alter the manner in which you walk in an attempt to ease the pain. However the altered walking pattern can place more mechanical stress on your knee joint. So, in some cases, problems in the hip or foot can be the actual source of your knee pain and it will need to be addressed as well.
There are many types of arthritis. The ones most likely to affect the knee are:
Osteoarthritis (OA). Osteoarthritis (degenerative arthritis) is the most common type of arthritis. It occurs due to mechanical wear and tear. It occurs when the knee cartilage deteriorates with age, use and poor mechanics.
Rheumatoid arthritis (RA). Rheumatoid arthritis is an autoimmune condition that can involve almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it can vary in severity and symptoms can even come and go.
Gout. In this type of arthritis, there is an accumulation of uric acid crystals in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
Pseudogout. This is often mistaken for gout. In pseudogout there is calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
Septic arthritis. At times, the knee joint can become infected, red, swollen and painful. Septic arthritis often occurs in conjunction with a fever, and there's usually there is no history of trauma before the onset of pain. Septic arthritis can rapidly cause widespread damage to the knee cartilage. If you are experiencing knee pain along with any of above symptoms, you need to seek medical care right away. You will need to get blood tests and possibly anti-biotics.
Patellofemoral pain syndrome is a general term that is used to refer to pain originating from between the kneecap (patella) and the underlying thighbone (femur). It's common in athletes and young adults who have a slight mal-tracking of the kneecap. It can also occur in older adults, who usually develop the condition as a result of arthritis of the kneecap.
Factors that can increase your risk of having knee problems are:
Additional weight. Being overweight increases the mechanical forces on your knee joints, even during normal activities such as walking or climbing stairs. It also increases your risk of osteoarthritis by hastening the degeneration of the cartilage in the joint.
Reduced muscle strength or flexibility. Muscle in conjunction with tendons and ligaments, help to stabilize the joints and proper flexibility helps you to achieve a full range of motion (ROM). So, a lack of strength and flexibility can increase the risk of knee injuries.
Certain occupations or sporting activities. Jobs that demand repetitive stress on the knees such as farming or construction can increase your risk of knee injuries. Also, some sports put greater stress on your knees than do others. Particularly stressful are basketball, jogging and running.
Previous injury. Having a previous knee injury makes it more likely that you'll injure your knee again. This is because there may be residual weakness or newly developed joint mis-alignment. An injury can also be a trigger for the development of osteoarthritis. You should see a therapist to rehabilitate your knee if you are unsure of the health of the joint.
Throughout your life, you will never evade knee pain totally. However, there are steps you can take to minimize the chance of injuries and subsequent joint deterioration:
Maintain a healthy weight. This is one of the best measures you can take to preserve healthy knees. Additional pounds equal additional wear and tear on your joints and this increases the risk of injuries and osteoarthritis.
Prepare your body to play your sport. Take the time to train for adequate strength and flexibility in order to prepare your muscles for the demands of your activity. Also work on your movement patterns with a coach or trainer to ensure that your technique and movement are as efficient as they can be. This will lead to less injuries in the long term.
Make smart exercise choices. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change or alternate your activities. You may want to consider alternating swimming, water aerobics or other low-impact activities with your regular activities.