- Chronic Knee Pain: Causes, Symptoms, and Diagnosis
- Knee pain: Common causes and when to see a doctor
- Knee bursitis
- Dislocated kneecap
- 11 Knee Pain Dos and Don’ts
- Knee Pain and Problems
- Treatment for knee problems
- Knee Pain Treatment, Diagnosis & Related Symptoms
- Knee pain facts
- What is knee pain?
- What are knee pain symptoms and signs?
- What causes knee pain?
- Acute knee injuries
- What medical conditions cause knee pain?
- Chronic use/overuse conditions
- Other causes
- What are risk factors for knee pain?
- When should see a doctor for knee pain?
- What procedures and tests diagnose knee pain?
- Radiologic tests
- Blood tests
- Removal of joint fluid (arthrocentesis)
- Which types of doctors treat knee pain?
- What is the treatment for knee pain?
- Physical therapy
- Will surgery treat and cure knee pain?
- Other therapies
- What natural home remedies relieve knee pain?
- What are the complications of knee pain?
- Can you prevent knee pain?
- Can knee pain come back after being treated?
Chronic Knee Pain: Causes, Symptoms, and Diagnosis
Chronic knee pain is long-term pain, swelling, or sensitivity in one or both knees. The cause of your knee pain can determine the symptoms you experience. Many conditions can cause or contribute to chronic knee pain, and many treatments exist. Each person’s experience with chronic knee pain will be different.
Temporary knee pain is different from chronic knee pain. Many people experience temporary knee pain as a result of an injury or accident. Chronic knee pain rarely goes away without treatment, and it isn’t always attributable to one incident. It’s most often the result of several causes or conditions.
Physical conditions or diseases can cause knee pain. These include:
Factors that may make chronic knee pain worse:
- injuries to the structure of the knee can cause bleeding and swelling and can create a chronic problem over time if not treated properly
- sprains and strains
- bad posture and form when doing physical activity
- not warming up or cooling down before or after physical activity
- improperly stretching the muscles
People who are overweight or obese are at a greater risk for knee problems. For every pound that you are overweight, your knee must absorb an extra 4 pounds of pressure when you walk, run, or climb stairs.
Other factors that increase your risk for chronic knee pain include:
- previous injuries or trauma
- athletic activity or physical exercise
The symptoms of chronic knee pain are different for each person, and the cause for the knee pain often affects how the pain feels. Chronic knee pain may present as a:
- constant ache
- sharp, shooting pain when in use
- dull burning discomfort
You may also experience chronic swelling and pain when the knee is touched.
Each possible cause of chronic knee pain requires different diagnostic tests. These include blood work, physical examination, X-rays, CT scan or MRI, and other imaging tests. The condition your doctor thinks you have will determine the types of tests you will undergo to see what’s causing your chronic knee pain.
Each underlying cause of chronic knee pain has a specific type of treatment. These treatments may include:
- physical therapy
Bursitis, a common cause of knee pain, is treated in the following ways:
Ice the knee for 15 minutes once an hour for three or four hours. Do not apply the ice directly to the knee; instead, cover your knee with a cotton towel. Place ice in a plastic zip-close bag, and then place the bag on the towel.
Wear cushioned, flat shoes that support your feet and don’t exacerbate your pain.
Avoid sleeping on your side. Use pillows positioned on either side of your body to prevent you from rolling onto your side. When lying on your side, keep a pillow between your knees.
Stay seated when possible. If you have to stand, avoid hard surfaces and keep your weight equally divided on both legs.
Lose weight if you are overweight or obese.
Some knee pain, especially pain caused by osteoarthritis, will ly be permanent. That’s because the structure of the knee is damaged. Without surgery or another type of extensive treatment, you’ll continue to feel pain, inflammation, and swelling in your knee.
The long-term outlook for chronic knee pain involves managing pain, preventing flare-ups, and working to reduce irritation to the knee.
You can prevent some, but not all, of the possible causes of knee pain. But you can’t prevent chronic knee pain. There are things you can do to alleviate the pain.
If your chronic knee pain gets worse because of overuse, or tends to be the most painful after physical activity, you can make lifestyle changes to help treat the pain. These approaches include:
- Warm up before exercise. Stretch your quadriceps and hamstrings before and after exercise.
- Try low-impact exercises. Instead of tennis or running, give swimming or bicycling a shot. Or mix low-impact exercises with high-impact exercises to give your knees a break.
- Lose weight.
- Walk down hills. Running puts extra force on your knee. Instead of running down an incline, walk.
- Stick to paved surfaces. Rough roads or pocked walkways may be hazardous to your knee’s health. Stick to smooth, paved surfaces a track or walking arena.
- Get support. Shoe inserts can help treat foot or gait problems that may be contributing to knee pain.
- Replace your running shoes frequently to ensure they still have proper support and cushioning.
Knee pain: Common causes and when to see a doctor
Severe knee pain can occur in people of all ages for a range of reasons. Knowing the cause of severe knee pain can help a person seek treatment, relieve symptoms, and regain mobility.
The knee is the joint between the bones of the upper and lower leg. It allows the leg to bend and provides stability to support the weight of the body. The knee supports motions such as walking, running, crouching, jumping, and turning.
Several parts help the knee to do its job, including:
Any of these parts are susceptible to disease and injury, which can lead to severe knee pain.
This article breaks down the common causes of severe knee pain into five categories: Trauma, infection, metabolic, degenerative disorders, and connective tissue disorders.
Share on PinterestEither direct or gradual trauma can cause knee pain.
The Arthritis Foundation lists the knee as one of the most injury-prone joints.
The overall structure and components of the knee increase the risk for certain types of injury, which can cause pain and prevent full function.
Common knee injuries occur because of tears in one of the three main ligaments of the knee.
- the anterior cruciate ligament (ACL)
- the medial collateral ligament (MCL)
- the posterior cruciate ligament (PCL)
Injuries to these ligaments are common in athletes.
A sudden twisting motion or change in direction can injure the ACL. This is one of the most common knee injuries.
People tend to injure the PCL with direct impact to the area, such as a car crash or football tackle. A direct blow to the knee can lead to MCL damage.
Ligament injuries often require surgery.
Knee trauma can also lead to injuries as a result of overworking or overstretching a tendon. Inflammation, tendinitis, or ruptures can cause knee pain. Engaging in activities that involve the tendons can cause tendon injuries, such as running, jumping, and lifting heavy items.
Patellar tendinitis is the term that describes irritation and inflammation of the patellar tendon in the knee. A severely ruptured tendon usually requires surgical repair.
Less severe cases can be treated with a rigid support called a splint that keeps the knee in a fixed position during the healing process.
An injury that inflames the bursae can lead to bursitis. The bursae are small, fluid-filled sacs that cushion the outside of the knee joint and make it possible for tendons and ligaments to glide easily over the joints.
A sudden blow to the front of the knee can injure the bursae. Alternatively, damage can occur if people spend a lot of time on their knees without protection. Bursitis can lead to swelling, warmth, pain, and stiffness in the knee.
Most people can resolve the symptoms of bursitis with therapy and oral medications, such as non-steroidal anti-inflammatory drugs (NSAIDs). Therapy can include rest, ice, elevation of the limb, and splinting.
People with serious bursitis might require steroid injections. Individuals will not normally need surgery to make a full recovery and will normally achieve full function with proper management and treatment.
Trauma from a fall or collision can cause fractures in the bones of the knee.
The knee contains several bones that can break, including the kneecap, also known as the patella.
Individuals with osteoporosis or other degenerative disorders that weaken bones can fracture their knee simply by stepping off a curb in the wrong way. Serious fractures require surgery, but some people with a knee fracture need only physical therapy.
Some injuries can cause the kneecap to move place.
Often, a doctor can replace the kneecap without issue. An X-ray can identify any accompanying fractures in the area. The individual may have to use a splint to allow the soft tissue around the patella to heal and regain strength. Occasionally, a person will require surgery to prevent further dislocations.
A dislocated knee is a rare but dangerous injury and differs from a dislocated kneecap. It takes a highly powerful blow to cause this type of damage. Though reversible, dislocation of the knee is extremely painful.
The doctor must reduce the dislocation and ensure that there are no further injuries. Injuries to the blood vessels and nerves around the knee are common with this injury, and it can be limb-threatening and life-threatening.
A doctor will almost always recommend surgery to repair the damaged structures in a knee dislocation. It can take about 6 weeks to heal from a dislocated kneecap.
This a medical emergency and requires immediate clinical attention.
Degenerative tissue disorders are a common knee complaint.
Osteoarthritis causes degeneration in the cartilage and surrounding tissues of the knee. It can produce pain, stiffness, and joint dysfunction.
The degenerative condition occurs most commonly as a result of aging. It occurs in 10 percent of men and 13 percent of women over the age of 60 years in the United States.
Although there is no cure for this degenerative disease, people can manage the symptoms with gentle exercise and pain relief medications.
Severe damage may lead to joint replacement or other forms of surgery. A doctor will initially order an X-ray to assess the extent of the damage and decide on the best course of treatment.
Share on PinterestRheumatoid arthritis can be a cause of knee pain.
Rheumatoid arthritis (RA) is an inflammatory autoimmune disorder that affects the joints.
The immune system attacks the joint tissues instead of harmful elements in the body.
Un degenerative tissue disorders, RA and other connective tissue disorders affect the lining of the joints. The result is a painful swelling in the knee joints. If a person does not receive treatment, RA can lead to bone erosion and even joint deformity.
Even though the pain might only occur in the knee area, RA can damage other parts of the body. Discuss treatment options with a doctor.
There is no cure for RA, but medication and treatment options are available. NSAIDs, corticosteroids, and biological agents are a few of the possible treatments, as well as disease-modifying anti-rheumatic drugs (DMARDs).
Metabolic causes of knee pain often occur alongside a disease that affects several parts of the body, such as gout.
A build-up of uric acid crystals in the joints can cause gout, one of the most common metabolic complaints that can affect the knee.
Gout is a form of arthritis and can be extremely painful. It causes swelling and inflammation in the knee and can reduce the range of motion in the area.
A doctor will often recommend anti-inflammatory medications or other treatments that help break down the chemicals in gout crystals.
Pseudogout is a similar condition. People commonly mistake this for gout, and it causes calcium-containing crystals to develop in the joint fluid, leading to swelling in the knee.
Treatment for gout and pseudogout are often similar.
Cellulitis is a very serious bacterial skin infection that can affect the knee and surrounding area.
Infection can even occur after a simple scrape on the knee if a person does not receive treatment for cellulitis. Symptoms often include redness in the infected area and skin that feels hot and extremely tender to the touch.
Share on PinterestInfection can occur in the knee, but ice packs are a helpful way to soothe the discomfort.
The infection can spread to other areas of the body, including the lymph nodes and bloodstream. Cellulitis can be life-threatening if there are delays in treatment.
Pay close attention to any scrapes or bruises, especially if they do not seem to be healing.
In most cases, an individual can treat cellulitis by taking antibiotics. Signs and symptoms normally disappear within a few days of treatment.
It is also possible for an infection called septic arthritis to occur in the joints of the knee, causing swelling, pain, and redness. Some individuals also complain of a fever.
Treatment is simple and effective if a person quickly receives care for septic arthritis, but leaving the infection untreated can lead to permanent damage to the cartilage of the knee.
A trained medical professional should perform tests to determine the direct cause of any knee pain.
They may reach a diagnosis by asking the following questions:
- When and how did the pain start?
- Is the pain linked to an injury?
- How severe is the pain?
- How has the pain changed over time?
- What makes the pain worse and what makes it feel better?
- What treatment has taken place so far?
- Has this ever happened before?
The doctor will be able to recommend a course of treatment appropriate for the cause of the pain.
What is the best way to identify the cause of my knee pain?
The best way to manage knee pain is to identify the cause, as follows:
- Metabolic causes: Is there a history of gout or symptoms including dehydration that could precipitate a gout attack? If you have a diagnosis of gout, are you managing the condition with medication? Keeping up your regimen could reduce knee pain.
- Trauma: You will normally be aware of what causes a trauma, unless it is a repetitive type of trauma, such as a sudden and drastic increase in running distance.
- Infection: Is the joint red, hot, or swollen? Does the patient have a history of infections elsewhere or a compromised immune system? An elevated temperature is also a sign of infection in the knee.
- Osteoarthritis: Was the onset gradual or sudden? With OA, the pain usually develops gradually. Excessive body weight is one of the more common findings in people with osteoarthritis of the knee, so if you are overweight, this could be contributing to knee pain.
- Connective tissue disorders: Do you have a pre-existing diagnosis of a connective tissue disorder? If so, have you been taking medications to control it? Are there other joints involved, as with rheumatoid arthritis? If one knee is involved, a connective tissue disorder will ly affect the other knee.
William Morrison, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
11 Knee Pain Dos and Don’ts
You can do many things to help knee pain, whether it's due to a recent injury or arthritis you've had for years.
Follow these 11 dos and don’ts to help your knees feel their best.
Don’t rest too much. Too much rest can weaken your muscles, which can worsen joint pain. Find an exercise program that is safe for your knees and stick with it. If you're not sure which motions are safe or how much you can do, talk with your doctor or a physical therapist.
Do exercise. Cardio exercises strengthen the muscles that support your knee and increase flexibility. Weight training and stretching do, too. For cardio, some good choices include walking, swimming, water aerobics, stationary cycling, and elliptical machines. Tai chi may also help ease stiffness and improve balance.
Don’t risk a fall. A painful or unstable knee can make a fall more ly, which can cause more knee damage. Curb your risk of falling by making sure your home is well lit, using handrails on staircases, and using a sturdy ladder or foot stool if you need to reach something from a high shelf.
Do use “RICE.” Rest, ice, compression, and elevation (RICE) is good for knee pain caused by a minor injury or an arthritis flare. Give your knee some rest, apply ice to reduce swelling, wear a compressive bandage, and keep your knee elevated.
Don't overlook your weight. If you're overweight, losing weight reduces the stress on your knee. You don’t even need to get to your “ideal” weight. Smaller changes still make a difference.
Don't be shy about using a walking aid. A crutch or cane can take the stress off of your knee. Knee splints and braces can also help you stay stable.
Do consider acupuncture. This form of traditional Chinese medicine, which involves inserting fine needles at certain points on the body, is widely used to relieve many types of pain and may help knee pain.
Don't let your shoes make matters worse. Cushioned insoles can reduce stress on your knees. For knee osteoarthritis, doctors often recommend special insoles that you put in your shoe. To find the appropriate insole, speak with your doctor or a physical therapist.
Do play with temperature. For the first 48 to 72 hours after a knee injury, use a cold pack to ease swelling and numb the pain. A plastic bag of ice or frozen peas works well.
Use it for 15 to 20 minutes three or four times a day. Wrap your ice pack in a towel to be kind to your skin.
After that, you can heat things up with a warm bath, heating pad, or warm towel for 15 to 20 minutes, three or four times a day.
Don’t jar your joint(s). High-impact exercises can further injure painful knees. Avoid jarring exercises such as running, jumping, and kickboxing. Also avoid doing exercises such as lunges and deep squats that put a lot of stress on your knees. These can worsen pain and, if not done correctly, cause injury.
Do get expert advice. If your knee pain is new, get a doctor to check it out. It's best to know what you're dealing with ASAP so you can prevent any more damage.
American Academy of Orthopaedic Surgeons: “Common Knee Injuries.”
Hochberg, M. Arthritis Care and Research, April 2012.
ArthritisToday.org: “Ways to Ease Knee Pain and Get Around.”
ArthtitisToday.org: “25 Treatments for Arthritis Hip and Knee Pain.”
University of Missouri Health Care: “Use of Heat and Cold for Pain Relief.”
Hospital for Special Surgery: “Frequently Asked Questions: What are some of the pharmacological treatments for osteoarthritis pain?”
ArthritisToday.org: “Injections and Procedures for Knee Pain.”
Hospital for Special Surgery: “Viscosupplementation.”
The Kaiser Permanente Medical Group: “Knee Meniscus Cartilage Injuries.” University of Michigan Health System: “Obesity and Anterior Knee Pain.” OTCSafety.org: “Pain Relievers and Fever Reducers.”
Advanced Physical Medicine: “4 Exercise Tips for Bad Knees.”
Harvard Health Beat: “The secret to joint pain relief – exercise.”
Arthritis Foundation: “Tai Chi: A Program for Better Living.”
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Knee Pain and Problems
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Knee pain is a common complaint among adults and most often associated with general wear and tear from daily activities walking, bending, standing and lifting.
Athletes who run or play sports that involve jumping or quick pivoting are also more ly to experience knee pain and problems.
But whether an individual’s knee pain is caused by aging or injury, it can be a nuisance and even debilitating in some circumstances.
What You Need to Know
- The most common causes of knee pain are related to aging, injury or repeated stress on the knee.
- Common knee problems include sprained or strained ligaments, cartilage tears, tendonitis and arthritis.
- Diagnosing a knee injury or problem includes a medical examination and usually the use of a diagnostic procedure(s) such as an x-ray, MRI, CT scan or arthroscopy.
- Both non-operative and surgical treatment options are available to treat knee pain and problems depending on the type and severity of the condition.
The knee is a vulnerable joint that bears a great deal of stress from everyday activities, such as lifting and kneeling, and from high-impact activities, such as jogging and aerobics.
The knee is formed by the following parts:
- Tibia. This is the shin bone or larger bone of the lower leg.
- Femur. This is the thighbone or upper leg bone.
- Patella. This is the kneecap.
Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee. Basically, the knee is 2 long leg bones held together by muscles, ligaments, and tendons.
There are 2 groups of muscles involved in the knee, including the quadriceps muscles (located on the front of the thighs), which straighten the legs, and the hamstring muscles (located on the back of the thighs), which bend the leg at the knee.
Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments on the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia (shin bone).
Many knee problems are a result of the aging process and continual wear and stress on the knee joint (such as, arthritis). Other knee problems are a result of an injury or a sudden movement that strains the knee. Common knee problems include the following:
- Sprained or strained knee ligaments and/or muscles. A sprained or strained knee ligament or muscle is usually caused by a blow to the knee or a sudden twist of the knee. Symptoms often include pain, swelling, and difficulty in walking.
- Torn cartilage. Trauma to the knee can tear the menisci (pads of connective tissue that act as shock absorbers and also enhance stability). Cartilage tears can often occur with sprains. Treatment may involve wearing a brace during an activity to protect the knee from further injury. Surgery may be needed to repair the tear.
- Tendonitis. Inflammation of the tendons may result from overuse of a tendon during certain activities such as running, jumping, or cycling. Tendonitis of the patellar tendon is called jumper's knee. This often occurs with sports, such as basketball, where the force of hitting the ground after a jump strains the tendon.
- Arthritis. Osteoarthritis is the most common type of arthritis that affects the knee. Osteoarthritis is a degenerative process where the cartilage in the joint gradually wears away. It often affects middle-age and older people. Osteoarthritis may be caused by excess stress on the joint such as repeated injury or being overweight. Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed and by destroying the knee cartilage. Rheumatoid arthritis often affects persons at an earlier age than osteoarthritis.
Sports injury prevention isn't a one-stop shop, especially for injuries ACL tears, which are four to eight times more common among women than men. Discover ways for women to help prevent this common injury.
In addition to a complete medical history and physical exam, other tests for knee problems may include:
- X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.
- Magnetic resonance imaging (MRI). This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle.
- Computed tomography scan (also called a CT or CAT scan). This test uses X-rays and computer technology to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
- Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscope), which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen; used to evaluate any degenerative or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation.
- Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient's bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
Treatment for knee problems
If initial treatment methods do not provide relief, and X-rays show destruction of the joint, the orthopaedist may recommend total joint replacement for the knee, also referred to as knee replacement.
Knee Pain Treatment, Diagnosis & Related Symptoms
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Knee pain facts
- Knee pain is a common problem with many causes, from acute injuries to complications of medical conditions.
- Knee pain can be localized to a specific area of the knee or be diffuse throughout the knee.
- Knee pain is often accompanied by physical restriction.
- A thorough physical examination will usually establish the diagnosis of knee pain.
- The treatment of knee pain depends on the underlying cause.
- The prognosis of knee pain, even severe knee pain, is usually good although it might require surgery or other interventions.
What is knee pain?
Pain is a common knee problem that can originate in any of the bony structures compromising the knee joint (femur, tibia, fibula), the kneecap (patella), or the ligaments, tendons, and cartilage (meniscus) of the knee.
Knee pain can be aggravated by physical activity, as well as obesity, affected by the surrounding muscles and their movements, and be triggered by other problems (such as a foot injury).
Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe.
With an acute injury, the patient often describes that they heard a loud pop and then developed intense pain in the knee. The pain makes walking or weight-bearing very difficult. The knee joint will begin to swell within a few hours because of bleeding within the joint, making it difficult to straighten the knee.
Click for more about torn ACL (anterior cruciate ligament tear) » Source: iStock
What are knee pain symptoms and signs?
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The location of the knee pain can vary depending on which structure is involved. With infection or an inflammatory process, the whole knee might be swollen and painful, while a torn meniscus or fracture of a bone gives symptoms only in one specific location. A Baker cyst will usually cause pain in the back of the knee.
The severity of the joint pain can vary, from a minor ache to a severe and disabling pain.
Some of the other signs and symptoms that accompany knee pain are
- difficulty weight bearing or walking due to instability of the knee,
- limping due to discomfort,
- difficulty walking up or down steps due to ligament damage (sprain),
- locking of the knee (unable to bend the knee),
- redness and swelling,
- inability to extend the knee, and
- shifting weight to the opposite knee and foot.
Source: “TibPlateauF” by James Heilman, MD
What causes knee pain?
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Knee pain can be divided into three major categories:
Below is a list of some of the more common causes of knee pain. This is not an all-inclusive list but rather highlights a few common causes of knee pain in each of the above categories.
Acute knee injuries
Fractures: A direct blow to the bony structure can cause one of the bones in the knee to break. This is usually a very obvious and painful knee injury.
Most knee fractures are not only painful but will also interfere with the proper functioning of the knee (such as kneecap fracture) or make it very painful to bear weight (such as tibial plateau fracture). All fractures need immediate medical attention.
Many fractures require significant force, and a thorough examination is performed to detect other injuries.
Ligament injuries: The most common injury is the ACL (anterior cruciate ligament) injury. An ACL injury is often a sports-related injury due to a sudden stop and change in directions. The remaining ligaments (posterior cruciate ligament, lateral collateral ligament, and medial collateral ligament) are injured less frequently.
Meniscus injuries: The menisci (medial and lateral) are made of cartilage and act as shock absorbers between bones in the knee. Twisting the knee can injure the meniscus.
Dislocation: The knee joint can be dislocated, which is a medical emergency that requires immediate attention. Knee dislocation can compromise blood flow to the leg and have other related problems. This injury often occurs during a motor-vehicle accident when the knee hits the dashboard.
Knee Pain See a medical illustration of the knee's anatomy plus our entire medical gallery of human anatomy and physiology See Images Source: “Patellar tendon rupture” by James Heilman, MD
What medical conditions cause knee pain?
Rheumatoid arthritis is an autoimmune condition that can affect any joint in the body. It can cause severe pain and disability, as well as swelling.
Gout is a form of arthritis that is most commonly found in the big toe, though it can also affect the knee. Gout tends to flare up and is extremely painful during the acute episodes. When there is no flare-up, the knee can be pain free.
With septic arthritis (infectious arthritis), the knee joint can become infected; this leads to pain, swelling, and fever. This condition requires antibiotics and drainage treatments as soon as possible.
Chronic use/overuse conditions
Patellar tendinitis is an inflammation of the tendons connecting the kneecap (patella) to the shinbone (the bone of the lower leg). Patellar tendinitis is a chronic condition often found in individuals repeating the same motion during exercise (such as runners and cyclists).
Patellofemoral pain syndrome is caused by degeneration or stress under the kneecap (patella) where it meets the thighbone (femur). Patellofemoral pain syndrome occurs in runners and cyclists.
Osteoarthritis: a wearing down of cartilage of the joint due to use and age
Prepatellar bursitis: Inflammation to the bursa (fluid-filled sac) in front of the kneecap may cause anterior knee pain.
Children can develop inflammation of the point of bony insertion of the patellar tendon (Osgood-Schlatter disease).
What are risk factors for knee pain?
Biomechanics: The knee joint is complicated in its operation and is used frequently throughout the day. Any change in the movement of the joint (leg-length difference, change in walking style due to back problems) can cause subtle changes and cause pain and injuries.
Excess weight: The stress on the knee joint is increased with excess weight. Obesity also increases the risk of knee osteoarthritis as the cartilage breaks down more rapidly.
Overuse during repetitive motions as are found during certain exercises (jogging, skiing) or work conditions (long periods of kneeling) can cause breakdown of cartilage and lead to pain.
When should see a doctor for knee pain?
Any pain that does not respond to rest or disappears within a few days should be evaluated by a doctor. In addition, the following are symptoms and signs in the knee that a doctor should evaluate: swelling, inability to bend, deformity, unable to walk or discomfort while walking, significant pain, and fever.
Osteoarthritis (OA): Treatment, Symptoms, Diagnosis See Slideshow Source: Getty Images
What procedures and tests diagnose knee pain?
A health care professional will begin by asking questions related to the person's general health and then specifically to the nature of the knee pain (how long, how severe, does anything make it feel better or worse, etc.).
Next, an examination of the knee will be performed. This will include bending the knee through the full range of motion, checking for stability of the ligaments, and evaluating for any tenderness and swelling.
It is often helpful to compare the results of the examination of the painful knee with the other knee. Frequently, this is all that is required to make a diagnosis and start treatment.
In several research studies, it has been found that an experienced examiner is as reliable as X-ray examination.
Sometimes the doctor might want to do further studies such as the following tests.
Plain X-ray can establish fractures and degenerative changes of the knee.
MRI is used to evaluate the soft tissues of the knee for ligament tears or cartilage and muscle injuries.
If gout, arthritis, or other medical conditions are suspected, a health care professional might order blood tests.
Removal of joint fluid (arthrocentesis)
Some conditions are best diagnosed by removal of a small amount of fluid from the knee joint. During arthrocentesis, a small needle is placed into your joint and fluid is withdrawn. This is done in a sterile method.
The fluid is then sent to the laboratory for evaluation. This procedure is especially helpful if an infected knee joint is suspected or to distinguish gout and different forms of arthritis.
If there is a collection of blood in the joint due to a traumatic injury, removing the fluid can help relieve the pain.
Which types of doctors treat knee pain?
Often knee pain can be evaluated and treated by your primary care doctor. If the knee pain requires surgery or the cause of the pain needs further evaluation, an orthopedic surgeon will usually be consulted. With arthritis, gout, or inflammatory joint problems a rheumatologist may be consulted.
What is the treatment for knee pain?
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Treatments for knee pain are as varied as the conditions that can cause the pain.
Medications might be prescribed to treat an underlying medical condition or for pain relief.
If you are taking over-the-counter anti-inflammatory pain medications regularly for your knee pain, you should see your doctor to be evaluated.
Sometimes physical therapy sessions to strengthen the muscles around the knee will make it more stable and help guarantee the best mechanical movements. Working with a physical therapist can help avoid injuries or further worsening of an injury.
Injecting medications directly into your knee might help in certain situations. The two most common injections are corticosteroids and lubricants. Corticosteroid injections can help arthritis and other inflammations of the knee. They usually need to be repeated every few months. Lubricants that are similar to the fluid already in your knee joint can help with movement and pain.
Will surgery treat and cure knee pain?
Knee operations range from arthroscopic knee surgery to total knee replacement. Arthroscopic knee surgery is a very common surgical procedure that allows the physician look inside your knee through a few small holes and a fiberoptic camera. The surgeon can repair many of the injuries and remove small pieces of loose bones or cartilage. This is a common outpatient procedure.
Partial knee replacement: The surgeon replaces the damaged portions of the knee with plastic and metal parts. Because only part of the knee joint is replaced, this procedure has a shorter recovery then a total knee replacement.
Total knee replacement: In this procedure, the knee is replaced with an artificial joint.
Acupuncture has shown some relieve of knee pain, especially in patients with osteoarthritis. Glucosamine and chondroitin supplements have shown mixed results in research studies.
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What natural home remedies relieve knee pain?
Over-the-counter pain medications can frequently alleviate the pain. If someone is taking these medications on a regular basis, he or she should see a health care professional to evaluate the knee pain for proper diagnosis and to avoid the potential side effects of chronic medication use.
The RICE mnemonic is often helpful, especially for minor injuries:
Rest: Rest the joint, and take a break from your usually activities involving the knee joint.
Ice: Applying ice can help with pain and inflammation.
Compress: A compression bandage can help prevent swelling and help knee alignment. It should not be tight and should be removed at night.
Elevate: Elevation can help with swelling and resting of the knee.
What are the complications of knee pain?
Frequently, knee pain will disappear without ever finding a specific cause. Depending on the underlying cause of the pain, the condition can progress and lead to more serious injuries or complications. Usually, these complications are long term and result in worsening pain or an increasing difficulty to walk.
Can you prevent knee pain?
There can be many reasons for knee pain. Therefore, there are different strategies to prevent the pain depending on the underlying cause.
Running on soft surfaces or decreasing the amount of running can help if the pain is due to overuse. Avoiding any direct injuries to the knee including wearing a seatbelt can prevent traumatic injuries.
Weight loss can be helpful for many different forms of knee pain.
Can knee pain come back after being treated?
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Frequently, knee pain will occur for a short period of time and then resolve. Sometimes it can return a few weeks or months later. For chronic knee pain, it is important to get it evaluated to avoid further damage to cartilage, bones, or ligaments. Prognosis depends on the underlying causes of the pain.
With modern surgical techniques, it's possible to relieve many of the knee pain syndromes and return to an active lifestyle.
Medically Reviewed on 11/5/2019
American Academy of Orthopaedic Surgeons. “Knee Exercises.” Feb. 2009. . “Knee Injuries.” Temple Orthopaedics & Sports Medicine. .
Meding, J.B., P.M. Faris, and K.E. Davis. “Bilateral Total Hip and Knee Arthroplasties: Average 10-Year Follow-Up.” J Arthroplasty May 22, 2017. Epub ahead of print.