Knee pain is a common complaint that affects people of all ages. In some individuals the pain is not very severe, while in some instances the pain is very severe requiring urgent medical attention. It is always important to determine the cause of knee pain, but in some cases no cause can be found despite intensive investigations and tests. Most cases of knee pain can often be treated at home but in a few individuals, hospitalisation might be required.
What is knee pain?
Knee pain can occur for many reasons, most commonly because of overuse, injuries or arthritis. You can experience knee pain at any age, but older people are more likely to develop it due to degeneration of the joint – a condition known as osteoarthritis. Knee pain might also be known as referred pain, that is, it is due to problems not related to the knee itself.
Depending on what is causing your pain, you may feel better with home measures such as rest, anti-inflammatory medication, and ice. If you have a more severe injury, you may need a procedure or a surgery.
Surgeons often use minimally invasive types of surgery (arthroscopic surgery) to repair damage to the knee like torn tendons or ligaments. These types of injuries can cause knee instability and pain. In cases when the damage is severe, your healthcare provider may recommend knee replacement surgery.
What causes knee pain?
Many conditions and injuries can make your knees hurt. Some common knee pain causes can include overuse, injuries, and arthritis.
Overuse
Repetitive activities can lead to pain. Some examples are:
• Patellofemoral pain (runner’s knee): pain under or around the kneecap, often related to mechanics, shape of the kneecap, or
• Osgood-Schlatter disease: In children, swelling in the shinbone below the kneecap due to overuse.
• Tendonitis due to repetitive jumping sports such as volleyball or basketball.
Injury
Sudden trauma can damage parts of your knee joint. Common knee injuries can include:
• Anterior cruciate ligament (ACL) injury or medial collateral ligament (MCL) injury: Damage to the main stabilising ligaments of the knee.
• Bursitis: Inflammation (swelling) of the fluid-filled sacs that cushion the knee joint.
• Kneecap dislocation: Movement out of place of your kneecap (the bone that covers your knee).
• Meniscus tear: Tear in the knee’s cartilage (slippery tissue that helps bones move together smoothly).
Arthritis
Arthritis is a condition that can impact many different joints in your body. When you have arthritis in your knee, it causes the joint to swell. This can be a painful condition. Arthritis in your knee is more likely to develop over time as you age. There are several distinct types of arthritis that can affect the knees, including rheumatoid arthritis and osteoarthritis.
Risk factors
A number of factors can increase your risk of having knee problems, including:
• Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and downstairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
• Lack of muscle flexibility or strength. A lack of strength and flexibility can increase the risk of knee injuries. Strong muscles help stabilise and protect your joints, and muscle flexibility can help you achieve full range of motion.
• Certain sports or occupations. Some sports put greater stress on your knees than do others. Alpine skiing with its rigid ski boots and potential for falls, basketball’s jumps, and pivots, and the repeated pounding your knees take when you run, or jog all increase your risk of knee injury. Jobs that require repetitive stress on the knees such as construction or farming also can increase your risk.
• Previous injury. Having a previous knee injury makes it more likely that you will injure your knee again.
Symptoms
The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:
• Swelling and stiffness
• Redness and warmth to the touch
• Weakness or instability
• Popping or crunching noises
• Inability to fully straighten the knee
Dealing with knee pain
Treatment for knee pain depends on what is causing it and how uncomfortable it is.
• Mild knee injuries often improve with rest, ice, and anti-inflammatory medications. Wearing a brace can stabilise the knee while it recovers.
• If arthritis is causing knee pain, your treatment may include medication and physical therapy.
• Doctors can usually repair tendon and ligament tears with minimally invasive surgery, if necessary.
• More serious knee pain may require knee replacement surgery.
No matter what caused your knee pain, physical therapy exercises can strengthen the muscles supporting your knee to help relieve discomfort.
How can I ease knee pain at home?
Your doctor or physical therapist can recommend home care to relieve knee pain. These may include:
• Applying heat or ice packs.
• Modifying activities to avoid causing pain.
• Practising gentle stretches or exercises.
• Taking over-the-counter pain relievers such as ibuprofen or acetaminophen.
• Topical treatments such as muscle creams or rubs.
• Wearing a brace to support the knee.
When should you see your doctor?
It is especially important to seek urgent medical attention if you have severe knee pain after a fall or accident, or if your knee is too painful or unstable to support your weight. You should also see your doctor if your knee is swollen, or you cannot extend it all the way. Call your doctor if you have pain that keeps bothering you longer than a few days.
Conclusion
Knee pain is a very common complaint. Knee pain can be caused by a sudden injury, an overuse injury, or by an underlying condition such as arthritis. Treatment will vary depending on the cause. Symptoms of knee injury can include pain, swelling, and stiffness. Many cases can be managed at home, but if symptoms persist you should seek medical attention. Not all knee pain is serious, but some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
