Knee Pain

Feb 28, 2014
2014 / March 2014

The knee provides stable support for the body. It is a hinge joint formed where the thigh bone (femur) meets the shin bone (tibia). Cartilage covers the ends of the femur and tibia and lines the back of the knee cap (patella), absorbing stress and allowing the knee to bend. Muscles power the knee and leg for movement. Tendons attach muscles to bone, and ligaments connect bones and brace the joint. When all the parts are healthy, our knees bend and straighten easily and rotate slightly, allowing us to walk, squat, climb steps and turn without pain. If any part is injured, the knee may hurt and not perform correctly.

Knee problems can be mechanical or inflammatory. Mechanical difficulties can arise from a direct blow or sudden movement that strains the knee beyond the normal range of motion. Osteoarthritis is a mechanical problem resulting from wear and tear on the knee’s parts; the cartilage gradually wears away and changes occur in the adjacent bone. Inflammatory knee pain can accompany rheumatic diseases such as rheumatoid arthritis or systemic lupus erythematosus (lupus), which cause swelling that can damage the knees permanently.

The location and severity of knee pain varies depending on the problem. There may be swelling and stiffness, redness and warmth to the touch, weakness and instability, popping or crunching noises and the inability to fully straighten the knee. If you experience any of these symptoms, see your health care provider. If you cannot bear weight on your knee; notice an obvious deformity in your leg or knee; have a fever in addition to redness, pain and swelling in your knee; or feel like your knee is unstable or gives out when you walk, see a specialist (orthopedist or orthopedic surgeon). A specialist will take your medical history, perform a physical assessment and order diagnostic tests such as an X-ray, bone scan, CT scan, MRI, ultrasound, arthroscopy, joint aspiration or biopsy.

Being overweight or obese increases your risk for knee problems; extra weight increases the stress on your joints during daily activities such as walking and going up and down stairs. Tight or weak muscles offer less support for the knees since they do not absorb enough of the stress exerted on the joint. Some sports place greater stress on your knees, such as alpine skiing, basketball, running and jogging (especially on hard surfaces like concrete). Having a previous knee injury makes it more likely you will reinjure your knee due to weakness in the joint. Having one leg shorter than another, misaligned knees, flat feet and problems with your back or hip can make you more prone to knee injuries by throwing off your alignment.

Treatments vary depending on the cause of pain. Your physician may prescribe medications to relieve the pain and treat the underlying condition, as in osteoarthritis, rheumatoid arthritis or gout, a form of arthritis. Physical therapy may be indicated to strengthen the quadriceps and hamstring muscles or to improve your balance. Arch supports, sometimes with wedges on one side of the heel, can shift pressure away from the side of the knee most affected by arthritis. In some cases, your orthopedist may suggest injecting corticosteroids directly into your knee joint to reduce the symptoms of arthritis and provide pain relief for a few months. A thick fluid similar to the synovial fluid that lubricates your knees can be injected to improve mobility and ease pain for up to six months.

Surgery is often the last option in treating painful knees. Before making any decision, consider the pros and cons of non-surgical rehabilitation and surgical reconstruction with rehabilitation in relation to what is best for you. If you choose surgery, your options include arthroscopic surgery, partial knee replacement and total knee replacement.

Over-the-counter medications such as acetaminophen, ibuprofen and naproxen may help ease knee pain. Some individuals find relief from rubbing their knees with creams containing numbing agents such as Lidocaine or capsaicin. Studies are mixed about the effectiveness of the supplements glucosamine and chondroitin in relieving osteoarthritis pain, but research suggests acupuncture may help.

You can take action to avoid knee injuries and perhaps delay joint deterioration. Maintain a healthy weight. Be in shape to play your sport and prepare your muscles for its demands. Get strong and stay limber; include flexibility exercises in your workout. Warm up before exercising and cool down afterward. If you have flat feet or foot problems that throw off your gait, invest in orthotics. Wear running shoes that fit and provide good support and cushioning. If you have osteoarthritis or chronic knee pain, you may need to change the way you exercise. Limit high-impact activities; try bicycling or swimming instead of running.

RICE

First aid for a knee injury:

Rest: Avoid activities that aggravate your pain.
Ice: Apply ice to decrease swelling and alleviate pain; 15 minutes every hour the first day, then 15 minutes four times a day.
Compress: Wear an elastic bandage on your knee.
Elevate: Raise your knee to decrease swelling.

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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