KNEE PAIN
Knee Pain & Causes
Knee pain is a common complaint when visiting the doctor. The pain can originate from within the knee joint or outside the knee joint. The causes of knee pain are varied: ranging from sudden injury due to a torn cartilage or a ruptured ligament, to an overuse injury or an underlying condition such as arthritis, gout or infections.
This pain can be triggered by other problems such as back conditions or a foot injury and can be aggravated by physical activity Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe. Knee pain can be caused by injuries, mechanical problems, and types of arthritis.
Knee pain caused by common knee injuries
ANTERIOR CRUCIATE LIGAMENT (ACL) INJURY
The anterior cruciate ligament (ACL) is one of four ligaments that connect your shinbone to your thighbone. People who frequently play basketball, soccer or other sports that require sudden acceleration-deceleration and changes in direction are at a higher risk of tearing their ACL.
The severity of the injury can range from a simple sprain to a complex tear. ACL tear symptoms include swelling of the affected knee as well as pain or instability in/of the knee whenever walking, running or climbing stairs.
FRACTURES
Falls and motor accidents may cause bones of the knee, including the kneecap (patella), to be broken. Osteoporosis, which weakens the bones, increases risks as one can sustain a fracture just by taking a wrong step.
For people with severe osteoarthritis, knee fractures can happen innocuously without any significant trauma. This type of pain is constant throughout, making weight-bearing very difficult on the painful knee.
PATELLAR TENDINITIS
Sports enthusiasts who run, ski, cycle or frequently take part in jumping sports are prone to developing inflammation in the patellar tendon.
This tendon is a connection for the quadriceps muscle that lies on the front of the thigh to your shinbone. When tendinitis occurs, one or more of your tendons gets irritated and inflamed.
KNEE BURSITIS
The bursae contains small fluid-filled sacs that provide cushioning to the knee joint. They also allow tendons and ligaments to glide over the joint smoothly. Knee injuries can cause inflammation in the bursae, leading to pain and discomfort.
The knee becomes progressively more painful if a patient walks or stands more. Pain related to Knee Bursitis is usually on the inner or middle part of the knee.
TORN MENISCUS
The meniscus is a tough, rubbery cartilage which acts as a shock absorber between your shinbone and thighbone. When carrying heavy objects, the meniscus can tear through sudden twists or movements.
Meniscus pain can present similar to fracture pain. It can present itself as locking of the knee when standing after being seated for some time. Other symptoms include finding it It is difficult to initiate standing and walking.
Knee Pain Caused By Mechanical Problems
DISLOCATED KNEECAP
A kneecap dislocates when the triangular bone (patella) that covers the front of your knee slips out of place, frequently to the outside of your knee. Sometimes you can see the dislocation under the skin.
HIP OR FOOT PAIN
When you have hip or foot pain, you may change the way you walk to avoid pain. However, this in turn places stress on other areas, such as your knee joint. Over time, the knee will degenerate with the increased unequal loading pressures on the knee, resulting in meniscal or cartilage injury.
ILIOTIBIAL BAND (IT BAND) SYNDROME
The Iliotibial band (IT band) is a tough band of tissue that extends from the outside of your hip to the outside of your knee. IT band syndrome occurs when the IT band becomes so tight that it rubs against the outer portion of your femur. Those who run long or cycle for long distances tend to be especially susceptible.
This type of pain can be mistaken as radicular pain from buttock to lateral part of the affected knee. It is the pulling and tightness of the left lateral thigh.
This tendon is a connection for the quadriceps muscle that lies on the front of the thigh to your shinbone. When tendinitis occurs, one or more of your tendons gets irritated and inflamed.
LOOSE BODY
A piece of bone or cartilage may end up breaking off and floating in the joint space after injury or degeneration. Although this phenomenon is in itself harmless, it will cause pain when the loose body interferes with knee joint movement.
It can present as a locking knee which has jammed up the movement of the knee. Depending on where the loose body is located, it can have pain-free intervals interspersed with sudden pain.
Knee Pain Caused By Types of Arthritis
GOUT
Uric acid crystals build up in the joint to form gout. Most people experience it in the big toe, but it can also occur in the knee. The excessive uric acid build-up in the body accumulates in the knee joint causing a severe inflammatory reaction.
When Gout occurs the knee is often red and swollen. It is painful even when performing non-weight bearing activities such as bending or extending the knee joint while lying in bed.
OSTEOARTHRITIS
Also known as degenerative arthritis, this is the most common type of arthritis. Especially common with old age, this happens after the cartilage in your knee deteriorates with use and wear-and-tear.
As one ages, the synovial fluid (lubricant) dries up. This increases friction between the articulating cartilage surfaces of the knee joint. The friction will cause accelerated wearing off of the cartilage, resulting in cartilage thinning and loss. Once the protective layer of cartilage is breached, the underlying bone will swell and inflame with any seemingly harmless weight bearing activities on the knee.
If untreated, the ongoing degeneration of the knee will result in destruction of the knee joint, resulting in pain, swelling and deformity of the knee. This will restrict the normal function of the knee, making it difficult to stand, walk or climb stairs.
PSEUDOGOUT
Pseudogout is often mistaken for gout but it is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout. It has similar inflammatory signs to gout but the uric acid levels are not elevated.
RHEUMATOID ARTHRITIS
This is an autoimmune condition that can affect almost any joint in your body, including your knees.
Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go. This is part of the systemic condition affecting many body organs/joints.
Similar to osteoarthritis, the inflammation and end-result of joint destruction is the same. The major difference is that this is immune-mediated and not due to age degeneration.
SEPTIC ARTHRITIS
Septic Arthritis is the infection of the knee joint, leading to symptoms like swelling, pain and redness. It often occurs with a fever, and there’s usually no trauma before the onset of pain.
Septic arthritis can quickly cause extensive damage to the knee cartilage. If you have knee pain with any of these symptoms, see your doctor right away.
This infective cause of painful knee is potentially dangerous and it can progress to systemic sepsis (generalised infection of the body), causing harm to other body organs. Severe localized septic arthritis can even result in loss of limb such as amputation of the leg to save the patient.
Symptoms Of Knee Pain
Due to the varied causes of knee pain, the location and severity of the pain may vary. However, you can watch out for accompanying signs and symptoms that include:
- Swelling and stiffness
- Popping or crunching noises
- Inability to fully straighten the knee
- Redness and warmth to the touch
- Weakness or instability
- Pain when putting weight on the knee
- Pain when walking, standing, or squatting
When Should You Seek Medical Care?
You should seek medical help when:
- You can’t bear weight on your knee or feel as if your knee is unstable (gives out)
- Have marked knee swelling
- Are not able to fully extend or flex your knee
- Have affected sleep due to painful knee
- Notice an obvious deformity in your leg or knee
- Experience a fever, in addition to redness, pain and swelling in your knee
- Experience severe knee pain that is associated with an injury
A Message About Knee Pain
Diagnosing Knee Pain
Preliminary Tests
Further Evaluation
Depending on the results of your preliminary tests, your doctor may further evaluate through these tests:
COMPUTERISED TOMOGRAPHY (CT) SCAN
CT scans can help diagnose bone problems and subtle fractures. A special kind of CT scan can accurately identify gout even when the joint is not inflamed.
JOINT ASPIRATION/BLOOD TESTS
Infection or inflammation can be detected through blood tests and/or sometimes a procedure called arthrocentesis. A needle is inserted into the swollen knee, a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.
MAGNETIC RESONANCE IMAGING (MRI)
This test, uses radio waves and a powerful magnet to create 3D images of the inside of your knee, is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.
ULTRASOUND
Sound waves are used to produce real-time images of the soft tissue structures within and around your knee. During the ultrasound, your doctor may move your knee into different positions to check for specific problems.
X-RAY
An X-ray can help detect bone fractures and degenerative joint disease.
