What are the common causes of knee pain. How can you treat knee pain at home. When should you see a doctor for knee pain. What diagnostic tests are used for knee pain. How can you prevent knee pain long-term.

Understanding the Anatomy of the Knee

The knee is a complex joint that plays a crucial role in our daily movements. It consists of bones, cartilage, ligaments, and tendons working together to provide stability and flexibility. To comprehend knee pain better, it’s essential to understand the basic anatomy of this joint.

Key Components of the Knee Joint

• Bones: Femur (thighbone), tibia (shinbone), and patella (kneecap)
• Cartilage: Meniscus and articular cartilage
• Ligaments: Anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL)
• Tendons: Quadriceps tendon and patellar tendon

Each of these components plays a vital role in the knee’s function. When any part is damaged or inflamed, it can lead to knee pain and mobility issues.

Common Causes of Knee Pain

Knee pain can stem from various sources, ranging from acute injuries to chronic medical conditions. Understanding these causes is crucial for proper diagnosis and treatment.

Injuries and Overuse

Many knee problems result from injuries or overuse of the joint. These include:

• Ligament tears (ACL, MCL)
• Meniscus tears
• Fractures
• Dislocations
• Tendinitis
• Bursitis
• Iliotibial band syndrome
• Patellofemoral syndrome

Do sports activities increase the risk of knee injuries? Yes, certain sports that involve sudden changes in direction, jumping, or direct impact to the knee can increase the risk of injuries. However, proper training, technique, and protective gear can help mitigate these risks.

Medical Conditions

Several medical conditions can cause or contribute to knee pain:

• Osteoarthritis
• Rheumatoid arthritis
• Gout
• Lupus
• Baker’s cyst
• Osgood-Schlatter disease
• Bone tumors (rare)

Can arthritis affect people of all ages? While osteoarthritis is more common in older adults, other forms of arthritis, such as rheumatoid arthritis, can affect people of any age, including children and young adults.

Recognizing Symptoms and Warning Signs

Identifying the specific symptoms of knee pain can help determine its cause and severity. Common symptoms include:

• Swelling and stiffness
• Redness and warmth around the joint
• Weakness or instability
• Popping or crunching noises
• Inability to fully straighten the knee

Are there any red flags that indicate a need for immediate medical attention? Yes, seek immediate medical care if you experience:

• Severe pain or swelling
• Visible deformity of the knee
• Inability to bear weight on the affected leg
• Fever accompanied by knee pain and swelling
• Signs of infection such as redness, warmth, and tenderness

Home Remedies and Self-Care for Knee Pain

For minor knee pain, several home remedies can provide relief and promote healing:

The RICE Method

RICE stands for Rest, Ice, Compression, and Elevation. This method is particularly effective for acute injuries and can help reduce pain and swelling.

1. Rest: Avoid activities that cause pain and put stress on the knee.
2. Ice: Apply ice packs for 15-20 minutes every 2-3 hours to reduce swelling.
3. Compression: Use an elastic bandage to provide support and reduce swelling.
4. Elevation: Keep the affected leg elevated above heart level when possible.

How long should you follow the RICE method? It’s generally recommended to follow the RICE method for the first 48-72 hours after an injury or when you first notice pain. However, if symptoms persist or worsen, consult a healthcare professional.

Over-the-Counter Pain Relief

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation. Acetaminophen can also provide pain relief but doesn’t address inflammation.

Is it safe to take pain relievers for extended periods? While these medications can be effective for short-term use, prolonged use may lead to side effects. Always follow the recommended dosage and consult your healthcare provider if you need to use them for more than a few days.

Professional Treatment Options for Knee Pain

When home remedies aren’t sufficient, professional medical treatment may be necessary. Treatment options can vary depending on the underlying cause of the knee pain.

Physical Therapy

Physical therapy plays a crucial role in treating many knee conditions. A physical therapist can design a program to:

• Strengthen muscles supporting the knee
• Improve flexibility and range of motion
• Teach proper body mechanics to prevent further injury
• Provide guidance on appropriate exercises and activities

How long does physical therapy typically last for knee pain? The duration of physical therapy can vary widely depending on the specific condition and its severity. Some patients may see improvement in a few weeks, while others may require several months of therapy.

Medications and Injections

In some cases, your doctor may prescribe medications or recommend injections to manage knee pain:

• Prescription-strength NSAIDs
• Disease-modifying antirheumatic drugs (DMARDs) for certain types of arthritis
• Corticosteroid injections to reduce inflammation
• Hyaluronic acid injections to improve joint lubrication

Are corticosteroid injections a long-term solution for knee pain? While corticosteroid injections can provide significant short-term relief, their long-term use is limited due to potential side effects. They are typically used as part of a broader treatment plan rather than a standalone solution.

Surgical Interventions

In severe cases or when conservative treatments fail, surgery may be necessary. Common surgical procedures for knee problems include:

• Arthroscopy for meniscus tears or cartilage damage
• Ligament repair or reconstruction (e.g., ACL reconstruction)
• Partial or total knee replacement for advanced arthritis

What factors determine if a patient needs knee surgery? The decision to perform surgery depends on various factors, including the specific diagnosis, severity of symptoms, impact on daily activities, age, overall health, and response to conservative treatments. Your orthopedic surgeon will carefully evaluate these factors before recommending surgery.

Diagnostic Procedures for Knee Pain

Accurate diagnosis is crucial for effective treatment of knee pain. Healthcare providers use various diagnostic tools and procedures to identify the underlying cause.

Physical Examination

A thorough physical examination is often the first step in diagnosing knee pain. The doctor will:

• Observe your gait and standing posture
• Check for swelling, warmth, and tenderness
• Assess range of motion and stability
• Perform specific tests to evaluate ligaments and menisci

What can a physical exam reveal about knee pain? A skilled healthcare provider can often make a preliminary diagnosis based on the physical exam alone. They can identify issues such as ligament instability, meniscus tears, and patellofemoral problems through specific maneuvers and tests.

Imaging Studies

Various imaging techniques can provide detailed information about the structures within and around the knee:

• X-rays: Show bone structure and can reveal arthritis, fractures, or misalignments
• MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, including ligaments, tendons, and cartilage
• CT (Computed Tomography) scan: Offers detailed cross-sectional images of the knee
• Ultrasound: Can be used to visualize soft tissue structures and guide injections

Is an MRI always necessary for diagnosing knee pain? While MRI can provide valuable information, it’s not always required. Many knee conditions can be diagnosed through a combination of physical examination and X-rays. MRI is typically reserved for cases where more detailed imaging is needed to guide treatment decisions.

Laboratory Tests

In some cases, blood tests or joint fluid analysis may be necessary:

• Blood tests: Can help diagnose inflammatory conditions like rheumatoid arthritis or gout
• Joint fluid analysis: Involves extracting a small amount of synovial fluid from the knee joint to check for infection, crystals (associated with gout), or other abnormalities

When are laboratory tests typically ordered for knee pain? Laboratory tests are most commonly ordered when systemic diseases or infections are suspected. They can help differentiate between various types of arthritis or identify the presence of an infection in the joint.

Preventing Knee Pain and Maintaining Joint Health

While not all knee pain is preventable, there are several strategies you can employ to reduce your risk and maintain healthy knees.

Maintain a Healthy Weight

Excess weight puts additional stress on your knees. Losing weight can significantly reduce the risk of knee pain and osteoarthritis.

How much does weight affect knee health? For every pound of weight loss, there’s a 4-pound reduction in the load exerted on the knee for each step. This means that even modest weight loss can have a substantial impact on knee health.

Exercise Regularly

Regular exercise helps strengthen the muscles that support your knees and improve flexibility. Low-impact activities are particularly beneficial:

• Swimming
• Cycling
• Elliptical machines
• Strength training (with proper form)

What types of exercises should be avoided if you’re prone to knee pain? High-impact activities like running on hard surfaces, jumping, or activities involving sudden changes in direction can stress the knees. If you enjoy these activities, make sure to build up gradually and use proper technique.

Use Proper Technique and Equipment

Whether you’re exercising, playing sports, or performing daily activities, using proper technique and appropriate equipment can help prevent knee injuries:

• Wear shoes that fit well and provide good support
• Use proper form when lifting weights or performing exercises
• Warm up before physical activities and cool down afterward
• Use protective gear when participating in high-risk sports

Are custom orthotics beneficial for preventing knee pain? Custom orthotics can be helpful for some individuals, particularly those with flat feet or other foot alignment issues that affect knee mechanics. However, they’re not necessary for everyone. Consult with a podiatrist or orthopedic specialist to determine if orthotics might be beneficial for you.

Listen to Your Body

Pay attention to early signs of knee discomfort and take appropriate action:

• Avoid pushing through pain during physical activities
• Allow adequate rest and recovery time between workouts
• Modify activities that consistently cause knee pain
• Seek medical advice if you experience persistent or worsening knee pain

How can you distinguish between normal post-exercise soreness and potentially harmful pain? Normal muscle soreness typically peaks 24-48 hours after exercise and gradually improves. Pain that is sharp, limits your range of motion, or persists beyond a few days may indicate an injury and should be evaluated by a healthcare professional.

Special Considerations for Athletes and Active Individuals

Athletes and highly active individuals face unique challenges when it comes to knee health. Proper training, injury prevention, and management strategies are crucial for maintaining performance and longevity in sports and physical activities.

Sport-Specific Training

Incorporating sport-specific training can help prepare your knees for the demands of your chosen activity:

• Plyometric exercises for explosive sports
• Balance and proprioception training
• Sport-specific drills to improve technique
• Cross-training to develop overall fitness and reduce overuse injuries

How can athletes balance intense training with knee health? Implementing periodization in training programs, which involves planned variations in training intensity and volume, can help prevent overuse injuries. Additionally, incorporating adequate rest and recovery periods is essential for maintaining knee health during intense training cycles.

Injury Prevention Programs

Many sports organizations have developed specific injury prevention programs targeting knee health:

• FIFA 11+ for soccer players
• PEP (Prevent Injury and Enhance Performance) Program
• Knee Injury Prevention Program (KIPP)

These programs typically include a combination of stretching, strengthening, plyometrics, and agility drills designed to improve neuromuscular control and reduce the risk of knee injuries.

Are injury prevention programs effective in reducing knee injuries? Research has shown that consistent implementation of well-designed injury prevention programs can significantly reduce the incidence of knee injuries, particularly in high-risk sports like soccer and basketball. However, adherence to the program is key to its effectiveness.

Return-to-Play Considerations

After a knee injury, a careful and gradual return to sports is crucial to prevent re-injury:

• Follow a structured rehabilitation program
• Meet specific strength and functional benchmarks before returning to full activity
• Gradually increase intensity and duration of sports-specific activities
• Use protective gear or bracing as recommended by healthcare providers

What criteria should be met before an athlete returns to full sports participation after a knee injury? While specific criteria may vary depending on the injury, general guidelines include:

• Full range of motion
• Adequate strength (typically at least 90% compared to the uninjured side)
• Successful completion of sport-specific functional tests
• Psychological readiness to return to play

The decision to return to play should always be made in consultation with healthcare providers and coaches to ensure the athlete’s safety and long-term knee health.

Knee pain: MedlinePlus Medical Encyclopedia

Knee pain is a common symptom in people of all ages. It may start suddenly, often after an injury or exercise. Knee pain also may begin as a mild discomfort, then slowly get worse.

Knee pain can have different causes. Being overweight puts you at greater risk for knee problems. Overusing your knee can trigger knee problems that cause pain. If you have a history of arthritis, it could also cause knee pain.

Here are some common causes of knee pain:

MEDICAL CONDITIONS

• Arthritis — Including rheumatoid arthritis, osteoarthritis, lupus, and gout
• Baker cyst — A fluid-filled swelling behind the knee that may occur with swelling (inflammation) from other causes, such as arthritis
• Cancers that either spread to your bones or begin in the bones
• Osgood-Schlatter disease
• Infection in the bones around the knee
• Infection in the knee joint

INJURIES AND OVERUSE

• Bursitis — Inflammation from repeated pressure on the knee, such as kneeling for a long time, overuse, or injury
• Tendinitis — Inflammation of the tendon with change in activities, can be related to overuse or deconditioned tissue
• Dislocation of the kneecap
• Fracture of the kneecap or other bones
• Iliotibial band syndrome — Injury to the thick band that runs from your hip to the outside of your knee
• 
  Patellofemoral syndrome — Pain in the front of your knee around the kneecap
• Torn ligament. — An anterior cruciate ligament (ACL) injury, or medial collateral ligament (MCL) injury may cause bleeding into your knee, swelling, or an unstable knee
• Torn cartilage (a meniscus tear) — Pain felt on the inside or outside of the knee joint
• Strain or sprain — Minor injuries to the ligaments caused by sudden or unnatural twisting

Simple causes of knee pain often clear up on their own while you take steps to manage your symptoms. If knee pain is caused by an accident or injury, you should contact your health care provider.

If your knee pain has just started and is not severe, you can:

• Rest and avoid activities that cause pain. Avoid putting weight on your knee.
• Apply ice. First, apply it every hour for up to 15 minutes. After the first day, apply it at least 4 times per day. Cover your knee with a towel before applying ice. Do not fall asleep while using ice. You can leave it on too long and get frostbite.
• Keep your knee raised as much as possible to bring down any swelling.
• Wear an elastic bandage or elastic sleeve, which you can buy at most pharmacies. This may reduce swelling and provide support.
• Take ibuprofen (Motrin) or naproxen (Aleve) for pain and swelling. Acetaminophen (Tylenol) can help relieve pain, but not swelling. Talk to your provider before taking these medicines if you have medical problems, or if you have taken them for more than a day or two.
• Sleep with a pillow underneath or between your knees.

Follow these general tips to help relieve and prevent knee pain:

• Always warm up before exercising and cool down after exercising. Stretch the muscles in the front of your thigh (quadriceps) and in the back of your thigh (hamstrings).
• Avoid running down hills — walk down instead.
• Bicycle, or better yet, swim instead of run.
• Reduce the amount of exercise you do.
• Run on a smooth, soft surface, such as a track, instead of on cement or pavement.
• Lose weight if you are overweight. Every pound (0.5 kilogram) that you are overweight puts about 5 extra pounds (2.25 kilograms) of pressure on your kneecap when you go up and down stairs. The amount of extra pressure is even greater when you jump. Ask your provider for help losing weight.
• If you have flat feet, try special shoe inserts and arch supports (orthotics).
• Make sure your running shoes are well made, fit well, and have good cushioning.

Further steps for you to take may depend on the cause of your knee pain.

Contact your provider if:

• You cannot bear weight on your knee.
• You have severe pain, even when not bearing weight.
• Your knee buckles, clicks, or locks.
• Your knee is deformed or misshapen.
• You cannot flex your knee or have trouble straightening it all the way out.
• You have a fever, redness or warmth around the knee, or a lot of swelling.
• You have pain, swelling, numbness, tingling, or bluish discoloration in the calf below the sore knee.
• You still have pain after 3 days of home treatment. 

Your provider will perform a physical exam, to include your knees, hips, legs, and other joints.

Your provider may do the following tests:

• X-ray of the knee
• MRI of the knee if a ligament or meniscus tear could be the cause
• CT scan of the knee
• Joint fluid culture (fluid taken from the knee and examined under a microscope)

Your provider may inject a steroid into your knee to reduce pain and inflammation.

You may need to learn stretching and strengthening exercises. You also may need to see a podiatrist to be fitted for orthotics.

In some cases, you may need surgery.

Pain – knee

• ACL reconstruction – discharge
• Hip or knee replacement – after – what to ask your doctor
• Hip or knee replacement – before – what to ask your doctor
• Knee arthroscopy – discharge

• Leg pain (Osgood-Schlatter)
• Lower leg muscles
• Knee pain
• Baker cyst
• Tendinitis

Cheung EC, McAllister DR, Petrigliano FA. Anterior cruciate ligament injuries. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller’s Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 98.

Huddleston JI, Goodman S. Hip and knee pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O’Dell JR, eds. Firestein & Kelley’s Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 51.

McCarthy M, Mcarty EC, Frank RM. Patellofemoral pain. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller’s Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 106.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Making Knees New Again | Johns Hopkins Medicine

How are your knees? If you’re like many people age 50 and older, they’ve been aching. If you’re 65 or older, you may have some degree of osteoarthritis, in which the cartilage that cushions the ends of the bones in the joints begins to degenerate or wear away.

Symptoms can range from stiffness to severe pain and limited mobility. So it’s probably not surprising that surgeons perform more than 700,000 knee-replacement surgeries in the United States each year.

Total knee replacement is very effective, but implants don’t last forever. Although they can last 20 years, one study found that about 14.9 percent of men and 17.4 percent of women who receive a total knee replacement will need another. The earlier you get your implant, the more likely you’ll be back in surgery at some point.

That’s why knee replacement should only be considered after you’ve tried everything else, says Harpal S. Khanuja, M.D., chief of hip and knee replacement surgery with the Department of Orthopaedic Surgery at Johns Hopkins. That includes following your doctor’s recommendations for losing weight, physical therapy, pain management, and modifying your activities.

“I tell people it’s time for a replacement when they can’t live the life they want to live; it is not a good solution for an occasional pain,” Khanuja says.

To keep knee replacement as a last resort, keep your knees healthy with these smart steps.

Hit a healthy weight.

Weight management is one of the top ways to fight osteoarthritis. Excess weight puts more pressure on your knees. This increases inflammation and likely contributes to disease progression. Every 10-pound loss relieves 30 pounds of force on your knee per step, says Khanuja.

One study found that overweight people who lost just 10 percent of their body weight experienced significantly less knee pain, could walk faster, and moved better. They also had lower levels of inflammation.

Get the right kind of exercise.

Moderate physical activity won’t increase your risk of osteoarthritis. In fact, by helping you maintain a healthy weight, it can actually reduce the risk. If your knees hurt, however, be smart. Don’t start training for a marathon or join a basketball team. Instead, says Khanuja, try lower-impact exercise such as swimming, walking, or using an elliptical machine.

Toss the high heels.

A study published in the journal Arthritis & Rheumatism found that wearing flat, flexible shoes significantly reduced pressure on knees and helped people with osteoarthritis walk better.

Definitions

Cartilage (kahr-ti-lij): Tough, flexible tissue that covers the ends of bones, allowing our joints to move without pain or friction. It also is what gives shape to our noses, ears and windpipe. When cartilage becomes damaged or inflamed, movement can be painful or limited.

Inflammation (in-fluh-mey-shun): The redness and warmth around a cut or scrape is short-term inflammation, produced by the immune system to aid healing. But another type called chronic inflammation, triggered by compounds from abdominal fat, gum disease and other factors, lingers in the body. Research suggests this type increases the risk for heart disease, diabetes, dementia and some forms of cancer.

Knee pain: causes, treatment, which doctor to consult

According to statistics, about 80% of people have experienced knee pain. Moreover, a pronounced pain syndrome may be accompanied by other symptoms: a feeling of weakness (as if the legs give way), clicking when moving, stiffness, inability to straighten the leg.

What causes pain in or under the knee? Is there an effective treatment? Which doctor deals with this problem?

Causes of knee pain

The most common reason for knee pain is an injury:

• A fracture of the knee joint is accompanied by very strong, sharp pain. It becomes more intense if you press on the damaged area. With a fracture, the joint swells, so you won’t be able to bend your knee.

• A dislocation is a displacement of bones. Accompanied by swelling of the knee, severe pain syndrome. A dislocation is not as harmless as it might seem. With an injury of this type, the joint capsule is often torn, tendons, nerves, and ligaments are damaged. If you do not turn to an orthopedic traumatologist in time or completely ignore a visit to a specialist, a habitual dislocation may develop. In this case, the joints and bones can move even with a slight load.

• When ligaments and tendons are torn, a crunch is heard, clicks are clearly distinguished during movement. The joint becomes too mobile. The pain is sharp, as if “shooting”. Theoretically, a person can move around, but when walking, the pain in the knee will be more intense.

• A meniscus tear most often involves a strong blow, as a result of which the knee joint begins to hurt, lose mobility, and swell. A torn meniscus often does not act as an independent injury: it is diagnosed in 75% of cases of knee joint injuries. A torn meniscus often occurs in athletes, dancers, and ballet dancers. But such damage also occurs in everyday life – for example, with a sharp movement, heavy physical exertion or a fall.

By the way, about sports. Runners’ knees often hurt – there is even such a thing as runner’s knee syndrome. Runner’s knee syndrome is a common sports injury in which the cartilage tissue of the patella softens and deforms. The injury occurs as a result of high loads on the knees. By the way, it affects not only runners, but also cyclists, fans of hiking, football players.

Which doctor treats knee pain?

If you are worried about knee pain, the logical question is: which doctor to make an appointment with. In case of pain caused by an injury, you should contact an orthopedic traumatologist as soon as possible.

The doctor will conduct a survey and examination of the patient, to clarify the diagnosis, he will send for examination. By the way, with knee injuries, only x-rays are not always prescribed. For example, when a meniscus is torn, it is not informative, so the patient is referred for an ultrasound of the joint or an MRI of the joints. An MRI will allow you to fully “see” the joint and assess its condition. In case of a fracture and dislocation of the knee, an x-ray is recommended (usually in several projections), in some cases an MRI is prescribed.

In addition, to clarify the diagnosis, the results of laboratory tests are required – most often this is a general and biochemical blood test.

Treatment of knee pain

To prescribe effective treatment, you must first identify the cause of the pain syndrome. For example, when a meniscus is torn, anti-inflammatory drugs are prescribed, the knee is fixed with a bandage. Please note that in the treatment of any knee injury, it is important to ensure that the injured area has complete rest. Splints and splints, which are needed for immobilization, will help reduce the load on the joint. Taping is also actively used – the so-called fixation of the joint with adhesive tapes-teips.

Additionally, the patient is prescribed painkillers that stop the pain syndrome. It can be tablets, ointments or gels.

In some cases, surgery is required. So, with a complete rupture of the ligaments of the knee joint, a low-traumatic operation is performed – arthroscopy.

Massage, reflexology, therapeutic exercises also help to cope with pain, strengthen the knee joint, speed up recovery. These methods “work” due to the fact that they help improve muscle tone, activate blood circulation in the knee joint.

The complex of services in the field of traumatology and orthopedics is provided by experienced specialists of the Scandinavian Health Center. The doctors of our multidisciplinary medical center treat injuries and post-traumatic complications, arthrosis, dislocations, bursitis, etc. In our clinic, you can undergo the necessary examinations, visit a physiotherapist, masseur. We offer affordable prices for services, regularly hold profitable promotions.

To make an appointment with a traumatologist, fill out the online form or contact our representatives by phone +7 (495) 645-00-54. You can also use the feedback form.

Treatment of Knee Diseases – Orthopedics Ruslana Sergienko

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