Knee pain is common. It affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage, medical conditions e.g. arthritis, gout and infections and overuse conditions such as tendinopathy and muscle injuries.
Many causes of mild knee pain will get better with simple home remedies such as rest, ice-packs and anti-inflammatory medication. Physiotherapy and knee supports can also help relieve knee pain. If simple things don’t help then it might be a good idea to get things checked out.
Is knee pain normal?
Is knee pain normal? Is a question I get asked a lot. It’s also a difficult one to answer. Most of us will have experienced some knee pain from time to time, perhaps after a long walk or after a slight injury. For most people, this type of knee pain will settle however if the pain is severe or doesn’t go away in a couple of weeks it could be a sign of a more serious condition such as arthritis.
What symptoms should I look out for?
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
When should I see a doctor about my knee pain?
Most knee pain will usually settle, however, you should see a doctor about your knee pain if you have some of the following symptoms
- Can't stand on your knee or feel as if your knee is unstable (gives way)
- Have a large knee swelling
- Aren’t able to fully extend or flex your knee
- Notice an obvious deformity in your leg or knee
- Have a fever, in addition to redness, pain and swelling in your knee
- Have severe knee pain that is associated with an injury
What are the causes of knee pain?
Knee pain can be caused by injuries, mechanical or alignment problems, types of arthritis and other problems.
Knee Injuries that cause knee pain.
A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:
Torn cartilage - The cartilage (also called the meniscus) is formed of tough, rubbery tissue and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee. It can also tear when crouching or kneeling. Many patients however won’t recall a specific injury. This is a common injury I see in my specialist knee clinic.
ACL injury - An ACL injury is a tear of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play football, netball, rugby or other sports that require sudden changes in direction.
Fractures - The bones of the knee, including the kneecap (patella), can be broken following falls or other accidents. People whose bones may have been weakened by osteoporosis can sometimes sustain a knee fracture with very minor falls or stumbles. Sometimes people can develop stress fractures if they train too much or have low vitamin D levels.
Knee bursitis - Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint. These can become inflamed and painful.
Patellar tendinopathy - Tendinopathy is irritation and inflammation of one or more tendons — the thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities may develop inflammation in the patellar tendon, which connects your knee-cap to your shinbone.
Mechanical problems that cause knee pain
Here are some examples of mechanical problems that can cause knee pain.
A Loose body - Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in your knee joint. This may not create any problems unless the loose body interferes with knee joint movement, in which case the effect is something like a doorstop blocking a door.
Iliotibial band syndrome - This occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. This is common in distance runners and cyclists.
Knee-cap pain - This occurs when your knee-cap (patella) tilts slightly out of place, usually towards the outside of your knee. In some cases, this leads to chronic rubbing on the back of the knee-cap which causes inflammation and pain at the front of your knee.
Hip or foot pain - If you have hip or foot pain, you may change the way you walk to take the load off painful joints. This altered way of walking can place more stress on your knee joint. In some cases, problems in the hip or foot can cause knee pain.
Knee arthritis is a common cause of knee pain
There are more than 100 different types of arthritis. The types most likely to affect the knee include:
Osteoarthritis. Sometimes called degenerative or “wear-and-tear” arthritis, osteoarthritis is the most common type of arthritis. It's a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis 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.
Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. Septic arthritis often occurs with a fever, and there's usually no injury 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, you should see your doctor right away.
Am I at risk of getting knee pain?
A number of factors can increase your risk of having knee problems, including:
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 an 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 to stabilize 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, football’s jumps and pivots all increase your risk of a 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'll injure your knee again.
How can I stop myself from getting knee pain?
Although it's not always possible to prevent knee pain, the following suggestions may help avoid serious injury and prevent or at least slow down joint deterioration:
Maintain a healthy body weight - It's one of the best things you can do for your knees. Every extra pound puts additional strain on your joints, increasing the risk of injuries and osteoarthritis.
Fit to play your sport - . To prepare your muscles for the demands of taking part in sports, make time for strength and conditioning. Work with a coach or trainer to ensure that your technique and movement are the best they can be. Practice perfectly. Make sure the technique and movement patterns you use in your sports or activity are the best they can be. Lessons from a professional can be very helpful.
Get strong and stay flexible - Weak muscles are a leading cause of knee injuries, you'll benefit from building up your quadriceps and hamstrings, which support your knees.
Balance and stability training - This helps the muscles around your knees work together more effectively. And because tight muscles also can contribute to injury, stretching is important. Try to include flexibility exercises in your workouts.
Be sensible about exercise - If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. Consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Sometimes simply limiting high-impact activities will make your knee pain better.
How can I Get Help With My Knee Pain?
As with any condition, it’s important to get the right diagnosis and the right advice and treatment sooner rather than later. Often if diagnosed early knee arthritis will respond to non-invasive treatments such as physiotherapy and exercise. If things aren’t settling then here at the My Knee Doc clinic we offer treatments such as specialist knee injections which can help you stay in control of your symptoms without the need for pain-killers.
If you’d like to find out more about how we can help or if you just want to speak to our specialist knee surgeon Mr Gareth Stables then click here and arrange your free call back.