Knee Issues
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Medical Encyclopedia
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Knee pain
Illustrations
Pain - knee
Knee pain usually results from overuse, poor
form during physical activity, not warming up or cooling down, or inadequate
stretching. Simple causes of knee pain often clear up on their own with self
care. Being overweight can put you at greater risk for knee problems.
Knee pain can be caused by:
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Arthritis
-- including rheumatoid, osteoarthritis, and gout,
or other connective tissue disorders like lupus.
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Bursitis
-- inflammation from repeated pressure on the knee (like kneeling for long
periods of time, overuse, or injury).
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Tendinitis
-- a pain in the front of your knee that gets worse when going up and down
stairs or inclines. Happens to runners, skiers, and cyclists.
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Baker's
cyst -- a fluid-filled swelling behind the knee that may accompany
inflammation from other causes, like arthritis. If the cyst ruptures, pain
in the back of your knee can travel down your calf.
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Torn or ruptured ligaments or torn cartilage (a meniscus
tear) -- can cause severe pain and instability of the knee joint.
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Strain
or sprain
-- minor injuries to the ligaments caused by sudden or unnatural twisting.
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Infection in the joint.
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Knee injuries -- can cause bleeding into your knee, which worsens the
pain.
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Hip disorders -- may cause pain that is felt in the knee. For example,
iliotibial band syndrome is injury to the thick band that runs from your hip
to the outside of your knee.
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Less common conditions that can lead to knee
pain include the following:
Many causes of knee pain, especially those
related to overuse or physical activity, respond well to self-care:
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Rest and avoid activities that aggravate the pain, especially weight
bearing activities.
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Apply ice. First, apply it every hour for up to 15 minutes. After the
first day, apply it at least 4 times per day.
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Keep your knee elevated as much as possible to bring any swelling down.
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Gently compress the knee by wearing an ace bandage or elastic sleeve.
Either can be purchased at most pharmacies. This may reduce swelling and
provide support.
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Take acetaminophen for pain or ibuprofen for pain and swelling.
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Sleep with a pillow underneath or between your knees.
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Call your health care provider if
Return to top
Call your doctor if:
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You cannot bear weight on your knee.
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You have severe pain, even when not bearing weight.
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Your knee buckles, clicks, or locks.
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Your knee is deformed or misshapen.
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You have a fever,
redness or warmth around the knee, or significant swelling.
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You have pain, swelling, numbness, tingling, or bluish discoloration in
the calf below the sore knee.
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You still have pain after 3 days of home treatment.
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What to expect at your health care provider's
office Return
to top
Your health care provider will perform a
physical examination, with careful attention to your knees, hips, legs, and
other joints.
To help diagnose the cause of the problem,
your doctor will ask medical history questions, such as:
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When did your knee first begin to hurt?
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Have you had knee pain before? What was the cause?
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How long has this episode of knee pain lasted?
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Do you feel the pain continuously or off and on?
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Are both knees affected?
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Is the pain in your entire knee or one specific location like the
kneecap, outer or inner edge, or below the knee?
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Would you say that the pain is severe?
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Does it feel bruised?
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Can you stand or walk?
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Have you had an injury or accident involving the knee?
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Have you overused the leg? Describe your usual activities and exercise
routine.
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What home treatments have you tried? Have they helped?
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Do you have other symptoms, like pain in your hip, pain down your leg or
calf, knee
swelling, swelling in your calf or leg, fever?
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The following diagnostic tests may be
performed:
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Fluid drawn from the knee and analyzed
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MRI of the knee if a ligament or meniscus tear is suspected.
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Your doctor may prescribe non-steroidal
anti-inflammatory drugs (NSAIDs) that are stronger than those available
over-the-counter. If those don't help, your doctor may inject a steroid to
reduce pain and inflammation.
Referrals to a physical therapist (to learn
stretching and strengthening exercises) and podiatrist (to be fitted for
orthotics) may be necessary. These help prevent repeated problems.
In some cases, surgery is needed. For
example, if arthritis is severe, a joint replacement may be recommended. Minor
ligament strain will heal with home care and torn ligaments may recover with use
of a knee brace. However, for significant tears or ruptures, as well as a torn
meniscus, arthroscopic
knee surgery is often needed.
Recovery from ligament and meniscus problems
is slow. Crutches and extended physical therapy may be needed.
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Increase your activity level slowly over time. For example, when you
begin exercising again, walk rather than run.
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Always warm up before exercising and cool down afterward. Stretch your
quadriceps and hamstrings.
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Replace your sports shoes often. Get good advice about proper footwear
for your foot shape and mechanics. For example, if you pronate (land on the
outside of your heel and turn your foot inward), consider anti-pronation
footwear.
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Updated by: Jacqueline A. Hart, M.D., Department of
Internal Medicine, Newton-Wellesley Hospital, Boston, Ma., and Senior Medical
Editor, A.D.A.M., Inc. Previously reviewed by Thomas N. Joseph, M.D., Department
of Orthopedic Surgery, NYU/Hospital for Joint Diseases, New York, NY. Review
provided by VeriMed Healthcare Network (11/14/2002).
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