HomeGeneral MedicineHow to identify if your Knee Pain is serious?

How to identify if your Knee Pain is serious?

Overview

Knee pain can affect persons of all ages and may start suddenly, mostly after strenuous exercise or an injury. Some common causes of knee pain are sudden injury, injury caused by overuse, or underlying conditions like arthritis. Knee injury symptoms can include stiffness, pain and swelling. Knee pain may also start as a mild discomfort, then progresses slowly to become worse.

What is Knee Pain?

Knee problems become more common as you age and you are at a higher risk of knee pain if you are obese or overweight. Pain in your knees can sometimes be the result of a sports injury too.

Knee pain may originate in any part of the bony structures of your knee compromising:

1.         The kneecap (patella),

2.         The knee joint (where the thigh and shin bones [femur, tibia and fibula] meet

3.         The cartilage (meniscus), ligaments and tendons

Knee pain can often be treated making use of some self-help measures at home unless it becomes severe. Treatment for knee pain may vary depending on the cause of the pain.

What causes knee pain?

There Are different causes for knee pain. Being overweight or obese actually puts you at greater risk for knee problems. In addition, overuse of your knee joint can also trigger knee problems that causes pain. Having a history of arthritis may also cause knee pain. Causes of knee pain is broadly classified in three categories:

  1. Acute Injury
  2. Meniscal tear (torn cartilage). Symptoms of torn meniscus include knee pain, popping, swelling and giving way.
  3. Torn ligament. A medial collateral ligament (MCL) injury or an Anterior Cruciate Ligament (ACL) injury may cause a swelling, an unstable knee, or bleeding into your knee
  4. Broken bone
  5. Strain or sprain. Minor injuries to your ligaments caused by unnatural or sudden twisting
  • Medical Conditions
  • Arthritis, including osteoarthritis, rheumatoid arthritis, gout and lupus
  • Baker cyst or a fluid-filled cyst that usually causes a feeling of tightness and pain in the back of your knee
  • Cancers that either begin in your bones or spread to the bones
  • Infection in the knee joint
  • Osgood-Schlatter disease
  • Injuries and Overuse
  • Kneecap dislocation
  • Kneecap Fracture or other bones
  • Pain in the front part of your knee, around the kneecap
  • Bursitis. An Inflammation caused from repeated pressure on the knee, like overuse, injury or kneeling for a long time
  • Iliotibial band syndrome. Overuse injury of connective tissues located on the lateral or outer part of your thigh and knee
  • Chondromalacia. softening of articular cartilage on the undersurface of your kneecap causing knee pain
  • Knee Osteoarthritis. A degenerative disease that gets worse with time
  • Tendinitis. Pain or inflammation of patellar tendon that connects the kneecap to your shin bone

What are the Signs and Symptoms of Knee Pain?

The site of knee pain can vary depending on which structure of the knee is involved. The whole knee may become painful or get swollen with infection or an inflammatory process, whereas a fracture of a bone or torn meniscus shows symptoms only in one specific spot.

A Baker cyst (a fluid-filled cyst) generally causes a feeling of tightness, and pain in the back of your knee. Severity of knee problem or knee joint pain can vary from a minor pain to a more severe and disabling pain. Other signs and symptoms that go with knee pain include:

  • Limping owing to discomfort
  • Difficulty bearing weight or walking due to knee instability
  • Difficulty walking up or down the steps owing to sprain (ligament damage)
  • Locking of the knee joint (unable to bend your knee)
  • Swelling, stiffness and redness in the knee
  • Popping or crunching noise

When to see a doctor for knee pain?

If your knee pain does not disappear within a few days or does not respond to rest, you should see a doctor for knee evaluation. In addition, if you have the following signs and symptoms, get it checked by a doctor:

  • Swelling
  • Deformity
  • Significant knee pain and fever
  • Unable to walk or pain while walking
  • Inability to bend

What are the procedures and tests to diagnose knee pain?

Your doctor will start by asking questions related to your general health and then specifically to the nature of your knee pain (for example, how severe, how long, if anything you do is making it better or worse, etc.).

Then, an inspection of your knee will be performed. This includes checking for stability of the ligaments, bending knee through full range of motion and checking for any swelling and tenderness. Often, this is all that is required to diagnose and start the treatment. However, the doctor sometimes may need further studies like the following tests.

  1. Radiologic Tests:
  2. Plain X-ray which can establish and degenerative changes and fractures of the knee
  3. MRI scan is used to assess soft tissues of your knee for ligament tears or muscle and cartilage injuries
  • Blood Tests:

If arthritis, gout, or other medical conditions are suspected, your doctor may recommend blood tests.

  • Arthrocentesis (Removal of joint fluid)

Some conditions are diagnosed by removing small amount of fluid from your knee joint. During the arthrocentesis procedure, a small needle is placed into the joint and the fluid is withdrawn in a sterile manner. The fluid thus removed is sent to the lab for study. This procedure is used especially if an infected knee joint is suspected or to diagnose gout and other forms of arthritis. If there is collection of blood in the knee joint due to trauma, removing the fluid might help relieve pain.

What is the treatment for knee pain?

Treatments for knee pain may vary depending upon the conditions that causes the pain.

Medications

Your doctor may prescribe medicines to treat an underlying condition or to relieve pain.

If you are regularly taking an over-the-counter anti-inflammatory pain medicines for your knee pain, you should see your doctor for a detailed evaluation.

Physiotherapy

Sometime, physiotherapy or physical therapy sessions to strengthen the muscles around your knee can make it more stable and help in mechanical movements. Working with a physical therapist often also helps in avoiding injuries or further worsening of any injury.

Injections

Injecting medicines directly into the knee may help in some situations. Corticosteroids and lubricants are two most common injections administered to relieve knee pain. Corticosteroid injections can help in relieving pain due to arthritis and other inflammations of the knee. They usually have to be repeated every few months, while lubricants that are similar to the fluid that are already in your knee joint help with pain relief and restoration of movement.

Can surgery treat and cure knee pain?

Knee surgeries range from arthroscopic knee surgery to total knee replacement (TKR).

Arthroscopic Knee Surgery

Arthroscopic knee surgery is a very common outpatient surgical procedure that helps a surgeon to look inside the knee using a fiberoptic camera through few small holes. Through this procedure, your surgeon can repair most  injuries and remove small pieces of loose cartilage or bones.

Partial knee replacement

In this procedure, the surgeon may replace the damaged portions of your knee with plastic and metal parts. As this procedure involves replacing only part of the knee joint, it has a shorter recovery compared to Total Knee Replacement (TKR).

Total Knee Replacement (TKR)

The procedure involves replacing total knee joint with an artificial joint.

What are the home remedies to relieve knee pain?

While over-the-counter pain medicines often alleviate knee pain, you should see a orthopaedic doctor if you are taking them on a regular basis , in order to avoid potential side effects of regular medication use.

For minor knee injuries, the R.I.C.E (Rest, Ice, Compression and Elevation) method often helps:

  • Rest: Rest your joint. Take a break from your routine activities involving the knee joint.
  • Ice: Apply ice pack for relieving pain and inflammation.
  • Compress: Use compression bandage to help prevent swelling and help in knee alignment. Please note that the compression band should not be too tight and has to be removed at night.
  • Elevate: Elevate the sore or injured knee preferably on a pillow while applying ice. This can help reduce the swelling and rest your knee.

How to prevent knee pain?

There are multiple reasons for knee pain. Therefore, depending on the underlying cause, there are different strategies to prevent knee pain. Reducing the amount of running/walking or running/walking on soft surfaces can help if your pain is due to overuse. Avoid any direct injuries to your knee including avoiding uneven and slippery surfaces while walking  and do  wear a seatbelt while driving,  to prevent traumatic knee injuries. Losing weight, if you are overweight, can also be helpful in alleviating for many different forms of knee pain.

Conclusion

Knee pain is a common condition with many causes, such as acute injuries, overuse and complications due to certain medical conditions. Symptoms of knee pain often include swelling, stiffness, redness, weakness or instability, popping or crunching noises and inability to straighten your knee fully. While the treatment of knee pain depends on the underlying cause, diagnosis of knee pain is usually established after a thorough physical examination. Reducing weight, if you are overweight and avoiding uneven and slippery surfaces while walking, may help prevent knee injuries that may cause knee pain.

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