What causes knee pain?
Knee pain, one of the most common orthopaedic conditions, is caused by damage to one or more of the knee’s components—the bones, muscles, tendons, and ligaments that comprise the joint. This damage can be caused by disease, chronic overuse, or acute injury, so knee pain can appear immediately or progress gradually over time. Oftentimes these are soft tissue injuries, like tendon, or ligament strains, but the bones of the knee—the femur, tibia, and patella—can also be damaged through overuse or injury.
Common Conditions
As stated above, the knee joint is made up of bones, tendons, ligaments and muscles, any of which can be damaged to the point that it causes knee pain. Some of the most common knee conditions Dr. O’Grady treats in his practice are:
Ligament injuries
The knee contains four major ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral cruciate ligament (LCL), and medial cruciate ligament (MCL). These ligaments connect the thigh bone (femur) to the bones of the shin (tibia) and outer leg (fibula) and help stabilize the joint as it moves throughout its range of motion. Any of these ligaments can be sprained or torn through injury or chronic wear-and-tear on the knee, but they are especially common in athletes of all ages, as pivoting, stopping abruptly, and landing all place a high level of stress on the knee. Symptoms of a ligament injury include loud “popping” sound or sensation, pain, swelling, loss of range of motion, and joint instability.
Meniscus Injuries
The meniscus is a large, C-shaped piece of cartilage located where the thigh bone (femur) meets the shin bone (tibia) in the knee. It acts as a shock-absorber between the two bones, allowing them to come into contact with one another and move through their range of motion without causing pain. Menisci can be torn by a sudden injury or chronic overuse and are described by how and where they present in the cartilage. Common symptoms include pain, stiffness, swelling, and a catching or locking sensation in the knee.
Fractures
There are three primary bones in the knee: the thigh bone (femur), which makes up the top of the joint; the shin bone (tibia), which makes up the bottom of the joint; and the kneecap (patella). Any of these three bones can be fractured by a sudden impact, whether resulting from a sports-related injury or a traumatic accident and cause extreme pain. These bones can also, when subjected to sustained stress, develop stress fractures, small breaks in the bone and can worsen over time if left untreated.
Bursitis
The bursa is a large, fluid-filled sac that provides lubrication and cushioning to the internal workings of the knee. Bursitis is an overuse injury resulting from the inflammation of this sac and can lead to pain, stiffness and swelling over time. It is very common in runners and other individuals who put a lot of stress on their knees.
Tendinitis
Commonly called “jumper’s knee” tendinitis is the result of chronic overuse of the knee. It can occur in the patellar tendon or the quadricep tendon and is associated with anterior knee pain.
Arthritis
Arthritis literally translates to “inflammation of the joint,” and describes any disease process which leads to cartilage loss. Arthritis in the knee is very painful because the wearing down of the knee’s cushioning cartilage if left untreated, will eventually lead to bone-on-bone contact. This leads to increased stiffness, pain, swelling and decreased use of the knee. The three most common types of arthritis are rheumatoid, which is caused by the body’s immune system; osteoarthritis, which is the most common form and describes the “wear and tear” that happens to a joint over time; and psoriatic arthritis, which is caused by psoriasis, an autoimmune disorder.
How is the cause of knee pain diagnosed?
If you are experiencing knee pain that will not respond to common home remedies like rest, cold therapy and elevation, the first step is to schedule an appointment with a qualified orthopaedic specialist. Your physician will start their investigation by taking a detailed family and personal medical history and conducting a thorough physical examination of the painful joint. If they determine it is necessary, they will also order some additional diagnostic testing, such as x-rays, or MRIs to better understand the cause of your knee pain. Armed with this information, your physician will include you in a detailed discussion of your diagnosis and available treatment options before moving forward with a care plan.
When should I seek medical help?
If you are suffering from knee pain that will not respond to home remedies like rest and ice, it is highly advisable for you to seek medical attention. While the pain may be tolerable now, it may not improve or continue to worsen.
What are the treatment options for knee pain?
There are a variety of treatment options available for knee pain. Based on your history, physical exam and applicable diagnostic test results, your physician could recommend lifestyle changes, like activity and diet modifications, medication, including non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, minimally-invasive treatments like orthobiologics or corticosteroid injections, or, if necessary, surgery. Regardless of which treatment option is deemed best for you, your physician will also work with you to develop a care plan specifically tailored for you.
As is the case with most things, the easiest way to treat knee pain is to prevent it from happening in the first place. Setting aside acute injury, the most common causes of knee pain stem from repetitive motion and general wear-and-tear on the joint. Activities like jogging on hard surfaces or jumping repeatedly result in a lot of repetitive stress, so if your passions require one of these activities, it is highly advisable to start a strength and flexibility program to help prevent injury. Furthermore, staying cognizant of your posture throughout the day, both during activity and at rest, will help ensure you do not place undue stress on your knee through misalignment of the joint.
