Knee pain

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 23, 2015
StartSymptomsKnee pain

The knee, being the largest joint in the body, is the most common musculoskeletal pain that makes people seek medical attention. In this increasingly active society, everyday wear and tear on the knees have caused an increase in knee problems. Knee pain can happen to anyone, due to its wide variety of causes.


Definition & Facts

Knee pain refers to discomfort that happens in and around a knee joint. This is a common complaint that anybody is prone to have. At any time, 26% of the United States population is suffering from knee pain.


Knee pain can be caused by injury and disease. When an injury affects the ligaments, tendons, or bursae in the knee, it causes pain. Damage to the surrounding bones, cartilage, and ligaments can also cause pain. ACL injuries are most common in people who play sports. This is the tearing of one of the ligaments that connects the thigh bones to the shin bone. This is caused by a sudden change in direction, so sports such a lacrosse, hockey, and basketball often cause an ACL injury.

A torn meniscus is another common knee injury. This is caused by suddenly twisting the knee as weight is put on it. Bursitis is when the bursae, or sacs of fluid around the knee, become inflamed. These sacs are here to keep the ligaments and joints working smoothly, so it causes pain if they do not work properly. Tendinitis is also a cause of knee pain. This is irritation and inflammation of the tendons in and around the knee. This is very common for runners, cyclists, and others involved in sports that require often knee use.

Body mechanical problems can also be a cause for knee pain. If other pain occurs, such as hip or foot pain, one might favor these pains, altering their walk in the process. This can put extra strain on the knees, causing pain. A dislocated kneecap can also be painful. This is when the kneecap, also called patella, slips out of place. Typically, it moved to the outside of the knee and in certain cases, it might stay displaced.

Distance runners are prone to having a problem called Iliotibial band syndrome. This is when the ligament extending from the outside pelvic bone to the outside tibia becomes very tight and rubs against the femur. Finally, a loose material in the body may cause knee pain. Degeneration of bone or cartilage can cause some breakage, which will float in the knee area. If this interferes with the movement of the knee, this can be very painful.

Several forms of arthritis can also cause pain to the knee. Osteoarthritis, the most common type, is a condition that occurs from the wear down of knee cartilage with age. Septic arthritis occurs when the knee becomes infected. This causes swelling and pain. Typically, this kind of knee pain is not caused by trauma. Septic arthritis can also come along with a fever and redness.

Rheumatoid arthritis is an autoimmune condition that is the most debilitating arthritis. This can affect any joint, including the knees. Gout, and more particularly, pseudogout, can cause knee pain. This is when crystals that contain calcium develop in the fluid of the joints.

When to see a doctor

With all of these causes of knee pain, it is important to know when a doctor should be consulted. Most forms of knee pain can be managed alone, especially those that appear slowly, or resulting from strenuous activity. Minor injuries that cause knee pain can be watched for up to two days with self-care before seeking medical treatment.

Self-care includes resting the knee, applying ice to the pain, applying compression to the knee, elevating the knee above the heart, and taking over the counter anti-inflammatory medication. If these do not help the pain, medical attention may need to be sought. If the knee pain is accompanied by a deformed joint, a popping noise, intense pain, inability to move the knee, or sudden swelling, it is best to go to the doctor. Also, if the knee pain occurred due to a forceful impact and also warmth and a fever, it is important to see a doctor.

Treatment & Therapy

The treatments for knee pain vary, depending on the underlying cause. The at-home method of raising the knee, icing the knee, compression, and resting the knee is always recommended as well as an over the counter anti-inflammatory. If a doctor deems that at-home treatment is insufficient, surgery may be required. If this is so, it will be followed be therapy to restrengthen the muscles around the knee.

Prevention & Prophylaxis

Several steps can be taken to prevent knee injury and pain. If surrounding muscles are strong, it is less likely to experience knee pain. Because knee pain can occur when large hip muscles are not strong, strengthening the gluteus maximus can help prevent knee pain.

A weak gluteus maximus causes the femur to become concave and the pelvis to drop. This creates an imbalance that causes painful stress on the hips, knee, and ankle with walking. Hip extensions are a great way to strengthen this area. Toning the core muscles is also an important way to keep the knees free from pain. Abdominal weakness causes unnatural tiling of the body, which results in awkward curvature and shifting of bones.

Strengthening the core keeps the spine in a neutral position and places the knees in the best position in order to move compression on the joints. Crunches are a goood way to strengthen the core, in addition to exercises such as pilates and abdominal ball exercises. A healthy weight is important when trying to prevent knee injury. Several studies have been carried out to measure the relationship between weight and knee pain. An overweight man is five times more likely to have knee osteoarthritis than a man of a healthy weight.

Research also shows a 10% decrease in weight results in a 28% increase in the function of the knee. For women, a study found that there is a 50% decrease for the risk of arthritis in the knee for every 11 pounds of weight lost. It is also important to wear the right shoes. Shoes that put strain on the knee are likely to end up causing pain. Shoes should be switched out often.