Knee Pain Causes and Treatments

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Knee pain can be caused by injury, overuse, medical conditions or age. Some knee pain can be treated at home with over-the-counter medications or ice. More serious joint conditions may need more intensive medication or even surgery. Here’s what you should know about knee pain and what you can do about it.

Clearly describing knee pain or knee issues to your health care team is an important tool in helping you feel better. Knee pain can originate in one place and be felt in another. (This is called referred pain.) It may be in the front, back or side of the joint. It may feel sharp and stabbing or dull and achy. Being able to identify where the pain is and what it feels like will help your provider effectively treat your knee pain.

  • Pain: Various types of knee pain include a dull ache; sudden onset of pain during activity; sharp, stabbing-type pain; or pain that gets worse with activity
  • Swelling: Presence of swelling around the knee joint
  • Stiffness: Difficulty in moving or bending the knee, with or without pain
  • Instability: Feeling of the knee giving way or being unstable, or difficulty in bearing weight on the affected leg
  • Limited range of motion: Inability to fully extend or flex the knee joint
  • Warmth or redness: Presence of warmth or redness in the knee area
  • Audible Sound: Grating, grinding or popping sensations in the knee joint, or audible “pop” sound at the time of injury

Common Causes of Knee Pain

Knee pain really can affect your quality of life. Understanding the cause of your pain will help you get the best treatment for your condition.

First, you should know knee anatomy. The knee is made of skin, bones and muscles. Ligaments and tendons connect the bones to muscles and other bones. The meniscus is a cushion of cartilage in the joint that protects the knee. The bursae are fluid-filled pads that also cushion the joint. Damage to any of these parts of the knee can cause the symptoms of knee pain mentioned above.

Mechanical or structural causes

This type of pain comes from damage to the parts of the knee. These can include:

  • Ligament tears, such as anterior cruciate ligament (ACL) tears
  • Meniscus tears
  • Cartilage damage
  • Dislocation
  • Loose body (a piece of bone or cartilage floating in the joint space that prevents the joint from working correctly or is causing irritation)
  • Patellar misalignment, describing when the kneecap is out of its correct place (This is sometimes a result of hip or foot pain that causes you to change how you walk.)

Inflammatory or rheumatic conditions

Some medical conditions cause inflammation and pain in the soft tissues in the knee. These include:

  • Osteoarthritis
  • Tendinitis, for example, patellar tendinitis or iliotibial (IT) band syndrome
  • Bursitis, which is an inflammation of the bursae
  • Arthritis and rheumatoid arthritis
  • Gout, which is a form of arthritis that causes sudden, severe pain and swelling in the joint
  • Reactive arthritis, which is joint pain and swelling caused by an infection elsewhere in the body

Overuse or repetitive strain injuries

Repeating movements the same way many times can put stress on the bones, joints and muscles.  The movement may be related to your job, exercise or how your body naturally moves. This can cause such injuries as a stress fracture, which is a tiny crack in the bone, or conditions such as runner’s knee, which is called that because it is common in people who run or play sports that involve running and jumping.

Traumatic or acute injuries

Other injuries that cause knee pain include:

  • Fractures, where the bones of the knee are broken or cracked
  • Ligament sprains or ruptures, where the connective tissue is torn or stretched beyond its capacity
  • Dislocation, which is when the kneecap is moved out of place
  • Contusions, or bruises on the bone

Other Causes

Septic arthritis occurs when the joint fluid and surrounding tissue are infected. Septic arthritis can be caused by bacteria, fungi or viruses.

Systemic chronic diseases such as lupus and fibromyalgia also can cause joint pain in the knee.

Home Treatment for Knee Pain

Mild to moderate knee pain often can be treated at home. Pain due to inflammation, arthritis or minor injury often will resolve without medical help. Home remedies can improve your comfort levels and help you manage symptoms.

If pain is moderate to severe, however, or if symptoms persist or get worse, you may need to seek medical attention for a full assessment.

A strain or sprain can be soothed with the RICE method:

  • Rest: Stop doing the activity that is causing the pain, if you can.
  • Ice: Apply a bag of ice wrapped in a towel to the knee. A bag of frozen vegetables, such as peas, can work if you don’t have ice.
  • Compression: Wrap the knee with a compression bandage to prevent swelling. Don’t wrap it too tightly; you want to keep good circulation.
  • Elevation: Keep the leg and foot elevated while resting.

You may find relief in alternating cold and heat therapy. A heating pad can help relieve pain, while cold treatment can help reduce inflammation.

  • Apply heat for up to 20 minutes at a time.
  • For the first two days after an injury, apply cold pads for 20 minutes, four to eight times a day.
  • Use a gel pack or other cold pack more often during the first 24 hours after the injury.
  • Never apply ice directly to the skin — use a towel or cloth between ice and skin.
  • Check that a heat pad isn’t too hot before applying.
  • Don’t use heat therapy if your joint is warm during a flare.
  • A warm shower or bath in the morning may ease stiff joints.

Over-the-counter medicines such as nonsteroidal anti-inflammatories (NSAIDs) also can relieve pain.

When to See a Doctor for Your Knee Pain

You can treat many causes of knee pain at home, but some will need medical attention, especially if your symptoms aren’t responding to home treatments.

Contact your health care provider if you notice any of the following:

  • Severe pain and swelling
  • Deformity or severe bruising
  • Symptoms in other parts of the body
  • Symptoms that persist longer than a few days or get worse instead of better
  • Signs of infection, such as a fever

Seek treatment if you can’t walk or your knee feels unsteady, if you have severe swelling, bruising or redness, or if you have had a recent injury to the knee area.

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Risk Factors That Can Contribute to Knee Pain

  • Weight: Excess body weight puts increased stress and pressure on the knee joints, leading to increased wear and tear, and an elevated risk of developing knee pain, especially osteoarthritis.
  • Aging and degenerative changes: As people age, the cartilage in the knee joint may naturally wear down, leading to conditions like osteoarthritis. Age-related changes in joint structure and function also can contribute to knee pain.
  • Repetitive activities: Engaging in activities that involve repetitive motions or prolonged stress on the knees, such as running, jumping, squatting, or kneeling, can lead to knee pain. These activities may cause overuse injuries, tendinitis or bursitis.
  • Muscle weakness or imbalances: Weak or imbalanced muscles around the knee can affect joint stability and alignment, leading to increased stress on the knee joint and potential pain. This is often seen in conditions like patellofemoral pain syndrome.
  • Improper footwear or training technique: Wearing inappropriate footwear or using incorrect techniques during physical activities can place additional stress on the knees and contribute to knee pain.

Diagnosing Knee Pain

The first step in diagnosing a knee condition is a physical exam and a health history. You will be asked questions about your current medical conditions, family health history and more. You may have blood taken to check for inflammation.

Although a thorough physical examination can help your health care provider understand your condition, sometimes more information is needed. There are several other types of tests your doctor may give you to help figure out what is going on. Those tests include:

  • X-ray:This uses electromagnetic waves to get a picture of your bones. X-ray can help see bone fractures and degenerative joint disease.
  • CT scan:CT scanners combine X-rays taken from many different angles to create a more detailed image of the inside of your body. CT scans can help see bone conditions and subtle fractures. A special kind of CT scan can identify gout with accuracy, even when the joint is not inflamed.
  • Ultrasound:This technology uses sound waves to produce real-time images of the soft tissue structures within and around your knee. The doctor may move your knee into different positions during the ultrasound to check for specific conditions.
  • MRI:This test uses radio waves and a powerful magnet to create 3D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.

Sometimes, an even more detailed look at what’s happening in the knee joint may be necessary. Arthroscopy is a minimally invasive surgery that uses a tiny camera to look inside your knee. Small cuts are made to insert a camera, and small surgical tools are used inside your knee for the procedure.

Treatments for Knee Pain

Once your doctor has given you a diagnosis, you will have a better idea of what treatment options are available to you. Knee pain treatment falls into roughly two categories: nonsurgical and surgical. Many people try nonsurgical treatment first, hoping to avoid surgery, but your health care team will help you make those choices.

Nonsurgical treatments for knee pain

  • Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
  • Physical therapy to strengthen the muscles around the knee and improve range of motion
  • Injections, such as corticosteroids
  • Assistive devices such as knee braces or orthotics that give added stability and alleviate pressure on the knee joint

Surgical treatments

Surgery is a good option if the joint is badly damaged or all other treatments have been considered or tried.

  • Arthroscopy

While this can be a diagnosing tool, arthroscopy also can be used to perform surgery. A minimally invasive procedure where a tiny camera is inserted into your knee to allow the orthopedist precisely to trim damaged cartilage, remove loose debris, irrigate the inside of the knee and even reconstruct a damaged ligament such as a torn ACL — a common injury.

  • Osteotomy (bone cutting)

This procedure is usually done to correct joint damage from arthritis. The surgery realigns the knee by either cutting the top of the shinbone or the bottom of the thighbone, while reshaping to shift weight off the knee.

The surgeon removes either the inside or outside of the knee joint and replaces it with artificial parts.

The surgeon will replace the ends of the femur (both inside and outside parts of the joint) and tibia with metal and plastic pieces. The surgeon may place a plastic button on the back of the kneecap to replace worn-out cartilage.

Norton Orthopedic Institute surgeons are leaders in the use of robotics that help your surgeon implant the parts of your new knee with superior precision. Placing the metal parts of the new joint and attaching them to your bone requires skill and planning to provide the best possible feel.

Choose Norton Orthopedic Institute for Your Hip or Knee Replacement

  • Same-day appointments are available with no referral required. When you’re ready to take care of the pain, you want to get started.
  • Schedule your appointments online or call (502) 559-5500.
  • Our fellowship-trained and board-certified orthopedic surgeons have the experience you can trust. They perform more than 800 hip replacements and 1,000 knee replacements every year.
  • Robotic-assisted surgeries provide added precision when placing your new joint. This gives a more natural feel that more closely matches your unique anatomy. Minimally invasive techniques get you started on your recovery faster and often allow you to go home the same day as your surgery.
  • Choose from 30 locations in Louisville and Southern Indiana for follow-up care.
  • Norton Healthcare is the first health system in the nation to be recognized as an Advanced Orthopedic & Spine Center of Excellence by DNV.
  • We help you get ready for surgery and through your recovery with educational programs available online and in person.
  • Medicare, Medicaid and most major commercial insurance plans are accepted.
  • Your free Norton MyChart account allows you to communicate with your provider, manage appointments, refill prescriptions and more from a mobile device or computer.

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