Pain

Knee Pain and Types of Knee Pain

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Knees that hurt, throb, swell, and ache can interfere with daily life. Because the knee is crucial to mobility, the quality of a person's life is affected if the knee(s) do not work properly or cause pain. Knee pain has many different causes, and it is either chronic (continual) or acute (immediate).

Chronic knee pain is caused by various conditions, injuries, or even infections; acute knee pain is most often the result of an injury. Causes of knee pain include, but are not limited to, dislocated kneecap, iliotibial band syndrome, bone fractures, anterior cruciate ligament (ACL) injury, torn meniscus, patellar tendinitis, knee bursitis, osteoarthritis, rheumatoid arthritis, septic arthritis, and gout.

A dislocated kneecap happens when the patella bone that "caps" the front of the knee shifts or slips to the outside of the knee. A dislocated kneecap is an acute injury that often results from the knee being forced to change direction too quickly, a fall, or a blow to the knee. The injury to the knee is often visible and apparent. Symptoms include, but are not limited to, pain and difficulty straightening and extending the leg. Diagnosis of a dislocated kneecap is obtained by physical examination; however, an X-ray is often required to make sure no fractures exist. Treatment typically involves a physician manipulating the kneecap back in its proper position and putting a splint in place to aid in healing the soft tissues around the kneecap. A dislocated kneecap usually heals in approximately 6 weeks.

Iliotibial (IT) band syndrome most often affects distance runners and/or walkers, cyclists, weightlifters, and hikers. IT band syndrome is an overuse injury that develops when the fibrous band of tissue (iliotibial band) that runs from the outer hip to the outer thigh and knee becomes so tense and taut that it creates friction with the outer section of the femur (thighbone). Symptoms include, but are not limited to, pain, inflammation, warmth and redness on the outside area of the knee, leg pain, and a clicking or popping sound when moving the knee. A physician can diagnose IT band syndrome and offer you home remedies to treat it. Treatment for IT band syndrome is usually self-care and includes resting and icing the knee and using pain relievers to help with inflammation and pain. IT typically resolves in 6 weeks. Physical therapy (to learn proper stretching techniques and exercise form) and massage therapy help in aiding the healing process and preventing future injury.

Vehicle crashes, sports injuries, and falls are often the cause of fractures or breaks in the knee. Osteoporosis can also lead to knee fractures. Symptoms of knee fractures include, but are not limited to, moderate to severe pain, swelling, redness, and warmth at the site. Diagnosis includes a physical examination by a physician and an X-ray. Depending on the severity of the fracture, a physician may cast and/or brace the knee or recommend surgery to fix or replace the kneecap. Self-care includes icing the knee, propping up the leg to reduce swelling, and taking pain medication until the knee heals.

Anterior cruciate ligament (ACL) injuries are especially common among soccer, basketball, tennis, football, volleyball players (and any other activity that requires sudden knee rotation such as gymnastics). ACL injuries occur when the ACL (a ligament that connects the tibia to the femur and, therefore, keeps the knee joint stabilized) tears. Symptoms include, but are not limited to, immediate severe pain, an audible "popping" noise or sensation in the knee, stiffness, swelling, and difficulty bearing weight and/or walking. Diagnosis of a torn ACL is obtained by a physician performing a physical exam, X-ray, MRI, and/or ultrasound. Treatment for a torn ACL is often physical rehabilitation and/or surgery. A physician will provide at-home, self-care activities and medications if needed.

A torn meniscus often occurs at the same time as a torn ACL. The meniscus is strong, elastic cartilage that protects the area between your shinbone and thighbone. Injury occurs when the knee is rotated too quickly especially when bearing weight. Symptoms of a torn meniscus are similar to a torn ACL. Diagnosis includes physical examination, X-ray, and MRI. In some cases, home care such as rest, icing, and medication may be sufficient to heal the injury. In more severe cases, surgery is required.

Patellar tendinitis or "jumpers knee" is an aggravation and swelling of the patellar tendon which joins the quadricep muscle to the shinbone. Volleyball players, skiers, and those involved in jumping sports and/or activities are at particular risk for developing Patellar tendinitis. Usually a doctor's physical examination is sufficient in diagnosing Patellar tendinitis; however, X-rays, MRI, and/or ultrasound may be ordered. Treatment usually involves physical therapy, pain medication, and home care. In more severe cases, corticosteroid injections and/or surgery may be recommended.

Knee bursitis is defined as inflammation in the bursa(e). Bursae are small sacs of fluid that cushion your knee joint. Inflammation of the bursa(e) often happens due to jobs and activities that require chronic kneeling on hardened surfaces (roofers, sheet metal workers, etc.). It can also occur due to acute injury or infection. Symptoms of knee bursitis are pain, swelling, warmth, redness, and limited mobility. A physician can perform a simple physical examination to diagnose bursitis. However, X-rays, MRI, and ultrasound may be ordered to rule out complications of knee bursitis or other causes of the knee pain and swelling. Treatment involves aspirating fluid from the knee (to determine if infection is present and to ease swelling), medication (antibiotics if infection is present), and physical therapy. Corticosteroid injections or surgery may be recommended if the bursitis is chronic and severe.

Various types of arthritis also cause knee pain; these include osteoarthritis, rheumatoid arthritis, septic arthritis, and gout. Sometimes referred to as degenerative arthritis, osteoarthritis develops when the cartilage of the knee degenerates with age. Rheumatoid arthritis is an autoimmune disease; the immune system is falsely alarmed and attacks many joints in the body including the knee. Septic arthritis develops from an infection of the knee and often is accompanied by a fever. Gout happens when uric acid crystals accumulate in the knee joint (However, it most often occurs in the big toe). A primary-care physician can diagnosis these forms of arthritic knee pain with a physical examination, X-rays, and bloodwork. A referral to a rheumatologist for further testing and treatment may be ordered. Treatment for arthritic knee pain includes medication (anti-inflammatory and/or antibiotic), physical therapy, and/or surgery.

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