Knee Pain

Knee Pain is a common complaint that affects people of all ages.  Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage.  Medical conditions such as arthritis, and infections can also cause knee pain.

Knee pain is a complaint in up to 20% of the general adult population, accounting for almost 3 million outpatient and emergency department visits per year.  Sports-related activity accounts for approximately 60% of knee injuries producing ligamentous laxity. In National Collegiate Athletic Association (NCAA) football, 1 major knee injury occurs per team every year. 

Triggers for knee pain

An important trigger for knee pain can be a meniscal tear.   A meniscal tear can either be caused by an injury during sports or is the consequence of chronic wear and tear. Additional triggers for knee pain can be knee arthrosis or a cruciate ligament rupture. Wear and tear as well as overloading and stress can also be frequent causes for knee pain.

The Knee Joint

The knee joint

The knee joint connects the two strongest and longest bones in the human body with each other, the femur (thigh bone) and the tibia (shinbone). Both menisci, the medial meniscus and the lateral meniscus, are located between these bones in the joint. These are two crescent-shaped discs of cartilage which serve as buffers. The bony knee cap (patella) lies in front of these discs like a type of quasi protective shield. The knee joint is stabilized by ligaments and muscles. The collateral ligaments run along the inside and the outside of the knee joint, and both the posterior (PCL) and the anterior cruciate ligaments (ACL) run across it.

Type of knee pain gives clues for the cause

Diseases, injuries or strain from one or more of these elements often trigger knee problems. Knee pain may express itself in different ways depending on which cause exists, and it can come in many forms: sometimes it is only expressed during exertion, such as while climbing stairs, going downhill while hiking or after sports. However, at other times it appears quite suddenly at night in bed or is rather a constant companion, and it can be either dull throbbing, sharp or chronic. They all have something in common: they provide the first important clues to the cause. Then those who are affected will know which self-help is possible and when they should turn to a specialist for the further treatment of knee problems. Treatment can be conservative, hence without any surgery, or via a surgery.

Pressing, pulling or sharp knee pain

Knee pain is described by those who are affected as pressing, pulling or sharp. It is sometimes accompanied by inflammatory swelling.  Additionally, the knee may feel very warm to the touch and there may be limited mobility.

Type of treatment

The triggers of pain in the knee also determine the type of treatment. It is often enough to protect the knee by elevating it, reducing movement and strain on it. If the knee is inflamed and swollen, it may help to cool the joint. A cruciate ligament rupture often requires a minimally invasive surgical procedure by an experienced physician to avoid long-term damage such as knee arthrosis. A meniscal tear must also be treated by a specialist to avoid cartilage wear and tear in the future.

What Is chronic knee pain?

Chronic knee pain is long-term pain, swelling, or sensitivity in one or both knees. The cause of your knee pain can determine the exact signs and symptoms you may experience. Many conditions can cause or contribute to chronic knee pain, and many treatments exist. Each person’s experience with chronic knee pain will be different.

What causes chronic knee pain?

 Temporary knee pain is different from chronic knee pain; many people may experience temporary knee pain as a result of an injury or accident. Chronic knee pain rarely goes away without treatment, and it isn’t always attributable to one incident. It’s most often the result of several causes or conditions.

Physical conditions or diseases that can cause knee pain:

  • osteoarthritis: pain, inflammation, and joint destruction caused by degeneration and deterioration of the joint.
  • tendinitis: pain in the front of the knee that is made worse when climbing, taking stairs, or walking up an incline.
  • bursitis: inflammation caused by the repeated overuse or injury of the knee.
  • chondromalacia patella: damaged cartilage under the kneecap.
  • gout: arthritis caused by the buildup of uric acid.
  • Baker’s cyst: a buildup of synovial fluid (fluid that lubricates the joint) behind the knee.
  • rheumatoid arthritis: a chronic autoimmune inflammatory disorder that causes painful swelling and can eventually cause joint deformity and bone erosion.
  • dislocation: dislocation of the kneecap most often the result of trauma.
  • meniscus tear: a rupture in one or more of the cartilage in the knee.
  • torn ligament: tear in one of the four ligaments in the knee. The anterior cruciate ligament (ACL) is the most commonly injured ligament.
  • bone tumors: the second most prevalent bone cancer is osteosarcoma and most commonly occurs in the knee.

Factors that may make chronic knee pain worse:

  • injuries to the structure of the knee can cause bleeding and swelling, and over time, if the injury is not treated properly, it can create a chronic problem
  • a sprain or strain
  • overuse
  • infection
  • bad posture and form when doing physical activity
  • not warming up or cooling down before or after physical activity
  • improperly stretching the muscles

Who is at risk for chronic knee pain?

People who are overweight or obese are at a greater risk for knee problems. For every pound that you are overweight, your knee must absorb an extra 4 pounds of pressure when you walk, run, or climb stairs.

Other factors that increase your risk for chronic knee pain include:

  • age
  • previous injuries or trauma
  • athletic activity or physical exercise

What are the symptoms of chronic knee pain? 

The symptoms of chronic knee pain are different for each person, and the cause for the knee pain often affects how the pain feels. Chronic knee pain may present as a:

  • constant ache
  • sharp, shooting pain when in use
  • dull burning discomfort
  • You may also experience chronic swelling and pain when the knee is touched.

Treatment

Although some knee injuries requires surgical intervention, many types of knee pain respond well to specialized physical therapy that includes Australian orthopedic manual therapy along with appropriate therapeutic exercise.  Maitland Australian Manual Therapy, practiced at our clinic has been clinically proven to reduce your pain and improve function.  Moreover, many randomized control trial research articles have proven that when you combine well delivered manual therapy with therapeutic exercise you require less visits to meet your goals compared to therapeutic exercise alone.

Research article for efficacy of physical therapy treatment for knee pain

http://ptjournal.apta.org/content/85/12/1301

Knee pain information on Youtube