Knee Pain Causes, Symptoms, Diagnosis, Treatment, Prevention And Home Remedies

Knee Pain Causes, Symptoms, Diagnosis, Treatment, Prevention And Home Remedies


Knee Pain Definition



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 - including arthritis, gout and infections - also can cause knee pain.

Knee Pain Causes, Symptoms, Diagnosis, Treatment, Prevention And Home Remedies
Incidence of knee pain increases with age. In the United States, about 20 million people seek medical care for knee pain each year. The condition can develop suddenly (acute knee pain) or gradually over time (chronic knee pain).

Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. In some cases, however, your knee may require surgical repair.

Knee Pain Causes


The knees are complex joints that often are damaged as a result of injury (trauma) or "wear and tear." In people over the age of 50, osteoarthritis is the most common cause for pain in the knees. Common causes in younger people include overuse and injury. Knee pain also can result from infections (e.g., osteomyelitis, septic bursitis) and certain medical conditions.

Common types of knee injuries include the following:

  • Bruises
  • Fractures (broken bone; e.g., fractured knee cap [patella], upper tibia, or lower femur)
  • Torn ligaments (e.g., anterior cruciate ligament [ACL] tear, medial collateral ligament [MCL] tear)
  • Torn cartilage (e.g., meniscus tear)
  • Knee sprains or strains (injury to ligaments or muscles)
  • Dislocated knee cap (patella)

Medical conditions that can cause knee pain include the following:

  • Arthritis (e.g., osteoarthritis, rheumatoid arthritis)
  • Bursitis (e.g., anserine bursitis, housemaid's knee [prepatellar bursitis])
  • Baker's cyst (fluid-filled sac that develops as a result of excess fluid production within the joint)
  • Chondromalacia patella (softening of the cartilage in the knee)
  • Gout (often causes pain in the big toe, but also can affect the knees)
  • Osgood-Schlatter disease (condition that usually develops in children during periods of rapid growth)
  • Osteochondritis dissecans (condition in which fragments of cartilage and bone in the knee become detached and inflamed)
  • Reiter's syndrome (inflammatory condition that also causes swelling and stiffness)
  • Synovitis (type of inflammation within the knee joint)
  • Tendonitis (e.g., jumper's knee [patellar tendonitis])

Abnormal alignment


Abnormal alignment in the legs (e.g., bowlegs, knock-knees) and bone tumors also can result in knee pain. Bone tumors can be benign (i.e., do not spread) or malignant (cancerous). Benign tumors include osteomas, osteoblastomas, and osteochondromas. Types of malignant bone tumors that can result in knee pain include osteosarcoma, chondrosarcoma (develops in cartilage), and Ewing's tumor.

The main risk factor for knee pain is age. Over time, wear and tear can cause pain, stiffness, and inflammation in the knees. People who are overweight are at increased risk.

Athletes often develop knee pain as a result of overuse or injury. Work-related factors, such as frequent heavy lifting, kneeling, stair climbing, and standing for long periods of time, also can increase the risk. Participation in physical activities and sports increases the risk for knee pain, especially if improper techniques (e.g., not warming up or cooling down correctly, poor body mechanics) are used.

Signs and Symptoms of Knee Pain


Knee pain can range from mild to severe and can vary from a dull ache to a stabbing, searing pain. It can develop suddenly (acute knee pain) or gradually over time (chronic knee pain), and may be constant or intermittent (i.e., come and go). Some types of knee pain worsen with activity or at night and radiate (spread) to other parts of the body (e.g., hips, back).

Depending on the cause, knee pain may be accompanied by other symptoms, such as inflammation, swelling, and stiffness (immobility). Symptoms that may indicate as serious condition and require immediate medical care include the following:
  • Deformed or misshapen knee joint
  • Inability to stand or bear weight on the affected leg
  • Inability to straighten or bend the knee
  • Infection (fever, warmth, redness)
  • Knee that locks or clicks
  • Pain accompanied by tingling, numbness, swelling, and discoloration below the knee
  • Severe pain and pain that worsens in spite of treatment

When to see a doctor


Call your doctor if you:

  • Can't bear weight on your knee
  • Have marked knee swelling
  • Are unable to fully extend or flex your knee
  • See an obvious deformity in your leg or knee
  • Have a fever, in addition to redness, pain and swelling in your knee
  • Feel as if your knee is unstable or your knee "gives out"


Diagnosing Knee Pain


When you go to the doctor with a potential knee injury, there are several methods to diagnose your knee pain.

Medical history: 


Your doctor will begin by taking a history. This is the who, what, where, why, when, and how long of your knee pain. Questions about whether the injury is acute or chronic, if there is swelling, and severe vs. minor pain will help your doctor narrow the potential causes.

Physical exam: 


This is usually the next step that physicians take to diagnose knee pain. Examining the knee and gently feeling it can help doctors narrow down the source of the pain or unsteadiness in the knee.

X-ray: 


If your doctor is uncertain about the nature of your knee pain, he may recommend an X-ray, which uses low amounts of radiation to record images of your bones and joints. If your knee pain is being caused by a bone problem, such as a fracture or osteoporosis (low bone density), it may show up on the X-ray, Gotlin says.


MRI: 


Short for “magnetic resonance imaging,” this procedure uses magnetic energy to examine the area inside your knee. Unlike X-rays, MRIs can take pictures of the body’s soft tissues, like its muscles and ligaments. For this reason, the procedure is often ordered when a doctor suspects that the soft tissue in the knee is damaged. Contrary to popular thought, MRIs don’t increase a patient’s risk for leukemia or other cancers.

Ultrasound: 


This tool used to diagnose knee pain uses sound waves to look inside your knee. Ultrasound is helpful if the doctor wants to inspect the bursa - the fluid-filled cavity inside the knee. It may also be helpful if there’s excess fluid around the knee - a condition known as effusion.

Radionuclide bone scan: If your previous diagnostic tests come back normal but your doctor still suspects a problem with the bone, he may recommend a bone scan to check for other problems.

Arthroscopy: 


During this surgical procedure, a doctor will make small incisions in the knee and insert a pencil-sized instrument called an arthroscope. The arthroscope has a magnifying lens and a light and is attached to a small camera. The images from the camera are then displayed on a television screen, helping the doctor to see the inside of the knee. Once the incision is made, the doctor can diagnose and sometimes treat the source of the knee pain. Tears to the meniscus - a protective piece of cartilage in the knee - can often be corrected during arthroscopy, for example.

With many diagnostic tools at their disposal, doctors can accurately diagnose your knee pain and help you decide on the right treatment option.

Treatment for Knee Pain


Treatment for knee pain varies and depends on the underlying cause. Knee pain caused by overuse or minor injury often can be treated using conservative measures, including RICE therapy (i.e., rest, ice, compression, and elevation).
  • Rest involves avoiding activities that worsen pain and keeping off the knee as much as possible. Crutches or a knee brace may be necessary.
  • Ice is used to reduce swelling. Ice packs can be applied for 15–20 minutes at a time every hour, or at least 4 times per day.
  • Compression involves supporting the knee using a firmly (not tightly) wrapped elastic bandage, compression stocking, or gel wrap. If swelling causes the bandage to become tight, it should be loosened immediately.
  • Elevation helps to minimize bruising and swelling. The knee should be kept above heart level (e.g., using a pillow) as often as possible.
Conservative treatment also may include over-the-counter or prescription medications. Common pain relievers include acetaminophen (e.g., Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen [Advil®, Motrin®], naproxen [Aleve®, Naprosyn®]). In addition to relieving pain, NSAIDs also reduce inflammation.

These medications should only be used as directed. They can cause side effects, some of which may be severe (e.g., gastrointestinal bleeding, ulcers, liver and cardiovascular damage).

Prescription medications may be used to treat knee pain that does not respond to conservative treatment. For more information about pain medications, please go to Pain Medications.

Knee infections (e.g., osteomyelitis, septic bursitis) are very serious and require aggressive treatment with antibiotics. If oral antibiotics are ineffective, they may be administered through an IV (intravenously). In severe cases, aspiration (removal of fluid) is necessary or the joint must be drained surgically (called surgical debridement).
Cortisone injections can be used to treat some types of knee pain that persist or worsen in spite of other treatments. This therapy involves injecting cortisone (a steroid and anti-inflammatory) directly into the knee joint to reduce pain and inflammation. Over time, cortisone injections can weaken or damage other tissues and structures within the joint (e.g., tendons).

Physical therapy (e.g., ultrasound, electric stimulation, cryotherapy, manual therapy, stretching) also may be used to reduce knee pain and inflammation. Physical therapy can strengthen muscles, reduce friction within the knee, and can help teach the patient proper body mechanics, reducing the risk for recurrence.

Some types of knee injuries (e.g., torn ligament or cartilage, ruptured tendon) are treated with arthroscopic surgery, also called arthroscopy. In this outpatient procedure, the surgeon makes a small incision and uses an arthroscope (device that includes a tiny camera connected to a monitor) to examine the knee joint.

Damaged tissue is then removed or repaired using surgical instruments inserted through additional small incisions. Arthroscopy, which usually takes about 1–1 ½ hours, can be performed under local, regional, or general anesthesia.

Following arthroscopic knee surgery, some patients need to use a cane or crutches for a short time, and other patients can walk carefully without assistance. Over-the-counter or prescription medications can be used to relieve pain and antibiotics may be prescribed to reduce the risk for infection. In most cases, recovery takes about 6 to 8 weeks.

Patients who have severe knee damage that does not respond to other treatments may require knee replacement surgery (also called arthroplasty). In total knee replacement, damaged bone and cartilage in the knee joint is removed and replaced with an artificial joint comprised of metal and plastic materials. Partial knee replacement, which is less common, involves replacing only one part of the joint. Total knee replacement alleviates knee pain in more than 90% of patients.

Knee replacement surgery usually takes about 2 hours and is performed under general or spinal anesthesia. Following surgery, most patients remain in the hospital for several days. Physical therapy is started as soon as possible and in most cases, patients begin exercising the artificial knee the day after the procedure.

Complications include blood clots, injury to nerves of blood vessels, and infection (rare). After knee replacement surgery, steps are taken to reduce the risk for complications. For example, medications to "thin" the blood, compression stockings, and elevating the legs can help reduce the risk for blood clots, and antibiotics can reduce the risk for infection.

Minimally invasive knee replacement surgery is a relatively new procedure that is performed through smaller incisions, using newer surgical techniques. Following this procedure, some patients experience less pain, require shorter hospitalization (usually 1–3 days), and recover more quickly; however, not all patients are good candidates for minimally invasive surgery.

Read more infomation for reference: 


Knee Pain Prevention And Home Remedies


General prevention tips


Wear your seat belt in a motor vehicle.

Don't carry objects that are too heavy. Use a step stool. Do not stand on chairs or other unsteady objects.

Wear knee guards during sports or recreational activities, such as roller-skating or soccer.

Stretch before and after physical exercise, sports, or recreational activities to warm up your muscles.
Use the correct techniques or positions during activities so that you do not strain your muscles.

Use equipment appropriate to your size, strength, and ability. Avoid repeated movements that can cause injury. In daily routines or hobbies, look at activities in which you make repeated knee movements.

Consider taking lessons to learn the proper technique for sports. Have a trainer or person who is familiar with sports equipment check your equipment to see if it is well suited for your level of ability, body size, and body strength.

If you feel that certain activities at your workplace are causing pain or soreness from overuse, call your human resources department for information on other ways of doing your job or to talk about using different equipment.

Tips specific to the knee


Keep your knees and the muscles that support them strong and flexible. Warm up before activities. 

Avoid activities that stress your knees, such as deep knee bends or downhill running.

Wear shoes with good arch supports.

Do not wear high-heeled shoes.

When playing contact sports, wear the right shoes that are made for the surface you are playing or running on, such as a track or tennis court.

Replace running shoes every 300 to 500 miles (480 to 800 kilometers). Experts recommend getting new athletic shoes every 3 months or after 500 miles of wear.

Tips specific to female athletes


Sports trainers recommend training programs that help women learn to run, jump, and pivot with knees bent to avoid knee injuries. In sports such as soccer, basketball, and volleyball, women who bend their knees and play low to the ground have fewer knee injuries than women who run and pivot with stiff legs.

Knee brace use


Some people use knee braces to prevent knee injuries or after a knee injury. There are many types of knee braces, from soft fabric sleeves to rigid, metal hinged braces, that support and protect the knee. If your doctor has recommended the use of a knee brace, follow his or her instructions. If you are using a knee brace to help prevent problems, follow the manufacturer's instructions for use.

Keep bones strong


Eat healthy foods such as milk, cheese, yogurt, and dark green, leafy vegetables like broccoli.

Exercise and stay active. Talk to your doctor about exercises and activities that are right for you. Begin slowly, especially if you have been inactive. For more information, see the topic Fitness.
Don't drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman. Drinking alcohol increases your chances of having weak bones (osteoporosis). It also increases your chances of falling.

Do not smoke or use other tobacco products. Smoking increases your chances of having osteoporosis. It also causes problems with the blood supply in your legs and slows healing.