Knee pain is a common complaint among adults and most often associated with general wear and tear from daily activities like walking, bending, standing and lifting. Athletes who run or play sports that involve jumping or quick pivoting are also more likely to experience knee pain and problems. But whether an individual’s knee pain is caused by aging or injury, it can be a nuisance and even debilitating in some circumstances.
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.
For many people—especially those who are overweight or lead a sedentary lifestyle—knee pain is practically inevitable—but it doesn’t have to be a lifelong affliction. The first step in combating knee pain is to understand where it is coming from. That means a proper diagnosis from a qualified medical professional is crucial in treating knee pain and preventing it from getting worse.
Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve pain. In some cases, however, your knee may require surgical repair.
Knee pain can be caused by a sudden injury, an overuse injury, or by an underlying condition, such as arthritis. Treatment will vary depending on the cause. Symptoms of knee injury can include pain, swelling, and stiffness.
Knee pain can be an extremely common complaint. While unpleasant and frustrating, the upside is that many causes of knee pain are often very treatable.
Diagnosing your knee pain first requires a focused medical history, one that sorts out the details of the pain, such as what it feels like (e.g. aching, sharp, or burning), where it’s located (e.g. front of or behind the knee), when it started (e.g., gradually or suddenly), and whether there was any recent trauma (e.g. blow to the knee).
What Is Knee Pain?
It’s not surprising that many of us have either experienced knee pain ourselves or heard someone complain about it. After all, it’s a common complaint that affects people of all ages, especially the elderly. In Singapore alone, one local study revealed that nearly half of the elderly experience knee pain. What’s concerning is that half of the participants chose to suffer in silence rather than consult their doctor for treatment.
Knee pain can originate anywhere from the knee’s bony structures (thigh and shin) to its muscles and tissues. Individuals may be able to point out exactly where the pain is coming from or say that their entire knee is aching. The nature of the problem likewise varies; some cases develop suddenly, while others observe a mild discomfort that gets worse over time. Overexertion or repeated stress on the knee may be causing the pain, but it’s also possible that the patient has an underlying medical condition like gout or arthritis. Determining the root cause is crucial because it will dictate the treatment, which can range from home remedies and exercises to medications and surgery.
What Are Knee Pain Symptoms and Signs?
The location of the knee pain can vary depending on which structure is involved. With infection or an inflammatory process, the whole knee might be swollen and painful, while a torn meniscus or fracture of a bone gives symptoms only in one specific location. A Baker cyst will usually cause pain in the back of the knee.
The severity of the joint pain can vary, from a minor ache to a severe and disabling pain.
Some of the other signs and symptoms that accompany knee pain are
- difficulty weight bearing or walking due to instability of the knee,
- limping due to discomfort,
- difficulty walking up or down steps due to ligament damage (sprain),
- locking of the knee (unable to bend the knee),
- redness and swelling,
- inability to extend the knee, and
- shifting weight to the opposite knee and foot.
What’s Causing My Knee Pain?
Being active is one of the best things you can do for your joints and the rest of your body. But injuries can happen, and they often involve the knees.
Some of the most common problems are sprained ligaments, meniscus tears, tendinitis, and runner’s knee. If you have an old knee injury that wasn’t properly treated, it may flare up now and then or hurt all the time.
Several other things can also cause knee pain, such as:
Bursitis. A bursa is a sac that holds a small amount of fluid that’s under the skin above your joint. It helps prevent friction when the joint moves. Overuse, falls, or repeated bending and kneeling can irritate the bursa on top of your kneecap. That leads to pain and swelling. Doctors call this prepatellar bursitis. You may also hear it called ”preacher’s knee.”
Dislocated kneecap. This means that your kneecap slides out of position, causing knee pain and swelling. Your doctor may call this “patellar dislocation.”
IT (iliotibial) band syndrome. The iliotibial (IT) band is a piece of tough tissue that runs from your hip down to the outer part of your knee. When you overdo activity, it can become inflamed over time. That causes pain on the outer side of the knee. It’s common among runners when going downhill.
Meniscal tear. Sometimes, a knee injury can cause cartilage to rip. These rough edges can get stuck in the joint, which causes pain and swelling. Many times, people will have the sensation of “catching” in the joint when they are active.
Osgood-Schlatter disease. This condition happens when you’re young, when bones and other parts of the knee are still changing. It can cause a painful bump below the knee, where a tendon from the kneecap connects to the shin. Overdoing exercise, and irritation at a point on the bottom of your knee called the tibial tubercle, often make this area hurt. The ache may come and go over time. It’s especially common in teenage boys and girls.
Osteoarthritis. This is the “wear and tear” type of arthritis. It’s a top cause of knee pain after age 50. This condition causes the knee joint to ache or swell when you’re active. Joints affected by osteoarthritis can also be stiff early in the day.
Patellar tendinitis. This means you have inflammation in the tendon that connects the kneecap to the shinbone. Tendons are tough bands of tissue that connect muscles to your bones. When you overdo exercise, they can become inflamed and sore. You may also hear it called “jumper’s knee” because repetitive jumping is the most common cause.
Patellofemoral pain syndrome. Muscle imbalance, tightness, and alignment problems of the legs usually cause this condition. It causes knee pain and occasional “buckling,” meaning your knee suddenly can’t bear your weight. It’s not due to an injury. It’s more common for women than for men.
How Are Knee Problems Diagnosed?
In addition to a complete medical history and physical exam, other tests for knee problems may include:
- X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.
- Magnetic resonance imaging (MRI). This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle.
- Computed tomography scan (also called a CT or CAT scan). This test uses X-rays and computer technology to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
- Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscope), which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen; used to evaluate any degenerative or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation.
- Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
Knee Pain Treatment
Only after confirming the root cause of your pain will the doctor decide on an appropriate treatment plan, which may include a combination of medications, injections, therapy, or surgery.
It’s common for doctors to prescribe medications, especially for patients who can no longer attend to their daily activities due to the knee pain. The type of medication depends on the nature of the pain: if there’s no inflammation, the doctor may decide to give you pain relievers like acetaminophen. On the other hand, if you have an inflamed knee, they may prescribe some non-steroidal anti-inflammatory drugs that treat the inflammation; examples include naproxen, ibuprofen, and mefenamic acid.
If you have an underlying condition that contributes to your knee pain problems, the doctor will most likely give you medications for that too.
There are also cases when your knee pain treatment includes injecting substances directly into your joint. For instance, the doctor may inject corticosteroid to help lessen pain and reduce arthritis flares. You may also receive hyaluronic acid to lubricate your joints.
Should the doctor discover that your knee pain occurs due to muscle weakness or incorrect movement, you may be recommended to undergo physiotherapy. Besides treating the pain itself, a common goal of this treatment is to strengthen your muscles and increase your range of motion to prevent further injuries.
Those who are active in sports or have jobs that contribute to their condition may need physical therapy to promote proper posture and movements.
Finally, there’s surgery. Usually, if you need surgery, you’ll have to undergo the operation right away. Two examples of surgeries are partial knee replacement surgery and total replacement surgery. In the partial knee replacement operation, the surgeon will replace the damaged part of your knee with plastic and metal materials. On the other hand, they’ll use high-grade metals to replace the damaged kneecap, shinbone, or thigh bone in total replacement surgery.
Home Remedies for Knee Pain
Are you experiencing knee pain and need immediate relief? If it’s just mild discomfort and you can still perform your daily duties, consider giving the following knee pain remedies a try:
The RICE mnemonic stands for Rest, Ice, Compress, and Elevate:
- Take plenty of rest and refrain from doing activities that worsen or trigger your knee pain as much as possible. If you can, avoid bearing weight on your knees.
- Apply ice. Cover the affected knee with a towel before ice application. On the first day, apply ice every 6 to 8 hours for a maximum of 15 to 20 minutes per application. After the first day, apply ice 4 times a day. It’s important to keep in mind that you cannot apply ice for too long as you may develop frostbite, so make sure to not fall asleep during ice application.
- Wear an elastic bandage to provide support and reduce swelling. Just a quick reminder: don’t wrap the compression bandage too tightly that it cuts off the circulation.
- And finally, to further reduce swelling, keep your knees elevated or raised above the level of your heart when you’re resting.
Alternate Heat and Cold Therapy
Besides the RICE method, another knee pain remedy is alternately applying a heating pad and a cold compress. As mentioned earlier, a cold compress helps reduce inflammation. A heating pad, in contrast, helps relieve the pain.
Alternately apply the heating pad and cold compress a couple of times a day for a maximum of 15 to 20 minutes per application. Whether you use a hot or cold compress, remember to wrap a towel around your knee.
Take Pain Relievers
In times when the pain or discomfort already interferes with your daily routine, consider taking a doctor-approved over-the-counter pain reliever.
We need more studies to confirm their effects, but some patients find comfort in applying a pain-relieving ointment on their affected knee. This method is excellent if you don’t do too well with oral pain killers. As of now, there are available topical NSAIDs in the market, although you need to get a prescription to buy them. Talk to your doctor about the possibility of applying them to your knee.
Sleep with an Additional Pillow
Getting plenty of rest is vital in recovery. Find a comfortable position that doesn’t trigger pain, and if it helps, consider adding an extra pillow below or between your knees.
Achieve a Healthier Weight
As the experts explain, excessive weight can put too much pressure on the knees. What’s even more concerning is that when the knees receive excessive pressure for extended periods, the risk of inflammation increases.
For this reason, it will be helpful to keep your weight at a healthy level. If you’re having a hard time with your weight loss goals, talk to your doctor about how you can modify your diet and exercise.
Do take note that while these are common home remedies for knee pain, it may not be suitable for everyone. If in doubt, consult a doctor or therapist for a personalised treatment plan.
Can You Prevent Knee Pain?
There can be many reasons for knee pain. Therefore, there are different strategies to prevent the pain depending on the underlying cause. Running on soft surfaces or decreasing the amount of running can help if the pain is due to overuse. Avoiding any direct injuries to the knee including wearing a seatbelt can prevent traumatic injuries. Weight loss can be helpful for many different forms of knee pain.
You can prevent some, but not all, of the possible causes of knee pain. But you can’t prevent chronic knee pain. There are things you can do to alleviate the pain.
If your chronic knee pain gets worse because of overuse, or tends to be the most painful after physical activity, you can make lifestyle changes to help treat the pain. These approaches include:
- Warm up before exercise. Stretch your quadriceps and hamstrings before and after exercise.
- Try low-impact exercises. Instead of tennis or running, give swimming or bicycling a shot. Or mix low-impact exercises with high-impact exercises to give your knees a break.
- Lose weight.
- Walk down hills. Running puts extra force on your knee. Instead of running down an incline, walk.
- Stick to paved surfaces. Rough roads or pocked walkways may be hazardous to your knee’s health. Stick to smooth, paved surfaces like a track or walking arena.
- Get support. Shoe inserts can help treat foot or gait problems that may be contributing to knee pain.
- Replace your running shoes frequently to ensure they still have proper support and cushioning.
Talk To A Doctor
A trained medical professional should perform tests to determine the direct cause of any knee pain.
They may reach a diagnosis by asking the following questions:
- When and how did the pain start?
- Is the pain linked to an injury?
- How severe is the pain?
- How has the pain changed over time?
- What makes the pain worse and what makes it feel better?
- What treatment has taken place so far?
- Has this ever happened before?
- The doctor will be able to recommend a course of treatment appropriate for the cause of the pain.