Knee Pain

Knee pain is one of the common problems which affects all age groups.

It can be caused due to many reasons which may include certain medical conditions like arthritis, gout, and infections and can contribute to the development of ruptured ligament or torn cartilage.

Knee pain can develop in any bone structure which comprises of the knee joint, the kneecap or ligaments and the cartilage of the knee.

The symptoms of knee pain may vary according to the cause of the problem, for example if infection or inflammation is involved, the knee might get swollen and become painful. 

Other symptoms may include the following:

• Problems in walking
• Limping due to discomfort
• Difficulty walking up or down the stairs due to ligament damage
• Locking of the knee (inability to bend the knee)
• Redness and Swelling
• Inability to extend the knee

The knee pain can be caused by acute injury like broken bone and torn ligament or a medical condition like ostearthritis.

The common causes of knee pain are mentioned below:

• Ligament injuries: Injuries to ligament more often to ACL (anterior cruciate ligament) is one of the major causes of knee pain.
• Torn meniscus: The injury to the tough, rubbery cartilage known as meniscus, which protects the shinbone and thigh bone can occur with sudden twist in your knee.
• Knee bursitis: Knee injuries may cause inflammation in the bursae which is a small sac of fluid protecting the knee joint.
• Patellar tendinitis: This is the condition where a patient experiences irritation and inflammation in tendons (which attach muscles to the bones).
• Osteoarthritis: Osteoarthritis is a condition in which the articular cartilage also called the protective surface of the knee has been damaged which causes swelling and pain in the tissues around the knee joint.
• Gout: In this condition crystallization of uric acid occurs at the knee joint which causes swelling and pain in the knee.
• Fractures: Any breakage in the knee bones will cause knee pain. Persons whose bones have become week due to osteoporosis can get knee fractures even by simply taking a wrong step.

Some mechanical issues as mentioned below could also occur in the patient with knee pain:

• Loose body: Sometimes, the patient may have a broken bone due to degeneration of bone or cartilage, which may float in the joint space without any problem. But the problem arises when this loose body interferes with the knee joint movement and causes pain.
• Iliotibial band syndrome: In this condition the patient will experience irritation on the outer wall of femur due to rubbing of the tightened iliotibial band, which is a tough sheet of tissue connecting pelvis to the knee.
• Dislocated kneecap: Dislocation of the kneecap, the triangular bone which protects the knees.
• Hip or foot pain, osteoarthritis (a degenerative disease), rheumatoid arthritis and septic arthritis are other common problems associated with knee pain.

The doctor may recommend the following diagnostic tests for identifying the cause of knee pain:

• X-ray for detecting any bone fractures or de-generative joint diseases.
• Computerized tomography (CT) scan or CT scan combined with X-rays helps in detecting the bone problems and loose bodies.
• Ultrasound to see real-time images of the soft tissues around the knee.
• Magnetic resonance imaging which produces 3-D images of the inside of the patient’s knee.
• Lab tests for detecting any infection like gout or pseudo gout which may include blood test and in certain cases, arthrocentesis, a clinical procedure of removing the synovial fluid from the knee with the help of a syringe, for inspection.

For the treatment of knee pain, the doctor may initially recommend painkillers to help reducing pain, but the proper treatment approach depends on the cause of the problem.

The doctor may suggest:

• Physical exercise and physical training to improve any problems in the muscles.
• Corticosteroid injections which may help reduce the symptoms of the arthritis.
• Surgery if the patient is suffering from injury that require surgery which may include:
  • Arthroscopic surgery which involves the use of fibre-optic camera and a narrow tool that is inserted into the knee which helps in removing the loose bodies, removing or repairing damaged cartilages and reconstructing the ligament. 
  • Partial knee replacement surgery in which the doctor will remove and replaces the damaged portion of the patient’s knee with metals and plastics. The surgeon only replaces the most damaged portion of your knee with parts made of metal or plastic.
  • Total knee replacement in which the doctor removes the entire damaged bone of a patient and replaces it with artificial joints that are made of metal alloys, high- grade plastic or polymers.

In order to prevent knee pain, one can follow the following precautions:

• A patient should keep his/her weight normal because extra weight might put extra strain on the joints.
• Exercising everyday can be beneficial. A patient can also take suggestions from a fitness trainer about how to perform specific exercises in a proper manner.
• Swimming, water aerobics or other low impact activities can provide relief to the patient.

One of the alternatives to allopathic remedies for knee pain includes oral or topical administration of natural supplements like ginger extract or Willow bark. Although there is no scientific evidence for the effectiveness of these medicines, some studies have claimed that these are beneficial in treating knee pain.

A study has showed that use of Glucosamine and chondroitin sulphate is also beneficial in knee pain.

Tai Chi, an ancient Chinese method for treatment of disease, which involves practicing mind-body exercises have also proved beneficial according to a study. Acupuncture is another alternative for relieving the knee pain mainly caused due to osteoarthritis. It involves the use of thin needles which are placed to the specific regions of the patient’s body.

There are several risks and complications associated with knee pain.

The factors which increase the risk of knee pain include:

• Excessive weight
• Certain structural abnormalities
• Tight or weak muscles
• Sports activities like basketball's jumps and pivots
• Any kind of previous injury

If left untreated, it may lead to various serious complications like increased pain, complete damage of the joint and disability.