Symptoms and treatment of Knee pain

Description

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

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

Symptoms

The location and severity of knee pain may vary, depending on the cause of the problem. The signs and symptoms that sometimes accompany knee pain include:

The swelling and stiffness
Redness and warmth to the touch
Weakness or instability
Popping or crunching noises
Inability to completely straightening the knee

When to see a doctor

Call your doctor if you:

Can't bear weight on the knee or feel as if the knee is unstable, or
Marked swelling of the knee
They are unable to extend or flex the knee
To see an obvious deformity of the knee or leg
You have a fever, in addition to redness, pain and swelling in the knee
You have severe knee pain that is associated with an injury

Causes

Knee pain can be caused by injuries, mechanical problems, types of arthritis and other problems.

Injuries

A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (pockets) around the knee joint, as well as the bones, cartilage and ligaments that form the joint. Some of the most common knee injuries include:

The acl injury. An acl injury is a tear of the anterior cruciate ligament (acl) — one of the four ligaments that connect the shin bone to your femur. An acl injury is particularly common in people who play basketball, football or other sports that require sudden changes in direction.
Fractures. The bones of the knee, including the patella (kneecap), can break during a fall or car accident. Also, people whose bones have been weakened by osteoporosis can sometimes sustain a knee fracture simply by stepping wrong.
Torn meniscus. The meniscus is the hard rubber of cartilage that acts as a cushion between the tibia and the femur. It can be torn if you suddenly twist your knee while bearing weight on it.
Knee bursitis. Some knee injuries cause inflammation in the bags, the small sacs of fluid that cushion the outside of the knee joint so that tendons and ligaments glide smoothly over the joint.
Patellar Tendinitis. Tendinitis is irritation and inflammation of one or more tendons of the thick, fibrous tissues that attach muscles to bones. This inflammation can occur when there is an injury to the patellar tendon, which runs from the kneecap to the tibia and allows you to kick, run and jump. Runners, skiers, cyclists, and those involved in jumping sports and activities that can develop patellar tendinitis.

Mechanical problems

Some examples of mechanical problems that can cause knee pain include:

Loose body. Sometimes the injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problem unless the release of the body interferes with the movement of the knee joint, in which case the effect is something like a pencil caught in the hinge of a door.
Iliotibial band syndrome. This occurs when the tough band of tissue that runs from the outside of the hip to the outside of the knee (iliotibial band) becomes so tight that it rubs against the outer portion of the thigh. Runners and cyclists are especially susceptible to iliotibial band syndrome.
Dislocation of the patella. This occurs when the triangular bone that covers the front part of the knee (kneecap) slips out of place, usually to the outside of the knee. In some cases, the kneecap may remain displaced and you will be able to see the dislocation.
Hip or foot pain. If you have hip or foot pain, you can change the way of walking to spare your painful joint. But this altered gait can put more stress on the knee joint and cause pain in the knee.

Types of arthritis

More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:

Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It is a wear and tear condition that occurs when the cartilage in your knee deteriorates with use and age.
Rheumatoid arthritis. The most critical of the form of arthritis, rheumatoid arthritis is an autoimmune disease that can affect almost any joint in the body, including the knees. Although rheumatoid arthritis is a chronic disease, which tends to vary in severity and may come and go.
Gout. This type of arthritis occurs when uric acid crystals accumulate in the joints. While gout most commonly affects the big toe, it can also occur in the knee.
Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. The knee is the most common joint affected by pseudogout.
Septic arthritis. Sometimes the knee joint can become infected, leading to swelling, pain, and redness. Septic arthritis often presents with fever, and there is no trauma before the onset of pain. Septic arthritis can quickly cause extensive damage to the cartilage of the knee. If you have knee pain with any of the symptoms of septic arthritis, see your doctor immediately.

Risk factors

A number of factors that may increase your risk of having knee problems, including:

The excess of weight. Being overweight or obese increases the stress on the joints of the knee, even during everyday activities such as walking or going up and down stairs. It also puts you at greater risk of osteoarthritis by accelerating the breakdown of articular cartilage.
The lack of muscle flexibility or strength. A lack of strength and flexibility may increase the risk of knee injuries. Strong muscles help to stabilize and protect your joints and the flexibility of the muscles can help you reach the full range of motion.
Certain sports or occupations. Some of the sports greatest stress on the knees than others. Alpine skiing, with its rigid ski boots, and the potential fall, basketball jumps and spins, and the repeated hitting your knees when running or jogging all increase your risk of knee injury. Jobs that require repetitive stress on the knees, such as construction or agriculture may also increase your risk.
Previous injury. Having a previous knee injury makes it more likely that you will injure your knee again.

Complications

Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increased pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you'll have similar injuries in the future.

Prevention

Although it is not always possible to prevent knee pain, the following suggestions can help prevent injuries and joint deterioration:

Keep the extra pounds. Maintain a healthy weight, it is one of the best things that you can do for your knees. Every extra pound puts additional strain on the joints, increasing the risk of injury and osteoarthritis.
Be in shape to play your sport. To prepare your muscles for the demands of sports participation, take the time for conditioning.
Practice to perfection. Make sure that the technique and movement patterns you use in your sport or activity is the best it can be. Lessons from a professional can be very useful.
Get strong, stay flexible.The weakness of the muscles are the main cause of knee injuries. You will benefit from the construction of the quadriceps and the hamstrings, the muscles in the front and the back of their thighs, that help support the knees. Balance and stability training helps the muscles around the knees to work together more effectively. And due to the tightness of the muscles can also contribute to the injury, stretching is important. Try to include flexibility exercises in their workouts.
Be smart about exercise. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the form of exercise. Consider the possibility of change of swimming, water aerobics, or in other low-impact activities — at least for a couple of days a week. Sometimes it is simply limiting high-impact activities will provide relief.

Get strong, stay flexible. The weakness of the muscles are the main cause of knee injuries. You will benefit from the construction of the quadriceps and the hamstrings, the muscles in the front and the back of their thighs, that help support the knees. Balance and stability training helps the muscles around the knees to work together more effectively.

And due to the tightness of the muscles can also contribute to the injury, stretching is important. Try to include flexibility exercises in their workouts.

Diagnosis

During the physical exam, your doctor is likely to:

Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
Check to see how far you can move your lower leg in different directions
Push or pull the joint to evaluate the integrity of structures of the knee

Imaging tests

In some cases, your doctor may suggest tests such as:

X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.
Computed tomography (CT scan). The CT scanners combine X-rays taken from different angles to create cross-sectional images of the inside of your body. The ct scan can help diagnose problems in the bones and subtle fractures. A special type of ct scan can accurately identify the drop even when the joint is not inflamed.
Ultrasound. This technology uses sound waves to produce real-time images of the soft tissue structures in and around your knee. Your doctor may want to move your knee in different positions during ultrasound to check for specific problems.
Magnetic resonance imaging (MRI). A magnetic resonance imaging (MRI uses radio waves and a powerful magnet to create 3D images of the inside of your knee. This test is particularly useful in the revelation of the lesions of soft tissues, such as ligaments, tendons, cartilage and muscles.

Laboratory tests

If your doctor suspects an infection or inflammation, it is likely that you will have blood tests and, sometimes, a procedure called arthrocentesis, in which a small amount of fluid is removed from the inside of the knee joint with a needle and sent to a laboratory for analysis.

Treatment

Treatments vary, depending upon what exactly is the cause of your knee pain.

Drugs

Your doctor may prescribe medications to help relieve the pain and treat the conditions that cause knee pain, such as rheumatoid arthritis or gout.

Therapy

The strengthening of the muscles around the knee will make it more stable. Your doctor may recommend physical therapy or different types of strengthening exercises based on the specific condition that is the cause of your pain.

If you are physically active, or the practice of a sport, you may need to exercises to correct movement patterns that may affect your knees and to establish a good technique during your sport or activity. Exercises to improve the flexibility and balance are also important.

The arch supports, sometimes with wedges on one of the sides of the heel, you can contribute to the change of the pressure away from the side of the knee joint most affected by osteoarthritis. In certain conditions, the different types of orthodontic appliances can be used to help protect and support the knee joint.

Injections

In some cases, your doctor may suggest an injection of medications or other substances directly into the joint. Examples include:

Corticosteroids. Injections of a corticosteroid medication in the knee joint can help reduce the symptoms of an episode of arthritis, and alleviate pain that can last for a couple of months. These injections are not effective in all cases.
The hyaluronic acid. A thick fluid, similar to the fluid that naturally lubricates joints, hyaluronic acid can be injected into your knee to improve mobility and relieve pain. Although study results have been conflicting on the efficacy of this treatment, the relief of one or a series of injections can last up to six months.
Platelet-rich Plasma (PRP). The PRP contains a concentration of different growth factors that appear to reduce inflammation and promote healing. Some studies have found that the PRP can benefit some people with osteoarthritis, but further studies are needed.

Surgery

If you have an injury that may require surgery, it is usually not necessary to have the operation immediately. Before making a decision, consider the pros and cons of both non-surgical rehabilitation, and surgical reconstruction in relationship to what is most important to you. If you choose to have the surgery, your options may include:

The arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair the damage to the joints using a fiber-optic camera and long, narrow tools inserted through small incisions around the knee. Arthroscopy can be used to remove the bodies from the knee joint, remove or repair the damaged cartilage (especially if it is the cause of your knee joint with lock), and to reconstruct the torn ligaments.
The partial knee replacement. In this procedure, the surgeon replaces only the most damaged part of the knee with metal and plastic. The surgery can usually be performed through small incisions, so is likely to recover more quickly than they are in the surgery to replace the entirety of your knee.
Total knee replacement. In this procedure, the surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.
The osteotomy. This procedure consists in the removal of bone from the femur or the tibia to better align the knee and relieve the pain of arthritis. This surgery can help to delay or avoid a total knee arthroplasty.

Lifestyle and home remedies

Over-the-counter medications such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may help to relieve the pain of the knee.

Some people find relief by rubbing the affected knee with creams that contain a numbing agent, such as lidocaine or capsaicin, the substance that makes chili peppers hot.

Self-care measures for a knee injury include:

Rest. Take a break from their normal activities to reduce the repetitive strain on your knee, give the injury time to heal, and help to prevent further damage. A day or two of rest can be all that you need for a minor injury. More severe damage is likely to need a longer recovery time.
Of ice. The ice reduces swelling and pain. A bag of frozen peas works well, as it covers his entire knee. You can also use a bag of ice wrapped in a thin towel to protect your skin. While ice therapy is generally safe and effective, do not use ice for more than 20 minutes at a time, due to the risk of damage to the nerves and the skin.
Heat. You may experience temporary relief of pain through the application of a hot compress or hot water bottle on the area of pain in your knee.
Compression. This helps to prevent the accumulation of fluid in the damaged tissues and maintains the alignment of the knee and stability. Search for a compression bandage, lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.
Elevation. To help reduce the swelling, try to shore up his injured leg on pillows or sitting up in a recliner.

Alternative medicine

The research suggests that acupuncture can help relieve knee pain caused by osteoarthritis. Acupuncture involves the placement of hair-fine needles into the skin at specific locations in the body.

Preparing for your appointment

It is likely to start by seeing your family doctor. Depending on the cause of your problem, he or she may refer you to a doctor who specializes in diseases of the joints (rheumatologist), joint surgery (orthopedic surgeon) or sports medicine.

What you can do

Before your appointment, you can write a list of answers to the following questions:

When did you begin experiencing symptoms?
Did a specific injury to your knee start to hurt?
The symptoms been continuous or occasional?
How severe are the symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?
What medications and supplements that you take regularly?

What to expect from your doctor

Your doctor may ask some of the following questions:

Do exercise or sport?
Was the pain caused by an injury?
Not produce swelling, instability, or locking of the knee?
You are experiencing the symptoms in other areas, or simply on your knee?
Have you ever had knee pain before? If so, do you know what is the cause?