The Most Common Causes and Treatment of Knee Pain



knee pain



Knee pain is a common complaint for people of all ages. Knee pain may result from injury, such as rupture of a ligament or cartilage, or due to some pathological conditions like arthritis, gout, and inflammation that can cause knee pain.

Many minor knee pain cases respond well to self-care procedures. Physical therapy helps a lot. However, knee pain may require surgical repair in some cases.

  
Osteoarthritis


Osteoarthritis is a major problem for the general population and affects most weight bearing joints.

It is often secondary to previous trauma such as ACL ruptures and previous surgery in meniscus.

Symptoms

There is gradual onset of diffuse pain around the knee and effusion.

The knee is usually stiff and more painful in the morning than in the afternoon.

In severe cases there is pain during rest. There are periods of better and worse symptoms. Clicking and crunching sounds can occur. It usually affects you walking.


Treatment

There is no definite cure for this condition.

However, there is a range of symptomatic relief treatments such as:

1-Physiotherapy to strengthen your lower limb muscles and reduce the loading on the knee joint.
2-NSAID (non-steroidal anti-inflammatory) to reduce pain.
3-Injections of synovial fluids, into the knee joint.
4-Arthroscopic debridement, excision of loose bodies inside the knee joint.

 Anterior Knee Pain



Anterior knee pain is not a diagnosis but a symptom that can be caused by a number of underlying diseases. 

This condition often occurs as a result of sudden changes in training habits or heavy house work, such as cleaning and standing for long periods in the kitchen.

Symptoms

Gradual onset of diffuse pain around the anterior part of the knee or around the patella.

It’s increased by prolonged sitting or squatting. This is called positive ‘movie’s sign’, it’s named like that because you are in the same position for a long period when you are watching a movie at the cinema.



The most common example on anterior knee pain is Chondromalacia


Chondromalacia means ‘degenerated cartilage’. 

The most common cause of chondromalacia is patellar maltracking. It means the patella is not moving on its right way or its track.


Symptoms

There is gradual onset of diffuse activity-induced pain around the anterior part of the knee. 

Prolonged sitting or squatting often trigger the symptoms (positive movie sign). Walking down stairs is more difficult than up.


Treatment

Long-term symptomatic and functional treatment by a physiotherapist is required.

Physical Therapy sessions will help strengthening vastus medialis muscle, which is responsible for correcting the patella track and reduce anterior knee pain.


Osgood Schlatter’s Disease

The condition is caused by excessive stress to the growth plate of the tibia bone, where the patellar tendon inserts. This condition typically is aggravated by jumping and running.

Symptoms

There is gradual onset of localized exercise-induced anterior knee pain and soreness at rest around the upper part of tibia in a young growing athlete, usually 12 to 16 years old, without preceding trauma.

It may be bilateral or affect the knees separately, depending on the growth of each leg.

Treatment

This temporary condition should be explained to the child and parents and treated by suggesting temporary modifications in training. The pain will disappear completely when the growth plate closes.


ACL Injury

The mechanism of injury is when the athlete suffers a hyperextension or valgus rotation sprain. 

But in many cases it is a non-contact injury, where the patient loses balance and twists the knee. 

The ligament can be ruptured partially or completely. In growing athletes the bone insertion can be avulsed (tibia spine fracture). 

This injury is often associated with other injuries to cartilage, menisci, capsule or other ligaments.


Symptoms

The symptoms are pain and immediate hematoma, caused by bleeding from the ruptured ligament.

This is an injury common in contact sports such as football, rugby and other high intensity sports. 

There is often a ‘pop’ sound from the knee at the time of the injury and an inability to continue activity.

Investigations

Clinical examination is the most important tool for diagnosis and should include tests for all ligaments and other structures in the knee. MRI can verify a complete ACL tears.

Treatment 

A patient with knee hematoma and a suspected ACL tear should be seen by an orthopedic surgeon to consider an early arthroscopy. 

This procedure can confirm the diagnosis. 

Reconstruction of the ligament is recommended for active athletes in pivoting sports. 

Sedentary people and participants in non-pivoting sports may recover through rehabilitation and physical therapy only.


  
Iliotibial Band Syndrome

This condition typically occurs as a result of sudden changes in training habits or over house work.

Symptoms

Gradual onset of localized activity-induced pain at the lateral part of the knee without preceding trauma. 

It is most common in long-distance runners and is often labelled ‘runner’s knee’.

Treatment

This injury most often responds to conservative treatment including rest from the aggravating causes.

Physical therapy sessions will help reduce the inflammation and so the pain.









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