Most people experience knee pain at some point in life. The various reasons go from repetitive strain injuries to general diseases. Determining the cause for knee pain early on will help with getting the proper treatment.
Knee pain, that isn't caused by an injury and there is no fever or other common symptoms involved can be safely monitored for a few weeks. If the pain doesn't ease or the pain prevents normal activity, a doctor with expertise in joint problems should examine the situation.
With young people as well as working age people the most common causes for knee pain, which start without an injury are different problems due to an overload on the knee. This can occur as knee bursitis (bursae in knee gets inflamed) or joint pain for example.
When too much load is placed on the knee too fast, it becomes painful. The treatment of these problems is almost always based on reducing the excessive or wrong type of load. Often the form of exercise related to the problem will have to be modified until the pain ends.
A typical cause for knee pain for young women is chondromalacia, which is when the cartilage of the kneecap starts to soften and fracture. This can be very painful especially at the beginning and often the pain includes crunching sounds when bending and stretching the knee.
The pain worsens when sitting down too long, climbing the stairs or squatting down.
The treatment used consists of physiotherapy and strengthening the quadriceps muscles on the front of the thigh. With some individual cases joint endoscopy and cleaning the loose cartilage pieces will prove to be useful.
Over 50 year olds almost always have some articular cartilage wear in the knee as this is part of the aging process. Often the knee pain is related to this, however with some patients this process is painless. The treatment of the articular cartilage wear depends on the severity of the issue.
The treatment is rehabilitative for the quadriceps muscles and often includes improving the functioning of the cartilage and pain relieving medicine. Joint wear is often related to the degeneration of the meniscus and the meniscus can tear even with small injury mechanisms.
Sometimes the wear is related to painful cracking or locking caused by the loose pieces of cartilage or a torn meniscus. Considering each case individually, treatment can be done with endoscopy procedures. Sometimes with younger patients it is possible that surgery will be needed to fix the incorrect overload on the lower limbs. Artificial joint operations are part of treating a difficult articular cartilage wear and for working age people this is a rare type of treatment.
When estimating knee problems attention should be payed to the lower body as a whole, because for example incorrect ankle and foot positions can lead to issues with overload on the knee and this can be the reason for knee pain. Overload issues are typically treated with footwear, insoles and physiotherapist's stretching instructions.
Knee structures, which are most prone to injuries are the meniscus, collateral ligaments and anterior cruciate ligament. A twisting injury can also cause the dislocation of the kneecap. Also, different levels of cartilage contusion are possible and with a more severe injury the joint surface bone can fracture.
If after an injury the knee gets swollen quickly or placing weight on it is hard, it should be examined and X-rayed as quick as possible. A quick swelling is often caused by internal haematoma in the joints, which is the result of a torn anterior cruciate ligament. Also, a fracture, which breaks the joint surface causes an internal haematoma in the joints. In these situations, the knee should be punctured, meaning emptied and a X-ray should be taken. The puncturing of the knee confirms the diagnosis, eases pain and improves movement in the knee.
With a torn anterior cruciate ligament surgery is often needed, but this is usually done after a few weeks when the worst pain and swelling have ceased and the range of motion in the knee has been restored. So, the treatment of the fracture depends fully on the type of fracture and the doctor will determine the correct treatment.
Tears in the meniscus are usually formed when the knee is bent and experiences a strong rotation movement. The tears cause prolonged swelling and pain in the knee. Other symptoms depend on the type of tear. A wide tear, that goes into a joint gap can "lock" the knee perfectly and in this situation the tear is aimed to be treated with an arthroscopy surgery as quickly as possible.The typical symptoms of a torn meniscus are painful cracking in the knee and a sensation of something going in between the joint. Small tears can occur without having strong symptoms and only prevent running for example.
Tears in the meniscus, which cause difficult pain symptoms or locking of the knee can be treated with an endoscopy treatment, in which the torn part of the meniscus is removed or put back in place. The treatment depends on the type of tear and the final treatment can only be decided in the endoscopy.
The knee's collateral ligaments support the knee sideways. A typical injury is when the knee twists outwards and the collateral ligament tears partly or fully. Treatment for these injuries consists of using hinge joints, which supports the knee and later on physiotherapy to recover the range of movement and muscle strength in the knee. Occasionally with collateral ligament injuries surgery is needed. Recovery is all in all slow and can take months. Naturally there can be other injuries related to the collateral ligament injury, such as a torn meniscus, which can be found in a MRI.
Most people experience knee problems at some point in life. The cause for the pain varies largely depending on the patient's age, general diseases, sport hobbies and possible accidents. Some issues and pain heal on their own with enough time, but some require treatment early on. With repetitive strain injuries an early on treatment and guidance can save from prolonging the symptoms and prevent from developing possible permanent injuries.