Knee Pain

The knee joint is one of the most versatile joints in the body. No machine comes close to the capabilities of your knee joint. Unfortunately, in addition to how versatile the knee joint is, it is also one of the most vulnerable joints to injury.

After years of use, your knee joint starts to show signs of aging or wear and tear. Pain and swelling in the knee joint can be a result of a genetic predisposition to knee problems, as a result of an injury that occurred many years earlier, or even the constant daily activities of bearing excess weight on your knees.

Minor knee problems, however, don’t always require a doctor’s care. For occasional knee pain and stiffness, your doctor will prescribe simple measures first.

Anatomy of the Knee

Your knee joint is the largest joint in your body and, perhaps, one of the most complex. This remarkable structure of muscles, bones, ligaments, and cartilage supports and stabilizes your knee as you bend, straighten and twist during daily activities.

Repetitive weight-bearing, however, has its price. The most common conditions that affect the knee are:

• Osteoarthritis:  Of all joints affected by this disease of wear and tear, the knee joint is the most common. Cartilage in your knee joint gradually deteriorates. This results in pain and aching in the knee joint when you move the knee or put weight on it.  Usually you’ll have stiffness upon waking in the morning that will gradually subside with movement. With extensive disease in the joint, you will feel pain and discomfort even without any movement at all.
  
  
• Chondromalacia:  This involves softening and loss of smooth cartilage that covers the backside of your knee cap. With softening of the cartilage, there is pain with movement of the knee joint, especially when you kneel down or walk down stairs.
  
  
• Bursitis:  Bursae are fluid-filled sacs that separate and cushion tendons where tendons attach to bones. Bursae reduce friction and make movement easier. Bursitis refers to inflammation of the bursae. Inflammation is a result of overuse such as repeated kneeling on hard surfaces, or a result from a direct blow.
  
  
• Popliteal cysts:  The membrane containing fluid that lubricates your knee joint may become inflamed. If so, a tender, bulging cyst may form behind your knee. Bending the knee makes the pain worse.
  
  
• Tendonitis:   Overuse can cause inflammation or a small tear in the hard, inelastic cords that attach your thigh muscle to your lower leg. Too much stair climbing or bicycle riding are typical activities that can cause tendonitis
  
  
• Torn cartilage:  Degenerative changes make even minor twisting more likely to tear cartilage such as the meniscus in your knee joint and cause pain. If you knee locks or gives way, that is a situation where you must see your doctor as soon as possible.

How to treat knee pain?

For occasional bouts of discomfort or stiffness, take regular doses of aspirin, acetaminophen or ibuprofen.

If pain is abrupt in onset:

• Protect or immobilize your knee to prevent further injury. Use an elastic wrap, splint, cane or crutches if you have these aids from a previous episode of knee pain. Try walking with a cane in the hand opposite your painful knee for a few days. This reduces the weight-bearing forces across your sore joint by 30 to 50 percent.
  
  
• Rest the joint by avoiding activities that cause pain, swelling or discomfort. Squatting, kneeling, and walking up or down hills causes you to place weight on your bent knees. That can aggravate your pain.
  
  
• Ice can be of benefit for the acute pain. Apply ice wrapped in a cloth towel for no more than 20 minutes several times a day. (If your skin turns white or blue, indicating possible frostbite, remove the ice immediately.) Cold is preferable to heat for the first few days because it reduces swelling and inflammation and speeds healing. Heat is usually best for chronic pain. It can also help relieve stiffness and prepare your muscles for strengthening exercises.
  
  
• Compress the knee joint with an elastic bandage until the swelling subsides. Loosen the wrap if pain increases or if numbness develops. The wrap should be snug but not too tight to decrease the circulating below the knee joint.
  
  
• Elevate the knee whenever possible above the level of your heart.