What Causes Knee Pain?

Knee pain, by itself is a symptom, rather than a diagnosis. Knee pain causes can be triggered by a variety of different reasons, and it can be located in different areas of the knee. For instance, some patients complain of the pain being in front of the knee, while others feel it deep within the joint, the back or on the sides. It is also not uncommon that the knee pain is the result of a condition of the hip, rather than of the knee.

Regardless of the underlying cause of the knee pain, one thing is for sure: it affects almost half of those that are aged 55 or above in Singapore. That being said, knee pain can often be resolved with appropriate treatment.

The first appropriate step in the management of the knee pain is to identify the cause of it. In order to do so, your doctor will make a diagnosis from the medical history and physical examination. X-rays of the knee or/and hip are routine. However, an MRI scan may be required if a soft tissue injury such as meniscus or cartilage tear is suspected as the X-rays will not reveal such conditions. If fluid is present in the knee (knee effusion), the fluid may be drawn out for laboratory investigations. 

Common causes of knee pain:

Osteoarthritis is one of the most common culprits behind knee pain. This is due to the wear and tear of the cartilage that comes with aging, and especially common after middle age. It is caused by the stress on the joints, especially the larger weight bearing joints in the lower body such as the knee and the hips. Besides the excruciating pain most patients complain about, they also experience an inflammation of the joints along with stiffness. Contrary to common belief, one should not just depend on the over-the-counter pain-relief medications. Get in touch with the specialist in order to discuss long-term management options as knee osteoarthritis is a condition that will get worse as you age. Your doctor would be able to advise you on whether and when a surgery may be required. Many types of surgeries have been performed depending on the age of the patient, the severity of the condition. A minimally invasive partial knee replacement is deemed one of the best option available for the older patients with lower demand.

Sports injuries are often the main culprit behind intense and acute knee pain. High impact sports can cause traumatic injuries such as ligament and meniscus tears. These are soft tissue injuries that may require immediate specialist attention. Some mild ligament strains (or partial tears) can be treated conservatively but complete tears of important ligaments like ACL (anterior cruciate ligament) may need to be reconstructed with a minor surgery as the patient can feel very unstable and the knee giving way easily. Similarly, persistent pain from a meniscus tear will need to be addressed with a keyhole surgery to prevent the knee from locking up and extending the tear. An untreated major meniscal injury may have long term consequences including arthritis of the knees.

Another category of sports injuries take place progressively, due to overuse of the joint, or/and inappropriate technique in the sport. This is not an exclusive problem of the professional athletes, though it does occur more frequently amongst this group. Pain in the front of the knee, the knee cap, is commonly due to the condition called patella tendinitis. Patella tendinitis typically goes with physiotherapy to strengthen the muscles in the lower body. If appropriate, the doctor may suggest radial shockwave therapy or injections into the joint.

Another commonly seen progressive injury from sports is the Iliotibial Tract Band (ITB) Syndrome. Simply put, the ITB syndrome arises when the tendon gets too tight or it suddenly becomes inflamed. This can affect the movement of the knee, thus preventing the patient from cycling or running or even walking. The pain triggered by the ITB syndrome can become very intense over the weeks or months, cause knee swelling and patients often complain of not being able to bend their knees to 45 degrees without pain. This condition is often helped by professional physiotherapy, oral anti-inflammatories and may even require a soft tissue injection.

The specific treatment for your knee pain depends on the cause. Some of these treatments are: proper casting, splinting, surgery and/or physiotherapy. Your doctor would discuss the condition causing your knee pain, as well as the treatment options with you.

In particular, please see the doctor immediately if:
Your knee pain came on suddenly, especially if it is after an injury.
Your knee pain prevents you from walking
Your knee joint is swollen, looks red and feels hot to touch

Also, please:
DO NOT take pain-relief medications without a doctor’s supervision if you have (or had) stomach/duodenum ulcers.
DO NOT continue with the a ctivities that causes your knee pain. It may further worsen your knee condition. 

If you are experiencing persistent knee pain, consult our knee specialist for a comprehensive consultation from diagnosis and treatment in our orthopedic clinic today! 

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