What is knee pain?
It’s not surprising that many of us have either experienced knee pain ourselves or heard someone complain about it. After all, it’s a common complaint that affects people of all ages, especially the elderly. In Singapore alone, one local study revealed that nearly half of the elderly experience knee pain. What’s concerning is that half of the participants chose to suffer in silence rather than consult their doctor for treatment.
Knee pain can originate anywhere from the knee’s bony structures (thigh and shin) to its muscles and tissues. Individuals may be able to point out exactly where the pain is coming from or say that their entire knee is aching. The nature of the problem likewise varies; some cases develop suddenly, while others observe a mild discomfort that gets worse over time. Overexertion or repeated stress on the knee may be causing the pain, but it’s also possible that the patient has an underlying medical condition like gout or arthritis. Determining the root cause is crucial because it will dictate the treatment, which can range from home remedies and exercises to medications and surgery.
Symptoms of Knee Pain
When your loved one suffers from knee pain, they may voice out that their knee feels “achy” or “painful.” But often, that’s not the entire story. If you ask them to explain further, they may report that they also feel or notice:
- Redness and warmth on the affected area
- Swelling and stiffness
- Instability and weakness
- Weird noises in the knee (sometimes popping or crunching)
- Limited movement, such as an inability to straighten or bend their knee
- Pain that only happens when they perform specific movements (going up or down the stairs)
- Consistent pain even when at rest
Ultimately, the severity and location of the knee pain depend on the root cause.
When should I see a doctor for knee pain?
When we experience knee pain, our first course of action may be to turn to home remedies. However, if not done right, self-diagnosis and treatment can do more harm than good. The best course of action you can take is to consult a doctor to find the root cause and get the right treatment.
Certain signs may indicate that something more serious is causing your knee to hurt. Make an appointment with the physician if you or your loved one:
- Cannot bear weight on one of both knee(s); often, patients describe this as their knee feeling unstable or “giving out” when they try to stand
- Experiences severe knee pain even when not bearing weight
- Hears buckling, clicking or locking sounds
- Notices swelling
- Cannot fully straighten or bend their knee
- Observes an obvious deformity in the knee
- Experiences fever along with pain, redness and swelling on the affected knee
- Experiences severe knee pain after an injury
- Notices swelling or bluish discolouration around the knee or in the calf below the affected knee
- Feels a numbing or tingling sensation in the calf below the affected knee
- Experiences pain even after 3 days of home remedies
Here’s an important reminder, though: you don’t need to wait for any of the above signs to occur before you seek medical help. If your knee causes considerable discomfort and interferes with your daily routine (e.g. you find it hard to sleep because of the pain), don’t hesitate to talk to your doctor.
If your knee pain limits your mobility and makes it hard for you to visit the hospital, don’t forget there are many ways to get in touch with a physician. You can hire a house call doctor who’ll go to your house or set an appointment to consult a doctor online.
Knee Pain Causes
As mentioned earlier, knee pain can happen due to a variety of reasons. In this discussion, we’ll classify the reasons into two categories: injuries and overuse, and medical conditions.
Sprain or Strain
A sprain happens when you injure your ligaments (i.e. the tissues that connect two bones together). On the other hand, a muscle strain occurs when you overstretch or tear a muscle or tendon (i.e. the tissues that connect muscles to the bone). Usually, a strain or a sprain results from a blow to the knee; it can also happen when you make sudden, twisting movements. People who suffer from a sprain or strain often experience pain, swelling and difficulty walking.
One of the most effective ways to treat muscle strain is with physiotherapy, a method of healing conditions such as arthritis through physical means. With physiotherapy, you can reduce the need for medication and perhaps even avoid surgery.
Torn Cartilage (Meniscus)
Trauma to the knee can also tear the meniscus (i.e. the tissue pads in the knees that promote stability and serve as shock-absorbers). Individuals with a sprain may also experience cartilage tearing. Should your doctor determine that you have a torn cartilage, you may need to wear a brace to protect your knees from further injury or undergo surgery to repair the tear.
Broken Bones (Fracture)
Have you been playing too hard? Did you recently suffer a fall or vehicular accident? If your knee pain occurs after such incidents, you may have broken a bone. For healthy people, fractures often happen after intense knee trauma. However, for the elderly and those with weaker bones due to osteoporosis, even a wrong step can lead to fractures.
Some accidents, such as an intense trauma, or sudden and forceful straightening of the leg, may result in dislocation of the kneecap, the triangular bone in front of the knee. The degree of dislocation varies, but some individuals may see and feel that the bone is “out of place.” Those who dislocated a kneecap may complain of difficulty in flexing or extending the leg.
Bursae are small fluid-filled sacs that reduce friction and promote smooth gliding motion in the knee joints’ moving parts. Sometimes, repetitive movements and injuries can lead to an inflammation of the bursae (bursitis) and cause knee pain.
Did you know that there are over 100 types of arthritis? And while not all types affect the knees, several kinds tend to cause knee pain. Examples include:
- Osteoarthritis – The most common type of arthritis that mainly occurs due to the wear-and-tear of the cartilage.
- Rheumatoid arthritis – The most incapacitating kind of arthritis, rheumatoid arthritis, happens because the patient’s immune system attacks its own tissues, causing inflammation and pain. Someone who has rheumatoid arthritis will most likely experience pain and swelling in other joints of their body as well.
- Gout – This kind of arthritis happens due to the buildup of uric acid crystals in the joint. While it most commonly affects the big toe, gout can also lead to knee pain.
Does your pain come with a “fluid-filled” swelling at the back of the knee? If yes, then it may be Baker’s cyst. Knee injuries can result in Baker’s cyst, but it can also happen along with health conditions like arthritis.
Sometimes, disease-causing organisms may enter the knee bones and joints, causing an infection that manifests into knee pain and inflammation. Examples include septic arthritis and osteomyelitis (bone infection).
Tumours that begin in the bones of the knee can lead to pain. Likewise, cancers that originate in other areas but spread to the knee can cause pain and discomfort.
Risk Factors for Knee Pain
Like other conditions, certain factors can increase a person’s risk of developing knee pain. These factors include:
Having excessive weight puts more stress or pressure on the knees, even during simple activities like walking or going up the stairs. Additionally, increased weight also heightens your risk of developing osteoarthritis, which may also cause knee pain.
Muscle Weakness and Lack of Flexibility
Having weak muscles and lacking flexibility does not directly cause knee pain, but they increase your risk of sustaining injuries that affect the knees. Strong muscles protect our joints and help us become more stable; being flexible, on the other hand, reduces the risk of injury by increasing our range of motion. When we say range of motion, we’re referring to the extent by which our joints can move.
Certain Occupations and Physical Activities
At least one study proved that people who worked in jobs that required them to kneel or stand for long periods are at a higher risk of experiencing knee pain. Moreover, engaging in selected sports that require repeated pivoting and jumping, such as basketball, may pose a higher risk of knee problems as well.
And finally, if you’ve had a knee injury before, you will be at an increased risk of sustaining another injury in the future.
Diagnosing Knee Pain
In the hospital or clinic, the doctor will most probably begin the examination by asking you questions about your general health. Afterwards, they will inquire about your knee issues. Expect questions like:
- How long have you been feeling the pain?
- Can you tell me exactly where it hurts?
- What kind of pain do you feel? (Mild, consistent discomfort? Severe and sharp?)
- What triggers the pain?
- Do you perform anything that gives you relief?
It’ll be beneficial to prepare the answers to the above questions before you visit your doctor. That way, you will not forget and miss out any detail that the doctor can make an accurate diagnosis and treat your condition.
After the interview assessment, there will be a physical examination. The doctor will look for visible signs of redness, swelling, bruising or deformity. He/she will then check for your range of motion by slowly bending or straightening the affected knee. It is also likely that they will gently move your knee in different directions.
Often, the results of the interview assessment and physical examination will be enough to make a diagnosis. If the doctor wants to do further testing or decides to confirm their diagnosis, they may recommend that you undergo any of the following diagnostic tests:
In most cases of knee pain, doctors recommend X-rays to check for fractures or visible signs of degeneration. If the doctor suspects that soft tissues are involved, they may order for a magnetic resonance imaging (MRI) scan, which creates a 3D image of the inside of the knee.
If the doctor suspects an infection or inflammation, they will take a sample of your blood and send it to the laboratory for testing. If it’s not a blood sample, they may insert a needle into your knee joint to collect some fluid.
Knee Pain Treatment
Only after confirming the root cause of your pain will the doctor decide on an appropriate treatment plan, which may include a combination of medications, injections, therapy, or surgery.
It’s common for doctors to prescribe medications, especially for patients who can no longer attend to their daily activities due to the knee pain. The type of medication depends on the nature of the pain: if there’s no inflammation, the doctor may decide to give you pain relievers like acetaminophen. On the other hand, if you have an inflamed knee, they may prescribe some non-steroidal anti-inflammatory drugs that treat the inflammation; examples include naproxen, ibuprofen, and mefenamic acid.
If you have an underlying condition that contributes to your knee pain problems, the doctor will most likely give you medications for that too.
There are also cases when your knee pain treatment includes injecting substances directly into your joint. For instance, the doctor may inject corticosteroid to help lessen pain and reduce arthritis flares. You may also receive hyaluronic acid to lubricate your joints.
Should the doctor discover that your knee pain occurs due to muscle weakness or incorrect movement, you may be recommended to undergo physiotherapy. Besides treating the pain itself, a common goal of this treatment is to strengthen your muscles and increase your range of motion to prevent further injuries.
Those who are active in sports or have jobs that contribute to their condition may need physical therapy to promote proper posture and movements.
Finally, there’s surgery. Usually, if you need surgery, you’ll have to undergo the operation right away. Two examples of surgeries are partial knee replacement surgery and total replacement surgery. In the partial knee replacement operation, the surgeon will replace the damaged part of your knee with plastic and metal materials. On the other hand, they’ll use high-grade metals to replace the damaged kneecap, shinbone, or thigh bone in total replacement surgery.
Home Remedies for Knee Pain
Are you experiencing knee pain and need immediate relief? If it’s just mild discomfort and you can still perform your daily duties, consider giving the following knee pain remedies a try:
Use the RICE method
The RICE mnemonic stands for Rest, Ice, Compress, and Elevate:
- Take plenty of rest and refrain from doing activities that worsen or trigger your knee pain as much as possible. If you can, avoid bearing weight on your knees.
- Apply ice. Cover the affected knee with a towel before ice application. On the first day, apply ice every 6 to 8 hours for a maximum of 15 to 20 minutes per application. After the first day, apply ice 4 times a day. It’s important to keep in mind that you cannot apply ice for too long as you may develop frostbite, so make sure to not fall asleep during ice application.
- Wear an elastic bandage to provide support and reduce swelling. Just a quick reminder: don’t wrap the compression bandage too tightly that it cuts off the circulation.
- And finally, to further reduce swelling, keep your knees elevated or raised above the level of your heart when you’re resting.
Alternate Heat and Cold Therapy
Besides the RICE method, another knee pain remedy is alternately applying a heating pad and a cold compress. As mentioned earlier, a cold compress helps reduce inflammation. A heating pad, in contrast, helps relieve the pain.
Alternately apply the heating pad and cold compress a couple of times a day for a maximum of 15 to 20 minutes per application. Whether you use a hot or cold compress, remember to wrap a towel around your knee.
Take Pain Relievers
In times when the pain or discomfort already interferes with your daily routine, consider taking a doctor-approved over-the-counter pain reliever.
We need more studies to confirm their effects, but some patients find comfort in applying a pain-relieving ointment on their affected knee. This method is excellent if you don’t do too well with oral pain killers. As of now, there are available topical NSAIDs in the market, although you need to get a prescription to buy them. Talk to your doctor about the possibility of applying them to your knee.
Sleep with an Additional Pillow
Getting plenty of rest is vital in recovery. Find a comfortable position that doesn’t trigger pain, and if it helps, consider adding an extra pillow below or between your knees.
Achieve a Healthier Weight
As the experts explain, excessive weight can put too much pressure on the knees. What’s even more concerning is that when the knees receive excessive pressure for extended periods, the risk of inflammation increases.
For this reason, it will be helpful to keep your weight at a healthy level. If you’re having a hard time with your weight loss goals, talk to your doctor about how you can modify your diet and exercise.
Do take note that while these are common home remedies for knee pain, it may not be suitable for everyone. If in doubt, consult a doctor or therapist for a personalised treatment plan.
Exercises to Strengthen Your Knee & Prevent Knee Pain
Patients who experience pain often do not want to move a muscle in the fear that it will worsen the discomfort. However, medical experts emphasise that being mobile is an integral part of relieving and preventing pain.
If you’re looking for simple exercises that help to strengthen your knees, consider the following:
Stretching increases your range of motion and thereby helps prevent future injuries. One simple stretch that you can do anytime, anywhere is the quadriceps stretch. To do this:
- Find a sturdy chair or wall to support yourself.
- Stand with your feet shoulder-width apart.
- Bend your right knee until your foot almost touches your glutes (butt cheek).
- Use your right hand to pull your foot toward your glutes as far as you can.
- Hold the position for about 30 seconds. If you worry that you’ll lose your balance, hold on to the wall or chair.
- Return to the starting position and change legs.
- Repeat twice on each leg.
Do you have osteoarthritis? If yes, then you might want to think about learning Tai chi. As of now, several studies have already revealed that Tai chi, a self-paced and non-competitive exercise, has helped individuals with osteoarthritis by improving their balance and mobility. Moreover, Tai chi can also help relieve pain.
Swimming is a great full-body workout, and for people experiencing knee pain, it’s also an excellent way to exercise while not bearing weight on your knees. You don’t need to hit the pool daily, but it adds to your physical activity if you can swim for an hour or two per week.
According to experts, walking is the best exercise for us. Why? Because it has no learning curve and you can do it whenever you like and wherever you are. Walking is a gentle way to get moving. Sure, you bear weight on your knees as you walk, but it’s not as stressful as other workouts.
Finally, you can also cycle to strengthen your knees and prevent injuries. Experts highlight that riding a bicycle gets you worked up, but like walking, it doesn’t put too much stress on your hips and knees. Another plus is that the movement helps lubricate the knee.
Reminders When Working Out
Excited to get started on your exercise routine? Before you do so, please take note of the following reminders:
- Stop exercising if you’re no longer comfortable. Experiencing chest pain or severe shortness of breath means you might be pushing yourself too hard.
- Warm up before working out and cool down after.
- Do not begin or change your exercise routine unless you have your doctor’s approval, especially if you have an underlying condition like heart disease or respiratory illness.
Performing the wrong exercises can worsen your knee pain. Hence, it’s always better to consult an expert about your exercise routine so that it improves your knee condition and reduces your risk of further injuries.
Here at Homage, our physiotherapists work closely together to customise a personalised recovery and rehabilitation plan that’s suitable for your knee pain. Furthermore, they’ll visit you at your doorstep so you don’t have to travel and can receive treatment and monitor your recovery in the comfort of your home.
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