Knee Pain—A Condition that Should Not Be Left Untreated

The knee is the largest joint in the body; it bears a tremendous amount of body weight and provides flexible movement for many of the activities performed by the body. When someone has knee issues or knee pain, it makes movement difficult and has a large impact on their quality of life. It is likely that many of us have heard complaints from our parents or other older relatives about knee or leg pain while walking or standing for long periods of time. Most people tend to think that these kinds of symptoms are nothing to worry about but, in fact, there are a number of hidden dangers behind the symptoms of knee pain, and this is a condition that should not be left untreated.

There are three main causes of knee pain:

• An accident or sports injury. Injuries of this kind can occur at any age. For the most part, however, this tends to be the cause of knee pain in younger people, teenagers or those of working age. The severity of this type of knee pain can vary anywhere from very light to very heavy pain. Some examples in this group include muscle inflammation, muscle tear, fracture, subluxation or dislocation, torn meniscus or a torn ligament. There will usually be knee pain or swelling immediately after an injury of this kind.
• Various types of arthritis, such as gout and rheumatoid arthritis. The cause of rheumatoid arthritis is not yet fully understood, while gout is caused by excess uric acid in the bloodstream. In addition to arthritis, this group includes certain types of bacterial infections, which can also cause knee pain.
• Age-related degenerative joint disease (osteoarthritis), due to the deterioration of the body in relation to age.  The knee joint has received impact pressure over the time until the natural cushioning between the joints or cartilage is deteriorated. When this happens, the bones of the knee joint rub more closely against one another with less of the shock-absorbing benefits of cartilage, resulting in friction and pain. This particular type of condition is more likely to be found in those aged 50 years and older, and is more common in women than in men.

Actually, there are a number of common activities that are a part of life that can directly increase the risk of knee pain, such as sitting cross-legged. Some people sit in these positions for long periods of time, and this can cause pain in the knees. Other risk factors include incorrect usage of the knees, being overweight, or having to lift or carry heavy weights as part of work or on a regular basis, as these can cause excess weight and force to be placed on the knees. Some people, as part of their daily life or routine, have to work in tall buildings and frequently have to walk up long flights of stairs, which, over time, can affect the knees as well. All of these types of behaviors can be considered risk factors that have the potential to contribute to knee pain as well.

1.  Pain and inability to stand or put your weight on the knee
2.  Knee pain that is severe and intensifying
3.  Knee joint stiffness or locking, or lack of full mobility
4.  Warmth or swelling in or around the knee joint

In terms of treatment for knee pain, the doctor will consider each individual case, looking at the possible causes and the level of intensity of symptoms. If the pain is acute, the doctor will instruct the patient to rest the knee joint, and may apply a knee wrap in order to help minimize knee movement temporarily. He/she may also give recommendations for the patient to modify daily activities so as to lessen use of and stress on the knee.

Physical therapy may include hot or cold compresses to help ease the pain. For some patients, anti-inflammatory or pain relief medication may also be prescribed—these are general painkillers which are not harmful to the body when taken in moderation. However, for patients who have chronic or long lasting knee pain and who are in the risk group for osteoarthritis, they will usually be treated with more specific medications. In these cases, the doctor will generally prescribe pain relievers or nonsteroidal anti-inflammatory medications (NSAIDs). These medications can sometimes have certain side effects, such as interference with digestion in some cases, and should only be taken under prescription and supervision of a doctor.

If medications and pain relievers resolve the issue, then nothing further needs to be done. If, however, after taking the oral medication, the pain does not subside, it may then be treated with injections. These include corticosteroid injections and hyaluronic acid supplement injections. Repeated use of corticosteroid injections is not without risks though, as repeated knee injections can have the opposite of the desired effect; that is, they can actually contribute to cartilage breakdown. Hyaluronic acid supplement injections are generally used for patients diagnosed with osteoarthritis. These are injected into knee joints to supplement the normally naturally occurring hyaluronic acid which has been broken down or deteriorated due to aging and use. Patients may also be prescribed glucosamine supplements in order to help delay or prevent progressive deterioration of knee cartilage.

Surgical Treatments

When other treatment methods, such as physical therapy and medication have been exhausted, and if the pain is still not alleviated, doctors may then consider knee surgery as an option worth pursuing. There are a few options for surgery, and the method is used depends on the cause and type of knee pain the patient is experiencing.

For younger patients exhibiting symptoms of osteoarthritis, the doctor may recommend a knee osteotomy to reshape and reposition the bones to take the weight off the damaged part of the knee and hopefully delay or prevent total knee replacement surgery. For patients with damaged meniscus, a surgical method known as arthroscopy can be used for treatment. In patients with constant and/or severe pain, osteoarthritis, or with knee damage or deformities, such as if the legs are bowed inward or outward at the knees, doctors will usually recommend total knee replacement surgery. This type of surgery has become increasingly popular in recent years as patients report positive results and faster recovery, together with the ability to walk again in just a short amount of time.

1. Use the correct techniques or positions during activities so that you do not strain your muscles. Avoid sitting on the floor, sitting cross legged, or squatting. Instead, try to sit in a chair with the seat at knee level. Refrain from frequent heavy lifting, and avoid walking or running up and down stairs or steep surfaces.
2. Keep your weight within the standard recommendation
3. Avoid activities that pose risk of injury to the knees
4. Work to strengthen your quadriceps, as these muscles play an important role in helping to support the knee joints and ligaments. Keeping the quadriceps and the muscles strong around the knee is key, as this will help to alleviate stress and strain on the knee joints and ligaments.

We have learned that knee pain can be caused by a variety of factors, and that there are likewise a wide variety of treatments available, depending upon the cause and the symptoms thereof. Most importantly, however, starting from today, we all need to pay more attention to caring for our knees. Our knee joints carry a perpetually heavy load, and if we don’t care for them, they may soon refuse to function properly and no longer bear the weight of our bodies, as they are supposed to do. That is, without proper care, our knees may wear out faster than we expect and normal activities may no longer be possible. Caring for our knees is something to which we should all give careful attention. If you start to notice symptoms of knee pain, do not leave them untreated, but rather seek medical attention and treatment early  in order to preserve your knee joints and their function for as long as possible.

Photo Credit: Alexandra E Rust via Compfight cc