Knee pain facts

• Knee pain is a common problem with many causes, from acute injuries to medical conditions.
• Knee pain can be localized or diffuse throughout the knee.
• Knee pain is often accompanied by physical restriction.
• A thorough physical examination will usually establish the diagnosis of knee pain.
• The treatment of knee pain depends on the underlying cause.
• The prognosis of knee pain is usually good although it might require surgery or other interventions.

What is knee pain?

Knee pain is a common problem that can originate in any of the bony structures compromising the knee joint (femur, tibia, fibula), the kneecap (patella), or the ligaments and cartilage (meniscus) of the knee. Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe.

The location and severity of Knee Pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany Knee Pain include:

• Swelling and stiffness
• Redness and warmth to the touch
• Weakness or instability
• Popping or crunching noises
• Inability to fully straighten the knee

When to see a doctor

Call your doctor if you:

• Can't bear weight on your knee
• Have marked knee swelling
• Are unable to fully extend or flex your knee
• See an obvious deformity in your leg or knee
• Have a fever, in addition to redness, Pain and Swelling in your knee
• Feel as if your knee is unstable or your knee "gives out"

Knee pain can be caused by injuries, mechanical problems, types of arthritis and other problems.

Injuries

A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:

• ACL injury. An ACL injury is the tearing of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play basketball, soccer or other sports that require sudden changes in direction.
• Fractures. The bones of the knee, including the kneecap (patella), can be broken during motor vehicle collisions or falls. People whose bones have been weakened by osteoporosis can sometimes sustain a knee fracture simply by stepping wrong.
• Torn meniscus. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.
• Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.
• Patellar tendinitis. Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

Mechanical problems

Some examples of mechanical problems that can cause knee pain include:

• Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement, in which case the effect is something like a pencil caught in a door hinge.
• Iliotibial band syndrome. This occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome.
• Dislocated kneecap. This occurs when the triangular bone (patella) that covers the front of your knee slips out of place, usually to the outside of your knee. In some cases, the kneecap may stay displaced and you'll be able to see the dislocation.
• Hip or foot pain. If you have hip or foot pain, you may change the way you walk to spare these painful joints. But this altered gait can place more stress on your knee joint. In some cases, problems in the hip or foot can refer pain to the knee.

Types of arthritis

More than 100 different types of arthritis exist. The varieties most likely to affect the knee include:

• Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It's a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
• Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.
• Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
• Pseudogout. Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
• Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. There's usually no trauma before the onset of pain. Septic arthritis often occurs with a fever.

Other problems

Patellofemoral pain syndrome is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It's common in athletes; in young adults, especially those who have a slight maltracking of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

Treatments will vary, depending upon what exactly is causing your knee pain.

Medications

Your doctor may prescribe medications to help relieve pain and to treat underlying conditions, such as rheumatoid arthritis or gout.

Therapy

Strengthening the muscles around your knee will make it more stable. Training is likely to focus on the muscles on the front of your thigh (quadriceps) and the muscles in the back of your thigh (hamstrings). Correcting suboptimal movement patterns is also helpful, along with establishing good technique during your sport or activity. Exercises to improve your balance also are important.

Arch supports, sometimes with wedges on one side of the heel, can help to shift pressure away from the side of the knee most affected by osteoarthritis. In certain conditions, different types of braces may be used to help protect and support the knee joint.

Injections

In some cases, your doctor may suggest injecting medications or other substances directly into your joint. Examples include:

• Corticosteroids. Injections of a corticosteroid drug into your knee joint may help reduce the symptoms of an arthritis flare and provide pain relief that lasts a few months. These injections aren't effective in all cases.
• Hyaluronic acid. A thick fluid, similar to the fluid that naturally lubricates joints, hyaluronic acid can be injected into your knee to improve mobility and ease pain. Although study results have been mixed about the effectiveness of this treatment, relief from one or a series of shots may last as long as six months.
• Platelet-rich plasma (PRP). PRP contains a concentration of many different growth factors that appear to reduce inflammation and promote healing. These types of injections tend to work better in younger people and in people with mild arthritis.

Surgery

If you have an injury that may require surgery, it's usually not necessary to have the operation immediately. Before making any decision, consider the pros and cons of both nonsurgical rehabilitation and surgical reconstruction in relation to what's most important to you. If you choose to have surgery, your options may include:

• Arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair your joint damage using a fiber-optic camera and long, narrow tools inserted through just a few small incisions around your knee. Arthroscopy may be used to remove loose bodies from your knee joint, remove or repair damaged cartilage (especially if it is causing your knee to lock), and reconstruct torn ligaments.
• Partial knee replacement surgery. In this procedure (unicompartmental arthroplasty), your surgeon replaces only the most damaged portion of your knee with parts made of metal and plastic. The surgery can usually be performed through small incisions, so you're likely to heal more quickly than you are with surgery to replace your entire knee.
• Total knee replacement. In this procedure, your surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

A number of factors can increase your risk of having knee problems, including:

• Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
• Lack of muscle flexibility or strength. A lack of strength and flexibility are among the leading causes of knee injuries. Tight or weak muscles offer less support for your knee because they don't absorb enough of the stress exerted on the joint.
• Certain sports. Some sports put greater stress on your knees than do others. Alpine skiing with its rigid ski boots and potential for falls, basketball's jumps and pivots, and the repeated pounding your knees take when you run or jog all increase your risk of knee injury.
• Previous injury. Having a previous knee injury makes it more likely that you'll injure your knee again.

Knee pain can be debilitating, especially when it prevents you from doing the activities you enjoy. Fortunately, there are many medications that can help relieve your knee pain and get back to your life.

1. Ibuprofen: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that works by reducing inflammation and swelling in the body. It's commonly used to treat back pain and arthritis, but can also help with knee pain.

2. Naproxen Sodium: Naproxen sodium is another NSAID that works similarly to ibuprofen, but may be more effective for people who have stomach ulcers or kidney problems. It's also available over-the-counter without a prescription, which makes it convenient if you're looking for something quick and easy to use at home without having to visit your doctor first.

3. Celebrex: Celebrex is another NSAID medication that's been around since 1994; it's been proven effective at treating osteoarthritis and rheumatoid arthritis as well but may have more side effects than some other medications on this list such as headaches or stomach upset if taken too frequently in high doses over an extended period of time

4. Capsaicin: Capsaicin is a topical cream that is used to treat knee pain by reducing nerve activity in the area where you apply it. It can be applied directly to the skin on your knee or thigh and should be avoided if you have sensitive skin or are allergic to chili peppers.

Symptoms
Pain in the knee joint,Pain when walking or running,Swelling around the knee joint,Tenderness when pressed on the outside of the knee
Conditions
Osteoarthritis,Patellofemoral pain syndrome (runner's knee),Medial compartment knee osteoarthritis,Chondromalacia patella (cartilage damage under the kneecap),Osgood Schlatter disease (inflammation of a tendon below the knee cap)
Drugs
Painkillers,Non-steroidal anti-inflammatory drugs (NSAIDs),Corticosteroids,Antibiotics,Anti-malarial drugs