KNEE PAIN

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INTRODUCTION

Pain around the knee is called knee pain. Pain is a common knee problem that can originate in any of the bony structures compromising the knee joint that is made up of the femur, tibia, fibula), the knee cap the patella, or the ligaments, tendons, and cartilage or meniscus of the knee. Knee pain is a common problem with many causes, from acute injuries to complications of medical conditions. Knee pain is often accompanied by physical restriction. Knee pain can be aggravated by physical activity, as well as obesity, affected by the surrounding muscles and their movements, and be triggered by other problems such as a foot injury. A thorough physical examination will usually establish the diagnosis of knee pain. The treatment of knee pain depends on the underlying cause. Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe.

 

WHAT MIGHT BE THE CAUSES OF YOUR KNEE PAIN?

Generally knee pain starts with aging process. Infection, inflammation and trauma are the major cause of the pain in the knee. Some causes are listed here;

·       Arthritis (Rheumatoid arthritis, Osteoarthritis, Gout)

·       Infection of the knee bone and joint.

·       Fracture of the bone, torn ligament, and meniscal tear.

·       Baker cyst.

·       Bone metastasis (secondaries)

·       Bone tumor

·       Dislocation of the knee cap.

·       Ligament tear (ACL, PCL)

·       Meniscal injury (Lateral, Medial)

·       Strain and sprain

·        

WHEN SHOULD YOU IMMEDIATELY SEEK MEDICAL HELP WITH KNEE PAIN (RED FLAG SIGNS) ?

There are some home remedies and preventive measure that can be adopted in order to relieve the pain. However if these measure fail and following singn persist then you can consult your physician.

·       You have severe pain restricting daily activity.

·       You can't fully flex your knee or you can't fully straighten it.

·       You have swelling, redness, warmth around the knee.

·       You can't bear the weight on your knee.

·       Limping due to discomfort.

·       Difficulty walking up or down steps due to ligament damage (sprain)

·        

 

WHAT ARE THE INVESTIGATIONS THAT ARE NEEDED TO BE DONE IN KNEE PAIN?

General examination of your knee is the must. Your physician will do a detail work up. That includes bending the knee through the full range of motion, checking for the stability of the ligaments, and evaluating for any tenderness and swelling.  It needs to look at knee joint, hip joint and ankle joint.

Certain investigations are mandatory;

·       Plain X-Ray of the knee.

·       CT scan of the knee.

·       MRI of the knee if ligament or meniscuses are torn along with other soft tissue injury.

·       Joint fluid culture if suspected infection (Arthrocentesis).

·       Blood test

 

HOW IS KNEE PAIN TREATED?

Knee pain can be managed conservatively in home as well as with medication. In some cases Surgery may be recommended as per the advice of your physician.

Home care:

·       Rest (Immobilization) and avoidance of the stress to the knee i.e. weight bearing  

·       Ice pack:  Cover ice pack in cloth and put it over the shoulder for 15 minute each and give rest of 15 minute. Repeat it 3 to 5 times a day for 3 to 5 days. It is helpful in minor trauma or injury. Swollen and warmer to touch.

·       Heat pack: Hot water bag can be helpful. These are effective in Muscle sore and tense.

·        Keep the knee raised as much as possible to reduce the swelling.

·        Use pillow below the knee.

·       Do exercise to stretch the muscle in the front of your thigh called quadriceps and in the back of your thigh called hamstrings.

Prevention:

·       Avoid jerky movement at the knee joint.

·       Swimming can be very helpful.

·       Weight reduction is another very important measure to be adopted in order to reduce knee pain.

Treatment:

·       Medicine, NSAIDS like Ibuprofen or aceclofenac can be used to reduce pain and swelling. Acetaminophen can reduce pain only.

·       Injections: Injecting medications directly into your knee might help in certain situations. The two most common injections are corticosteroids and lubricants. 

·       Physical therapy: Sometimes physical therapy sessions to strengthen the muscles around the knee will make it more stable and help guarantee the best mechanical movements and further worsening of an injury.

·        Surgery: In some cases surgeries are required. Knee operations range from arthroscopic knee surgery to total knee replacement. Your physician will advise you the best modality of surgery.

·       Other therapies: Acupuncture has shown some relief of knee pain, especially in patients with osteoarthritis. Yoga is also another modality that can be helpful.