Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

Knee pain is a common phenomenon that plagues most of the people irrespective of their age. It can be the outcome of a torn cartilage or a ruptured ligament. Medical complications, such as infections, gout or arthritis (painful inflammation and stiffness of the joints) can also give way to knee pain. Minor knee pain can be eased by self-care remedies such as physical therapy or by putting on knee braces. However, few complications might demand surgical repair. Pain can be managed by the pain management specialists.

Tips to manage knee pain

1. Medications such as naproxen, ibuprofen and acetaminophen can be administered to help remedy knee pain.
2. You can seek relief by massaging your knees with ointments constituting of a number of agents such as capsaicin or lidocaine.
3. Keep away from your usual chores to prevent repetitive strains on the knees, thus, allowing the injury to heal as well as to stay safe from further damage.
4. Applying an ice pack in a towel can ease the inflammation and pain. But do not extend its usage for more than 20 minutes because that might harm the skin and nerves.
5. Compression bandages can inhibit fluid accumulation in the damaged tissues aiding knee alignment stability. Ensure that it is tight enough to render support to your knees without actually obstructing blood circulation.
6. To pacify the swelling, try resting your sore leg on a pillow (the idea here is to keep the affected leg elevated to reduce further pain).
7. Shed off your extra pounds as being overweight increases chances of other disorders such as osteoarthritis.
8. Go for regular work outs to enhance and maintain the flexibility of your muscles as excessively weak or abnormally tight muscles can contribute to injuries. Be smart while choosing your method of exercise based on the condition you are suffering from.

Knee Pain - 8 Effective Ways to Manage it

If you are the on the wrong side of your fifties, then you will know the importance of regular checkups to the orthopedist. Aging related physical changes such as greying hair and wrinkles are a few things that you can cope with easily, however, when it comes to the health of your bones and muscles, you need to be very careful. You need to be particular about being active, as it can help reverse or reduce the risks of most of the bone disorders that you may suffer from. Ageing affects both the muscles and bones, but not always in the same manner. So, it is important that you understand how each is affected by ageing.

Changes in your muscles due to aging
As you age, your muscles tend to lose strength and size. This can make you prone to fatigue, weakness and a decrease in your tolerance levels to exercise. The various factors that play a role in this are:

Modifications in your nervous system can impair the ability of the muscle to contract.
The muscle fibers in the body reduce both in size and number.
The replacement rate of the muscle tissue in the body falls.
Changes in your bones due to aging
Ageing impacts the structure of the bone and leads to a loss of the bone tissue. Aging causes low bone mass, thus rendering them weak. This means a simple fall can have a serious effect on your bones.
The various causes that can bring about these changes are:

Loss of vital minerals such as calcium
Being physically inactive
Undergoing hormonal changes in the body such as menopause, wherein the body loses minerals from the bone tissues. In case of men, progressive decline of sex hormones can lead to changes in the bone structure.
Common conditions that affect your musculoskeletal system in your old age:

Osteoporosis: This disorder results from a loss of bone density resulting in fragile bones. This makes the bones highly susceptible to fractures and breakage.
Rheumatoid arthritis: An autoimmune disorder that usually develops after the age of 40; here, the immune system of the body attacks the body tissues, thus leading to inflammation in your joints.
Osteoarthritis: It is a disorder of the joints which is caused by deterioration of the cartilage that cushions the joints.

Old Age - How It Impacts Your Muscles & Bones?

Knee pain is one of the most common and painful ailments that can limit mobility. Injuries can result in cartilage or meniscal tears or sprains too. Obesity is another reason because of which knee pain is on the rise. Also, regular wear and tear of ligaments and tendons around the knees due to old age is another cause. These days, with reduced physical activities and sedentary lifestyles, the rate at which knees are wearing out has also become accelerated. Whatever the reason, a correct diagnosis followed by prompt treatment can help. Over the years, physiotherapy has been playing an important role in treating knee injuries. Whether to supplement the various drugs to reduce pain and inflammation or to avoid surgery, physiotherapy has helped many and its popularity is growing every day. Here are some ways that physiotherapy can help reduce pain.

Improve flexibility of tendons: The knee cap is an area where there are lot of tendons and ligaments, coordinating to enable movement. Careful exercising can ensure that the flexibility of tendons and ligaments is improved, thereby making your knee movement easier and less painful.
Improves blood supply: As we all know, proper movement requires good blood supply. Exercising with special focus on the knee ensures that blood supply is improved, and thereby the supporting ligaments and tendons function optimally.
Enhances the knee cap function: The knee cap is that portion which joins your thigh bone to your calf bones. This is prone to slip out of place, especially with arthritis and injuries. This can be painful and limit movement to a great degree. Focused exercises aimed at improving knee cap function will ensure that the knee cap has a wider range of function, and does not slip out of its socket easily.
Reduce rigidity: Once you start physiotherapy, you will feel your knees getting more flexible. The rigidity that had set in as a result of injuries and/or old age will also reduce over a period of time.
Slow down the wear and tear: When you start physiotherapy after knee damage, continuing the exercise routine, of course with expert guidance, can reduce the pace at which further damage might happen. A word of caution though. Be sure to consult an experienced physiotherapist before you begin. Exercising in a bad manner can do equal or more harm than the original injury or old age itself.

Knee Pain and Physiotherapy

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

Knee pain is something that can affect anyone - irrespective of their age. While sometimes it may be of minor importance - and can easily be handled by self-care, often, lingering pain is a manifestation of some other serious underlying problem, such as arthritis. In this case, it is imperative that you consult a doctor and take appropriate measures to combat it.

Causes :

Arthritis: The chief cause of lingering knee pain, arthritis itself can be of a number of types:
 Osteoarthritis, which is a result of deterioration of cartilages due to wear and tear
 Rheumatoid Arthritis, an inflammatory chronic disorder
 Septic Arthritis, causing pain, swelling and redness.
 Gout caused due to the development of uric acid crystals in the joints
Fractures: These are caused by the breaking up of the kneecap due to falls or collisions.
ACL Injuries: Caused due to the tearing of the anterior cruciate ligament (that connects the femur and the shinbone). Especially common in sportspersons such as footballers or basketball players.
Meniscus tears: The meniscus or the rubber-like cartilage (that acts as a shock absorber) can be torn by sudden jerks or excess pressure.

Symptoms:The major symptoms of knee pain include weakness, redness, instability, stiffness or the inability to properly straighten or move the leg. Often, a deformity is also visible, such as a bone sticking out of the leg - in which case it is advisable to consult a doctor immediately.

Possible risks :Factors which include the odds of being inflicted by knee pain and cause serious complications include :
Being overweight: This exponentially increases the stress or pressure that is applied on the knee joints - even in doing mundane tasks like walking up and down stairs.
Excessive physical activity: Some activities, such as sports apply excess stress on the knees as compared to other tasks.
Loss of muscle flexibility: Tightness or weakness in muscles causes increasing number of problems in the knees.

All About Knee Pain

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