Dr. M K Majezine

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.

Fibromyalgia is a disorder that causes widespread body pain along with sleep deficits, memory loss, mood problems and fatigue. Symptoms may be triggered after a surgery, physical trauma, infection, or stress. Women are much more vulnerable to this disease than men. Many people affected with fibromyalgia may have suffered from headaches, backaches, depression, anxiety, tension, temporomandibular joint 
disorders and irritable bowel syndrome. Most of these patients have undergone multiple consultation with various doctors and undergone many tests, but no diagnosis could be made. These patients are often ignored by doctors and family members as always "complaining of pain".

Symptoms of Fibromyalgia:

1. Extensive Pain: Pain related to fibromyalgia is often depicted as a dull pain that lasts for at least three months. Pain can involve any body part like back,neck, chest, arms, legs. Patients have pain in multiple areas of body and painful areas change over time.
2. Fatigue: Patients afflicted with this disorder feel tired even after sleep. Such people are reported to sleep for longer hours than normal people, but their sleep often gets disrupted due to sleep apnoea and restless leg syndrome.
3. Cognitive Difficulties: These patients find it difficult to concentrate at work and also suffer from memory deficits in daily activities.
4. Other Symptoms: These patients may also have symptoms like burning urination, urgency of urination, numbness,loss of appetite, tingling sensation,diarrhoea, constipation, tinnitus, depression etc

Diagnosis of fibromyalgia:
There are no specific test to diagnose fibromyalgia. Diagnosis is made by a doctor specialised in Pain Medicine using clinical methods based on symptoms and examination. Blood tests like Haemogram, Thyroid function test, RA Factor, ESR are done to rule out other diseases which can cause similar symptoms. 

Treatment of Fibromyalgia:

1. First step in treating these patients is to accept their problem and discuss with patient and family members regarding the presence of such disease entity.
2. Lifestyle changes like active involvement in cardiovascular exercises, swimming, yoga, meditation are important to control symptoms.
3. Conventional painkillers do not work in these patients. They requires special medications prescribed by a Pain Specialist for control of symptoms.
4. Counselling of patient is beneficial for associated depression.