Pain is a common knee problem that can originate in any of the bony structures compromising the knee joint (femur, tibia, fibula), the kneecap (patella), or the ligaments, tendons, and cartilage (meniscus) of the knee. 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). Knee pain can affect people of all ages.
Causes
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 a tear 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 may 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 and cyclists 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 have hip or foot pain, may change the way 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 cause knee pain.
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. Septic arthritis often occurs with a fever, and there’s usually no trauma before the onset of pain. Septic arthritis can quickly cause extensive damage to the knee cartilage. If you have knee pain with any of these symptoms, see your doctor right away.
Other problems
Patellofemoral pain syndrome is a general term that refers to pain arising between the kneecap (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.
Symptoms of knee pain
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
Risk factors
A number of factors can increase your risk of having knee problems, including:
- Excess weight: Being overweight or obese increases stress on the knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
- Lack of muscle flexibility or strength: A lack of strength and flexibility can increase the risk of knee injuries. Strong muscles help to stabilize and protect your joints, and muscle flexibility can help to achieve full range of motion.
- Certain sports or occupations: Some sports put greater stress on the knees than do others. Alpine skiing with its rigid ski boots and potential for falls, basketball’s jumps and pivots, and the repeated pounding the knees take when you run or jog all increase the risk of knee injury. Jobs that require repetitive stress on the knees such as construction or farming also can increase the risk.
- Previous injury: Having a previous knee injury makes it more likely that injure the knee again.
Diagnosis
During the physical exam, the doctor is likely to:
- Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
- Check to see how far you can move your lower leg in different directions
- Push on or pull the joint to evaluate the integrity of the structures in your knee
Imaging tests
In some cases, your doctor might suggest tests such as:
- X-ray: The doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.
- Computerized tomography (CT) scan: CT scanners combine X-rays taken from many different angles, to create cross-sectional images of the inside of the body. CT scans can help diagnose bone problems and subtle fractures. A special kind of CT scan can accurately identify gout even when the joint is not inflamed.
- Ultrasound: This technology uses sound waves to produce real-time images of the soft tissue structures within and around your knee. The doctor may want to move the knee into different positions during the ultrasound to check for specific problems.
- Magnetic resonance imaging (MRI): An MRI uses radio waves and a powerful magnet to create 3D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.
Lab tests
If the doctor suspects an infection or inflammation, you’re likely to have blood tests and sometimes a procedure called arthrocentesis, in which a small amount of fluid is removed from within the knee joint with a needle and sent to a laboratory for analysis.
Homeopathic management
Knee pain can be treated wonderfully well with medicines, which are natural and therefore, safe for use. Natural medicines are helpful in both acute and chronic knee pain. They are safe for use among all age groups, without any risk of toxicity. They help in relieving the pain in the knee and the accompanying symptoms such as swelling, tenderness and stiffness. The aim of homeopathy is not only to remove the symptom of knee pain but to cure its underlying cause.
As far as therapeutic medication is concerned, several well-proved homeopathic medicines are available for knee pain that can be selected on the basis of cause, location, sensation, modalities and extension of the knee pain. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person.
Homeopathic medicines
Bryonia Alba
Bryonia is another one of the most wonderful medicines for knee pain from bursitis. It has shown great results when knee pain, accompanied by swelling, worsens from the smallest movement. Absolute rest brings relief from pain.
Rhus tox
Rhus Tox is one of the best medicines for knee pain with stiffness. The pain and stiffness of the knees get better with walking. It is indicated when knee pain comes with the symptoms of severe pain in damp weather, intense pain after initial movement which tends to gets better in continuous motion.
Colchium
Colchicum is well indicated when acute gouty pain in the knees appears with marked swelling and heat. The knee is very sensitive to touch and the slightest touch causes unbearable pain. Movement of the knee worsens the pain in such cases.
Silicea
This preparation is useful in curing knee pain which retains the sensation of being tightly bound during all times.
Calcarea Carb
The remedy is best suited when the knee pain gets worse on rising from a seat and walking. Persons who need to be prescribed Calcarea Carb are usually overweight.
Ruta
It is one of the most helpful medicines for knee pain when the pain worsens on climbing up and down the stairs. Pressure over the knee may provide momentary relief.
Causticum
It is indicated when pain in the knee is accompanied by marked stiffness and cracking (sound) in knee joint.
Salicylic Acid
It is considered for acute arthritic knee pain. Where the knee is highly inflamed, painful and may be accompanied by high fever, Salicylic Acid is the most reliable of medicines for knee pain to take. The slightest touch or movement of the knee will worsen the pain in such instances.
Symphytum
It is prominently used for knee pain from fractured knee joint. Symphytum, commonly known as Knit Bone, helps promote the union of fractured bones and decreases knee pain arising from the fracture, making it one of the most reliable medicines for knee pain. It helps by promoting callus formation required to re-unite the bone.
Benzoic acid
It is considered in knee pain from gout when gouty nodes are formed over the knee joint. The person experiences pain and cracking sound in knee joint on movement. Tearing and stitching pain is felt in the knees along with swelling. The pain gets worse at night. Benzoic acid has proved the most effective medicines for knee pain in such cases and resulted in complete healing and cure.
Apis Mellifica
It offers much help when the main complaint is knee pain with marked swelling. The slightest touch and pressure over the knee worsen the pain.
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