Struggling with Knee Pain: Seeking Solutions for Weakness and Discomfort

Inability to bear weight on the knee?

I have been experiencing knee pain in both legs for two years.
I have consulted many doctors (orthopedics, rehabilitation, rheumatology, and neurology) at major hospitals.
Some doctors indicated that I have patellar malalignment, while others said it is not severe.
Rheumatology tests came back normal, and there is no significant degeneration.
Elevating my legs while sitting does not provide relief, and taking anti-inflammatory medication has not helped either.
A physical therapist suggested core muscle training, but it caused pain in my lower back.
After multiple consultations, I found that doctors, based on X-rays and blood test results, determined that there were no significant abnormalities and subsequently did not provide further attention.
Despite seeking help multiple times, my knees still cannot bear weight, making it difficult to climb stairs, walk uphill, squat, kneel, or sit with my legs straight for extended periods.
I cannot stand for long, which causes significant inconvenience and suffering in my daily life.
I hope to receive assistance from the physician.
Thank you.

007, 50~59 year old female. Ask Date: 2017/05/14

Dr. Shi Guozheng reply Orthopedics

It could be a spinal issue compressing the nerves, leading to weakness in both knees.
Typically, if it were degenerative arthritis of the knee, there would usually be pain and some degenerative changes in the knee joint.
Medication treatment can also provide improvement.
If symptoms persist, it is advisable to consult a physician for an examination to check for any spinal issues.
If there are no problems with the spine, you can continue treatment for osteoarthritis of the knee, considering options such as hyaluronic acid injections or autologous platelet therapy.

Reply Date: 2017/05/14

More Info

Knee pain can be a complex issue, especially when it persists for an extended period, as you have described. It is understandable that after consulting multiple specialists without finding a definitive solution, you may feel frustrated and hopeless. Based on your description, it seems that you have undergone various evaluations, including X-rays and blood tests, which have not revealed any significant abnormalities. However, the ongoing pain and functional limitations you are experiencing are very real and warrant further exploration.

First, let's address the potential causes of your knee pain. Patellar malalignment, such as patellar tilt or patellar tracking issues, can lead to discomfort and functional limitations. While some doctors may have downplayed the severity of your patellar malalignment, it can still contribute to pain, especially if the surrounding muscles, tendons, and ligaments are not functioning optimally. Weakness in the quadriceps, hamstrings, and hip muscles can exacerbate these issues, leading to further discomfort and instability.

Given that you have experienced pain while performing core strengthening exercises, it may be beneficial to reassess your rehabilitation approach. Core stability is essential for overall body mechanics, but if you are experiencing pain in your lower back while attempting these exercises, it may indicate that your form needs adjustment or that you may need to start with gentler exercises. A physical therapist can help tailor a program that focuses on strengthening the muscles around your knee without exacerbating your back pain. This may include low-impact exercises, such as swimming or cycling, which can help build strength without putting undue stress on your joints.

In addition to strengthening exercises, consider incorporating flexibility and mobility work into your routine. Tight muscles around the hips, quadriceps, and hamstrings can contribute to knee pain. Stretching these muscle groups regularly may help alleviate some discomfort and improve your range of motion. Gentle yoga or Pilates classes can also be beneficial for improving flexibility and core strength while being mindful of your knee and back.

Another aspect to consider is the use of supportive devices. A knee brace or orthotic inserts may provide additional stability and support, especially during activities that require more knee function, such as climbing stairs or walking on uneven surfaces. However, it is essential to choose the right type of support, as improper use can lead to further issues.

If conservative measures do not yield improvement, you may want to discuss the possibility of imaging studies beyond X-rays, such as an MRI, with your physician. An MRI can provide a more detailed view of the soft tissues around the knee, including cartilage, ligaments, and tendons, which may reveal underlying issues that X-rays cannot detect.

Lastly, consider the psychological aspect of chronic pain. The frustration and limitations you are experiencing can lead to feelings of helplessness and anxiety. Engaging in mindfulness practices, such as meditation or cognitive behavioral therapy, can help you cope with the emotional toll of chronic pain and improve your overall well-being.

In summary, while it may feel discouraging to have seen multiple specialists without a clear resolution, there are still avenues to explore. A comprehensive approach that includes targeted physical therapy, flexibility training, supportive devices, and possibly further imaging studies may help you find relief. Additionally, addressing the psychological aspects of chronic pain can be beneficial. It is crucial to advocate for yourself and continue seeking solutions until you find a treatment plan that works for you.

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