Chronic Knee Pain: Symptoms and Treatment Options

Knee stabbing pain (chronic condition)

In the past, I often experienced trauma to my knee, which has made my left knee extremely sensitive.
Even a slight bump causes intense pain, to the point where I would moan in agony.
Touching my knee also results in sharp pain, and squatting down is very painful as well.
The pain is not a dull ache in the bones but rather a radiating sharp pain that feels like it comes from within.
However, it gradually improves and becomes less painful, but I still cannot tolerate any impact or pressure; applying pressure at certain angles also causes sharp pain.
This cycle has been ongoing, and visually, my knee appears normal without any redness or swelling.
I have had this symptom since middle school, and it has persisted for a very long time.
I have consulted a doctor who suggested it might be chronic bursitis, and X-rays showed no significant issues with the bones.
1.
Does this symptom resemble bursitis?
2.
What are the main symptoms of bursitis, and if it is bursitis, how can it be treated? Thank you, doctor.

Lao Mao Bing Gao Zhong Sheng, 10~19 year old female. Ask Date: 2017/07/25

Dr. Li Yongheng reply Orthopedics

Hello, based on your symptoms, chronic bursitis is the most likely diagnosis.
It is important to avoid any impact to the affected area.
For acute severe pain, ice therapy should be applied, while for chronic mild pain, heat therapy is recommended.
If symptoms persist, a low-dose corticosteroid injection can be administered locally, as low-dose corticosteroids are generally safe for the body.
Extracorporeal shock wave therapy for soft tissue may also be considered, but it is not covered by insurance and will require out-of-pocket payment.
Wishing you a speedy recovery.

Reply Date: 2017/07/25

More Info

Chronic knee pain can be a debilitating condition that significantly affects daily activities and overall quality of life. Your description of the symptoms, including sharp, radiating pain with minimal impact and sensitivity to touch, suggests that you may be experiencing a condition related to the knee joint, such as bursitis or patellofemoral pain syndrome.

Understanding Your Symptoms
1. Bursitis: The knee has several bursae, which are small fluid-filled sacs that help reduce friction between tissues. Inflammation of these bursae, known as bursitis, can lead to pain and tenderness, especially when pressure is applied. Symptoms typically include localized pain, swelling, and increased sensitivity in the affected area. Given that your pain worsens with touch and pressure, this could be a plausible diagnosis.

2. Patellofemoral Pain Syndrome (PFPS): This condition is characterized by pain around the kneecap (patella) and can be exacerbated by activities such as squatting, climbing stairs, or sitting for prolonged periods. It often results from overuse, muscle imbalances, or biomechanical issues. The sharp, radiating pain you describe could align with PFPS, especially if you experience discomfort during specific movements.

3. Chronic Inflammation: Chronic inflammation in the knee joint, possibly due to repetitive stress or previous injuries, can lead to persistent pain. This inflammation may not always present with visible signs such as swelling or redness, which can make diagnosis challenging.

Treatment Options
1. Rest and Activity Modification: It is crucial to avoid activities that exacerbate your symptoms. This may include reducing high-impact exercises, avoiding prolonged sitting, and steering clear of movements that put pressure on the knee.

2. Physical Therapy: A physical therapist can design a personalized exercise program to strengthen the muscles around the knee, improve flexibility, and correct any biomechanical issues. This can help alleviate pain and prevent further injury.

3. Ice and Heat Therapy: Applying ice to the knee can help reduce inflammation and numb the pain, especially after activities that aggravate your symptoms. Heat therapy may also be beneficial for relaxing tight muscles and improving blood flow.

4. Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and reduce inflammation. However, it’s essential to consult with a healthcare provider before starting any medication.

5. Corticosteroid Injections: If conservative treatments fail, corticosteroid injections may provide relief by reducing inflammation in the affected area.

6. Surgical Options: In cases where conservative management does not yield results, surgical intervention may be considered. This could involve arthroscopy to clean out the joint or repair damaged tissues.

7. Alternative Therapies: Some patients find relief through acupuncture, massage therapy, or chiropractic care. These alternative treatments can complement traditional approaches and may help alleviate pain.

Conclusion
Given your long-standing symptoms and the impact on your daily life, it is essential to seek a comprehensive evaluation from an orthopedic specialist. They may recommend imaging studies, such as MRI, to assess the soft tissues around the knee and rule out any underlying conditions. Early intervention and a tailored treatment plan can significantly improve your symptoms and enhance your quality of life. Always remember to communicate openly with your healthcare provider about your symptoms and treatment preferences to find the best approach for your situation.

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