Knee Pain: Causes, Treatment, and When to See a Doctor

Knee issues

Hello Doctor: I would like to ask about the follow-up to my previous question: https://adoctor.tw/article/165337 [email protected].
My left knee feels best in the morning, but it becomes uncomfortable in the evening, with a slight, vague pain.
I'm not sure if this is due to being active throughout the day.
According to the doctor's assessment, if it is tendonitis, should I keep my leg straight while resting, or is it sufficient to sit with my leg at a 90-degree angle? Is heat therapy necessary? If so, how long should I apply it? Additionally, I've noticed that sometimes there is a specific spot that feels uncomfortable, but after a couple of days, that spot seems to move, although it remains in the area just above the knee.
On February 9, after taking a shower, I felt a slight tingling sensation on the surface of my left calf, but it didn't last long.
How long should I wait before seeing a doctor if my knee doesn't improve? Since there are no obvious changes in appearance and the pain isn't severe, I'm unsure if a clinic visit would lead to a diagnosis.
I need to start working after the New Year, which will require a lot of walking, and I'm a bit concerned.

Xiao Mei, 20~29 year old female. Ask Date: 2021/02/09

Dr. Shi Guozheng reply Orthopedics

It could be tendinitis.
If the pain improves after resting for a few days, then it's not a concern.
However, if it doesn't get better, you should consult a physician.

Reply Date: 2021/02/09

More Info

Knee pain can be a complex issue, often stemming from various causes such as injuries, overuse, or underlying medical conditions. Understanding the nature of your knee pain is crucial for effective treatment and management. Based on the information provided, it seems you are experiencing discomfort primarily in your left knee, which worsens in the evening and after a day of activity. This could indicate a few potential issues, including tendonitis, patellofemoral pain syndrome, or even early signs of osteoarthritis.

Causes of Knee Pain
1. Tendonitis: This is an inflammation of the tendons around the knee, often caused by overuse or repetitive strain. Symptoms typically include pain during movement and tenderness around the affected area.

2. Patellofemoral Pain Syndrome: Often referred to as "runner's knee," this condition can cause pain around the kneecap, especially during activities that put stress on the knee, such as climbing stairs or sitting for long periods.

3. Osteoarthritis: This degenerative joint disease can lead to pain and stiffness in the knee, particularly after prolonged activity or at the end of the day.

4. Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion the knee joint, can also lead to pain and discomfort.

Treatment and Management
1. Rest and Activity Modification: It's essential to give your knee a break, especially if you notice that certain activities exacerbate your pain. Avoid high-impact activities and consider low-impact exercises like swimming or cycling.

2. Ice and Heat Therapy: Applying ice to the knee can help reduce inflammation and numb the pain, especially after activity. Heat can be beneficial for relaxing and loosening tissues and stimulating blood flow. You can alternate between ice and heat, applying each for about 15-20 minutes.

3. Stretching and Strengthening Exercises: Gentle stretching can help maintain flexibility, while strengthening exercises can support the knee joint. Focus on the quadriceps, hamstrings, and calf muscles. However, consult a physical therapist for a tailored exercise program.

4. Knee Positioning: When resting, it’s generally recommended to keep your leg straight to avoid putting additional strain on the knee. Sitting with your knee at a 90-degree angle is acceptable, but ensure you change positions frequently to avoid stiffness.

5. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain and reduce inflammation. However, consult your doctor before starting any medication.

When to See a Doctor
If your knee pain persists for more than a few weeks, worsens, or is accompanied by swelling, redness, or significant instability, it’s advisable to seek medical attention. A healthcare professional can perform a thorough examination, possibly including imaging studies like X-rays or MRIs, to determine the underlying cause of your pain.

Conclusion
Knee pain can significantly impact your daily activities, especially if you need to be mobile for work. While self-care measures can be effective, it's crucial to monitor your symptoms closely. If you notice any new symptoms, such as numbness in your calf or persistent pain, don't hesitate to consult a healthcare provider. Early intervention can prevent further complications and help you return to your normal activities more quickly. Remember, your health is paramount, and addressing these concerns proactively is the best approach.

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