Which Specialist Should I See for Chronic Knee Pain?

For a long-standing chronic illness, it's unclear which specialty to consult?

Since experiencing severe knee pain while climbing stairs several years ago, I have had recurrent episodes.
Initially, my knee feels uncomfortable (it feels very tight while walking), followed by significant stiffness and swelling in my calf.
In the past two months, I have also developed pain from my knee to the lateral side of my hip (it feels similar to cramping).
Due to these symptoms, I cannot sit or stand for long periods, and I have been unable to maintain stable employment for years.
Whenever the discomfort becomes too severe, I have to resign, leading to ongoing financial difficulties.
I have seen orthopedic specialists multiple times (who all said there are no issues with the bones), and medications and physical therapy have not resolved the problem.
The symptoms have become quite severe recently, and I am feeling very down.
Which specialist should I consult? (Given the current severe pandemic situation, I would prefer not to visit the hospital frequently.
I kindly request guidance on which specialty to see directly, as I would like to avoid having to first visit a family medicine doctor.)

Xiao Ping, 30~39 year old female. Ask Date: 2021/02/23

Dr. Liao Yaopan reply Family Medicine

Hello, if the orthopedic consultation has confirmed that there are no issues, it is recommended to seek further evaluation from a rheumatologist.
Please note that online consultations are not equivalent to in-person visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2021/02/23

More Info

If you have been experiencing chronic knee pain for several years, especially after an incident like climbing stairs, it is understandable that you are feeling frustrated and concerned about your health. Given the symptoms you described—tightness in the knee, stiffness and swelling in the calf, and pain radiating from the knee to the side of the hip—it is crucial to find the right specialist who can address your issues effectively.

Based on your situation, I recommend that you see an orthopedic specialist who focuses on knee disorders. Orthopedic surgeons are trained to diagnose and treat a wide range of musculoskeletal issues, including chronic knee pain. Since you have already consulted with orthopedic doctors who indicated that there are no bone issues, it may be beneficial to seek out a specialist who has a particular interest in knee pain or sports medicine. These specialists often have more experience with soft tissue injuries, cartilage issues, and other non-bony causes of knee pain.

In addition to orthopedic specialists, you might also consider consulting a rheumatologist if there is a suspicion of an underlying inflammatory condition, such as arthritis. Rheumatologists specialize in autoimmune and inflammatory diseases that can affect the joints and may provide insights into chronic pain that is not solely related to structural issues.

Another option is to see a physiatrist (a specialist in physical medicine and rehabilitation). Physiatrists focus on restoring function and improving quality of life for patients with musculoskeletal issues. They can provide a comprehensive evaluation and may recommend a tailored rehabilitation program, including physical therapy, to help manage your symptoms.

If you are experiencing significant pain and discomfort that affects your daily life, it may also be worth considering a pain management specialist. These doctors focus on treating chronic pain through various methods, including medication management, physical therapy, and interventional procedures.

While it is understandable that you want to avoid frequent hospital visits, it is essential to find a specialist who can provide a thorough evaluation and appropriate treatment plan. If possible, try to gather any previous medical records, imaging studies, or treatment histories to share with the new specialist. This information will help them understand your condition better and tailor their approach to your needs.

In the meantime, consider engaging in gentle exercises that promote flexibility and strength without putting too much strain on your knee. Low-impact activities such as swimming or cycling can be beneficial. Additionally, using ice packs to reduce swelling and over-the-counter pain relievers (as advised by your healthcare provider) may help alleviate some discomfort.

Lastly, do not hesitate to express your concerns and frustrations to the specialist you choose. Open communication about your symptoms and their impact on your daily life is crucial for finding the right treatment plan. Remember, you deserve to find relief from your chronic pain and improve your quality of life.

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