Persistent Knee Pain: Causes and When to Seek Help

Knee pain...??

I often experience knee pain after walking for about 3 to 4 hours.
This has been happening since I was 12 years old, and it has occurred intermittently since then.
Sometimes the pain comes on suddenly, and it feels like my knee is being pulled apart.
Other times, it happens after walking for too long, but the sensation is always the same—it feels like my knee is being stretched.
I initially thought it was due to growth, but after so many years, my height has remained only 158 cm.
I have researched and found that being overweight can contribute to knee pain, but I only weigh 47 kg.
I would like to ask the doctor what this condition might be.
I have considered seeing a doctor, but my mother says it's not a serious issue and that it's unnecessary.
Is that true? Thank you.

Xiao Ai, 10~19 year old female. Ask Date: 2003/11/28

Dr. Chen Xingyuan reply Orthopedics

Knee Pain
Dear Netizen,
There are many causes of knee pain, including issues related to the joints, bones, ligaments, menisci, and muscles.
If the pain occurs only after walking for 3 to 4 hours, it is generally unlikely that there is a significant problem with the knee joint itself.
Overuse or poor posture, such as wearing high heels, lifting heavy objects, or excessive stair climbing, may be the primary factors to consider.
However, I still recommend that you visit an orthopedic clinic for a detailed examination.

Wishing you health and happiness!
Sincerely,
Dr.
Chen

Reply Date: 2003/11/28

More Info

Persistent knee pain, especially when it occurs after prolonged walking or sudden movements, can be a sign of various underlying issues. Given your history of knee pain since the age of 12, it is essential to consider both structural and functional causes that may be contributing to your discomfort.

Possible Causes of Knee Pain
1. Patellofemoral Pain Syndrome (PFPS): This condition is common among adolescents and young adults, especially those who are active in sports or physical activities. It is characterized by pain around the kneecap (patella) and can be exacerbated by activities such as walking, running, or climbing stairs. The sensation of the knee "being pulled" or "opening up" could be related to the alignment of the patella during movement.

2. Chondromalacia Patella: This condition involves the softening and breakdown of the cartilage on the underside of the kneecap. It can lead to pain and a feeling of instability in the knee, particularly during activities that put stress on the joint.

3. Meniscus Tears: The meniscus is a cartilage structure that acts as a cushion between the thigh bone and shin bone. A tear can occur due to injury or degeneration over time, leading to pain, swelling, and a feeling of the knee locking or giving way.

4. Ligament Injuries: Injuries to the ligaments in the knee, such as the anterior cruciate ligament (ACL) or medial collateral ligament (MCL), can cause pain and instability. These injuries often occur during sports or sudden changes in direction.

5. Osteoarthritis: Although more common in older adults, early signs of osteoarthritis can develop in younger individuals, especially if there is a history of joint injuries. This degenerative condition can lead to pain, stiffness, and swelling in the knee.

6. Overuse Injuries: Repetitive stress on the knee joint from activities such as running or jumping can lead to overuse injuries, resulting in pain and inflammation.

When to Seek Medical Help
While your mother may believe that your condition is not severe, it is crucial to listen to your body. Persistent knee pain, especially if it has been ongoing for several years, warrants a medical evaluation. Here are some indicators that you should seek help:
- Persistent Pain: If the pain continues to interfere with your daily activities or worsens over time, it is essential to consult a healthcare professional.

- Swelling or Inflammation: If you notice swelling around the knee joint or if the knee feels warm to the touch, this could indicate an underlying issue that needs attention.

- Instability: If you experience a sensation of the knee giving way or locking, this could suggest a more serious injury that requires evaluation.

- Difficulty with Movement: If you find it challenging to walk, climb stairs, or perform other activities due to pain, it is time to seek medical advice.

Recommended Actions
1. Consult a Healthcare Professional: A visit to an orthopedic specialist or a physical therapist can help determine the exact cause of your knee pain. They may recommend imaging studies, such as X-rays or MRI, to assess the condition of your knee joint.

2. Physical Therapy: Engaging in a physical therapy program can help strengthen the muscles around the knee, improve flexibility, and address any biomechanical issues contributing to your pain.

3. Weight Management: While your weight seems to be within a healthy range, maintaining a balanced diet and engaging in low-impact exercises can help reduce stress on the knee joint.

4. Activity Modification: Consider modifying your activities to avoid those that exacerbate your knee pain. Low-impact exercises, such as swimming or cycling, may be beneficial.

5. Pain Management: Over-the-counter pain relief medications, such as NSAIDs, can help manage pain and inflammation. However, consult with a healthcare provider before starting any medication.

In conclusion, while your knee pain may not seem severe, it is essential to take it seriously, especially given its persistence over the years. Seeking medical advice can provide you with a clearer understanding of your condition and appropriate treatment options to improve your quality of life.

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