Knee Sensory Loss: Causes and Treatment Options

Diminished sensation in the anterior aspect of the knee?

Hello, doctor.
I have been doing aerial yoga once a week and occasionally engaging in light aerobic exercises without any impact or falls that could injure my knees.
One day, I started to feel a tingling sensation in my knee, similar to being numbed, and it felt like a lump when I touched it, but I could walk normally.
Later, I began to experience an electric shock-like sensation when straightening or bending my knee, as if it were stuck with tape.
This sensation disappeared after about two weeks, leaving only a sensory issue in the front of my knee.
I do not experience pain while walking or exercising, but occasionally I feel a deep ache that lasts only a few minutes, and there is some odd feeling when my knee bears weight.
I have been reducing the stress on my knee.

Reflecting on the day before the symptoms began, I recall a yoga pose where I suddenly felt a sharp pain in my knee when lifting my leg, and the next day, I started experiencing numbness and subsequent symptoms.
It has been about three months now; the electric sensation has disappeared, and I can move my knee freely, but the numbness and the feeling of being numbed still persist.

I consulted a rehabilitation specialist; the first one suggested lumbar spine compression and provided lumbar traction therapy, but it didn't seem effective.
The second specialist noted some swelling in my knee, and an ultrasound indicated a ligament injury.
The doctor also found tenderness when pressing on the inner side of my knee (the same area on my right knee does not have this issue).
I am currently undergoing treatment for my knee and would like to ask if the numbness requires a consultation with a neurologist.
I am unsure whether the lumbar spine compression or the ligament inflammation is causing the sensory insensitivity in the front of my knee, and I am concerned that three months might affect nerve recovery.
Thank you!

Cao Xiaojie, 20~29 year old female. Ask Date: 2023/06/08

Dr. Jiang Junyi reply Neurology

Dear Ms.
Tsao,
Your symptoms of "electric shock sensation have disappeared, and your knee can move freely, but the feeling of numbness and the desire for anesthesia still persist." It seems that the nerves are gradually healing.
I recommend increasing your intake of B vitamins and remind you to stand up every half hour to perform stretching exercises to avoid nerve compression and muscle tightness, which could exacerbate your symptoms.
It is advisable to visit a neurology outpatient clinic for follow-up examinations, preferably with a physician specializing in peripheral nerves, as they have more experience with electromyography testing.
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health, peace, and happiness.
Dr.
Jiang Jun-Yi, Neurology Department, Taoyuan Hospital

Reply Date: 2023/06/08

More Info

Understanding knee sensory loss can be complex, as it may arise from various underlying causes, including nerve compression, ligament injuries, or even referred pain from other areas such as the lumbar spine. Based on your description, it seems that your symptoms began following a specific yoga movement that may have caused a sudden strain or injury to your knee.

Possible Causes of Knee Sensory Loss
1. Nerve Compression: The sensation of numbness or a "pins and needles" feeling in the knee could indicate nerve compression. This can occur due to issues in the lumbar spine, such as a herniated disc or spinal stenosis, which may compress the nerves that innervate the knee.
2. Ligament Injury: The ultrasound findings of ligament injury could also contribute to altered sensations in the knee. Ligaments play a crucial role in stabilizing the joint, and any damage can lead to changes in proprioception (the sense of joint position) and sensory feedback from the knee.

3. Inflammation: Inflammation in the knee joint, whether from a ligament injury or synovitis, can lead to swelling and pressure on surrounding nerves, potentially causing sensory changes.

4. Referred Pain: Sometimes, pain or sensory changes in the knee can be referred from other areas, such as the hip or lower back. This is particularly relevant if there is an underlying issue in the lumbar spine.

Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the knee, improve stability, and potentially alleviate symptoms. A physical therapist can also provide exercises to improve proprioception and balance.

2. Pain Management: If you experience discomfort, non-steroidal anti-inflammatory drugs (NSAIDs) can be effective, provided you do not have contraindications. If NSAIDs are not suitable, other pain management strategies, such as ice therapy or topical analgesics, may be beneficial.

3. Neurological Evaluation: Given your ongoing sensory issues, consulting a neurologist may be prudent. They can perform specific tests to evaluate nerve function and determine if there is any significant nerve compression or damage that requires intervention.

4. Imaging Studies: If not already done, further imaging studies such as an MRI of the lumbar spine may be warranted to assess for any nerve compression that could be contributing to your symptoms.

5. Activity Modification: It’s wise to continue to modify your activities to avoid exacerbating your symptoms. Gradually reintroducing activities while monitoring your symptoms can help you gauge what movements are safe.

Prognosis
The prognosis for sensory loss in the knee largely depends on the underlying cause. If it is due to a temporary issue such as inflammation or mild nerve compression, symptoms may improve with conservative management. However, if there is significant nerve damage or structural issues, recovery may take longer and could require more intensive treatment.

Conclusion
In summary, your symptoms of knee sensory loss could stem from a combination of factors, including potential nerve compression and ligament injury. It is essential to continue working with your healthcare providers, including physical therapists and possibly neurologists, to address these issues comprehensively. Early intervention and appropriate management can significantly improve your outcomes and help you return to your regular activities, including yoga and other forms of exercise.

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