Left Knee Pain and Disc Herniation: Causes and Treatments

Left knee pain; herniated disc?

Hello Doctor, since last summer, I've been experiencing issues with my left knee.
I cannot bend my leg for long periods; otherwise, the area around my knee becomes very sore.
After bending it for a long time, when I try to straighten my leg, I feel something (not small, not a bone) moving in my knee, accompanied by severe pain.
Once, during class, I was in a cramped position and couldn't stretch my leg, which caused such intense pain that I almost fainted.
I also encounter similar problems when watching movies or on crowded buses.
Additionally, during sports, my left knee often feels particularly weak.
At its worst, even a slight squat causes pain in the knee area, making it impossible to squat.
I feel that this issue is affecting my flexibility; I find it difficult to straighten my leg and touch the ground with both hands, and even if I can, it's a struggle due to the pain.

I would like to know what this problem might be and how it can be treated.
I previously had an X-ray that showed some disc herniation, and recently I feel like the symptoms have worsened.
Sometimes, I experience significant soreness on both sides of my buttocks, as well as in my back and the sides of my waist, which feels like a sharp pain that prevents me from sleeping well.
Is there a way to completely cure this? Also, since I will be enlisting in the military next year, I have heard that disc herniation can be re-evaluated for physical fitness.
How should I go about this? Thank you.

aqun, 20~29 year old female. Ask Date: 2000/11/15

Dr. Lin Junliang reply Orthopedics

The user may have issues with the left patella (kneecap), which we refer to as patellofemoral pain syndrome.
It is recommended to visit an orthopedic clinic for further examination.
Additionally, lower back pain does not necessarily indicate a herniated disc.
Typically, the diagnosis of a herniated disc relies on clinical symptom assessment, spinal imaging, computed tomography (CT), or even magnetic resonance imaging (MRI).
If repositioning is required due to a herniated disc, please first visit a hospital for examination and obtain a military service diagnosis certificate (which requires personal identification, an ID card, and two 2-inch photos) before proceeding to the military service office.

Reply Date: 2000/11/15

More Info

Understanding left knee pain and disc herniation involves recognizing the interconnectedness of various musculoskeletal issues and their potential impact on overall mobility and quality of life. Based on your description, it seems you are experiencing significant discomfort in your left knee, particularly when bending or straightening it, along with a history of disc herniation. Let's break down the potential causes and treatments for your symptoms.

Causes of Left Knee Pain
1. Patellofemoral Pain Syndrome (PFPS): This condition is characterized by pain around the kneecap (patella) and is often exacerbated by activities that put stress on the knee, such as squatting, climbing stairs, or sitting for long periods. Symptoms include a feeling of instability or a "catching" sensation in the knee, which aligns with your description of feeling a hard area moving in your knee.

2. Meniscus Tear: The meniscus is a C-shaped cartilage that acts as a cushion between your thigh bone and shin bone. A tear can occur due to twisting motions or heavy lifting, leading to pain, swelling, and difficulty bending the knee.

3. Ligament Injuries: Injuries to the ligaments, such as the anterior cruciate ligament (ACL) or the posterior cruciate ligament (PCL), can cause pain and instability in the knee. These injuries often occur during sports or physical activities.

4. Osteoarthritis: This degenerative joint disease can lead to pain and stiffness in the knee, especially after prolonged periods of inactivity or after physical exertion.

5. Disc Herniation: While primarily affecting the lower back, a herniated disc can lead to referred pain in the legs, including the knee. This occurs when the herniated disc compresses nearby nerves, leading to pain, numbness, or weakness in the affected leg.

Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the knee, improve flexibility, and enhance overall function. A physical therapist can design a program tailored to your specific needs, focusing on exercises that strengthen the quadriceps and hamstrings while promoting proper knee alignment.

2. Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation. However, it’s essential to consult with a healthcare provider before starting any medication, especially if you have a history of gastrointestinal issues.

3. Activity Modification: Avoiding activities that exacerbate your knee pain is crucial. This may include limiting high-impact sports or exercises that require deep knee bending. Instead, consider low-impact activities such as swimming or cycling, which can help maintain fitness without stressing the knee.

4. Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation and provide temporary relief from pain. This option should be discussed with your healthcare provider to determine its appropriateness for your situation.

5. Surgery: If conservative treatments fail and your symptoms persist, surgical options may be considered, especially if there is a significant structural issue such as a meniscus tear or severe osteoarthritis.

Addressing Disc Herniation
Given your history of disc herniation, it’s crucial to manage this condition concurrently with your knee pain. Here are some strategies:
1. Core Strengthening: Strengthening the core muscles can provide better support for the spine and reduce the risk of further disc issues. Exercises that focus on the abdominal and back muscles can be beneficial.

2. Posture and Ergonomics: Maintaining proper posture while sitting, standing, and lifting can help alleviate pressure on the spine. Ergonomic adjustments in your workspace can also make a significant difference.

3. Regular Monitoring: Since you mentioned the possibility of re-evaluating your military fitness due to your disc condition, it’s advisable to consult with a spine specialist or orthopedic surgeon who can assess your current status and provide guidance on any necessary adjustments to your physical activity or military duties.

Conclusion
In summary, your left knee pain and history of disc herniation are likely interconnected, and addressing both issues holistically is essential for recovery. Engaging in physical therapy, modifying activities, and considering pain management strategies can significantly improve your symptoms. Additionally, consulting with healthcare professionals specializing in orthopedics and rehabilitation will provide you with a comprehensive treatment plan tailored to your needs. Remember, early intervention and consistent management are key to preventing further complications and enhancing your quality of life.

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