Knee Pain: Causes, Symptoms, and Treatment Options

Knee problems?

Hello, doctor.
My condition has persisted for nearly two months.
I haven't engaged in any intense exercise; I only traveled abroad in May.
I wonder if walking too much could be the cause.
Initially, I felt a sensation in my left knee as if the ligaments were being stretched when kneeling, accompanied by sudden severe pain.
However, straightening my leg alleviated the pain.
After about a week, I began to experience similar sensations even when bending my leg, and it started only in my left knee.
Eventually, my right knee also began to feel tight in the joint.
Bending my knees causes pain and a feeling of weakness in the knees.
When walking, it feels like the cartilage in my knees is shifting, making it very uncomfortable.
It's not just walking that is uncomfortable; sometimes even standing is painful.
Additionally, I experience pain above the knee joint.
During this time, I also consulted a traditional Chinese medicine practitioner, but the results were minimal.
I saw specialists in rehabilitation and orthopedics, who suggested that it might be due to cartilage damage and knee joint instability.
They advised me to strengthen my quadriceps through exercises.
I have been consistently exercising for nearly half a month, but recently, I have been experiencing pain in my lower back, thighs, and knees while walking.
(I also have scoliosis; could this be a contributing factor?) I am truly unsure about what the problem is.
Could you please provide some insights? Thank you.

susanne, 20~29 year old female. Ask Date: 2005/08/23

Dr. Shi Guozheng reply Orthopedics

It could be an issue with the cartilage in the patella, or it may be due to improper alignment or instability of the knee.
It's important to consult another physician to determine the exact condition.
Quadriceps training may take three to six months to show results, so it is essential to continue the exercises for effectiveness.

Reply Date: 2005/08/23

More Info

Knee pain can be a complex issue, often stemming from various causes, and it can significantly affect one's quality of life. Based on your description, it seems that you are experiencing a combination of symptoms that may be related to soft tissue injuries, potential cartilage damage, and possibly underlying biomechanical issues.

Causes of Knee Pain
1. Soft Tissue Injuries: The sudden onset of pain when kneeling or bending the knee could indicate a strain or sprain of the ligaments or tendons around the knee. This is especially likely if you have engaged in activities that involve repetitive knee bending or prolonged periods of kneeling.

2. Cartilage Damage: The sensation of the knee feeling unstable or the cartilage "moving" could suggest issues with the meniscus or articular cartilage. Damage to these structures can lead to pain, swelling, and a feeling of instability.

3. Patellar Tracking Issues: If the patella (kneecap) does not move smoothly within its groove during knee flexion and extension, it can cause pain and discomfort. This can be exacerbated by weakness in the quadriceps muscles, which are crucial for stabilizing the knee.

4. Referred Pain: Given your history of scoliosis, it is possible that your spinal alignment could contribute to knee pain. The body often compensates for misalignments, which can lead to overuse or strain in certain areas, including the knees.

Symptoms to Monitor
- Pain Location: Note where the pain is most intense (e.g., front, sides, or back of the knee) as this can help in diagnosing the issue.

- Swelling and Stiffness: Persistent swelling or stiffness, especially after activity, can indicate inflammation or joint effusion.

- Instability: A feeling of the knee giving way or being unable to support weight can suggest ligamentous instability or meniscal tears.

Treatment Options
1. Rest and Activity Modification: Avoid activities that exacerbate your pain, such as kneeling or climbing stairs. Allowing time for recovery is crucial.

2. Physical Therapy: Since you have already been advised to strengthen your quadriceps, working with a physical therapist can help you develop a tailored exercise program that focuses on strengthening the muscles around the knee, improving flexibility, and enhancing overall stability.

3. Ice and Compression: Applying ice to the knee can help reduce inflammation and pain. Compression wraps can also provide support and reduce swelling.

4. Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. However, consult with a healthcare provider before starting any medication.

5. Injections: If conservative treatments fail, corticosteroid injections or hyaluronic acid injections may provide relief for inflammation and pain.

6. Surgical Options: In cases of significant cartilage damage or persistent instability, surgical interventions such as arthroscopy may be considered to repair or remove damaged tissue.

When to Seek Further Evaluation
If your symptoms persist despite conservative management, or if you experience increased swelling, significant pain, or a loss of function, it is essential to follow up with an orthopedic specialist. Advanced imaging studies, such as MRI, may be necessary to assess the internal structures of the knee more thoroughly.

Conclusion
Knee pain can arise from various factors, including soft tissue injuries, cartilage damage, and biomechanical issues. A comprehensive approach that includes rest, physical therapy, and possibly medical interventions can help alleviate your symptoms. Given your history of scoliosis, it may also be beneficial to address any underlying spinal issues that could be contributing to your knee pain. Always consult with healthcare professionals for personalized advice and treatment options tailored to your specific condition.

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