Knee Pain: Causes, Symptoms, and Treatment Options

Knee

Hello: Since I was young, I have experienced knee pain that extends to my calves, which worsens in the winter due to the cold and becomes more painful in the summer when exposed to fans or air conditioning.
It is especially severe at night when I sleep.
In the past, I could relieve the pain by placing heavy objects on my legs, but that no longer works, perhaps due to my age! I have seen a doctor who diagnosed me with congenital genu valgum (knock-knees).
If this is the case, I am unsure how to treat it, as I am unable to sleep at night due to the pain! Thank you!

Chen, 40~49 year old female. Ask Date: 2001/07/08

Dr. Lin Junliang reply Orthopedics

Patellar dislocation can initially be treated with rehabilitation therapy; if ineffective, surgical intervention may be considered.

Reply Date: 2001/07/08

More Info

Knee pain is a common issue that can arise from various causes, and understanding these causes, symptoms, and treatment options is essential for effective management. Based on your description, it seems you have been experiencing knee pain since childhood, which has now extended to your lower legs, particularly worsening in colder weather or when exposed to air conditioning. This chronic discomfort, especially at night, can significantly impact your quality of life.

Causes of Knee Pain
1. Congenital Conditions: You mentioned a diagnosis of congenital genu valgum (knock-knees) with lateral patellar dislocation. This condition can lead to misalignment of the knee joint, causing uneven wear on the cartilage and resulting in pain. The misalignment can also affect the surrounding muscles and ligaments, leading to additional discomfort.

2. Osteoarthritis: As we age, the cartilage that cushions the knee joint can wear down, leading to osteoarthritis. This condition is characterized by joint pain, stiffness, and swelling, particularly after periods of inactivity or excessive use.

3. Tendinitis: Inflammation of the tendons around the knee, such as patellar tendinitis, can cause pain, especially during activities that involve jumping or running.

4. Bursitis: Inflammation of the bursae (small fluid-filled sacs that cushion the knee joint) can lead to pain and swelling, particularly when bending or straightening the knee.

5. Injury: Previous injuries, such as ligament tears or meniscus injuries, can lead to chronic pain if not properly rehabilitated.

Symptoms
- Pain: This can be localized around the knee or radiate down to the lower leg.

- Stiffness: Especially after sitting or lying down for extended periods.

- Swelling: This may occur due to inflammation or fluid accumulation in the joint.

- Reduced Range of Motion: Difficulty in bending or straightening the knee fully.

- Instability: A feeling that the knee may give way during activities.

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 joint function. A physical therapist can tailor exercises to your specific needs, focusing on strengthening the quadriceps and hamstrings, which support the knee.

2. Medications: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen) can help reduce pain and inflammation. If pain persists, a healthcare provider may prescribe stronger medications or topical treatments.

3. Injections: Corticosteroid injections can provide temporary relief from inflammation. Hyaluronic acid injections may also be considered to lubricate the joint.

4. Lifestyle Modifications: Weight management is crucial, as excess weight can place additional stress on the knees. Low-impact exercises such as swimming or cycling can help maintain fitness without exacerbating knee pain.

5. Assistive Devices: Using knee braces or orthotic inserts can help stabilize the knee and improve alignment, reducing pain during activities.

6. Surgery: In severe cases, surgical options such as arthroscopy, osteotomy, or knee replacement may be considered, especially if conservative treatments fail to provide relief.

7. Alternative Therapies: Some individuals find relief through acupuncture, massage therapy, or chiropractic care. These methods can help alleviate pain and improve mobility.

Conclusion
Given your long-standing knee pain and its impact on your daily life, it is essential to consult with an orthopedic specialist who can provide a comprehensive evaluation and tailored treatment plan. They may recommend imaging studies, such as X-rays or MRI, to assess the condition of your knee joint and surrounding structures. Early intervention can help manage symptoms effectively and improve your quality of life. Remember, it is crucial to address both the symptoms and the underlying causes of your knee pain for long-term relief.

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