Knee Pain: When to Seek Further Medical Evaluation

Joint pain

Hello, I have been experiencing numbness and pain in the ligament below my right knee joint for 2 weeks.
It doesn't hurt when lying down, but sitting causes pain due to the pulling of the ligament below the knee, making it impossible for me to drive (after driving, my entire right leg becomes extremely painful and numb).
I can walk, but riding a bicycle is very painful.
After enduring it for a week, I visited Tzu Chi Hospital twice starting from March 6.
The doctor mentioned it is a tendon issue and advised me to rest and apply heat, prescribing Voltaren and a topical pain relief ointment.
However, there has been no improvement in the numbness and pain so far.
Should I consider going to a larger hospital for an MRI to check for any abnormalities in the ligaments, or do you have any other recommendations? Thank you!

han, 40~49 year old female. Ask Date: 2006/03/11

Dr. Shi Guozheng reply Orthopedics

The pain in the ligament below the right knee is likely due to the patellar ligament.
The pain during stretching may be caused by inflammation.
The treatment is relatively straightforward, which involves sufficient rest and medication to alleviate the symptoms.
Consulting another physician is an option, but whether an MRI is necessary will depend on the physician's examination and assessment of the situation.

Reply Date: 2006/03/11

More Info

Knee pain, especially when associated with specific symptoms such as numbness and persistent discomfort, can be a complex issue that warrants careful evaluation and management. Based on your description, it seems that you have been experiencing significant pain and numbness in the area below your right knee joint for two weeks. The fact that the pain is exacerbated by certain activities, such as driving and cycling, but not present when lying down, suggests that there may be an underlying issue that needs further investigation.

When to Seek Further Medical Evaluation
1. Persistent Symptoms: Since you have already consulted with a physician and have been following their recommendations (rest, heat application, and medication) without improvement, it is advisable to seek further evaluation. If symptoms persist beyond a couple of weeks despite conservative management, this is a clear indication that additional diagnostic measures may be necessary.

2. Severity of Pain: The intensity of your pain, especially if it is affecting your ability to perform daily activities (like driving), is another reason to seek further medical attention. Pain that interferes with your quality of life should not be ignored.

3. Neurological Symptoms: The numbness you are experiencing could indicate nerve involvement. If the pain is accompanied by tingling, weakness, or any other neurological symptoms, it is crucial to have a thorough neurological evaluation.

4. Physical Examination Findings: If your current physician has not conducted a comprehensive physical examination or if you feel that your concerns are not being adequately addressed, it may be time to seek a second opinion. A thorough examination can help identify any mechanical issues, such as ligament injuries or tendon problems.

Diagnostic Imaging
Given your symptoms and the lack of improvement with conservative treatment, pursuing imaging studies such as an MRI (Magnetic Resonance Imaging) is a reasonable next step. An MRI can provide detailed images of soft tissues, including ligaments, tendons, and cartilage, which can help identify any underlying injuries that may not be visible on X-rays.

Potential Conditions to Consider
1. Tendinopathy: This is a common issue that can occur in the tendons around the knee, particularly if there has been an increase in physical activity or strain. It can lead to pain and dysfunction.

2. Ligament Injuries: While your initial assessment suggested a tendon issue, it is also important to rule out any ligament injuries, such as an ACL (anterior cruciate ligament) or MCL (medial collateral ligament) injury, which can cause similar symptoms.

3. Nerve Compression: Conditions such as a herniated disc in the lumbar spine can lead to referred pain and numbness in the lower extremities. This should be considered, especially if the symptoms are not localized to the knee.

4. Patellar Tendonitis: Often referred to as "jumper's knee," this condition can cause pain below the kneecap and may be exacerbated by activities like cycling or running.

Next Steps
1. Consult a Specialist: If you have not already done so, consider seeing an orthopedic specialist who focuses on knee injuries. They can provide a more targeted evaluation and treatment plan.

2. Imaging Studies: Request an MRI to assess the condition of the ligaments and tendons around your knee. This will help in diagnosing any potential injuries that may require specific treatment.

3. Physical Therapy: If imaging reveals no significant structural issues, a referral to a physical therapist may be beneficial. They can provide exercises to strengthen the muscles around the knee, improve flexibility, and address any biomechanical issues contributing to your pain.

4. Follow-Up: Ensure that you have a follow-up appointment scheduled to discuss the results of any imaging studies and to adjust your treatment plan as necessary.

In conclusion, while initial conservative management is important, your ongoing symptoms warrant further investigation. Seeking a second opinion and potentially undergoing imaging studies will help clarify the diagnosis and guide appropriate treatment. Remember, it is essential to advocate for your health and ensure that your concerns are addressed comprehensively.

Similar Q&A

Understanding Knee Pain: When to Seek Further Evaluation and Treatment

Hello, I would like to ask the doctor about knee joint pain. If touching the knee does not cause pain but there is pain inside, does that indicate a problem? Recently, I have experienced pain in my left knee while walking. I have had previous injuries but did not seek any treatme...

Dr. Shi Guozheng reply Orthopedics
Knee injuries can be painful for a period of time. However, if the pain persists for an extended duration, such as six months, it is likely that there are still underlying issues. In addition to bones, the knee joint contains cartilage, ligaments, and menisci, all of which can al...

Understanding Knee Pain: When to Seek Further Medical Evaluation

Hello Doctor, a while ago I was kneeling on the ground, and when I got up, it seemed like I injured my knee. As a result, I experience pain in my right knee when going up and down stairs and when squatting. The pain is severe enough that I wake up at night when my knee is bent. I...

Dr. Shi Guozheng reply Orthopedics
It could be inflammation of the patella; if you're concerned, you can get an X-ray.

Understanding Knee Pain: When to Seek Neurological Evaluation

Hello, Dr. Jiang... My mother has been experiencing knee pain for the past three months, with symptoms fluctuating. However, in the last two weeks, not only has the knee pain worsened, but she is also experiencing pain throughout her entire leg, making it difficult for her to wal...

Dr. Jiang Junyi reply Neurology
Hello, Miss: You mentioned that "knee pain" may need to consider knee joint inflammation. Pain or swelling in the joint, especially during excessive activity or when going up and down stairs, or when standing up after prolonged sitting, can be more pronounced. In the m...

Understanding Knee Pain: When to Seek Medical Advice After Injury

Hello Doctor, I would like to ask you a question. Many years ago, I was in a car accident and injured my left knee. At that time, I delayed seeking medical attention, and my entire knee was swollen and bruised, making it impossible to walk. The doctor drained a significant amount...

Dr. Shi Guozheng reply Orthopedics
You need to see an orthopedic specialist again. Typically, after a knee injury, there may be a hematoma, and some structures within the joint, such as the anterior cruciate ligament, meniscus, or others, may sustain damage. If the injury is not severe, it may heal on its own over...