Pain Below the Knee: Causes and Solutions - Orthopedics

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Hello Chiouya,
Thank you for reaching out with your concerns about your husband's knee pain. It sounds like he is experiencing discomfort below the knee, particularly in the area around the patella (kneecap), which can be quite distressing. Let's delve into the potential causes and solutions for this issue.


Understanding the Pain
From your description, it seems that your husband experiences pain primarily in the afternoon, especially when descending stairs or applying pressure to the knee. This pattern of pain can often be attributed to several factors:
1. Patellofemoral Pain Syndrome (PFPS): This condition is common among individuals who have a sedentary lifestyle or engage in activities that put stress on the knee joint. PFPS is characterized by pain around the kneecap, particularly during activities like stair climbing or sitting for prolonged periods.

2. Tendinitis: Inflammation of the tendons around the knee, such as the patellar tendon, can lead to pain, especially with movement. This is often exacerbated by repetitive activities or sudden increases in physical activity.

3. Osteoarthritis: Although your husband is relatively young, early signs of wear and tear on the knee joint can occur, particularly if there is a history of previous injuries or if he has a sedentary lifestyle that leads to muscle weakness around the knee.

4. Bursitis: Inflammation of the bursae (small fluid-filled sacs that cushion the knee joint) can also cause localized pain, especially when pressure is applied.

5. Referred Pain: Sometimes, pain in the knee can be referred from other areas, such as the hip or lower back, particularly if there are underlying issues in those regions.


Recommendations for Management
Given that your husband has already undergone an X-ray with no significant findings, here are some steps you can consider to help alleviate his symptoms:
1. Physical Therapy: A physical therapist can provide a tailored exercise program to strengthen the muscles around the knee, improve flexibility, and enhance overall function. This is particularly important for someone who has a sedentary job.

2. Activity Modification: Encourage your husband to avoid activities that exacerbate the pain, such as heavy lifting or excessive stair climbing. Gradually increasing his activity level can help build strength without overloading the knee.

3. Ice and Rest: Applying ice to the affected area after activities can help reduce inflammation and pain. Resting the knee during flare-ups is also crucial.

4. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and inflammation. However, he should consult with a healthcare provider before starting any medication.

5. Weight Management: If applicable, maintaining a healthy weight can reduce stress on the knee joints, potentially alleviating pain.

6. Ergonomic Adjustments: Since your husband works in an office, ensuring that his workspace is ergonomically designed can help reduce strain on his knees. Regular breaks to stand and stretch can also be beneficial.


Further Investigations
If the pain persists despite these interventions, or if it worsens, it may be worthwhile to consider further imaging studies, such as an MRI, to assess for soft tissue injuries that may not be visible on X-rays. Additionally, consulting with an orthopedic specialist who focuses on knee issues could provide more insights and targeted treatment options.

In summary, while your husband’s knee pain is concerning, there are several strategies to manage and potentially alleviate his symptoms. Encouraging him to stay active, seek physical therapy, and make lifestyle adjustments can significantly improve his quality of life. If symptoms persist, further evaluation may be necessary to rule out any underlying conditions.

Best wishes for your husband's recovery!