Chronic Knee Pain and Its Spread: A Student's Journey - Rehabilitation

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Knee pain for two months, sometimes accompanied by hand numbness. Now the pain in the leg has spread to the groin area?


Hello doctor, I am a design student who often sits for long periods and uses the computer for drawing.
I started exercising in early September (running, cycling, squats, etc.).
By late September, I felt some stiffness in my left knee, so I stopped exercising.
In early October, I visited an orthopedic doctor and had an X-ray done.
The doctor diagnosed me with left knee joint inflammation, fluid accumulation in the front thigh, and knee swelling.
After taking muscle relaxants and anti-inflammatory medication a few times, the swelling in my knee decreased somewhat, but it did not completely go away.

In late October, I had an ultrasound of both knees, and it was noted that my left knee showed only signs of chronic inflammation.
However, after stopping the muscle relaxants, the swelling in my knee began again.
At the end of October, I visited a rehabilitation specialist and started undergoing shortwave and electrical therapy for both knees (due to compensating with my right leg for a long time, I was rehabilitating both knees).
I went twice a week; initially, the swelling decreased a bit, but later, due to my busy academic schedule, I couldn't attend, and my legs began to feel sharp pain from the calves to the thighs, including the outer side of the knee.

I returned to the rehabilitation department, and the doctor suspected I might be compressing a lumbar nerve, so I underwent lumbar traction (12 kg, while I weigh 50 kg).
An X-ray of the lumbar spine was scheduled, but after the traction, I experienced back pain, and at night, my hands felt tense, leading to numbness the next morning.
I then went for a massage.
A few days later, I consulted another orthopedic and neurology department.
The neurologist conducted nerve conduction tests on my hands and performed an X-ray of my cervical spine.
During the visit, the neurologist had me perform single-leg jumps and squat three times in a row to check for any movement disorders.
After seeing the doctor, my knee felt very stiff, and going down stairs was uncomfortable.
That day, I wore a knee brace.
The orthopedic doctor reviewed X-rays of both legs from the front and side and said there were no issues and that I didn't need rehabilitation or to wear a brace.
However, whenever I walked for a long time, my legs would feel sore and tight, and my condition was not as good as before I started exercising.
A week later, after reviewing the lumbar X-ray report, the doctor said there were no issues, and my spine had not degenerated, but further tests were needed to check for disc herniation.
However, the doctor did not arrange for that test due to high costs.
The cervical X-ray report indicated some misalignment (similar to that of a 40-year-old), but it did not affect hand function.
The area of my hand was under long-term nerve compression (as a design student, I often use the computer with my left elbow resting on the desk).
With proper care, it would recover.
After taking some B vitamins, I noticed that my hands did not feel numb anymore.
One night, my left hand felt tense while sleeping, and the discomfort even spread to my left chest, making me feel like I was going to die.
A few days later, I visited a traditional Chinese medicine practitioner who provided acupuncture and medication, stating that my nerves were not functioning well, which led to heart weakness, and prescribed heart medication.
Later, I returned to the rehabilitation department, where the doctor arranged for a specialized therapist to assist me with rehabilitation.
The frequency of electrical therapy and shortwave treatment was reduced to once a week due to the "health insurance system," "hospital policies," and "inconvenience of scheduling with specialists." I wanted to save on registration fees, so I went for acupuncture twice more.
After acupuncture, I felt okay for a day, but after a few days, my legs would easily feel sore again.
I then saw the neurologist again because my legs were sore, and my arms began to feel sore as well.
I underwent upper and lower limb nerve conduction tests and blood tests, which showed no neurological issues.
However, my legs continued to show no improvement.
My left knee now has bruising (without any impact), and my right knee previously had bruising but does not anymore.
When I stand for a long time (around 15 minutes) while showering, I start to feel sharp pain in my left knee, so I now wear a knee brace after showering to alleviate the pain.
To relieve the leg soreness that has persisted for two months, I recently started using a foam roller on my lower limbs since I have been supporting my body with my arms (similar to a side plank).
Last night, I felt soreness in the muscles behind my right armpit, but it improved after a good night's sleep.
One day, I went out and walked all day; the outer side of my left thigh and hip felt sore, and my left hip was also sore.
Today, the upper inner part of my left leg is sore, which later turned into soreness above my left groin.
I intended to go out for a slow walk, but after taking a few steps, the upper inner part of my left leg began to feel sharp pain, followed by soreness in the groin area, making me abandon the idea of walking.

In summary, the original knee pain has spread to my entire leg, even affecting my hip and groin.
When my groin hurts, my calf, thigh, and knee do not hurt (but I cannot be certain since I haven't walked much).
Please advise me on which specialty I should see, what exercises I should do, and how I can rehabilitate myself.
Over the past three months, I have seen orthopedic, rehabilitation, neurology, and traditional Chinese medicine specialists numerous times, undergone rehabilitation, taken many muscle relaxants, and had acupuncture three times.
Recently, the neurologist prescribed muscle relaxants and B vitamins for me, but I feel they are becoming less effective.

Additionally, during this period, I have seen many doctors who told me there were no issues and advised me to exercise more.
However, whenever I walk for a long time, I experience soreness, and when that happens, I have to use the foam roller and stretch.
If I do not maintain the correct posture or exert myself improperly, my hands and shoulders become sore, making me reluctant to walk.
However, the doctors say that if I do not walk, my circulation will worsen, and my legs may become weaker.
I really do not want to keep telling those around me about my physical problems, especially since I am still young and in college...

N Zi, 20~29 year old female. Ask Date: 2015/12/17

Dr. Chen Wayda reply Rehabilitation


It is recommended to see Professor Hou Sheng-Mao at National Taiwan University Hospital's Orthopedics Department.

Reply Date: 2015/12/17

More Info


Chronic knee pain, especially in a young student like yourself, can be a complex issue that often stems from a combination of factors, including overuse, improper biomechanics, and possibly underlying conditions. Your journey through various medical consultations and treatments highlights the multifaceted nature of knee pain and its potential to affect other areas of the body, such as the hips and lower back.

From your description, it seems that your knee pain began after you started exercising, which is a common trigger for many individuals, especially those who may not have been active previously. The inflammation and swelling in your left knee, as noted by your doctor, could be indicative of patellar tendinitis or another form of overuse injury. The accumulation of fluid in the knee joint (effusion) is often a response to irritation or injury in the joint, and it can lead to feelings of stiffness or a "catching" sensation, which you described as "卡卡的."
The fact that your pain has spread to other areas, including your thighs and hips, suggests that you may be compensating for the discomfort in your knee by altering your movement patterns. This compensation can lead to additional strain on other muscles and joints, resulting in a cascade of pain and discomfort. It’s also worth noting that prolonged sitting, especially in a design-related field, can lead to tightness in the hip flexors and hamstrings, which may further exacerbate knee pain.

Given your situation, it’s crucial to approach your recovery holistically. Here are some recommendations that may help you manage your symptoms and improve your overall function:
1. Physical Therapy: Since you have already seen various specialists, consider returning to a physical therapist who can provide a tailored rehabilitation program. They can assess your movement patterns, strength, and flexibility to create a specific exercise regimen that addresses your unique needs.

2. Strengthening Exercises: Focus on strengthening the muscles around your knee, particularly the quadriceps, hamstrings, and hip muscles. Exercises like straight leg raises, wall sits, and step-ups can be beneficial. However, ensure that these exercises are performed with proper form to avoid further injury.

3. Stretching and Flexibility: Incorporate regular stretching into your routine, especially for the quadriceps, hamstrings, and hip flexors. This can help alleviate tightness and improve your range of motion.

4. Modify Activities: While it's important to stay active, you may need to modify your activities to avoid exacerbating your knee pain. Low-impact exercises such as swimming or cycling can be good alternatives to running or high-impact activities.

5. Use of Ice and Heat: Applying ice to your knee after activity can help reduce inflammation, while heat can be beneficial for muscle relaxation before exercise.

6. Ergonomic Adjustments: Since you spend long hours at a desk, ensure that your workstation is ergonomically set up to minimize strain on your body. Consider using a chair that supports your lower back and allows your feet to rest flat on the floor.

7. Gradual Return to Activity: As your symptoms improve, gradually reintroduce activities. Start with shorter durations and lower intensities, and listen to your body. If you experience pain, it may be a sign to scale back.

8. Consult a Sports Medicine Specialist: If your symptoms persist despite conservative management, consider seeking a consultation with a sports medicine physician who specializes in musculoskeletal injuries. They can provide further insights and may suggest imaging studies or other interventions if necessary.

9. Mindfulness and Stress Management: Chronic pain can be exacerbated by stress and anxiety. Incorporating mindfulness practices, such as yoga or meditation, can help manage stress and improve your overall well-being.

In conclusion, chronic knee pain can be a challenging condition, especially for a young student like yourself. It’s essential to take a comprehensive approach to your recovery, focusing on strengthening, flexibility, and proper movement patterns while also addressing any ergonomic concerns related to your studies. Remember, recovery takes time, and it’s important to be patient with yourself as you work towards regaining full function.

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