Persistent Knee Pain After Two Accidents: What Should I Do?

Car accident November 2013

Hello, I had two car accidents in November 2013, both impacting the same area of my left knee.
After the second accident, I experienced significant pain during that week.
A few days after the second accident, I had an X-ray, and the doctor said there were no major bone injuries.
Three weeks later, I noticed that my left knee would hurt a bit whenever it came into contact with hard objects or the ground, but it wasn't as painful as immediately after the accident.
Almost a month later, I had another X-ray, and the doctor again confirmed that there were no bone injuries.
This time, he mentioned that the knee naturally bears a lot of weight, and recovery can take time, varying from three to six months or even up to a year.
He advised me to minimize the use of my knee.

Starting in February 2014, I significantly reduced activities like standing or running.
By March 2016, aside from about 14 days of running in February 2014, I have not run since.
I still experience discomfort when my knee is touched or when I go up and down stairs, and it feels slightly swollen.
After a year and three months, I had another X-ray, which still showed no abnormalities.
Since my right knee does not have these issues, should I consider further examinations? What kind of tests should I undergo, or can I just ignore it? Thank you for your assistance.

At sign, 20~29 year old female. Ask Date: 2016/02/25

Dr. Chen Yongxue reply Orthopedics

Hello, sometimes inflammation of the periosteum can persist for a long time, causing discomfort for the patient.
Please visit the outpatient clinic for a physical examination.
If the pain has lasted too long, you might consider trying a corticosteroid injection, which may be effective.
Thank you.

Reply Date: 2016/02/25

More Info

Persistent knee pain after multiple accidents can be quite concerning, especially when the pain persists despite normal X-ray findings. It’s important to understand that while X-rays are excellent for identifying fractures and dislocations, they do not always reveal soft tissue injuries, which could be the source of your ongoing discomfort.

Given your history of two accidents impacting the same knee, it’s possible that you may have sustained soft tissue injuries, such as ligament sprains, meniscus tears, or even damage to the cartilage. These types of injuries can lead to chronic pain, swelling, and instability in the knee joint. The fact that you experience pain when touching the knee or during activities like climbing stairs suggests that there may be underlying issues that need to be addressed.

Here are some steps you can take to further evaluate and manage your knee pain:
1. Consult a Specialist: Since your pain persists and affects your daily activities, it would be wise to consult an orthopedic specialist who can perform a thorough evaluation. They may recommend advanced imaging studies such as an MRI, which can provide detailed images of the soft tissues in your knee, including ligaments, tendons, and cartilage.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can design a rehabilitation program tailored to your specific needs, focusing on strengthening the muscles around the knee, improving flexibility, and enhancing stability. This can help alleviate pain and prevent further injury.

3. Activity Modification: While you have been advised to reduce knee usage, it’s also important to engage in low-impact activities that do not exacerbate your pain. Swimming or cycling can be good alternatives that allow you to maintain fitness without putting excessive strain on your knee.

4. Pain Management: Over-the-counter pain relievers, such as acetaminophen or NSAIDs (if you are not allergic), can help manage pain and inflammation. However, it’s crucial to use these medications as directed and consult with a healthcare provider if you have any concerns.

5. Knee Support: Depending on the severity of your symptoms, using a knee brace or support may provide additional stability and alleviate discomfort during activities. However, if you experience significant pressure or pain while wearing a brace, it’s best to consult with a healthcare professional for advice on the appropriate type of support.

6. Monitoring Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any activities that seem to trigger or alleviate the pain. This information can be valuable for your healthcare provider in diagnosing the issue.

7. Surgical Consultation: If conservative measures do not provide relief and your quality of life is significantly impacted, discussing surgical options with an orthopedic surgeon may be warranted. They can evaluate whether any surgical interventions, such as arthroscopy, are necessary to address underlying issues.

In conclusion, while your X-rays have not shown any significant bone injuries, the persistence of your knee pain warrants further investigation. Soft tissue injuries can be subtle and may require specialized imaging and treatment. It’s essential to take proactive steps to address your symptoms and prevent further complications. Seeking a comprehensive evaluation from an orthopedic specialist will be a crucial step in your recovery journey.

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