Main causes of knee pain
The diagnostic search is highly dependent on age and circumstances. Sharp pain after twisting the leg indicates damage to the meniscus or ligaments. Pain in the front, which intensifies when going down stairs and sitting for a long time, is characteristic of patellar problems. Gradually increasing pain when walking with morning stiffness for up to half an hour is typical for osteoarthritis. Sudden night pain with redness and severe soreness is a reason to rule out gout or infectious arthritis.
- Osteoarthritis of the knee joint
- Meniscus injury
- Sprain and rupture of ligaments
- Patellofemoral pain syndrome
- Patellar tendonitis
- Gout and other crystalline arthritis
- Rheumatoid and reactive arthritis
- Baker's cyst under the knee
Risk factors
The knee suffers from anything that increases stress on it or impairs muscle function. Each extra kilogram greatly increases the pressure on the cartilage when walking and especially when going down stairs. A weak quadriceps femoris muscle reduces the stability of the joint, and previous injuries and surgeries change the biomechanics. Kneeling work, jumping sports and sudden increases in training volume are typical triggers for active people.
- Excess body weight
- Previous injuries to the meniscus and ligaments
- Thigh muscle weakness
- Jumping and contact sports
- Working on your knees
- Age over 50
- Gout, diabetes
What signs indicate what?
It is important to pay attention not only to the pain itself, but also to the accompanying symptoms. Rapid swelling in the first hours after injury indicates accumulation of blood in the joint and often means a ligament rupture or fracture. Swelling that appears within a day is usually associated with effusion from a meniscal injury. Morning stiffness for more than an hour and damage to other joints make one think of inflammatory arthritis rather than arthrosis.
- A click at the time of injury and rapid swelling - a ligament rupture is likely
- Joint blockage - typical for meniscus damage
- Crunching and starting pain are typical for arthrosis
- Pain in the front when going down stairs - a problem with the patella
- Redness and heat – gout or infection
- Dense swelling under the knee - Baker's cyst
Surveys
They start with an examination: the doctor checks the range of motion, the stability of the ligaments, the presence of effusion and performs meniscus tests. X-rays in a standing position show narrowing of the joint space, osteophytes and deformation of the leg axis. Ultrasound clearly shows the effusion, Baker's cyst and the condition of the tendons. An MRI is prescribed if a meniscal or ligament tear is suspected. Blood tests are needed if there are signs of inflammation or if multiple joints are affected; with significant effusion, a puncture with examination of the fluid is informative.
- Examination and tests for menisci and ligaments
- X-ray of the knee joints, if possible with a load
- Ultrasound of the knee joint
- MRI of the knee joint
- Complete blood count, C-reactive protein
- Uric acid for suspected gout
- Joint puncture for severe effusion
What to do and how to treat it
In the first days after injury, rest, cold, elastic fixation and elevated position of the leg help. For chronic pain, the basis of treatment is not pills, but strengthening the thigh muscles and losing weight: this has been proven to reduce pain due to arthrosis. Painkillers are used in a short course as prescribed by a doctor. Physiotherapy and orthoses complement the treatment. Intra-articular injections are discussed individually. Arthroscopy is performed in case of true blockade and damage to the meniscus, and endoprosthetics is performed in case of severe arthrosis, when the pain persists at rest.
- Rest, cold and fixation in the first days after injury
- Weight loss
- Exercises for the quadriceps femoris muscle
- Short course anti-inflammatory drugs
- Physiotherapy and kinesiotherapy
- Orthoses and canes for severe arthrosis
- Arthroscopy for joint blockade
- Endoprosthetics for severe arthrosis