Knee Pain: Causes
There are many possible causes of knee pain. You rely on your knees to support your weight and absorb the force and shock of movement throughout the day. The knee joint is a complex structure consisting of several supporting ligaments, shock absorbing cartilage, lubricating joint fluid, multiple bursa to help ligaments and tendons slide smoothly, a patella (kneecap), the femur, the tibia, and the fibula. In addition to these joint structures, there are multiple muscles, tendons, nerves, fascia, and blood vessels that work together to enable this intricately designed joint to function properly.
We rely on this highly complex system to provide movement as well as absorb impact shock and strain over our lifetimes. Often, however, knees become injured by trauma or damaged by degeneration or disease. Some of the problems that can develop in knee joints include osteoarthritis, tear of the cartilage (meniscus), anterior cruciate (ACL) tear, posterior cruciate ligament tear, medial collateral ligament (MCL) tear, joint dislocation, sprain of ligaments, tendinitis, fibromyalgia, Baker's cyst, rheumatoid arthritis, gout, chondromalacia (runner’s knee), and many others.
What Should You Do If You Have Knee Pain:
If you have knee pain that is not improving with conservative care, it is important to get an evaluation by a physician experienced with treating orthopedic conditions. Often, surgery is not required. In most cases, a conservative approach is indicated before turning to surgical options.
Knee Pain Treatment Options:
1. Allowing minor injuries to heal normally.
Many common injuries will heal on their own without any specific treatment. If however knee pain is worsening or persisting more than a couple of weeks, evaluation by a physician is indicated.
2. Use of Over-the-Counter Medications.
Using medications such as over-the-counter acetaminophen (e.g. Tylenol) or NSAID’s (e.g. naproxen or ibuprofen) for people to these sorts of medications are not contraindicated can give significant relief of mild to moderate degenerative changes or minor injuries.
3. Physical therapy for Knee Pain
Physical therapy can help strengthen the muscles that stabilize the need as well as improve range of motion, decreased swelling, decreased pain, and help a person return to optimal function following an injury or degeneration of the knee joint. Knee braces are often used to help "unload" the stress on the joint. This can give significant improvement in pain for those wanting to delay surgery.
4. Prescription medications for Knee Pain
Prescription medications such as anti-inflammatory medications or short courses of pain medications can sometimes be helpful during the healing process or to help with optimizing physical therapy.
5. Knee Injections can often be helpful.
- Viscosupplementation with medications such as Hyalgan, Synvisc, Orthovisc, etc. can help provide pain relief and improvement in function. These medications help lubricate and provide a liquid padding to the cartilage of the knee. This can result in improved overall function and decreased pain. These injections usually have to be repeated over time but can delay the need for surgery in many cases.
- Injection of corticosteroids like prednisone is common but recent research suggests that it may not be as helpful as once thought and may even hasten the degeneration of the cartilage inside the joint.
- Injection of other substances such as PRP (platelet rich plasma) or stem cells harvested from a person's fat or bone marrow can be injected into the knee joint. Although most insurance companies do not cover this treatment and consider it “investigational", there has been significant research suggesting that it can improve pain and possibly even regenerate cartilage.
6. Knee Surgery
Surgical intervention is used when conservative means do not give adequate results of improved pain or function. Some surgery can be performed arthroscopic plate such as shaving bone spurs, repairing torn menisci, or repairing torn ligaments. For other people with severely degenerated joints and very little if any cartilage left, partial or total knee joint replacement may be necessary.
If you are experiencing knee pain, please give our clinic a call. We focus on nonsurgical solutions to knee pain. We know that most people would rather solve or treat their knee pain without surgery if possible. However, for those whom nonsurgical treatment does not give adequate results, we work closely with many orthopedic surgical groups in order to provide a comprehensive approach to knee pain.
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