Does your knee throb when you sit too long? Maybe you feel a sharp pain when you pivot from side to side. If you feel daily discomfort, you’re part of a large group. Roughly 25 percent of adults live with knee pain, according to the American Academy of Family Physicians.
When your knees hurt, it can be harder to walk, run or enjoy your favorite activities. Achy knees can also make it difficult for you to work or even take care of yourself. Knowing why your knee hurts can help you find the right treatment and get you back to your daily routine.
In a recent webinar, Todd Kelley, MD, an orthopedic surgeon and joint replacement specialist with The Christ Hospital Health Network, discussed the most common causes of knee pain, treatment options and ways to boost your recovery.
Dr. Kelley says acute injuries, inflammation, referred pain and arthritis are the top four culprits behind knee pain. Whether you’ve had this discomfort for a while or just noticed your symptoms, here’s what he wants you to know.
A bit about your knee
Your knee is a complex joint that plays a large role in your mobility. Four bones—your thigh bone (femur), shin bones (tibia and fibula) and kneecap (patella)—come together in your knee joint. You have two types of cartilage that cushion those bones—articular cartilage and the meniscus.
Additionally, your knee contains four big ligaments. Your anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) stabilize your knee during front-back motions. And your medial collateral ligament (MCL) and lateral collateral ligament (LCL) keep your knee steady during side-to-side or back-and-forth movements. Lastly, your muscles and tendons power the joint to control movement.
Acute injuries
The most common injuries are tears to your cartilage, ligaments, and tendons, as well as bone fractures.
Cartilage tear
Most cartilage tears affect your meniscus. They happen when you forcefully twist or rotate your knee. In addition to pain and a pinching sensation, tears make it hard for you to bend and straighten your knee. A torn meniscus can heal in children because the cartilage still has a blood supply. But adults may consider a surgery called a knee scope to shave away any loose parts of the meniscus that cause discomfort.
Ligament tear
A sudden change of direction or blow to your knee can trigger a tear. Torn ligaments cause instability, limited range of motion, pain, and swelling. Some tears can heal on their own with rest, ice, and physical therapy, Dr. Kelley says.
Tendon tear
Tendon tears usually happen when your muscle forcefully contracts like when you’re running fast or land hard after a jump. These tears cause bruising, pain, and swelling. They also make it difficult for you to straighten or put weight on your knee. Minor tendon tears heal with rest, ice and physical therapy. More severe tears may require surgery to repair and reattach your tendon.
Bone fracture
Falls or accidents can break any bone in your knee joint. Depending on the type of fracture, some may heal without surgery. If your bone breaks into several pieces or the bone fragments separate from each other, you may need surgery with plates and screws to fix it.
Stress fracture
These breaks are also called subchondral insufficiency fractures. They happen when your bone isn’t strong enough to support you. Stress fractures are subtle. They don’t show up well on X-rays, so you may need an MRI for diagnosis. They are more common in women because women lose bone density with age. To help a stress fracture heal, Dr. Kelley says you should limit your activities for several months.
Inflammation
Dr. Kelley says overusing your knee or repeating the same motions can cause irritation and swelling (inflammation). Tendonitis and bursitis are two common types of inflammation.
Tendonitis
Your tendons get inflamed when they pull hard on your bones over time. This can happen with activities like running, jumping, or squatting. To relieve tendonitis, Dr. Kelley recommends anti-inflammatory medications like ibuprofen, ice and changing movements to avoid repeatedly using the same tendon.
Bursitis
With this condition, you develop irritation in your bursa, the fluid-filled sacs around your joints that help your tendons glide around your bones. Tendonitis can trigger bursitis. It also happens to people who frequently kneel and put a lot of pressure on their knees. To reduce bursitis, Dr. Kelley says you should take anti-inflammatory medications and avoid direct pressure on your bursa.
Referred pain
In some cases, referred pain can be the cause of your knee discomfort, Dr. Kelley says.
“With referred pain, you might have knee pain,” he says. “But the pain could be coming from somewhere else in your body. For example, hip arthritis can sometimes send pain down the thigh to the knee.”
Another example is sciatica—pinched nerves in the lower back— which can prompt knee pain for many people. The sciatic nerve travels from your lower back, down your leg, around your knee and into your foot. Pressure on that nerve causes pain all along your leg that can concentrate around your knee. Conservative treatments like anti-inflammatory medication or physical therapy can treat mild discomfort. You may need surgery if your pain is severe.
Arthritis
Arthritis in your knee is chronic inflammation caused by general wear and tear on your joint. Over time, the cartilage that cushions your bones disappears. As a result, your bones rub against each other, causing achiness, pain and stiffness. X-ray images are used to diagnose your condition.
If you have arthritis, you may experience:
Knee arthritis treatments
There is no cure for arthritis. But you can take steps to reduce your pain and discomfort. Dr. Kelley says you should be as healthy as possible for these tactics to succeed.
“To combat your arthritis, we have to think about your overall health,” he says. “This is true whether we’re thinking of nonsurgical or surgical treatments.”
You can maximize your chances for pain relief if you:
Nonsurgical treatments
Dr. Kelley recommends conservative treatments as a first-line defense against arthritis pain. Options to reduce your discomfort include:
Anti-inflammatory medication like ibuprofen
Cortisone injections for inflammation and pain relief
Over-the-counter pain relievers like acetaminophen
Physical therapy and supervised exercise
Switching to low-impact exercises
Topical pain relievers like diclofenac cream
Walking supports like braces, canes or walking sticks
Weight loss
Surgical treatment
Knee replacement surgery may be an option if nonsurgical methods don’t work, your X-ray confirms you have arthritis, and you’ve followed all the previously mentioned steps to improve your health. For this procedure, surgeons remove the parts of your knee where your bones rub together. They replace your bones with a mechanical joint made of metal and plastic parts. Dr. Kelley says most knee replacements last roughly 20 years and relieve up to 90 percent of your pain.
Knee replacement is outpatient surgery for most people, so you can go home the same day. Any bruising, pain or swelling will improve over the next several weeks. Doctors recommend starting physical therapy the day after surgery. Physical therapy—either in the clinic or at home—can last several months, depending on your progress.
Schedule an appointment for knee pain
If you’re experiencing new or long-term knee pain, talk with one of our orthopedic specialists. We can identify the cause of your discomfort and work with you to create the best treatment plan.
Request an appointment or call 513-791-5200.