Causes of Knee Pain

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Introduction

Knee pain is one of the most common symptoms experienced by individuals across all ages. It may arise immediately following intense physical activity or emerge as mild discomfort gradually worsening over time due to wear and tear. It is crucial to consult a healthcare professional promptly regarding knee pain to address any underlying issues.

Anatomy of the Knee

The knee joint is formed by three bones: the femur (thighbone), tibia (shinbone), and the patella (kneecap). These bones articulate to create the knee joint, supported by an intricate structure of muscles, ligaments, tendons, menisci, cartilage, and bursae. The menisci act as articular discs facilitating movement and absorbing shock. The bursa functions as a cushion, providing a lubricated area for tendons to slide over bones during motion. Ligaments and tendons lend stability, protecting the joint from excessive movement. Biomechanical changes can lead to pain or discomfort in the knee.

Common Symptoms

• Knee stiffness
• Swelling and warmth around the knee
• Audible popping or grinding noise during movement
• Inability to fully straighten or bend the knee (locking)
• Weakness or instability (feeling of giving way)

Anterior Knee Pain

• Patellofemoral Pain Syndrome: This results from the maladaptive tracking of the kneecap during movement, causing unilateral or bilateral pain, which intensifies during activities such as stair climbing or prolonged sitting.
• Patellar Tendinitis ("Jumper’s Knee"): Characterized by dull pain due to tendon inflammation, worsening sharply with jumping or stair climbing. It frequently affects athletes involved in sports like basketball, volleyball, and soccer. Conditions like tight hamstrings or knock-knees increase susceptibility.
• Osgood-Schlatter's Disease: Presents as pain below the kneecap, usually during adolescence. Activities like running and jumping exacerbate symptoms, leading to a bony lump due to new bone formation where tendons exert pressure.
• Bursitis: Caused by inflammation of fluid-filled pads cushioning bones and tendons, usually resulting from overuse or repetitive motions.

Medial/Inner Knee Pain

• Meniscal Tear: Involves tears in the meniscus near the inner knee joint, often associated with aging, which leads to increased pain with bending.
• Ligament Tear: Pain due to injury causing instability in the ligament.

Outer/Lateral Knee Pain

• Iliotibial Band Syndrome (ITBS): Inflammation of the iliotibial band causing lateral knee pain, usually intensified by movement.
• Meniscal Tear: Occurs as tears on the outer meniscus.

Posterior Knee Pain

• Baker’s Cyst (“Popliteal Cyst”): Pain felt behind the knee, worsening with prolonged standing or activity. This fluid-filled sac can enlarge or rupture, especially if associated with conditions like arthritis.
• Meniscal Tear: Particularly if the tear is located in the back of the meniscus.

Risk Factors

• Being overweight
• Prior injuries
• Biomechanical issues
• Muscle weakness

Self-Management for Acute Knee Pain

• Rest and avoid pain-aggravating activities, especially weight-bearing exercises.
• Apply ice for 20 minutes every hour on the first day, then at least five times daily thereafter.
• Elevate the knee to reduce swelling.
• Use support bandages or sleeves for joint support.
• Take over-the-counter NSAIDs for pain and swelling.
• Sleep with a pillow under or between your knees.

Preventive Measures

• Lose weight if necessary, as excess weight increases knee pressure during activities.
• Strengthen muscles surrounding the knee.
• Perform warm-up and cool-down exercises, including quadriceps and hamstring stretches.
• Avoid running downhill; walk instead.
• Opt for cycling or swimming over running.
• Choose smooth, soft surfaces for running or walking.
• Consider orthotics if foot problems exist.

Most mild knee pain improves with self-care management. Physical therapy and chiropractic treatments can also be beneficial. Consulting a physician is always recommended for persistent issues.

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