Knee pain: your all-you-need-to-know guide

Knee pain is a common problem that can affect people of all ages. It can be caused by various factors, such as injury, overuse, arthritis, infection or other medical conditions. Depending on the cause and severity of the pain, different treatments may be available.

Here to explain more in this article below is highly esteemed consultant orthopaedic surgeon, Mr Rafik Yassa.

What are the causes of knee pain?

There are many potential causes of knee pain. Some of the most common causes of knee pain are:

• Injury: The knee is a complex joint that consists of bones, cartilage, ligaments, tendons and muscles. Any of these structures can be damaged by trauma, such as a fall, a twist, a collision or a sports injury. Some of the common knee injuries include sprains, strains, tears, fractures, dislocations and bursitis.
• Overuse: Repeated or excessive stress on the knee can lead to inflammation, irritation or wear and tear of the tissues. This can happen due to activities such as running, jumping, cycling or squatting. Overuse can also cause tendinitis, which is an inflammation of the tendons that connect the muscles to the bones.
• Arthritis: Arthritis is a group of diseases that cause inflammation and degeneration of the joints. There are many types of arthritis that can affect the knee, such as osteoarthritis, rheumatoid arthritis, gout, and pseudogout. Arthritis can cause pain, stiffness, swelling and reduced range of motion in the knee.
• Infection: The knee can become infected by bacteria, viruses or fungi that enter through a wound or spread from another part of the body. Infection can cause fever, redness, warmth and pus around the knee. If left untreated, infection can damage the joint and lead to serious complications.
• Other medical conditions: Some medical conditions that affect other parts of the body can also cause knee pain. For example, diabetes can damage the nerves and blood vessels in the legs and feet, leading to neuropathy and poor circulation. Other conditions that can cause knee pain include osteoporosis, fibromyalgia, and cancer.

What are the main associated symptoms of knee pain?

The symptoms of knee pain may vary depending on the cause and severity of the condition. Some of the common symptoms include:

• Pain in or around the knee
• Swelling or bruising of the knee
• Difficulty bending or straightening the knee
• Difficulty walking or bearing weight on the leg
• Popping or clicking sounds in the knee
• Locking or instability of the knee
• Deformity or misalignment of the knee

How is knee pain treated?

The treatment of knee pain depends on what’s causing it and how uncomfortable it makes you. Some of the possible treatments include:

• Self-care: Mild knee injuries often improve with the RICE regime (Rest, Ice, Compression, Elevation). Wearing a brace can stabilise your knee while it recovers. If arthritis is causing knee pain, weight loss, strengthening exercises and water exercise can help to relieve symptoms.
• Physical therapy: A physical therapist can teach you exercises and stretches to improve your strength, flexibility and balance. They can also use techniques such as massage, ultrasound or electrical stimulation to reduce pain and inflammation.
• Medication: Your doctor may prescribe medications to help relieve pain and to treat the conditions causing your knee pain, such as rheumatoid arthritis or gout. Some of the medications include analgesics, anti-inflammatories, corticosteroids or antibiotics.
• Injections: Some knee problems related to the knee joint itself or ligaments and tendons around the knee joint could be amenable for PRP i.e Platelet Rich Plasma Injection or Steroid injection.
• Surgery: If your knee pain is severe or does not respond to other treatments, you may need surgery to repair or replace the damaged structures in your knee. 

When is surgery considered for knee pain, and what surgical procedures are available?

Surgery is considered for knee pain when other treatments have failed to provide adequate relief and when the pain interferes with your daily activities and quality of life. Surgery may also be indicated if you have severe joint damage, deformity, or instability.

The decision to have surgery depends on several factors, such as your age, weight, activity level, knee size and shape, and overall health. Your surgeon will check your knee’s range of motion, stability and strength, and use X-rays to assess the extent of damage. You will also discuss the risks and benefits of surgery, the types of artificial joints and surgical techniques available, and the expected outcomes and recovery process.

Some of the common surgical procedures for knee pain include:

• Arthroscopy: A minimally invasive keyhole surgery that uses a small camera and instruments to examine and repair the damaged structures inside the knee joint.
• Meniscectomy: A surgery that removes the torn part of the meniscus, which is a cartilage cushion between the bones of the knee.
• Ligament reconstruction: A surgery that replaces a torn ligament, such as the anterior cruciate ligament (ACL), with a graft from another part of your body or a donor.
• Joint replacement: A surgery that removes the damaged surfaces of the knee joint and replaces them with metal and plastic components. This option could be partial or total knee replacement. Your surgeon would be able to discuss the pros and cons of each in line with the national guidance e.g. NICE (National institute of Health and Clinical Excellence) guidelines and BASK (British Association for Surgery of the Knee).
• Osteotomy: this is bone setting procedure to realign the lower limb and to reduce pain.

To schedule in an appointment with Mr Rafik Yassa today, visit his Top Doctors profile.