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Knee Pain

Knee pain refers to any discomfort or pain in and around the knee.

The location of knee pain can help identify the problem. Pain on the front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as in chrondromalacia patella. Pain on the sides of the knee is commonly related to injuries to the collateral ligaments, arthritis, or tears to the meniscuses. Pain in the back of the knee can be caused by arthritis or cysts, known as Baker’s cysts. Baker’s cysts are an accumulation of joint fluid (synovial fluid) that forms behind the knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the joint, or infection.

Instability, or giving way, is also another common knee problem. Instability is usually associated with damage or problems with the meniscuses, collateral ligaments, or patella tracking.
 
 

Description of knee pain.

Knee pain is very common. Each year, millions of Americans visit the doctor for knee pain. It is the most frequent reason for visits to an orthopedist (bone and joint surgeon).

To understand the various causes of knee pain, it is important to know how the knee functions. The knee refers to the joint where the femur (thigh bone) meets the tibia (largest lower leg bone). In front of this joint lies the patella (knee cap). The joint is lined by a membrane called a synovial sac. The synovial sac produces synovial fluid which acts as a lubricant much in the way that oil lubricates the moving parts of machinery. Other tissues that make up the knee joint include cartilages, muscles, tendons, and ligaments. The upper end of the tibia has cartilaginous shock absorbers called "menisci" (meniscus). Other protective structures are the bursae, which cushion areas of friction in the joint. Most of the muscles involved with joint mobility originate in the thigh, cross the knee joint, and attach to the tibia.

The knee supports two to three times a person's body weight. It is a complex joint that allows for a considerable range in mobility. In addition to simple flexion (bending) and extension (straightening) movements, the knee joint is designed to allow for rotation, gliding, and rolling movements. To allow for complex mobility and joint stability, joint strength was sacrificed, making the knee very prone to injury.

Causes & symptoms of Knee Pain

Common Causes of Knee Pain

Causes & symptoms

Knee pain is a symptom of many different diseases and conditions. Short-term knee pain may be the result of excess stress on the knee. Possible causes of knee pain include:

  • Arthritis. Osteoarthritis (joint degeneration), rheumatoid arthritis (joint inflammation), and septic arthritis (joint infection) can cause knee pain.
  • Bursitis. Inflammation of the bursae of the knee can cause knee pain. Bursitis can be caused by infection, gout, rheumatoid arthritis, injury, illness, or chronic irritation (crawling or kneeling)
  • Cysts. A cyst is a fluid-filled sac. Cysts associated with the knee can cause swelling and knee pain or discomfort.
  • Fracture. Breakage or crack in any of the bones associated with the knee joint can cause knee pain.
  • Gout. A faulty chemical process leads to high levels of uric acid in the blood which causes inflammatory arthritis, crystal deposits in joints, joint destruction, and joint pain.
  • Ligament injury or instability. The ligaments supporting the knee may be injured or strained by persons who participate in sports, particularly football, rugby, lacrosse, basketball, skiing, soccer, and volleyball. Accidents can also cause ligament damage.
  • Loose bodies. This condition refers to any loose objects that float around the knee and cause problems. They also are called "joint mice" because of their elusive nature.
  • Meniscus conditions. Damage, usually in the form of a tear, to the menisci can be caused by degenerative changes associated with advancing age or are sports-related. Sports which commonly cause menisci damage include football, basketball, soccer, tennis, lacrosse, and skiing.
  • Osteonecrosis. Degeneration of the bones associated with the knee causing pain and deformity.
  • Patellofemoral pain. Also known as anterior knee pain syndrome, this condition is characterized by pain around the knee cap. The exact cause of patellofemoral pain is unknown but probably related to muscle inadequacy, lack of flexibility, rapid growth, or bone positioning

Diagnosis

Knee pain can be diagnosed and treated by an orthopedic surgeon. Diagnosis is based primarily on medical history and physical exam. The diagnosis begins with a detailed medical history to fully characterize the knee pain. The knee will be bent to determine the range of motion and palpated (felt with the hands) to detect the presence of any abnormalities. The physical exam may include any of a number of different tests designed to detect injuries by manipulating the knee and leg. X rays may be taken. In some cases more advanced testing may be carried out using magnetic resonance imaging (MRI), computed tomography (CT), or contrast arthrography (x ray following injection of a contrast solution).

Treatment

Most alternative treatments for knee pain aim at reducing pain, inflammation, and stiffness. Persons experiencing long-term or severe knee pain should consult a physician to determine the underlying cause.

Herbals

Several herbal remedies are recommended to relieve knee pain. Some remedies are used externally, while others involve internal use of herbs.

The following herbs may relieve knee pain and/or associated symptoms when used externally:

  • basil and sage oil rub: knee pain
  • comfrey (Symphytum officinale) oil rub: joint stiffness and aching joints
  • eucalyptus (Eucalyptus globulus) essential oil rub: swelling
  • ginger (Zingiber officinale) root hot compress or bath: joint stiffness, arthritis, and degenerative joint disease
  • lavender (Lavandula officinalis) essential oil rub: joint stiffness and aching joints
  • mustard (Sinapsis alba) powder bath or paste (with alcohol): knee pain
  • red pepper (Capsicum) lotion: arthritic pain and swelling
  • St. John's wort (Hypericum perforatum) oil rub: joint stiffness and aching joints
  • wintergreen (Gaultheria procumbens) oil rub: chronic pain

The following herbs may relieve knee pain and/or associated symptoms when used internally:

  • celery (Apium graveolens) decoction or tincture: swollen joints and gout
  • chamomile (Matricaria recutita): spasms and swelling
  • deadly nightshade (Atropa belladonna) plaster: swollen joints
  • devil's claw (Harpagophytum procumbens) tablets: swollen joints
  • flaxseed (Linus usitatissimum) oil: lubricates joints
  • feranium (Pelargonium odoratissimum): chronic pain
  • jamaican dogwood (Piscidia erythrina): pain and swelling
  • lemon (Citrus limon) juice: swollen joints
  • prickly ash (Zanthoxylum americanum) tea: joint pain
  • white willow (Salix alba) tablets or decoction: swollen joints and joint pain
  • wild lettuce (Lactuca virosa): pain and swelling

Other remedies for knee pain.

Various other alternative treatments that can be helpful in relieving knee pain include:

  • Acupressure. Pressing the Stomach 36 point located below the knee caps tones muscles and relieves joint pain anywhere in the body. Pressing the Spleen 9 points located below the kneecap on the inside of each leg relieves knee pain.
  • Acupuncture. Inflammation and pain may be relieved by acupuncture. The large intestine meridian is the most effective channel for pain relief. A National Institutes of Health consensus panel found that acupuncture may be an effective treatment for osteoarthritis pain.
  • Aromatherapy. Aromatherapy with essential oils is sometimes recommended. The essential oil of peppermint relieves pain and decreases inflammation. The essential oil of rosemary relieves pain and relaxes muscles.
  • Chinese medicine. Knee sprain and contusion (bruise) are treated by application of Shang Ke Xiao Yan Gao (Relieve Inflammation Paste of Traumatology) and ingestion of Die Da Wan (Contusion Pill). Once the initial pain and swelling have been reduced, the patient can apply Shang Shi Zhi Tong Gao (Relieve Damp-Inducing Pain Medicinal Plaster).
  • Exercise. Regular moderate exercise can reduce pain by improving the strength, tone, and flexibility of muscles. The endorphins released while exercising may also be helpful.
  • Food therapy. Following a detoxification diet may restore nutritional balance to the body and relieve joint pain. Animal proteins may induce joint pain caused by inflammatory conditions, such as arthritis, so following a vegetarian diet may be helpful.
  • Homeopathy. Rhus toxicodendron is recommended for joint and arthritis pain that is worse in the morning and relieved by warmth. Kali bichromicum is indicated for persistent, severe pain. Other homeopathic remedies can be designed for specific cases by a homeopathic practitioner.
  • Hydrotherapy. A warm compress can relieve joint stiffness and dull pain. A cold compress or ice pack can relieve sharp, intense pain.
  • Magnetic therapy. Magnetic fields may increase blood flow and block pain signals.
  • Massage. Joint pain may be relieved by massaging the area above and below the painful joint. Massaging with ice packs may interfere with pain signals and replace them with temperature signals.
  • Reflexology. Knee pain may be relieved by working the knee reflex points.
  • Rolfing. This deep, sometimes painful, massage therapy may speed healing and reduce pain.
  • Supplements. Knee pain may be relieved by taking vitamin C to promote healing, the B vitamins to balance the nervous system, which reduces pain, and calcium to increase bone strength.

Allopathic treatment of Knee Pain

Knee pain may be relieved by taking nonsteroidal anti-inflammatory drugs such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). More severe pain may be treated with prescription pain relievers such as tramadol or a narcotic. Additional treatment for knee pain depends upon the underlying cause and may include injection of drugs into the knee, surgery, wearing a brace, and/or physical therapy.

Prevention of Knee Pain

Strengthening the leg muscles may help prevent knee pain caused by overworking the joint. In addition, a stronger knee may prevent injury to the joint. Squats are an easy exercise that will strengthen the quadriceps (front thigh muscles) and hamstrings (back thigh muscles). The yoga warrior posture strengthens the muscles around the knee and increases range of motion.

 

 

 

   

   

This web site is intended for your own informational purposes only. No person or entity associated with this web site purports to be engaging in the practice of medicine through this medium. The information you receive is not intended as a substitute for the advice of a physician or other health care professional. If you have an illness or medical problem, contact your health care provider.

Arthritis can develop as a result of an infection. For example, bacteria that cause gonorrhea or Lyme disease can cause arthritis. Infectious arthritis can cause serious damage, but usually clears up completely with antibiotics. Scleroderma is a systemic disease that involves the skin, but may include problems with blood vessels, joints, and internal organs. Fibromyalgia syndrome is soft-tissue rheumatism that doesn't lead to joint deformity, but affects an estimated 5 million Americans, mostly women. The approximate number of cases in the United States of some common forms of arthritis.

Arthritis-Symptom.com is an informational out reach of the Consumer Health Information Network. It is our goal to provide up to date information about arthritis and other inflammatory and bone conditions in a easy to understand format.

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Most of the information in the site is compiled by editors from information provided by the National Institutes of Health. We are in the process of updating our pages. In the past we have not made reference to the source for information provide by our editors. In the next few weeks we hope to have all our pages marked as to the source.

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