Knee Joint Pain: Why You Shouldn’t Just Brush It Off

Knee Joint Pain Symptoms - Dr Andrew Dutton

Knee joint pain is a symptom that could potentially occur to anyone – young or old. Since everyone’s perception and tolerance of pain varies from person to person, this experience is personal. Regardless of what degree a person is feeling it, pain is an initial sign that something is not right. For anyone who might have felt this type of discomfort, this warrants a closer look so that appropriate intervention can be taken.

Don’t Let Knee Pain Linger

The knee may appear simple on the outside, but internally it is a network of bones, cartilage, tendons, muscles, ligaments, nerves and blood vessels. All these parts work together like a complicated piece of bioengineering that allows us to move or make the steps we often take for granted.

We may not realise it, but the knee is one of the most stressed-out joints in the human body. Each part moves in different directions all at once making it prone to injury with a single misstep. For such a small part, the knees are vulnerable to many problems that can be sorely debilitating. Knee problems are even considered as one of the five leading causes of disability in Singapore.

This highlights the importance of a prompt response to the problem because the longer that knee pain is left to linger, the worse the condition becomes.

Causes of Knee Joint Pain

There are three main classifications for the causes behind knee joint pain – acute injuries, underlying conditions, and overuse injuries. Knowledge of these causes can point you towards the right step to take in terms of prevention and relief.

Acute

This is often a result of an accident or sudden injury. It may be caused by trauma due to a hard stop or a violent twist of the knee.

Some examples of an acute knee injury include the following:

  • Muscle strain – This usually occurs in sports-related activities requiring rapid acceleration and deceleration (e.g. basketball, soccer, and softball). Pain is accompanied by swelling of the knee joint. 
  • Meniscus tears – The tear can be felt like a pop. While most people may still be able to walk with the injured knee, it will gradually stiffen and swell in a few days.
  • Patellar dislocation – Although it may be extremely painful, this injury is reversible. It can occur when one makes a sudden turn while the leg remains planted on the floor.
  • Patellar tendon rupture – This is characterised by a sudden onset of pain which makes walking difficult. This can be acquired through activities like running, jumping, or squatting to pick something up. 
  • Knee fracture – This may be caused by a fall or collision. Pain is often associated with swelling and the inability to straighten the knee. 
  • Unhappy Triad of the knee – This is a severe knee injury that is accompanied by intense pain and rapid swelling. 

Underlying Conditions

Knee pain can sometimes be a symptom of a pre-existing condition. In such cases, the doctor will prioritise the diagnosis and treatment of the condition to consequently alleviate knee joint pain and other accompanying symptoms. The goal is to reduce inflammation and restore joint function. 

Here are some of the conditions that can result in knee joint pain. 

  • Knee Arthritis – Arthritis comes in forms that are characterised by severe pain that worsens with age. The knees can also feel swollen and stiff, limiting a person’s range of motion.
  • Knee Tumor – Pain associated with tumor growth can be felt intermittently, and it eventually becomes a constant sensation. It is more notable at nighttime, such that it can even disrupt sleep.
  • Infection – Conditions like cellulitis or septic arthritis is associated with pain, swelling, and redness.
  • Systemic Lupus Erythematosus (SLE) – This condition causes arthritic pain that is associated with stiffness, swelling, tenderness, and warmth in the joints. It usually affects joints in distal areas of the body, like the knees. 
  • Lyme Disease – Joint pain is among the late symptoms of this tick-borne disease. Episodes become less frequent and less severe over time. 
  • Obesity – Increases the risk of osteoarthritis in the knee, eventually increasing the pressure on the knee joint. Exercise and weight loss can help reduce symptoms and improve knee function.
  • Sexually Transmitted Diseases (STDs) – STDs like gonorrhea (gonococcal arthritis) and chlamydia (reactive arthritis) can result in knee joint pain. 
  • Hip Joint Pathology – In some cases, knee pain is actually referred pain that stems from hip problems.

Overuse

As the name suggests, overuse injuries are sustained through repetitive movement. The problem may stem from intrinsic (anatomical or biomechanical) or extrinsic factors (training errors).  When certain movements are applied in such a way that adaptation by the knee joint cannot occur, the overload of weight can cause microscopic injuries which eventually leads to painful sensations.

Common overuse injuries include:

  • Patellar Tendinopathy or Jumper’s KneeThis is a result of the patellar tendon being overstressed. This is a sports-related injury that usually results from frequent jumping on hard surfaces. 
  • Chondromalacia – An overuse injury which is caused by chronic friction between the patella and the groove in the femur. This causes a dull, aching pain at the front of your knee right behind your kneecap. This also comes with a creaky sound or a grinding sensation. 
  • IT (Iliotibial) band syndrome is also a problem that is caused by overdoing an activity, and it is characterised by a sharp, burning pain on the outer side of the knee. 
  • Knee BursitisAlso called as the “housemaid’s knee,” or “roofer’s knee” based on the occupational histories. This happens through a prolonged kneeling position. It is usually mildly painful. 

Diagnosis of Knee Joint Pain 

  • X-ray – For viewing fractures, joint alignment, joint space and bone spurs
  • CT (Computerized Tomography) Scan – Suitable for diagnosing fractures
  • MRI (Magnetic Resonance Imaging) – Useful in diagnosing injuries to the tendons, cartilage, ligaments and menisci by creating a 3D image 
  • Knee Arthroscopy – A minimally invasive procedure that can visualise the internal structures of the knee to help identify what is causing knee pain
  • Joint Aspiration – Since the knees and its bursae are filled with fluid, obtaining samples by aspirating them with a thin needle can be done especially if symptoms suggest an infection or crystalline arthritis. 

Treatment of Knee Joint Pain 

  • Initial Treatment Also referred to as emergency treatment, this includes activity limitations to speed up recovery, prevent further damage, and to protect the knee from future injuries. 
  • ExercisesExercise is recommended to reduce pain and disability of the affected joint. Depending on the injury or condition behind knee pain, there are different exercises to help stretch and strengthen the joint and its surrounding structures. However, any exercise program should be done only after sound medical advice. Professional monitoring also ensures proper execution and prevents further damage. 
  • MedicationsThere are different prescription and over-the-counter pain medications to alleviate knee joint pain. Pain relief can also be achieved through medications that target underlying conditions. Since drug interactions are likely, especially with patients taking other medications, a thorough discussion must be had with the primary care physician. 
  • SurgeryThis intervention is used to repair structural issues like a fractured bone, torn cartilage or ligament which can cause severe knee pain. However, surgery can’t fix every knee problem. There should be a thorough evaluation and proper patient selection. There are also less invasive surgical options like knee arthroscopy, which is a preferred treatment because there is less discomfort and earlier recovery.

However severe knee pain is, it remains true that immediate attention and action is necessary to provide relief. As explained above, knee joint pain can come from a myriad of causes and may vary in severity. It can be either be felt as slight discomfort or it can leave you severely debilitated. However, through prompt medical intervention, you will be able to address the problem, restore joint function, and prevent complications.

Don’t allow knee pain to linger and risk it getting a hold on your life! Seek professional help and book an appointment today with Harvard Fellowship-trained orthopaedic surgeon, Dr. Andrew Quoc Dutton