What Is Knee Swelling
Swelling in the knees is a common problem with many possible causes. Knee joints are complicated structures with a number of parts that can cause pain, including:
- Tendons, which connect muscles and bones
- Ligaments, which connect bones to other bones
- Cartilage, which covers the ends of bones and cushions them from each other
Knees have a heavy workload in our lives and bear our weight much of the time. Many kinds of injuries, arthritis, and other problems caused by repetitive use can lead to swelling, an accumulation of fluid in a particular part of the body.
Types Of Outer Knee Pain
There are several health conditions that may cause outer knee pain.
Iliotibial band syndrome develops if a band of connective tissue rubs on the outside of your knee. The iliotibial band is a thick band of fibrous tissue that runs from your hip to below your knee on the outside of your leg. If you bend and straighten your leg a lot, it can cause this tissue to become sore and inflamed where it passes over the bottom of your thigh bone and meets your knee. This type of problem is most common in runners and cyclists.
Lateral collateral ligament injury is caused by a blow to the inside of your knee, which stretches the outside of your knee and injures the ligament. A ligament is a band of tissue that connects one bone to another. The lateral collateral ligament runs down the outer side of your knee.
Meniscal injury is damage to the meniscal cartilages inside your knee. These cartilages act like shock absorbers and may tear when you twist your knee with your foot still on the ground. This type of injury is common in sports where you have to change direction suddenly for example, football and skiing. It can also happen in jobs that involve lifting and twisting for example, construction or manual labour. The meniscus can tear without any particular injury as you get older because of wear and tear.
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Pain On The Outside Of The Knee
- A burning pain at the outside of the knee may be due to iliotibial band syndrome. The iliotibial band is a ligament running down the outside of the thigh to the outside of the knee which can become inflamed and irritated.
- A tear in one of the two menisci can cause pain, swelling, and a feeling that the knee is giving way or locking.
- A burning sensation at the side of the knee can indicate pressure on the menisci and sometimes can be due to a fluid filled cyst.
Risk Factors For A Swollen Knee
- Being overweight or obese your knees are weight-bearing so any excess weight puts more strain on them, which can damage your knee joint over time obesity also increases the risk of osteoarthritis, which is a common cause of a swollen knees
- Playing certain sports if you take part in sports that involve pivoting, rotating or twisting your knees, youre at greater risk of knee injuries, which cause swelling
- Your age your risk increases as you get older
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Pain At The Back Of The Knee
- A sharp stabbing pain at the back of the knee can commonly be due to hamstring tendonitis, caused by inflammation of the tendons connecting the hamstring to the knee. A common cause is overuse, and the pain becomes more apparent with continued use.
- A swelling and tightness behind the knee might be due to inflammation of the popliteal bursa . This is often due to there being another mechanical abnormality within the knee producing excess fluid.
- Pain at the back of the knee may also be due to a tear in the posterior part of the meniscus.
Common Causes Of Inner Knee Pain
There are a variety of causes of inner knee pain. Many of them can be linked to an injury. Some of the most common incidents that cause knee injury and pain include falls, sports injuries, or increased activity.
Adults particularly those older than 60 are most likely to experience knee pain. However, inner knee pain can also occur in children and adolescents.
According to the American Academy of Family Physicians, the most common causes of inner knee pain in children are:
- patellar subluxation
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When To Speak To A Doctor
For most people, minor knee problems should begin to settle within 6 weeks.
But its always best to speak to a GP if your knee pain gets worse, or your knee starts to lock or give way, and hurts when youre not moving it.If youre not able to extend or bend your knee at all, it needs to be checked out as soon as possible. Look out for any deformities or lumps around the knee joint too.
A GP can make a referral for you to see a specialist for further investigation or treatment.
Phone 111 if you have difficulty putting any weight on your sore leg or your knee becomes immediately swollen after an injury.
This article has been medically reviewed by Dr Rhianna McClymont, Lead GP at Livi.
Possible Causes Of A Burning Or Stabbing Knee Pain
Some knee pain is due to overstretching or excessive strain put on the ligaments and tendons of the knee, possibly by sporting exercise such as athletics or cycling. The ligaments and tendons can become overstressed, irritated and inflamed causing pain. A very common cause of this type of pain is a tear in the meniscal cartilage or surface cartilage of the knee.
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When To See A Doctor
Consult a doctor if knee pain does not improve with rest or occurs with other symptoms. Also, see a doctor after a sudden injury, such as from blunt force trauma.
In addition, it is important to receive professional care if there are any indications of an infection, such as a fever or pus coming from a wound.
What Questions Might A Healthcare Provider Ask To Diagnose Arthritis Of The Knee
Your healthcare provider will interview you when you report your symptoms. Some questions might include:
- Does anyone in your family have arthritis of the knee?
- Does your knee swell up?
- Is your skin often red?
- Is your skin often warm?
- Do you have symptoms in one knee or both?
- How long have you had these symptoms?
- What medications do you take?
- How severe is your pain?
- Do you struggle to walk?
- Do the symptoms interfere with your daily activities?
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How Much Is Knee Wrap For Swelling
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What Foods Can Help Reduce Leg Swelling
The best foods to reduce swelling may vary depending on the underlying cause. However, some general tips include eating a healthy diet that is low in salt, drinking plenty of water to stay hydrated, eating plenty of fruits and vegetables, and avoiding processed foods.
It is also important to consult with a doctor or nutritionist to develop a personalized diet plan that will help reduce swelling in your legs.
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Treatments That Have Already Been Instituted
Many patients have undergone physiotherapy, steroid injection or previous arthroscopy. The success of previous therapies guides further management.
If a patient has not undergone physiotherapy this may be the first port of call particularly in anterior knee pain related to patellofemoral joint dysfunction. History of previous surgery, in particular total knee replacement or cruciate ligament reconstruction, associated with new onset of symptoms should warrant a referral to the orthopaedic surgeon.
What Causes Severe Knee Pain
The most common causes of severe knee pain are:
- Bone Injuries: fractures and joint dislocations
- Ligament Injuries: ACL, PCL, MCL or LCL tears
- Meniscus Tears: damage to the knee carilage
- Gout Knee: an inflammatory condition
Other possible causes of severe knee pain include knee arthritis, septic arthritis and cellulitis.
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When To See Your Doctor
Severe knee pain can be an indication that there is something serious going on and you should see your doctor if:
- Your knee looks deformed
- You cant put any weight through the leg
- Your knee movements are limited cant fully bend or straighten the knee
- You have severe knee pain at night or when resting
- Your knee keeps giving way
- You feel unwell or have a fever
- There is redness or the knee feels hot
- There is major swelling around the knee
- Your symptoms persist or get worse
- You have pain, swelling, redness, tingling or numbness in the calf
What Are The Signs & Symptoms Of A Knee Injury
The signs and symptoms of a knee injury depend on the cause. Most knee injuries cause pain. A knee injury may also lead to the knee feeling weak, “giving way,” or “locking.” Someone with a knee injury might not be able to fully bend or straighten the knee. The injured knee may be swollen or bruised.
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How Is Arthritis Of The Knee Treated
Healthcare providers can’t cure knee arthritis. But they have some tips that might reduce the severity of your symptoms and possibly stop the arthritis from getting worse, including:
- Maintain a healthy weight.
- Exercise using low-impact activities instead of high-impact activities . Aim for about 150 minutes of exercise per week.
- Wear shock-absorbing inserts in your shoes.
- Apply heat or ice to the area.
- Wear a knee sleeve or brace.
- Physical therapy exercises that help with flexibility, strength and motion.
- Use a cane.
Most people have stage 4 arthritis when they get surgery.
What Is Osteoarthritis Of The Knee
Osteoarthritis of the knee happens when the cartilage in your knee joint breaks down, enabling the bones to rub together. The friction makes your knees hurt, become stiff and sometimes swell. While osteoarthritis in the knee cant be cured, there are many treatments to slow its progress and ease your symptoms. Surgery is an option for more severe forms of osteoarthritis.
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What Are The Common Causes Of Knee Pain
Sustaining an injury is by far the most common and often unavoidable reason for experiencing knee pain and swelling.
A meniscus tear is a typical knee injury, particularly for athletes or people who play contact sports. The meniscus is a piece of cartilage that cushions your femur and tibia . There are two in each knee joint.
Whether your injury is a sprain, torn ligament or menisci, dislocation or broken bone, youll usually get some fairly instant knee pain, swelling and tenderness. And the knee pain will be more intense depending on how badly youre injured, explains Dr Rhianna McClymont.
Underlying conditions usually cause knee pain to come on more gradually instead. While this list is by no means exhaustive, GPs tend to see the following conditions causing chronic knee pain.
Other Inner Knee Pain Treatments
If your inner knee pain worsens after several days, or if basic at-home remedies dont alleviate symptoms, you should go see your doctor.
Some treatment methods for more serious knee injuries include:
- Steroid injection. This injection is used to treat pes anserine bursitis.
- Physical therapy. Therapy often involves stretching, exercises, and ultrasound therapy.
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Severe Knee Pain Symptoms
Severe knee pain is often accompanied by other symptoms which can help you to work out what is wrong.
Severe Knee Pain & Swelling
Severe Knee Pain & Instability
Severe knee pain accompanied by instability usually points to a ligament injury. If the knee gives out completely i.e. collapses so that you stumble or fall, it is likely that you have ruptured one of the knee ligaments, such as a complete ACL tear.
If however the knee feels wobbly but doesn’t actually give way, it’s likely that a ligament was overstretched but remains intact, known as a knee sprain.
Swollen, Red & Hot Knee
Severe knee pain that is accompanied by swelling, redness and heat is most likely due to gout or septic arthritis or cellulitis and may require antibiotics.
Sudden, Severe Knee Pain
Severe knee pain that comes on very suddenly at night with no obvious cause usually indicates gout knee.
If however the severe knee pain started after some kind of accident e.g. fall, RTA or sports, then you may have broken or dislocated part of the knee. Knee cap injuries are particularly common.
Severe Knee Pain With Deformity
If your knee looks deformed or out of shape, you problem have some kind of bony injury. If there is a large obvious lump on the outer side of the knee, you’ve probably got a dislocated kneecap.
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What Are The Types Of Arthritis Of The Knee
There are around 100 types of arthritis. The most common types that might affect your knees include:
- Osteoarthritis is the most common of the types on this list. Osteoarthritis wears away your cartilage the cushioning between the three bones of your knee joint. Without that protection, your bones rub against each other. This can cause pain, stiffness and limited movement. It can also lead to the development of bone spurs. Osteoarthritis gets worse as time passes.
- Post-traumatic arthritis is a type of osteoarthritis. The cartilage starts thinning after trauma to your knee . Your bones rub together, and that causes the same symptoms as osteoarthritis: pain, stiffness and limited movement. Your knee arthritis symptoms might not start until years after the trauma.
- Rheumatoid arthritis is an autoimmune disease. A healthy immune system causes inflammation when it’s trying to protect you from an infection, injury, toxin or another foreign invader. The inflammatory response is one way your body protects itself. If you have rheumatoid arthritis, you have an unhealthy immune system that triggers inflammation in your joints even though theres no foreign invader. The inflammation causes pain, stiffness and swelling of the synovial membrane, which can also wear away your cartilage.
How Are Knee Injuries Diagnosed
To diagnose a knee injury, health care providers ask about how the injury happened and what symptoms it causes.
The health care provider will do a physical exam that includes pressing on the knee and legs and moving them in certain ways. These tests can show what part of the knee is injured.
Imaging tests done sometimes used include:
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Medial Collateral Ligament Sprain
Injury to the medial collateral ligament is fairly common and is usually the result of acute trauma. The patient reports a misstep or collision that places valgus stress on the knee, followed by immediate onset of pain and swelling at the medial aspect of the knee.11
On physical examination, the patient with medial collateral ligament injury has point tenderness at the medial joint line. Valgus stress testing of the knee flexed to 30 degrees reproduces the pain . A clearly defined end point on valgus stress testing indicates a grade 1 or grade 2 sprain, whereas complete medial instability indicates full rupture of the ligament .
Fluid Outside The Knee Joint
The most common cause of excessive fluid in the soft tissue surrounding the knee is prepatellar bursitis. This is inflammation of a fluid-filled sac which cushions the kneecap . The buildup can be seen and felt at the top of the kneecap. It is not something you would see under the knee.
An injury such as a contusion may also cause localized swelling. In some cases, the buildup of blood and fluid may mimic an acute injury of the knee joint.
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