Mildly Swollen But Painless Knee: Possible Cause
The most common cause of non-traumatic knee swelling is a misalignment of the large tibia bone that comprises the lower part of the knee joint, says Eugene Charles, DC, Diplomate of applied kinesiology and author of Journey to Healing: The Art and Science of Applied Kinesiology.
This frequently happens insidiously through daily activities where you turn your leg and foot out repetitively.
These subtle movements include getting out of a chair or car seat and going up stairs.
Over time the tibia bone rotates slightly out of alignment and needs to be realigned through a precise chiropractic or osteopathic adjustment.
Resting it only helps because you are not using it, but rest alone does not fix the underlying cause of the knee problem specifically the misalignment of the knee joint itself.
Injuries That May Lead To Knee Swelling
- Meniscal tears
Needless to say, the gravity of some of these conditions is worse than others. For instance, malignant tumors are far worse than mild sprains, osteoarthritis is a localized issue whereas rheumatoid arthritis involves your entire immune system, and so on and so forth.
Now that weve got the basics covered, lets move on to why youre really here.
What About A Petallar Tracking Problem
The patella is the kneecap. Women are more likely than men to experience a tracking issue with the patella, which can lead to pain, a feeling of fullness in the knee, and swelling.
But sometimes there may only be the funny feeling and the swelling.
Dr. Charles explains, In over 33 years in practice, predominantly a sports injury practice, I have found that most patella tracking problems occur due to a rotated tibia bone which alters the movement of the patella.
Turning your leg and foot outwards when exercising, especially during leg extensions or lunges, are a common cause.
It can also be due to a weakness of the medial quadricep muscle, relative to the outer quadriceps.
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Youre Trying To Relax
When your body is at rest, you may notice the mild to moderate pains that you could more easily ignore when your mind was preoccupied with busy thoughts during your waking hours.Additionally, when you sleep, your body produces less cortisol. While high cortisol levels can lead to heart disease, healthier levels can help your body reduce inflammation.
Since most joint pains are caused by or worsened by inflammation, moderate amounts of cortisol can help your body manage this inflammation. But when your body is relaxed, such as when youre trying to go to sleep, your body has less cortisol to mitigate the swelling and irritation in your knees.
Muscles Weak And Strong
Maintaining flexible muscles around your knee that are strong enough to support your body may help to alleviate or prevent tightness in the knee area. Strong legs, hips, and buttocks are thought to reduce knee tightness.
Research surrounding the benefits of strong leg muscles in relation to knee tightness varies. According to a 2010 study that looked at over 2,000 knees of men and women who had or were at risk for osteoarthritis, neither hamstring nor quadriceps strength predicted frequent knee symptoms such as pain, aching, and stiffness.
Still, having strong quadriceps may help to reduce the risk of knee problems, since stronger muscles can help to support the knee joint.
A 2014 study that was conducted over five years with 2,404 participants who also had or were at risk for osteoarthritis, found that weak quadriceps were associated with an increased risk of worsening knee pain in women but not in men. Researchers acknowledged that their longer study built on similar studies of shorter duration , and smaller group sizes, to support the link between leg muscle strength and knee pain. Their study suggests there may also be sex-specific differences in risk factors for worsening knee pain.
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Understanding An Infused Knee
If you have knee pain or an injury to your knee, swelling may be a factor. Swelling is usually obvious because of the change in your kneeâs appearance. But other signs of knee swelling include discomfort, pain, or loss in your range of motion. â
Knee swelling is often the result of:
- Traumatic injuries like fractures and meniscus or ligament tears
- Infections in your knee, which are rare but can be severeâ
- Overuse of the joint from repetitive movements â
Of all causes, overuse is the most common reason for an infused knee. Fluid buildup is your bodyâs way of protecting the area from extra damage. You may have minor swelling after a vigorous activity. This can also be an early sign of arthritis. If you have persistent swelling, talk to your doctor about your concerns.
An infused knee can happen at the front of your knee, called an anterior injury. It can also happen at the back of your knee, called a posterior injury. Anterior swelling is much more common than posterior because of the way we use our knees for activities.
Bursitis Could Be To Blame
Often confused with arthritis, bursitis is another condition that can cause swollen knees. Bursitis is a reaction in which sacks of fluids, blood vessels, and nerve endings that cushion your jointscalled bursaebecome inflamed, explains Dr. Gladstone. Typically, bursitis occurs across the front of the knees as a result of excess pressure and friction on the joint over time.
Those little blood vessels bleed and the bursa produces excess fluid, which creates this giant, swollen pouchlike a bubble of fluid just below the skin, Dr. Gladstone says. These inflamed pouches, which can take on all sorts of shapes and sizes, can be incredibly painful to put pressure on.
Bursitis is most common in people who work a lot on their knees, like carpenters, plumbers, and tile-setters, says Dr. Gladstone. However, a good fall can cause bursitis, too.
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How Does An Orthopedist Treat Fluid On The Knee
The team of orthopedic knee specialists begins with a thorough exam and testing to identify the underlying condition causing the liquid accumulation.
They review your health information and symptoms and complete a physical exam. When necessary, your physician may order blood tests, other lab work, X-rays, and magnetic resonance imaging scans.
Once your orthopedist understands your needs, they may recommend an aspiration treatment to extract fluid from the swollen knee joint.
During this process, your doctor numbs the site and uses a hollow needle to drain fluid from the knee. They may also provide a knee brace to stabilize and support your leg.
Your doctor can also recommend treatment for the underlying issue causing your symptoms.
Common Causes Of Fluid In The Knee
There are various issues that may cause fluid in knees. Here are some of the most common:
Knee Trauma or Injury – Trauma occurs when the knee joint is impacted from an outside force, resulting in injury to the knee. The type of fluid to enter the knee from a traumatic injury is usually blood or excess joint fluid, though other types of fluid in the knee may be present. The most common forms of knee injury to cause fluid in knees are:
- Meniscus Tears
- Ligament Injuries, such as ACL Tears
- Overuse Injuries
Arthritis – The are several types of arthritis that may cause fluid on the knee. The most common types that cause excessive knee fluid are:
- Osteoarthritis – the natural wear and tear of the cartilage around the knee due to aging
- Rheumatoid arthritis – a chronic inflammation of the joints due to an autoimmune disease
- Gout – a type of arthritis where a patient’s nutritional intake may cause uric acid to build up in the joints
Infection or Inflammation – When areas of the knee are inflamed, this causes the knee to swell with fluid as the body combats the injury or bacteria in the area. A common form of inflammation that causes fluid in knees is bursitis. Bursa are cushioning sacs around the body which when inflamed may cause swelling or excess knee fluid.
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What Is The Best Way To Get Rid Of Fluid On The Knee
This is purely situational. Whats best for you may be different for someone else.
- The RICE method is essentially first-aid for fresh injuries.
- Oral over-the-counter medications like pain relievers and NSAIDs are solid options but topical salicylates may be better if the former give you gastric distress.
- Corticosteroids may also be prescribed if OTC options dont work or if the knee swelling is caused by autoimmune disorders
- Your doctor may also order antibiotics if bacterial infections are what caused the swelling and knee pain.
- Knee joint aspiration can also be an option to quickly evacuate the water inside your knees.
- Minimally invasive and extensive knee surgeries may be required if structures in and around your joint need repair.
You May Have An Autoimmune Condition
In addition to rheumatoid arthritis, a number of other autoimmune conditionsin which the immune system attacks the body in various wayscan contribute to swelling and pain throughout the body, including in the knees.
Though less common, systemic autoimmune conditions, like lupus, may cause swelling, Dr. Gladstone says. Like Lyme, these conditions may explain inflammation in the knees when nothing else can. Along with pain and swelling, people with autoimmune conditions often experience chronic fatigue, muscle aches, and low fevers.
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Extracorporeal Shock Wave Therapy
Extracorporeal shock wave therapy involves sending shock waves into the area of the bone with bone marrow edema to increase circulation, promote healing, and decrease the intensity of nerve signals to improve pain and function of the knee joint. A large treatment probe is placed on the outside surface of the skin around the knee joint to deliver shock waves into the bone through the overlying skin and muscles. Extracorporeal shock wave therapy is a noninvasive procedure performed on an outpatient basis.
Rapid Knee Swelling Without An Injury
Occasionally, a swollen knee develops rapidly without any injury. The most common causes of this are:
1. Infection: Infections increase in the amount of fluid produced in the joint resulting in a swollen knee. Knee infections usually develop after surgery or a deep cut, but sometimes an infection in your body can spread to your joint.
It is very difficult for your body to fight an infection within a joint and sometimes surgery is required before the swelling will go down.
2. Gout Knee: High levels of uric acid cause sharp, needle like crystals to form in your joints leading to inflammation and water on the knee.
Gout is usually treated with medication and appropriate diet. Find out more about the causes, symptoms and treatment options in the Gout Knee section.
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Otc Pain Relievers Nsaids And Topical Salicylates
Over-the-counter medications are also options. You can buy them virtually anywhere without needing a doctors prescription and come in various brands and types.
Per MedlinePlus, there are 2 main types of oral OTC pain relievers you can buy:
- Acetaminophen , and
Acetaminophen has no anti-inflammatory properties but it does help you manage the pain. Popular examples include Tylenol and Panadol.
NSAIDs, on the other hand, have anti-inflammatory properties as well as pain-relieving properties. Examples include Advil, Aleve, Celebrex, and several others.
Apart from oral medication, you could also get topical salicylates.
Topical salicylates are technically still considered NSAIDs, so they can also help reduce pain and swelling.
For those of you whose stomachs dont react well to oral NSAIDs, these topical alternatives may be the better option.
However, Harvard says that topical NSAIDs arent as effective as their oral counterparts because your body absorbs less of the medicine. So, you might not feel the same exact relief. Also, dont apply these on wounds or rashes.
Water On The Knee Symptoms Causes And Solutions
Water on the knee is characterized by the accumulation of fluid and inflammation around the knee joint. When this occurs your knee may appear puffy and larger than usual. You may also find that it feels stiff and painful when you place weight on it and is sore to the touch. All of this can cause discomfort while walking up and down stairs, kneeling, and squatting. If you are experiencing symptoms of water on the knee you should consult your doctor to determine the best course of treatment for you.
Water on the knee is also known as knee joint effusion and swelling.
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Surgical And Other Procedures
Treating the underlying cause of a swollen knee might require:
- Arthrocentesis. Removing fluid from the knee can help relieve pressure on the joint. After aspirating joint fluid, your doctor might inject a corticosteroid into the joint to treat inflammation.
- Arthroscopy. A lighted tube is inserted through a small incision into your knee joint. Tools attached to the arthroscope can remove loose tissue or repair damage in your knee.
- Joint replacement. If bearing weight on your knee joint becomes intolerable, you might need knee replacement surgery.
Your doctor might also recommend physical therapy to improve your knee’s function and strength.
Potential Causes Of Knee Swelling
Whether water on the knee is mildly annoying or painfully debilitating, a person will want to identify the likely cause and treat the symptoms to help reduce the likelihood of future problems. Chronic or long-standing swelling may lead to joint tissue damage, cartilage degradation, and bone softening, therefore treatment is usually recommended.
This article describes 12 conditions that frequently cause knee swelling, also called water on the knee.
1. Injury to the kneeTrauma to the knee’s bones, ligaments, tendons, bursae, meniscus, or articular cartilage can cause pain and swelling. Serious injury can cause blood to flood into the knee joint, leading to significant swelling, warmth, stiffness, and bruising. This condition is called hemarthrosis and warrants urgent medical care.
A patient should also seek medical attention if knee pain is severe, if the affected leg cannot bear weight, or if there is suspicion of a broken bone.
2. Knee osteoarthritisDegeneration of the cartilage of the knee joint can result in an overproduction of joint fluid, causing the knee to swell. A swollen knee due to knee osteoarthritis is typically accompanied by pain.
In fact, evidence suggests people who have severe knee pain from osteoarthritis are more likely to experience knee swelling. One study2 found that:
People should seek medical attention immediately if they think their symptoms may be caused by septic bursitis.
See Gout Treatment
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Osteoarthritis And Rheumatoid Arthritis
Osteoarthritis and rheumatoid arthritis are two common types of arthritis that can lead to knee tightness. Osteoarthritis causes the cartilage in the knee to erode, leading to malalignment. Rheumatoid arthritis causes damage to the lining of the joints, which leads to inflammation. Both types of arthritis can lead to limited function and range of motion, deformity, and tightness.
Exercises that strengthen the surrounding muscle groups may help your range of motion and knee stability.
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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How Do I Prevent Knee Synovitis
The main way to prevent knee synovitis symptoms is to protect your knees from injury. However, in the case of an autoimmune condition that causes frequent swelling of the knee, injury prevention will only do so much. But, paying attention to the health of your knees and minding injury prevention techniques will still go a long way in decreasing pain and other symptoms. Even with the most preparation and caution, injuries happen. In case of an injury causing knee synovitis or internal bleeding in the joint, take care of your knee before the pain and condition turns chronic. Patients can help prevent a chronic knee synovitis diagnosis with:
- Stretching the knee every day, maintain flexibility of the surrounding structures
- Exercising the knee and building muscle tissue, aerobic exercise in particular will help to get the blood moving and flush out excess fluid
- Strength training will improve the strength of not only the surrounding muscles of the knee, but also the surrounding soft tissues
- Seeking prompt medical attention as soon as you suspect a bleed in the joint, whether it be from injury or a compromised immune system
- Losing weight so as to decrease pressure on the knees
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Treatments For Swollen Knee
Your treatment will depend on whats causing your swollen knee and how painful it is. Your doctor will recommend the most appropriate treatment after diagnosing the underlying cause.
In most cases, youll be advised to take painkillers. You can also apply ice and elevate your knee to help reduce the swelling. Sometimes removing some of the fluid in your knee helps reduce the pain and stiffness.
Other treatments include:
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