Swelling Behind The Knee
Reviewed by: KPE Medical Review Board
There are a number of different causes of swelling behind the knee.
The most common is a Bakers Cyst where there is inflammation of the popliteal bursa at the back of the knee.
Sometimes there is back of knee swelling and pain, other times there is a lump behind the knee but no pain associated with it. It might be that only one knee is swollen, or there may be swelling behind both knees.
Most times when the back of the knee is swollen, it can be treated with a combination of rest, regular ice, compression bandages, exercises and physical therapy, but some case may require knee surgery.
What Is Heart Failure
Heart failure doesnât mean the heart has stopped working. Rather, it means that the heart works less efficiently than normal. Due to various possible causes, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart canât pump enough oxygen and nutrients to meet the body’s needs.
The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. The kidneys may respond by causing the body to retain fluid and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested. Congestive heart failure is the term used to describe the condition.
Acute Kidney Failure Complications
Acute kidney failure can sometimes cause complications. These include:
- Fluid buildup. Acute kidney failure can sometimes cause a buildup of fluid in your body. If fluid builds up in your lungs, this can cause shortness of breath.
- Chest pain. If the lining that covers your heart becomes inflamed, you may have chest pain.
- Acidic blood . If your blood has too much acid due to acute kidney failure, you can end up with nausea, vomiting, drowsiness, and breathlessness.
- Muscle weakness. When your body’s fluids and electrolytes are out of balance, you can get muscle weakness. In serious cases, this can lead to paralysis and heart rhythm problems.
- Permanent kidney damage. Acute kidney failure can become chronic and your kidneys will stop working almost entirely or completely. This is called end-stage renal disease. If this happens, you will need to go on permanent dialysis or get a kidney transplant.
- Death. Acute kidney failure can lead to loss of kidney function that is so bad, it can cause death.
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General Puffiness Or Swelling Caused By Water Retention
Signs of this kind of edema include puffiness of the hands, feet and / or face. This kind of edema is temporary and goes away without treatment. It can happen because you have been standing or sitting for too long. Edema is common after a long flight, for example, or in people who have to stand for long periods at work. Many women experience edema during their monthly period or during pregnancy. Edema in pregnancy is usually harmless, although it can be a sign of other problems if blood pressure is also high.
What Are The Symptoms Of Heart Failure
You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include:
- Congested lungs. Fluid backup in the lungs can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.
- Fluid and water retention. Less blood to your kidneys causes fluid and water retention, resulting in swollen ankles, legs, abdomen , and weight gain. Symptoms may cause an increased need to urinate during the night. Bloating in your stomach may cause a loss of appetite or nausea.
- Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.
- Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a rapid or irregular heartbeat.
If you have heart failure, you may have one or all of these symptoms or you may have none of them. They may or may not indicate a weakened heart.
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What Will The Doctor Do
Your doctor will want more information about the swelling in your leg. For example, when it started, if it hurts and whether it comes and goes or stays much the same. They will also want to know if you have been on any recent long journeys or had any times when you were not very mobile recently, and if you are on any medicines.
The doctor will examine your legs and then may go on to examine other areas. This might include your chest and/or tummy and groins.
Stages Of Heart Failure
In 2001, the American Heart Association and American College of Cardiology described the “Stages of Heart Failure.” These stages, which were updated in 2005, will help you understand that heart failure is often a progressive condition and can worsen over time. They will also help you understand why a new medication was added to your treatment plan and may help you understand why lifestyle changes and other treatments are needed.
The stages classified by the AHA and ACC are different than the New York Heart Association clinical classifications of heart failure that rank patients as class I-II-III-IV, according to the degree of symptoms or functional limits. Ask your doctor what stage of heart failure you are in.
Check the table below to see if your therapy matches what the AHA and ACC recommend. Note that you cannot go backward in stage, only forward.
The table below outlines a basic plan of care that may or may not apply to you, based on the cause of your heart failure and your special needs. Ask your doctor to explain therapies that are listed if you do not understand why you are or are not receiving them.
The New York Heart Association clinical classifications of heart failure rank people as class I-II-III-IV, according to the degree of symptoms or functional limits. You can ask your doctor if you want to know what stage of heart failure youâre in.
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Treatment Options For Knee Injuries
As you can see there are many possible causes of your non-injury related knee pain and swelling! As always, we at OhMy.Health recommend that you see your trusted health care practitioner who should do a through examination of your knee joint.
These exercises for knee pain are safe to do for almost all knee conditions, but if in doubt check in with your physical therapist.
If you have any swelling in your knee joint, you should also follow the tried and trusted RICE protocol. It stands for Rest, Ice, Compression, and Elevation.
If you have been unlucky enough to sustain a knee ligament or meniscal injury, you will find lots of specific knee injury related content covered in our knee meniscus and knee ACL videos where there are great physio approved exercises and loads of good tips and information in Karins videos.
Remember to join up for our newsletter, so that you can keep yourself informed, always be the first to know when our new exercise videos are released and enable you to always be kind to your joints!
Acute Kidney Failure Diagnosis
Your doctor will start with a physical exam. Then, theyâll order tests of your blood, urine, and kidneys.
Blood tests. These measure substances in your blood.
- Creatinine is a waste product in your blood thatâs made by muscle activity. Normally, itâs removed from your blood by your kidneys. But if your kidneys stop working, your creatinine level rises.
- Urea nitrogen is another waste product in your blood. Itâs created when protein from the foods is broken down. Like creatinine, your kidneys remove this from your blood. When your kidneys stop working, your urea nitrogen levels rise.
- Serum potassium is a substance found in your blood that balances water levels in your bloodstream. Kidney disease can cause either high or low potassium levels.
- Serum sodium is another substance in your blood that helps with fluid balance in your body. High sodium levels can mean that your kidneys arenât working properly because your body canât get rid of the right amount of sodium.
Urine tests. Your doctor will check your pee for blood and protein. Theyâll also look for certain electrolytes. The results help your doctor understand whatâs causing your kidney failure.
Urine output measurement. This measures how much urine you pass in 24 hours. You will get a container to take home, pee into, and then return to the lab after a full 24 hours. It can help your doctor determine why youâre having kidney failure.
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Medicine Side Effects As A Cause Of Edema
Edema can also be a side effect of certain drugs. This is because drugs can cause the bodys water and sodium levels to become unbalanced.
The excess sodium or water levels may also contribute to kidney dysfunction. When medications cause swelling, it is often mild edema in the legs.
Medications known to cause weeping edema include:
- NSAIDs like naproxen or ibuprofen
Will I Have To Have Any Tests
This will depend on the information the doctor has obtained by listening to you and examining you. In some cases, no further tests will be needed. In others, tests will be advised. These might include:
- Testing your urine. This can usually be done in the doctor’s surgery. The urine is tested with a dipstick to see if there is any protein in it, which might suggest a kidney problem, for example.
- Blood tests. You might have blood tests to check you for anaemia, heart failure or a DVT. Tests may be done to check the function of your kidney, liver or thyroid gland.
- A chest X-ray. This would check you for conditions such as heart failure or a pulmonary embolism.
- An ultrasound scan of the leg. This can look at the nature of the swelling and establish where it is coming from. It can be helpful to diagnose tendon problems , DVT and other problems in the veins of the legs.
- An X-ray if a fracture or infection of the bone is suspected.
Depending on the results of these tests, other investigations may be needed in some cases.
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Leg Swelling In A Single Leg
Swelling of the arms, feet, ankles, and legs is called edema. It is caused by extra fluid collecting in the tissues. Because of gravity, extra fluid in the body settles to the lowest part. That is why the legs and feet are most affected. You have swelling in a single leg.
Some of the causes for swelling in only one leg include:
Infection in the foot or leg
Muscle strain or tear in the affected leg
Blockage of the leg’s lymphatic system
A Baker’s cyst
Long-term problem with a vein not working well
Swollen, twisted vein in the leg
Insect bite or sting on the foot or leg
Injury or recent surgery on the foot or leg
Blood clot in a deep vein of the leg
Inflammation of the joints of the lower leg
Medical treatment will depend on what is causing your swelling.
If You Feel Pain Behind Your Knee When Bending Or Squatting:
You may be feeling a symptom of Patellar Tendonitis . This is caused by repetitive activity like kicking, jumping or running. The repetitive exercise puts a lot of strain on the tendon resulting in tiny tears and inflammation along the patellar tendon. Other symptoms include pain just below the kneecap, pain with any pressure to the knee, aching and stiffness after activity, knee stiffness in the morning and thickening of the patellar tendon.
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Chronic Pain Behind The Knee
Pain at the back of the knee may occur gradually. You are unlikely to be able to pinpoint the exact time your injury occurred. These injuries often start out as a niggle which you will attempt to ignore. Eventually they become progressively worse.
Chronic knee injuries can be more difficult to treat so do not ignore the early signs!
Leg Pain And Weakness
If you’re experiencing pain or weakness in your legs and have difficulty walking, you may have peripheral vascular disease. Other PVD symptoms include:
- Numbness in your legs
- A sense of cold in the calf or foot, especially compared to the other side
- A change in the color of your legs
- Sores that won’t heal on your feet or legs
- If you’re experiencing these signs of PVD, see your doctor
Leg swelling as a single symptom that lasts more than a few days requires an office visit with a primary care physician or cardiologist, Dr. Bhakta emphasized. There’s about an 85 percent chance that leg swelling is related to chronic venous insufficiency or side effects from medications such as high blood pressure medications called calcium channel blockers or corticosteroids. But you need a health care provider’s direction to determine the cause.
If leg swelling is accompanied by shortness of breath or chest pain, go to the ER.
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Do I Need To See A Doctor
If you don’t know why you have swollen legs, or you know the reason but it isn’t settling then see your doctor. There are so very many causes for swollen legs that it is important to make sure it isn’t due to something which needs treatment.
If your legs swell up a little in the hot weather but go down again overnight, you don’t need to see a doctor. Or if both ankles are a little puffy after a long flight but there is no pain or redness of the calf, and the puffiness settles quickly then you do not need to see a doctor. Minor swellings from bites or trivial injuries don’t usually need medical attention. In most other situations, it is wise to consult a health professional. If you have swollen legs and are pregnant, make sure you keep your regular appointment with your midwife. Your midwife will regularly check your blood pressure, and check your wee for protein to make sure your swollen ankles are not a sign of anything serious.
Is This An Emergency
Chronic swelling in the legs as a symptom by itself isn’t typically a medical emergency, Dr. Bhakta said. “Call and make an appointment with your primary care physician or cardiologist. The biggest concern with vein-related leg swelling, he said, is that the signs also could be connected to pulmonary hypertension.
The first thing your primary care physician or cardiologist likely will do is perform an ultrasound examination of your leg veins and an ultrasound of your heart an echocardiogram, Dr. Bhakta said.
The most often recommended non-medical treatment is compression stockings, which compress the veins and ensure that blood continues to flow.
If the exam shows that the valve in a leg vein is deteriorating to a significant degree, your doctor may recommend venous ablation. In this procedure, a medical-grade adhesive seals off the damaged vein.
If your doctor determines that your leg swelling is related to pulmonary hypertension or heart failure , you’ll probably undergo additional tests to determine the best treatment. Treatments for both pulmonary hypertension and heart failure include medications and surgery.
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Can Surgery Be Used To Treat Heart Failure
In heart failure, surgery may sometimes prevent further damage to the heart and improve the heart’s function. Procedures used include:
- Coronary artery bypass grafting surgery. The most common surgery for heart failure caused by coronary artery disease is . Although surgery is more risky for people with heart failure, new strategies before, during, and after surgery have reduced the risks and improved outcomes.
- Heart valve surgery. Diseased heart valves can be treated both surgically and non-surgically .
- Implantable left ventricular assist device . The LVAD is known as the “bridge to transplantation” for patients who haven’t responded to other treatments and are hospitalized with severe systolic heart failure. This device helps your heart pump blood throughout your body. It allows you to be mobile, sometimes returning home to await a heart transplant. It may also be used as destination therapy for long-term support in patients who are not eligible for transplant.
- Heart transplant. A heart transplant is considered when heart failure is so severe that it doesn’t respond to all other therapies, but the person’s health is otherwise good.
Why Am I Retaining Water In My Legs
The body becomes unable to eliminate fluid properly when certain medical conditions are present. Standing for long periods of time causes fluids to pool in the legs, thus increasing water retention. Hot weather can also lead to fluid retention because the body is less efficient at removing fluid from the body.
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