Causes Of Knee Pain And How To Fix Them
Sports doctor Jordan Metzl explains the most common knee injuries and how to manage them.
So you’ve got knee pain from running. Whether you’re a complete beginner, or you’re two weeks into your latest cycle, knee pain is frustrating. We spoke to sports doctor Jordan Metzl, who explains four of the most common causes of knee pain from running, and what you can do about them:
Conditions That May Cause Knee Problems
Problems not directly related to an injury or overuse may occur in or around the knee.
- Osteoarthritis may cause knee pain that is worse in the morning and improves during the day. It often develops at the site of a previous injury. Other types of arthritis, such as rheumatoid arthritis, gout, and lupus, also can cause knee pain, swelling, and stiffness.
- Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the knee below the kneecap. It is especially common in boys ages 11 to 15.
- A popliteal cyst causes swelling in the back of the knee.
- Infection in the skin , joint , bone , or bursa can cause pain and decreased knee movement.
- A problem elsewhere in the body, such as a pinched nerve or a problem in the hip, can sometimes cause knee pain.
- Osteochondritis dissecans causes pain and decreased movement when a piece of bone or cartilage or both inside the knee joint loses blood supply and dies.
How To Prevent Throbbing Knee Pain At Night
If chronic knee pain is keeping you awake at night, there are many steps you can take to help prevent the painful symptoms. With a few preventative measures, you can help avoid waking up with sharp pains in your knee.
According to Dr. April Chang-Miller, who is a specialist in rheumatology, this is what you can do to prevent knee pain at night:20
- Make sure that your bed, pillows, and blanket are comfortable and dont add to your discomfort.
- Make sure that your bed allows you to have a comfortable sleeping position.
- Take a warm bath or shower before going to bed to help relax your joints and muscles.
- Avoid drinking stimulants like alcohol or coffee before going to bed to help you sleep better.
- Prop your legs up with a pillow to help reduce knee pain while sleeping.
- Dont exercise within 3 hours before going to bed. However, remember that exercise helps to reduce knee pain over time.
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How Are Knee Problems Diagnosed
In addition to a complete medical history and physical exam, other tests for knee problems may include:
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X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.
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Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body can often determine damage or disease in a surrounding ligament or muscle.
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Computed tomography scan . This test uses X-rays and computer technology to make horizontal, or axial, images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
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Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube , which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen used to evaluate any degenerative or arthritic changes in the joint to detect bone diseases and tumors to determine the cause of bone pain and inflammation.
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Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
Iliotibial Band Friction Syndrome
Your iliotibial band is a thick piece of tissue and fascia that runs down the outer side of your thigh. Sometimes it can become irritated with overuse or repeated stress. This is a common running injury known as iliotibial band friction syndrome .
Symptoms of ITBS include:
- Pain on the outside part of your thigh near your hip or knee
- A feeling of tightness near your hip or knee
- Difficulty walking or running
The pain from ITBS usually gets worse with increased activity and better with rest. Many people benefit from physical therapy to learn stretches and strengthening exercises for ITBS.
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Lack Of Sleep Makes Pain Worse
It can be easy to get stuck in a cycle where you cant sleep because of knee pain. That lack of sleep can actually make your pain worse. Sleep is vital for healing and rejuvenation. Without sleep, you have less energy to expend on healing as you need to focus your bodily processes on staying alert and awake.If nighttime knee pain causes you to toss and turn, you may end up accidentally further straining your knee by sleeping in an uncomfortable position.
Diagnosis Of Pain Behind The Knee
Your doctor will examine your knee and take a history, asking about:
- the type of pain you have, when it started and whether it comes and goes
- how active you are
- any activity, accident or injury that could have caused it
If you have signs of a popliteal cyst, your doctor may suggest an ultrasound scan. If they suspect a posterior cruciate ligament injury, they may suggest an X-ray or a magnetic resonance imaging scan.
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Mayo Clinic Q And A: Pain After Knee Replacement Surgery
DEAR MAYO CLINIC: It has been months since I had knee replacement surgery, but my knee is still hurting. Can anything be done at this point, or does the surgery just not eliminate pain in some patients?
ANSWER: Although its uncommon, a small percentage of patients continue to have chronic knee pain after knee replacement surgery. But when that happens, you dont have to just put up with the pain. Have your situation evaluated. Several additional treatment options may ease chronic knee pain after knee replacement.
Knee replacement surgery, also known as knee arthroplasty, is one of the most common orthopedic surgeries performed today. It is most often used to repair joint damage caused by osteoarthritis or rheumatoid arthritis that causes severe knee pain and makes it hard to perform daily activities.
During knee replacement, a surgeoncuts away the damaged bone and cartilage from your thighbone, shinbone andkneecap, and replaces it with an artificial joint. For most people, kneereplacement significantly improves mobility and relieves knee pain. But in somepatients, the pain persists after surgery.
Your first step in dealing withongoing knee pain in this situation is to make an appointment to see thesurgeon who performed your knee replacement. He or she can evaluate your kneeand check for possible complications from the surgery, such as an infection ora problem with the artificial joint.
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Peripheral Arterial Disease And Claudication
Peripheral artery disease can reduce blood flow in the arteries of the lower legs, leading to claudication . This is due to narrowed or blocked arteries in the mid-thigh or the knee.
With claudication, you may feel pain in your buttock, hip, thigh, calf, and/or foot upon walking short distances. Some people experience pain in their leg while lying in bed at nightthis is a sign that the condition is getting worse.
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When Will My Kneecap Start To Feel Better
One broad caveat to keep in the back of your mind. Many of you are thinking that a few weeks are enough time to start to see improvements with treatments such as exercise or physical therapy. Sadly thats not going to happen. It is not unusual for it to take 3-4 months before you start to see significant improvement in your pain. Furthermore, it is not uncommon for it to take 8-12 months for a complete resolution of your symptoms. This is important I wouldnt want to seek a surgeons consultation because 4-6 weeks of therapy and exercise left you with persistent pain.
Down below.. under coping strategies, we list a few things to try that can calm down your pain while we give the exercise time to work.
What Can Cause Knee Pain Without Injury
Most people assume that their knee pain isnt severe or in need of medical attention because they havent suffered a significant injury. While that may be true sometimes, damage to your knee joint can also occur slowly over time, and affect you just as much as a significant accident or injury can.
First, lets stop with assumptions. Any pain you are experiencing is a sign that something is not right. So, why not have a specialist take a look? With extensive imaging, a trained orthopedic specialist can get to the bottom of your nagging knee pain and try to help relieve some of that distress. If you havent suffered an injury, however, your doctor will want to diagnose the pain and possible causes. There are some more common causes for non-trauma related knee pain:
Arthritis
Either rheumatoid arthritis or osteoarthritis can cause leave you with severe knee pain, even without a fall or injury. Osteoarthritis can be characterized by the pain and swelling you continue to feel as you age. Your joints are not indestructible, and the structure inevitably wears down over time. Rheumatoid arthritis, on the other hand, is a chronic disorder that also causes joints to swell. If you suspect RA is behind your knee pain, you might have pain in other joints, as well.
A tear
Bursitis
Tendonitis
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When To See A Healthcare Provider
Many people with thigh pain are able to treat it on their own, while others need medical attention right away. So how do you know when a healthcare provider is necessary for your thigh pain?
In general, it is better to err on the side of caution. If you have thigh pain that you are unsure about or that does not get better with time and/or medication, see your healthcare provider for a proper diagnosis.
Signs and symptoms that warrant a visit to a medical professional include:
- Severe pain that limits your ability to function. If you are having difficulty walking normally due to your pain, visit your healthcare provider.
- Pain that is accompanied by fever or malaise. This could be a sign of infection, and your healthcare provider should check things out.
- Thigh pain with redness, swelling, and warmth of your skin. This may be a sign of a blood clot and requires immediate medical attention.
- A muscle strain or tear may cause your thigh to look deformed. A visit to an orthopedic surgeon may be needed to accurately diagnose and treat your condition.
- Thigh pain that comes on suddenly and limits your ability to walk could be due to a pinched nerve in your back. An orthopedist can diagnose this condition.
Most cases of thigh pain can be diagnosed accurately by your healthcare provider or orthopedist. Some thigh pain that is caused by nerve compression or neurological conditions may require a neurologist to get an accurate diagnosis and treatment plan.
Anterior Knee Pain: The Basics
Pain in the front of the knee or anterior knee pain can affect people in all age groups. Approximately 25% of people will suffer from pain in the front of their knees at some time in their lives. I have seen teenagers who can longer participate in sports, and I have 70 years olds who can no longer walk downstairs without fear of their knee giving way. Why is our kneecap or patella so prone to bothering us like this?
The cause of anterior knee pain might vary based on your age, level of activity, and your chosen sports. We can see people who are inactive and suffer from pain in the front of the knee, and we can also see people who are highly trained and disciplined who are suffering from pain around the kneecap. The majority of people who have pain in the front of their knee do not recall any injury.
In the majority of cases of anterior knee pain, we do not find anything significant wrong with your X-rays or MRI scans. It seems that the pain in the front of the knee is often due to imbalances, weakness patterns, movement patterns, and complex issues that can take a while to figure out. Yes, some of you might have a cartilage defect or some early arthritis in the front of your knee but believe it or not, the majority of you will have pretty normal-appearing imaging studies. That has led to a significant change in our approach to anterior knee pain over the years.
Anterior knee pain is particularly common in young women and many runners.
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The Joint Pain Relief Workout: Healing Exercises For Your Shoulders Hips Knees And Ankles
Is joint pain holding you back? Perhaps an achy ankle or sore knee is making it difficult to enjoy a run through your favorite park or even taking a short walk. Or maybe a throbbing hip or shoulder prevents you from whacking a golf ball or performing simple tasks like carrying a bag of groceries. The exercises in this report, The Joint Pain Relief Workout: Healing exercises for your shoulders, hips, knees, and ankles, can help relieve ankle, knee, hip, or shoulder pain, and help you become more active again, which can help you stay independent long into your later years.
Quadriceps Or Hamstring Tendonitis
Overuse and repeated stress to your thigh muscles may cause inflammation in your tendons. This condition is known as tendonitis.
Symptoms of quad or hamstring tendonitis include:
- Pain in the front or back of your thigh, usually near your knee or hip
- Difficulty walking or climbing stairs due to pain
- A feeling of weak muscles in the front or back of your thigh
Symptoms usually last for four to six weeks and slowly get better with gentle exercises such as walking, leg raises, wall squats, and the Nordic hamstring stretch.
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Patello Femoral Pain Syndrome
Pain under and around the kneecap, or patella, is not uncommon. The stress on the cartilage is enormous when squatting.
In addition, it’s a joint where calcium deposits tend to form, not unlike “toothpaste shoulder”.
Falls directly onto the kneecap, or simply long hours of kneeling in the garden can injure the cartilage, deposits of rough calcium crystals form, and then it becomes arthritis. Patello Femoral Pain syndrome responds remarkably well to conservative chiropractic help of the knee.
Treatment And Prevention Tips For Pain Behind The Knee
When you experience knee pain that doesnt go away within a day or two, you should seriously consider health care. Here are a few tips on protecting your knee in situations where you might have a minor knee injury or experience reoccurring knee problems.
- Avoid activities that cause pain
- Apply ice
- Keep knee raised to bring down any swelling
- Sleep with a pillow underneath or between your knees
- Avoid running up and down stairs walk carefully
- Dont forget to warm up before exercising or engaging in sports
- When you run, do it on smooth, soft surfaces instead of rough pavement
- Swim instead of running
- If you are overweight, consider ways to lose a few pounds
- Make sure you wear well-made running shoes
- Consider shoe inserts for better arch support
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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.
When To See Your Doctor
Don’t wait if your knee pain is sudden and intense. Pick up the phone if it won’t go away or gets worse.
To make a diagnosis, your doctor might take X-rays or other images of your knee. Blood or knee fluid samples can help confirm or rule out certain conditions. Treatment may include medication, special exercises, braces, or in some cases surgery. Losing weight could help lessen pressure and strain on your knees.
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Lower Leg Bone Fracture
A bone break or fracture in one of your lower leg bones may be caused by falling or by a traumatic blow to your leg, such as a car accident.
This injury may cause severe calf pain. Additionally, your lower leg may be quite swollen, making it difficult to walk or bear any weight on your leg.
A complete bone break can cause your leg to look deformed. This can also happen if the broken bone does not heal properly. To prevent this from happening, you may need a cast or, in some cases, surgery.
Is The Sound That My Knee Makes Bad
As we reviewed in a popular post about the sounds that our knees make, we discussed that the majority of these sounds are not mechanical or dangerous! That means that you are probably not bone on bone or grinding away the insides of your knee when you bend it. Yes, these sounds can be annoying or even embarrassing, but they are rarely dangerous. The most common cause of this grinding sensation or sound is actually due to inflammation of the tissues inside the knee. You do not need cortisone or lubricating injections to treat these sounds or sensations.
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