Osteonecrosis Of The Knee
Osteonecrosis is a condition in which bone tissue dies due to a lack of adequate blood supply. People typically notice severe pain on the inside of the knee with tenderness and joint swelling as well as pain when bending or straightening the knee. These symptoms may cause a person to limp when walking.
Osteonecrosis in the knee is not common. It is most likely to occur after an injury, but it can also develop gradually in absence of a trauma. Older women who have osteoporosis are at the greatest risk for osteonecrosis.
Pain Behind Knee: Common Causes Symptoms And Treatment
Written byDr. Victor MarchionePublished onNovember 23, 2016
Pain behind knee is not unusual, but it can hurt and limit movement. Developing a clear understanding of pain behind knee causes can be important.
When we refer to pain behind knee, we are really talking about discomfort or soreness behind the knee joint. This uncomfortable feeling can happen to a person who still has movement in their knee or it can severely limit movement. Sometimes, pain behind knee is accompanied by inflammation or a burning sensation. In many cases, the soreness is nothing to worry about. There are situations where the pain does not disappear, and there is swelling or even bruising. If this happens to you, it is important to seek medical attention.
Physical Therapy For Knee Pain
One of the major components of rehabilitation for knee pain is physical therapy. Our app has a series of exercises to help you work on all the muscles that stabilize the knee joint. In fact, at some point, it should become your mainstay to treating your knee pain.
Start SlowYou dont have to go do it all at once. Straight leg raises and quad sets while lying down should be good enough while you deal with pain. Once the pain eases, you can do more complex exercises. This is particularly important if you havent been active for a while. The goal here is to ease your joints into exercise. Dont push yourself too hard. By doing so, you will overwork your muscles, strain the joint and worsen the knee pain.
Build Over TimeYou dont have to go do it all at once. Straight leg raises and quad sets while lying down should be good enough while you deal with pain. Once the pain eases, you can do more complex exercises. This is particularly important if you havent been active for a while. The goal here is to ease your joints into exercise. Dont push yourself too hard. By doing so, you will overwork your muscles, strain the joint and worsen the knee pain.
Initially, you may be asked to simply flex your knee multiple times. This may seem silly but its a gradual step up. Once youve learned the basics and have established a foundational routine, you can step up through the program, but you will need some hand-holding in the beginning.
Read Also: How To Tape An Arthritic Knee
How Did You Hurt Your Knee
Traumatic injuriesare noticeable right away and worsen dramatically the next day as pain and inflammation set in. traumatic injuries typically occur playing sports, during slips, falls, and other work-related accidents. The trauma is caused by the injury exceeding the tolerance of knee structures leading to breaks, ruptures or tears.
Knee ligaments, bones, and menisci are the most commonly damaged structures in the knee joint. Injuries to bone and connective tissue result in long term pain and will impede normal knee function for some time after the initial injury. Less serious traumatic injuries may result in only painful, superficial contusions which heal relatively quickly. If you believe you have incurred serious knee trauma you should visit a doctor as soon as possible. If bone or connective tissue within your joint is damaged a surgical assessment could be required.
Overuse injuriestypically cause knee pain that comes and goes and varies in intensity. Sometimes our favorite activities subject our knees to stressful movement patterns repetitively. Think jumping, squatting, kneeling, running, lunging type movements. Moving in this way over and over again can irritate knee structures such as bursae, tendons, and articular cartilage.
Degenerative Joint Disease is the number one cause of long term disability relating to knee pain. Pain often comes on slowly and over time those affected by arthritis will experience constant pain while performing weight-bearing activities.
You Felt Or Heard A Pop
Sometimes, a popping sound after a movement can indicate something is out of place.
Oftentimes this type of sound upon injury is indicative of a ligamentous injury, says Schwabe. Not all ligamentous injuries are full tears, though, and not all require surgery.
However, if you also experience excessive swelling and instability, get it checked out by an M.D. If you only have a mild sprain then you will be able to rehab it with physical therapy, he says.
The pop is what you hear as a result of a ligament tear, a meniscus tear, strained tendons, or a dislocated kneecap. Usually what happens is youll simultaneously hear and feel the pop.
If youre not familiar with the meniscus, its the cartilage in the knee that functions as a shock absorber. Each knee has two menisci, and theyre shaped like horseshoes. The medial meniscus is on the inside of the knee, and the lateral meniscus is on the outside.
The popping sensation can be difficult to explain, but youll certainly know it when it happens to you. Though the sound originates in the knee, youll hear it as though it was directly in your ear. Its as if the sensation travels up your body, and when it gets to your brain, it becomes audible.
If the pain is severe, youll want to visit a doctor as soon as possible. Surgery is often the recommended course of action, but physical therapy and other non-invasive remedies may be prescribed as alternatives.
You May Like: How To Exercise With Knee Pain
Facts You Should Know About Knee Pain
- Knee pain is a common problem with many causes, from acute injuries to complications of medical conditions.
- Knee pain can be localized to a specific area of the knee or be diffuse throughout the knee.
- Knee pain is often accompanied by physical restriction.
- A thorough physical examination will usually establish the diagnosis of knee pain.
- The treatment of knee pain depends on the underlying cause.
- The prognosis of knee pain, even severe knee pain, is usually good although it might require surgery or other interventions.
The Pros And Cons Of Cortisone Shots
If you’re experiencing pain that makes it difficult for you to start physical therapy to address your knee problem, your doctor might recommend that you get an injection of cortisone to lessen the pain.
The shot injects a corticosteroid drug and a local anesthetic into the joint to temporarily relieve pain and swelling. But it isn’t a long-term fix. “Often people think that injections, especially cortisone injections, will fix a knee problem. What they do is provide a window of pain relief so you can make progress with rehabilitation,” says Dr. Rebecca Breslow, an instructor in orthopedic surgery at Harvard Medical School. “But when cortisone injections are overused, there is some evidence that they can actually accelerate osteoarthritis.”
In short, while cortisone shots put you on the path to healing, they should be used judiciously and aren’t a permanent solution to the underlying problem that’s causing your knee pain.
Also Check: How To Avoid Knee Replacement Naturally
For Tendinitis Runners Knee Gout And Bursitis
The treatment for conditions that cause swelling, redness, and dull, burning pain usually starts with resting the joint. Ice your knee to control swelling. Elevate and stay off your joint to promote healing.
Your doctor may recommend or prescribe NSAIDs like ibuprofen. Lifestyle changes, such as wearing protective kneepads and going to physical therapy, can help you manage pain and experience fewer symptoms.
You may need to make changes to your diet, especially if youre treating gout.
You Notice An Obvious Deformity
If you notice your knee jutting outward in a way it never has before, take note. A dislocated or fractured patella can cause injuries like this, explains Brian Schwabe, C.S.C.S., board-certified sports physical therapist based in Los Angeles.
While some deformities occur over time, when the deformity is a result of an injury, it could be the result of a fracture or chronic wear on the knee joint. If you are already experiencing any kind of misalignment in your lower extremities, then you could be more prone to this type of injury.
If you notice a bone deformity after an injury, he recommends seeking the assistance of an orthopedic doctor immediately.;The doctor will likely take x-rays as well as perform a visual diagnosis to determine if you need surgery.
Read Also: What Can Cause Sudden Knee Pain
What Are The Complications Of Knee Pain
Frequently, knee pain will disappear without ever finding a specific cause. Depending on the underlying cause of the pain, the condition can progress and lead to more serious injuries or complications. Usually, these complications are long term and result in worsening pain or an increasing difficulty to walk.
You Have Significant Difficulty Walking
Of course, many knee injuries make it painful and hard to walk. ;For people with severe knee injuries, it is usually very hard if not impossible to walk. ;You will often need to be helped off the field and require crutches. ;Anyone who is placed on crutches should be considered to have a serious knee injury until an Orthopedic Surgeon evaluates you. ;In many of these cases, an urgent X-ray is useful to rule out a fracture if the athlete cannot put any weight on the knee.
Recommended Reading: What’s Good For Arthritis In The Knee
How Are Knee Problems Diagnosed
In addition to a complete medical history and physical exam, other tests for knee problems may include:
X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.
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.
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.
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.
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.
Your Knee Feels Unstable Or You Felt A Pop
Most ACL tears and patella dislocations occur from a twisting, non-contact injury.; A typical story is that you were turning or twisting hard, and you felt a pop.; As I mentioned earlier, most patella dislocations will reduce or go back into their usual place on their own.; But if your patella remains dislocated the knee will look strange.;
If you felt or heard a loud pop as you twisted or turned to avoid another player, then you may have torn your ACL. Other causes of popping include a patella or kneecap dislocation.;;If you felt or heard a loud pop in your knee, then there is a strong chance that you have a severe knee injury. ;Most ACL injuries and patella dislocations are non-contact injuries. ;A running back turning to head upfield. ; A striker moving laterally to avoid the defense. ;These are familiar stories when we see high school and college athletes who have torn their ACL. ;
This post dives further into the immediate management of suspected ACL injuries.
You May Like: Which Knee Brace For Meniscus Injury
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
Also Check: Why Does My Knee Keep Popping Out Of Place
What Medical Conditions Cause Knee Pain
Rheumatoid arthritis is an autoimmune condition that can affect any joint in the body. It can cause severe pain and disability, as well as swelling.
Gout is a form of arthritis that is most commonly found in the big toe, though it can also affect the knee. Gout tends to flare up and is extremely painful during the acute episodes. When there is no flare-up, the knee can be pain free.
With , the knee joint can become infected; this leads to pain, swelling, and fever. This condition requires antibiotics and drainage treatments as soon as possible.
Chronic use/overuse conditions
Patellar tendinitis is an inflammation of the tendons connecting the kneecap to the shinbone . Patellar tendinitis is a chronic condition often found in individuals repeating the same motion during exercise .
Patellofemoral pain syndrome is caused by degeneration or stress under the kneecap where it meets the thighbone . Patellofemoral pain syndrome occurs in runners and cyclists.
Osteoarthritis: a wearing down of cartilage of the joint due to use and age
Prepatellar bursitis: Inflammation to the bursa in front of the kneecap may cause anterior knee pain.
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:
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.
Rheumatoid Arthritis Of The Knee
Rheumatoid arthritis is an autoimmune condition that causes the tissue around the joint to become inflamed and thickened. Chronic inflammation often leads to damage and loss of cartilage.
Rheumatoid arthritis occurs in about 0.6 percent of the U.S. population and is two to three times more common in women.
Symptoms of rheumatoid arthritis are similar to other types of arthritis in the knee:
Treatment For Inside Knee Pain
Once your doctor determines the cause of the pain inside knee, he or she will be able to suggest forms of treatment.
Treatment varies depending on the severity of the injury. Immediate treatment after traumatic injuries include RICE and anti-inflammatory over-the-counter medications such as ibuprofen or aspirin.
If a more serious injury such as an MCL tear is present, then arthroscopic surgery to repair the torn ligament may be necessary. In all cases, physical therapy may be beneficial, because strengthening the muscles around knee will help reduce pain inside the knee both before and after surgery . Speak with your doctor about all of your options in regards to your inside knee pain.
You May Like: What Causes Burning In The Knee
What You Can Do
Take over-the-counter NSAID drugs like ibuprofen and naproxen to ease pain and swelling. RICE — rest, ice, compression, and elevation — can often help, too: Get off your feet. Raise your leg so it’s higher than your heart. Put a cold pack in a thin cloth or towel on your knee for 10-20 minutes at a time, several times a day. Wrap an elastic bandage around your knee when you’re up and about, snug but not tight.