Knee Pain - Causes

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What are diseases and conditions that can cause knee pain, and what is the treatment for this knee pain?

Pain can occur in the knee from diseases or conditions that involve the knee joint, the soft tissues and bones surrounding the knee, or the nerves that supply sensation to the knee area. In fact, the knee joint is the most commonly involved joint in rheumatic diseases, immune diseases that affect various tissues of the body including the joints to cause arthritis.

Arthritis is inflammation within a joint. The causes of knee joint inflammation range from noninflammatory types of arthritis such as osteoarthritis, which is a degeneration of the cartilage of the knee, to inflammatory types of arthritis (such as rheumatoid arthritis or gout). Treatment of the arthritis is directed according to the nature of the specific type of arthritis. Many people suffer from arthritis; the pain and discomfort can be so limiting that some patients may require a total knee joint replacement. Knee replacement surgery often allows the patient to regain much of their mobility.

Swelling of the knee joint from arthritis can lead to a localized collection of fluid accumulating in a cyst behind the knee. This is referred to as a Baker cyst and is a common cause of pain at the back of the knee.

Infections of the bone or joint can rarely be a serious cause of knee pain and have associated signs of infection including fever, extreme heat, warmth of the joint, chills of the body, and may be associated with puncture wounds in the area around the knee. These infections are often diagnosed by aspirating joint fluid accumulations with a needle (joint aspiration) and examining the fluid microscopically and with microbial culture techniques. Treatment involves antibiotics and sometimes joint surgery.

Tumors involving the joint are extremely rare (for example, synovial sarcomas, and giant cell tumors). They can cause ambulatory problems with local pain. Treatment usually involves surgery; a few individuals may require amputation of the knee and lower leg. Treatments and surgery depend on the tumor type.

The collateral ligament on the inside of the knee joint can become calcified and is referred to as Pellegrini-Stieda syndrome. With this condition, the knee can become inflamed and can be treated conservatively with ice packs, immobilization, and rest. Infrequently, it requires a local injection of corticosteroids.

Osgood-Schlatter disease is caused by chronic inflammation at the area of the tendon below the kneecap where it attaches to the tibia bone. This can cause local pain and tenderness of the attachment point. It requires treatments to reduce inflammation, restricted activity, and gradual rehabilitation. Osgood-Schlatter disease is a common cause of pain in the front of the knee in children.

Chondromalacia refers to a softening of the cartilage under the kneecap (patella). It is a common cause of deep knee pain and stiffness in younger women and can be associated with pain and stiffness after prolonged sitting and climbing stairs or hills. While treatment with anti-inflammatory medications, ice packs, and rest can help, long-term relief is best achieved by strengthening exercises for the quadriceps muscles of the front of the thigh.

Bursitis of the knee commonly occurs on the inside of the knee (anserine bursitis) and the front of the kneecap (patellar bursitis, or "housemaid's knee"). Bursitis is generally treated with ice packs, immobilization, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) or aspirin and may require local injections of corticosteroids (cortisone medication) as well as exercise therapy to develop the musculature of the front of the thigh.

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See what others are saying

Comment from: ThereseInAZ, 55-64 Female (Patient) Published: November 01

When I was 12 years old my right knee cap was almost shattered by a baseball bat. I was in the hospital for two weeks and the doctors wanted to fuse my knee cap (stiff leg). My parents wouldn't hear of it. I am 55 now and have had orthoscopic surgery, suffer from severe knee swelling, popping, grinding, unbearable pain and now walk with a noticeable limp (my knee can't bear my weight). Physicians have warned about arthritis and the probable knee cap replacement in ten years (that was fifteen years ago). However, knee cap replacement is expensive, painful and has no guarantee's it will work. I guess I am headed for the remainder of my life as a handicap.

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Comment from: Rusty4474, 75 or over Female (Patient) Published: December 12

I have had a total knee replacement a couple of years back with no problems. Now I have tremendous pain on the lateral area when I try to walk. I just had a three phase bone scan and waiting for results. No doctor appt for nearly three weeks. I absolutely cannot walk and feel something needs to be done. The other knee which is natural is fine. Any ideas on what is happening.

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