By James P. Jamison, MD
Knee pain can arise from a number of causes. It may start fairly suddenly, known as acute, or it can be a gradual onset and may last longer, known as chronic pain.
Acute knee pain is usually due to an injury or an inflammatory problem, while chronic knee pain is most commonly due to arthritis.
Why Does My Knee Hurt?
First, we need to know a little bit about how the pain started. Did it start all of a sudden? If so, was there an injury or other event that may have caused it?
Or maybe it has been sneaking up on you, gradually getting worse over weeks or months.
When does it hurt? Do you experience pain when you’re walking, on the steps, all the time, or is there some variation? Does it keep you up at night?
What have you been doing to treat it? Have you tried Ibuprofen (Advil/Motrin) or Aleve, or Acetomenophen (Tylenol)? Have you tried ice and rest? Maybe you’ve worn a knee wrap or brace?
When having a look at your knee, I note if there is any fluid in the joint, where it is tender to touch, and whether there is any instability.
Tenderness at the joint line suggest either a cartilage (meniscus) tear and/or arthritis.
Instability, or too much “give” in the knee suggests a ligament injury, especially if the pain started after an injury.
Fluid in the joint can result from arthritis, cartilage tear, ligament injury, as well as gout.
Assessing the hip is also important, because sometimes hip pain may be the cause of pain that patients think is actually at their knee (it sounds strange, but it can be true).
Age matters, too. Knee problems in younger patients under 40 more commonly result from an injury or some sort of sports-related activity.
Adults in their 40’s and 50’s are more likely to experience the more common issues of cartilage tears with arthritis starting to become a problem. Later on, from 60’s on, arthritis is the major culprit.
What Can I Do to Treat My Pain?
Now what do we do about it? Anyone who comes in with new-onset knee pain needs an X-ray and will be assessed by everything mentioned above.
In most cases, conservative (non-surgical) treatment is where you should start.
If arthritis seems to be the problem, we will discuss trying anti-inflammatory medications, a cortisone injection, bracing, and physical therapy.
If a cartilage tear or ligament injury is a concern, an MRI (magnetic resonance imaging) may be indicated.
In cases that a lot of fluid in the joint that makes the knee so tight that it is hard to move it, we will sometimes draw that fluid out, which is referred to as joint aspiration, because it is necessary to help with the diagnosis and to make the knee more comfortable. Evaluating the fluid can be important in figuring out what is going on, such as with gout.
If you have a knee problem, we can help. Call Youngstown Orthopaedic Associates for an appointment or come to our Urgent Care Center to be seen by one of our knee specialists. We will be glad to see you.
Dr. James P. Jamison, M.D., is an orthopedic specialist with a focus on hip and knee joint replacement and reconstruction surgery. Referrals to Dr. Jamison by your primary care physician can be made by calling (330) 758-0577, Ext. 1102.
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