Why Does My Knee Hurt?
The knee is the largest and most complex joint in the body. It is vital for movement and is in constant motion from the moment we arise to the time we go to bed. Because of this, the knee is vulnerable to injury. Sudden twists and turns can strain or tear many of the structures within the knee.
A sprain is the most common knee injury. Usually, this occurs when the knee is subjected to a force that it cannot usually tolerate. A slip on the grass or a fall over a toy in the house can injure one of the vital ligaments in the knee. The two main ligaments in the knee are the collateral ligaments and the cruciate ligaments. A good indicator of this injury is severe pain and sudden swelling. A physician should be consulted if this happens.
Another common injury is a cartilage injury — otherwise known as a meniscus injury. The meniscus is the soft pad between the two bones of the knee — the femur and the tibia. It acts as a shock absorber during all weight-bearing activities, such as walking, climbing stairs and running. If the meniscus is torn, the knee will swell and hurt with most activities. The knee can also buckle during walking or stair climbing with a meniscus tear.
Not all knee pain is due to injury. Wear of the knee can also lead to arthritis, a typical finding in people over the age of 50. As we age, the cartilage surface lining the knee deteriorates leading to pain complaints. Simple activities such as gardening — and even walking more than several blocks — can cause the knees to hurt and swell with arthritis.
One of the best ways to help prevent a knee issue is to exercise. Fewer than 10 percent of Americans participate in regular exercise. A strengthening program builds up the muscles around the knee. This helps to protect the knee when subjected to a sudden force, such as a twisting motion.
An exercise program doesn’t have to be strenuous to be effective. Walking, swimming, dancing and bicycling are all great activities for maintaining fitness as we age.
Just 30 minutes of exercise several times a week can provide significant health benefits. The classic form of exercise includes weight training, stretching and aerobic conditioning. This regimen can be modified based on fitness level, age and available time. The 30 minutes can also be broken down into shorter periods. For example, you can spend 15 minutes working in the garden in the morning and 15 minutes walking in the afternoon.
If performing these activities causes knee pain, you can try several measures to ease the discomfort. Anti-inflammatory medications can be helpful, but do not exceed the recommended doses. A soft or hinged brace can provide the needed support if the knee feels unstable. Ice packs can help control swelling, especially after strenuous activities. Of course, if you experience severe pain after any activity or injury, consult your physician.
When arthritis causes knee pain, other options besides surgery are available. Cortisone, which is basically an injectable anti-inflammatory medication, can provide temporary relief from knee pain. Take care to avoid too frequent injections, which can hasten the arthritic process.
A more recent option, viscosupplementation — otherwise known as an injectable lubricant, can provide more sustained pain relief. Basically, it contains hyaluronic acid in a thick gel that coats the joint surfaces and provides pain relief in early to moderately advanced arthritic knees for about one year. It has no significant side effects and can be repeated indefinitely.
If your knee continues to hurt despite these measures, there may be a more serious problem. Your doctor will probably order further diagnostic studies, such as X-rays or an MRI. Most of the time, the source of the pain will be identified and recommendations made by your orthopedic surgeon. Arthroscopic surgery is an excellent means to identify injuries within a knee, such as a torn meniscus or torn anterior cruciate ligament. Most of the time both of these injuries can be corrected with this outpatient procedure.
More involved procedures — such as partial and total knee replacements — are reserved for patients with end-stage arthritis, for which the pain cannot be controlled with simpler means.
Obviously, the most effective way to avoid knee pain is to do everything possible to prevent it. Whether your knee pain is from an injury or arthritis — eating well, maintaining reasonable body weight, and exercising can go a long way to relieve knee pain and hopefully mean fewer visits to your orthopedic surgeon.