Knee pain explained

Knee pain
Field:Orthopedics

Knee pain is pain in or around the knee.

The knee joint consists of an articulation between four bones: the femur, tibia, fibula and patella. There are four compartments to the knee. These are the medial and lateral tibiofemoral compartments, the patellofemoral compartment and the superior tibiofibular joint. The components of each of these compartments can experience repetitive strain, injury or disease.

Running long distance can cause pain to the knee joint, as it is a high-impact exercise.

The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:

Causes

Injuries

Some common injuries based on the location include:[1]

Fractures

Diseases

Some of the diseases of cause of knee pain include the following:

Inflammations

Deformities

Common deformities of the knee include:

Syndromes

Dislocations

Cold temperature

Knee pain is more common among people working in the cold than in those in normal temperature. Cold-induced knee pain may also be due to tenosynovitis of the tendons around the knee, in which cold exposure has a specific role, either as a causative or a contributing factor.[15] Frank arthritis has been reported in children due to frostbite from extreme cold causing direct chondrocyte injury.[16]

There is also a hereditary disease, familial cold autoinflammatory syndrome (FCAS), which often features knee pain, in addition to hives, fever and pain in other joints, following general exposure to cold.

Knee pain due to less physical movement

A lower level of physical activity and a work environment where one is required to sit in a chair during the work day is one reason for developing knee joint pain, as the lower degree of physical movement tends to weaken the knee muscles. Blood vessels also can be affected, leading to development of painful conditions. Working on building strength through a full range of motion is crucial for rebuilding strength and getting rid of knee pain. As age progresses the movement of the knee joint involves higher friction with adjacent tissue and cartilages.

Other causes

Referred knee pain

Referred pain is that pain perceived at a site different from its point of origin but innervated by the same spinal segment.[17] Sometimes knee pain may be related to another area from body. For example, knee pain can come from ankle, foot, hip joints or lumbar spine.

Diagnosis

Knee MRIs should be avoided for knee pain without symptoms or effusion, unless there are non-successful results from a functional rehabilitation program.[18]

In some diagnosis, such as in knee osteoarthritis, magnetic resonance imaging does not prove to be clear for its determination.[19]

Management

Although surgery has a role in repairing traumatic injuries and broken bones, surgeries such as arthroscopic lavage do not provide significant or lasting improvements to either pain or function to people with knee pain, and therefore should almost never be performed.[20] Knee pain is pain caused by wear and tear, such as osteoarthritis or a meniscal tear. Effective treatments for knee pain include physical therapy exercises,[21] pain-reducing drugs such as ibuprofen, joint stretching,[22] [23] knee replacement surgery, and weight loss in people who are overweight.

Overall, a combination of interventions seems to be the best choice when treating knee pain. Interventions such as exercises that target both the knee and the hip, foot bracing, and patellar taping are all recommended for use with patients who have knee pain.[24]

Current evidence suggests that psychological factors are elevated in individuals with patellofemoral pain.[25] Non-physical factors such as anxiety, depression, fear of movement, and catastrophizing are thought to have a linear correlation with increased pain experience and decreased physical function. Catastrophizing is defined as imagining the worst possible outcome of an action or event.[26] The psychosocial factors may have either a positive or negative impact on adherence to rehabilitation programs for managing knee pain. Furthermore, studies have found knee pain to be negatively associated with health-related quality of life, and an increase in knee pain to be associated with a reduction in patient-reported quality of life, as compared to those with no or stable knee pain, even in the relatively younger middle-aged population.[27]

Epidemiology

About 25% of people over the age of 50 experience knee pain from degenerative knee diseases.

Society and culture

In the United States, more than US$3 billion is spent each year on arthroscopic knee surgeries that are known to be ineffective in people with degenerative knee pain.

Notes and References

  1. Web site: Green . Shelby . Knee Pain Location Chart . Feel Good Life . 24 November 2022 . feelgoodlife . 17 December 2022.
  2. Darlene Hertling and Randolph M.Kessler. Management of Common Musculoskeletal Disorders. Third Edition.
  3. van der Heijden RA, Lankhorst NE, van Linschoten R, Bierma-Zeinstra SM, van Middelkoop M . Exercise for treating patellofemoral pain syndrome . The Cochrane Database of Systematic Reviews . 1 . CD010387 . January 2015 . 25603546 . 10.1002/14651858.CD010387.pub2 . 10898323 .
  4. Web site: Osteochondritis Dissecans. The Lecturio Medical Concept Library . 22 August 2021.
  5. Web site: Definition of Osteochondritis dissecans. 20 February 2009 . Shiel Jr WC . MedicineNet, Inc..
  6. Book: Soft Tissue and Bone Tumours: WHO Classification of Tumours. 2020. International Agency for Research on Cancer. 978-92-832-4502-5. Synovial chondromatosis. 368–369.
  7. Web site: Neoplasm. https://web.archive.org/web/20190926221344/https://www.lexico.com/en/definition/neoplasm. dead. September 26, 2019. Lexico. Oxford University Press.
  8. Web site: Ankylosing Spondylitis. The Lecturio Medical Concept Library . 22 August 2021.
  9. Web site: Reactive Arthritis. The Lecturio Medical Concept Library . 22 August 2021.
  10. Web site: Tuberculosis (TB). www.who.int. en. 2020-05-08.
  11. Web site: Septic Arthritis. The Lecturio Medical Concept Library . 22 August 2021.
  12. Web site: Osteomyelitis. The Lecturio Medical Concept Library . 22 August 2021.
  13. Web site: What Is Hemophilia? . cdc.gov . 12 May 2020 . U.S. Centers for Disease Control . 3 April 2021.
  14. Web site: Gout. The Lecturio Medical Concept Library . 9 September 2020. 22 August 2021.
  15. Pienimäki T . Cold exposure and musculoskeletal disorders and diseases. A review . International Journal of Circumpolar Health . 61 . 2 . 173–82 . May 2002 . 12078965 . 10.3402/ijch.v61i2.17450 . free .
  16. Carrera GF, Kozin F, McCarty DJ . Arthritis after frostbite injury in children . Arthritis and Rheumatism . 22 . 10 . 1082–7 . October 1979 . 486219 . 10.1002/art.1780221006 . free .
  17. Carol Mattson Porth. Pathophysiology:concepts of altered health states. Publisher:Lippincott. Third Edition. Page 853.
    • Dixit S, DiFiori JP, Burton M, Mines B . Management of patellofemoral pain syndrome . American Family Physician . 75 . 2 . 194–202 . January 2007 . 17263214 .
    • Atanda A, Ruiz D, Dodson CC, Frederick RW . Approach to the active patient with chronic anterior knee pain . The Physician and Sportsmedicine . 40 . 1 . 41–50 . February 2012 . 22508250 . 10.3810/psm.2012.02.1950 . 25791476 .
    • Pappas E, Wong-Tom WM . Prospective Predictors of Patellofemoral Pain Syndrome: A Systematic Review With Meta-analysis . Sports Health . 4 . 2 . 115–20 . March 2012 . 23016077 . 3435911 . 10.1177/1941738111432097 .
    • Rixe JA, Glick JE, Brady J, Olympia RP . A review of the management of patellofemoral pain syndrome . The Physician and Sportsmedicine . 41 . 3 . 19–28 . September 2013 . 24113699 . 10.3810/psm.2013.09.2023 . 24177847 .
    • Roush MB, Sevier TL, Wilson JK, Jenkinson DM, Helfst RH, Gehlsen GM, Basey AL . Anterior knee pain: a clinical comparison of rehabilitation methods . Clinical Journal of Sport Medicine . 10 . 1 . 22–8 . January 2000 . 10695846 . 10.1097/00042752-200001000-00005 . 25418309 .
  19. Culvenor AG, Øiestad BE, Hart HF, Stefanik JJ, Guermazi A, Crossley KM . Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis . British Journal of Sports Medicine . 53 . 20 . bjsports–2018–099257 . June 2018 . 29886437 . 6837253 . 10.1136/bjsports-2018-099257 .
  20. Siemieniuk RA, Harris IA, Agoritsas T, Poolman RW, Brignardello-Petersen R, Van de Velde S, Buchbinder R, Englund M, Lytvyn L, Quinlan C, Helsingen L, Knutsen G, Olsen NR, Macdonald H, Hailey L, Wilson HM, Lydiatt A, Kristiansen A . Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline . BMJ . 357 . j1982 . May 2017 . 28490431 . 5426368 . 10.1136/bmj.j1982 .
  21. Lack S, Neal B, De Oliveira Silva D, Barton C . How to manage patellofemoral pain - Understanding the multifactorial nature and treatment options . Physical Therapy in Sport . 32 . 155–166 . July 2018 . 29793124 . 10.1016/j.ptsp.2018.04.010 . 11449/171014 . 46921956 . free .
  22. https://www.nwo.nl/onderzoek-en-resultaten/onderzoeksprojecten/i/22/28022.html Knee Reviver
  23. Web site: Kniedistractie - UMC Utrecht. www.umcutrecht.nl.
  24. Crossley KM, van Middelkoop M, Callaghan MJ, Collins NJ, Rathleff MS, Barton CJ . 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions) . British Journal of Sports Medicine . 50 . 14 . 844–52 . July 2016 . 27247098 . 4975825 . 10.1136/bjsports-2016-096268 .
  25. Maclachlan LR, Collins NJ, Matthews ML, Hodges PW, Vicenzino B . The psychological features of patellofemoral pain: a systematic review . British Journal of Sports Medicine . 51 . 9 . 732–742 . May 2017 . 28320733 . 10.1136/bjsports-2016-096705 . free .
  26. Web site: Definition of CATASTROPHIZE. www.merriam-webster.com . 2019-03-12.
  27. Singh . Ambrish . Campbell . Julie A. . Venn . Alison . Jones . Graeme . Blizzard . Leigh . Palmer . Andrew J. . Dwyer . Terence . Cicuttini . Flavia . Ding . Changhai . Antony . Benny . September 2021 . Association between knee symptoms, change in knee symptoms over 6-9 years, and SF-6D health state utility among middle-aged Australians . Quality of Life Research . 30 . 9 . 2601–2613 . 10.1007/s11136-021-02859-5 . 33942204. 233487528 .

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