The most common musculoskeletal complaint that doctors receive is knee pain. The onset of knee pain can start at any age, with an increasingly active society. The causes can be varied and the treatment can differ depending on the diagnosis. The possible causes can range from simple muscle strain, tendonitis or some specific arthritis.
The main function of the knee joint is to bend, bear the whole body’s weight and straighten. The knee relies on a number of structures including bones, cartilage, ligaments and tendons.
The knee joint consists of three bones – thigh bone or the femur, tibia – one of the bones in lower area(calf), kneecap/patella in the front of the femur.,.
The dense fibrous bands that connect the bones are called ligaments. Knee includes four ligaments, which connect the femur to the tibia. The anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) provide rotational stability to the knee. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) in the inner and lateral sides provide medial and lateral stability to the knee.
Tendons connect muscles to the bones. The two important tendons are the quadriceps tendon that connect the quadriceps muscle and the patellar tendon connecting the patella to the tibia.
Cartilage & Menisci:
At the top and between the tibia and the bottom of the femur are covered by a thick soft tissue coating/covering which gives a smooth surface and provides a layer of cushion along with another structure called Menisci which serves as a cushion to our knee joint.
These are fluid filled sac cushioning the knee.There are three important groups of bursae in the knee – prepatellar bursae in the front of the patella, pes anserine bursae inside the knee below the joint and infrapatellar bursae under the patellar.
What are the causes for Knee Pain?
In this article, let us discuss a few causes for constant knee pain.
- Knee Injuries: Knee injuries can be common for anyone, especially sportspersons. They can be sprains, strains and tears.
- Tendonitis: When a tendon swells up and leads to soreness or pain, we can consider it tendonitis.
- Osgood-Schlatter’s disease: A condition that affects children and young individuals where the bony limp below the kneecap is swollen or becomes painful during or after the exercise.
- Patellofemoral Pain Syndrome: A common knee problem where there is persistent pain behind or around the kneecap. It is usually felt taking the stairs, running, squatting etc and is very common in children and young adults.
- Knee Arthritis: This condition makes the joints in the knee swell. It is more likely to develop as we grow old.
The diagnosis for knee pain treatment would be different depending on the severity of the pain. The doctor is likely to inspect the knee for swelling, pain, bruising, tenderness and warmth. They might push or pull the joints to evaluate the bone structure in the knee. And also, they would check how far we are able to move our lower legs.
The treatment options for Knee pain can be prescribed as per the condition of the patient.
Physical Therapy / Physiotherapy
For mild cases, physical therapy is prescribed after careful diagnosis. Therapy helps in strengthening the muscles around the knee to make it more stable. Depending on the cause of the pain, the doctor will recommend physical therapy or strengthening exercises. If the patient is physically active or is a sportsperson, exercises to correct movement patterns that are causing pain have to be practiced along with flexibility exercises.
Doctors may suggest injective medical procedures, where medications or other substances are directly injected into our joints.
- Corticosteroids: Corticosteroid injections are injected into the knee joint to reduce arthritis flare, providing pain relief that will last a few days, weeks to months.
- Hyaluronic Acid: This thick fluid is similar to the fluid that naturally lubricates joints and is injected into the knee to ease pain and improve mobility.
- Platelet-rich plasma(PRP): PRP contains a concentration of different growth factors that promote healing and reduce inflammation.
Surgery is required when there is a possible injury.
- Arthroscopic surgery: Using a fiber-optic camera, long and narrow tools are inserted through small incisions to repair joint damage. In most cases, it is used to remove loose bodies from the knee joint, repair or remove damaged cartilage.
- Knee replacement surgery: The damaged portion of the knee is replaced with metal or plastic alloys. The damaged bone & cartilage is cut from the thigh bone in this type of surgery.
- Osteotomy: To align the knee and relieve arthritis pain, bone is removed from the thigh bone or shinbone.
Regenerative medicine/Interventional orthopedics:
- In regenerative medical procedures, stem cells are extracted from our bone marrow and then turned into a concentrate.
- This concentrate is then injected into the affected joints with the help of image guidance or ultrasound, which will help in regrowth of the bone structure and help in healing the area.
- This procedure eliminates the risk of surgery with minimally invasive procedures.