Knee Pain

KNEE PAIN

DEFINITION

  • Pain in the knee.

Causes of Knee Pain

  • Arthritis (e.g., degenerative, gouty, infectious, inflammatory, traumatic)
  • Baker's Cyst (popliteal cyst)- This is a fluid collection in a cyst that bulges out from the knee joint. Symptoms include painful or painless swelling in the area behind the knee.
  • Bursitis - Prepatellar bursitis is a fluid filled sack localized on the inferior aspect of the anterior knee.
  • Cellulitis - Medical term for skin infection
  • Overuse injury, tendonitis
  • Patellofemoral pain syndrome (chondromalacia patellae)
  • Trauma (e.g., contusion, dislocation, fracture, sprain, strain)

Some Signs and Symptoms that Could be SERIOUS

  • Severe pain and unable to walk
  • Knee swelling with fever (possibility of infection of knee joint)
  • Unilateral calf pain and/or swelling (possibility of blood clot in leg)

See More Appropriate Topic (instead of this one) If

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WHEN TO CALL YOUR DOCTOR

Call your doctor now (night or day) if:

  • You feel weak or very sick
  • Severe pain (can't stand or walk)
  • Fever and swollen knee joint
  • Redness of skin around knee
  • Pain or swelling in one calf

Call your doctor within 24 hours (between 9am and 4pm) if:

  • You think you need to be seen

Call your doctor during weekday office hours if:

  • You have other questions or concerns
  • Swollen knee joint
  • Fluid-filled sack just below knee cap
  • Limping
  • Symptoms interfere with work or school
  • Knee pain persists longer than 7 days
  • Knee pain is a recurrent problem
  • Knee giving way (or buckling) when walking, is a recurrent problem
  • Knee locking (i.e., joint gets stuck, catching), is a recurrent problem

Self care at home if:

  • Mild knee pain and you don't think you need to be seen
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HOME CARE ADVICE

  • Knee Pain after Overuse: Muscle strain and joint irritation are very common following vigorous activity. Such activities include sports like tennis and basketball, jogging, and certain types of work.
    • Local Cold: Apply a cold pack or ice bag (wrapped in a moist towel) to the area for 20 minutes. Repeat in 1 hour, then every 4 hours while awake. Continue this for the first 48 hours after an overuse injury. (Reason: reduce the swelling and pain)
    • Local Heat: Beginning 48 hours after an injury, apply a warm washcloth or heating pad for 10 minutes three times a day to help increase circulation and improve healing.
  • Rest Your Knee for the next couple days. Avoid activities that worsen your pain. Reduce activities that put a lot of strain on the knee joint (e.g. deep knee bends, stair climbing, running).
  • Pain Medication: For pain relief, take acetaminophen every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg).
    • Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug.
    • Do not take ibuprofen for more than 7 days without consulting your doctor.
    • Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  • Expected Course: If your knee pain does not get better during the next week or if it recurs, then you should make an appointment with your doctor.
  • Call Your Doctor If:
    • Knee pain persists longer than 7 days
    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

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REFERENCES

  1. Bjordal JM, Ljunggren AE, Klovning A, Slordal L. Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomized trials. BMJ. 2004;329(7478):1317.
  2. Calmbach WL, Hutchens M. Evaluation of patients presenting with knee pain: Part II. Differential diagnosis. Am Fam Physician. 2003;68(5):917-22.
  3. Calmbach WL, Hutchens M. Evaluation of patients presenting with knee pain: part I. History, physical examination, radiographs, and laboratory tests. Am Fam Physician 2003;68:907-12.
  4. Dearborn JT, Jergesen HE. The evaluation and initial management of arthritis. Prim Care. 1996;23(2):215-40.
  5. Pioro MH, Mandell BF. Septic arthritis. Rheum Dis Clin North Am. 1997;23(2):239-58.
  6. Roberts DM, Stallard TC. Emergency department evaluation and treatment of knee and leg injuries. Emerg Med Clin North Am. 2000;18(1):67-84.
  7. Solomon DH, Simel DL, Bates DW, et.al. Does this patient have a torn meniscus or ligament of the knee? JAMA. 2001;286(13):1610-1620.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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