By Dr. Clayton Hodges
Chronic knee pain is a common problem among young people and older adults. Often, knee pain is associated with knee injuries and/or arthritis. The good news is that there are a variety of treatments for knee pain.
When the knee is unstable, that is, it has lost ligament stability, the knee undergoes abnormal movement. When this happens, you may have a meniscus tear, cartilage wear and tear, or thinning. This can be a problem if it becomes chronic and allows a person’s knee to move abnormally. This often results in people avoiding activities they would normally undertake, and even feeling discomfort or disability in normal activities such as descending a curb, climbing stairs, or walking on uneven ground.
ACL injuries are the most common ligament injuries that require surgery. These often involve non-contact injuries, in which someone plants their foot and twists their body in a way that twists their knee. Typically what you will see after an ACL injury is rapid swelling and an inability to walk on it. These mean serious injuries that need to be attended to in a timely manner.
Cartilage damage can result from an acute injury, such as a torn ACL. Common symptoms include persistent pain, swelling or fluid in the knee, locking or locking of the knee. In acute injuries, you may see swelling in the knee. Treatments for cartilage damage include knee injections, knee bracing, physical therapy, or surgery.
Meniscus tears are also a common knee injury and can occur with an acute injury or over time. The meniscus works as a shock absorber and helps distribute pressure evenly in the knee joint. When you have part of your meniscus missing or torn it can cause symptoms and in the long run it can lead to increased pressure on the cartilage which can lead to the development of arthritis. Once you’ve torn the meniscus, it’s unlikely to heal on its own.
Common symptoms of a meniscus tear include sharp pain when bending or twisting the knee, and in severe cases, the knee may lock or bind. Symptoms may improve with physical therapy, knee injections, or nonsteroidal anti-inflammatory drugs. If these measures fail, arthroscopic surgery can be considered to repair the meniscus, which preserves critical function and decreases the risk of developing arthritis.
Knee arthritis can also cause knee pain and it is a huge problem worldwide, leading to decreased quality of life, decreased economic income and a myriad of other issues. Symptoms of arthritis of the knee are pain that gets worse with walking or as the day progresses, swelling, which can be constant or intermittent, stiffness when first using the knee after the sleep or resulting from sitting and, in advanced cases, knee deformity. Cartilage wear and tear is the key factor in the development of arthritis, so it is important to prevent cartilage damage or take action soon after a knee injury to restore cartilage.
It’s also important to reduce the load on your knees through activity modification, low-impact exercise, braces, and weight loss. Small changes in weight can have a huge impact on the load on your knees. Ten pounds of weight loss equals 40 pounds of knee loading. Reducing the load on the knee is the single most important step that many patients can take to improve their knee arthritis symptoms.
Depending on the severity of knee pain, many treatments are available including physiotherapy, non-steroidal anti-inflammatory drugs such as ibuprofen, bracing, injections, knee realignment, partial or complete knee replacement. To find out which treatment might be right for you, talk to your doctor.
Clayton Hodges, MD, is a board-certified orthopedic surgeon in sports medicine at the UT Health East Texas Orthopedic Institute.