What Is the Guideline for Knee Pain?

Introduction:

In the modern era, knee pain is rapidly increasing among individuals due to traumatic musculoskeletal injuries or chronic overuse. It is characterized by the onset of poorly defined throbbing or dull pain and resolves on its own when it is due to minor trauma. In other cases, like arthritis, the pain may be long-lasting. The wide range of treatment modalities is based on the severity and extent of the conditions.

What Is Knee Pain?

The knee is the biggest joint in the body, which bears the entire body weight resulting in stress. The menisci and slippery cartilage (shock-absorbing cartilage) protect and cushion the joint surface during stress. Meanwhile, it promotes a smooth, gliding path on movement. In addition, the anterior cruciate and medial collateral ligaments join the thigh and lower leg bones. A disturbance in this complex structure can contribute to joint pain.

What Are the Types of Knee Pain?

Knee pain is broadly classified into four types based on the onset, injury, and severity.

• Acute Pain Due to Trauma: The sudden onset of pain after traumatic injury results in effusion (abnormal collection of fluids in and around the knee joint) or disruption of surrounding tissue of the joint. Most probably due to a history of forceful knee flexion or collision (violent movement) and rapid joint twisting.

• Chronic Pain Due to Overuse: Chronic pain is associated with prolonged physical activity and worsens even with fewer physical loads. Chronic pain is associated with osteoarthritis and is often characterized by tenderness, swelling, and muscle inflexibility. Chronic knee pain is more prevalent among athletes involved in running and jumping.

• Acute Pain Due to Overuse: Acute knee pain is caused by minor trauma or acceleration of pre-existing conditions (like arthritis and tendinopathy - inflammation of the tendon) due to overuse. The acute onset of pain is the characteristic feature of degenerative meniscus injury or osteoarthritis.

• Generalized Knee Pain: Some systemic conditions like lupus erythematosus, gout, sickle cell disease, leukemia, and malignancy can contribute to acute or chronic knee pain with or without effusion, along with fever, night sweats, chills, malaise, weight loss, or fatigue.

What Are the Major Contributing Factors to Knee Pain?

The most common contributing factors of knee pain include:

• Arthritis: Degradation and thinning of cartilage are common among older age groups, affecting both hip and knee joints.

• Bursitis: Painful condition due to inflammation of the fluid-filled sac (bursae) and reduced cushioning effects of bone tendon and muscle around the joint.

• Tendonitis: Inflammation of the joint tendon.

• Trauma: Fractures of bone and tear and wear of muscle or tendon are expected, with traumatic injuries predominately causing severe joint pain.

• Sports injury: Sprain (ligament of a joint is stretched or torn) is considered the most common sports injury.

• Other Medical Conditions: They include autoimmune diseases (rheumatoid arthritis).

What Is the Risk Factor for Knee Pain?

Predominantly, an individual's lifestyle and physical health can contribute to risk factors for knee weight (obese) directly impacting the knee joint, and a lazy lifestyle decreases the flexibility of muscles. The other risk factors are:

• Age.

• History of joint injuries.

• Smoking.

What Are the Other Symptoms Associated With Knee Pain?

The pain due to trauma or overuse and systemic conditions left with symptoms of:

• Swelling.

• Redness.

• Warmth.

• Crackling sound on joint movement.

• Muscle stiffness.

• Fever.

• Night sweats.

• Chills.

• Fatigue and malaise.

How to Diagnose Knee Pain?

The diagnosis is based on past medical conditions, prior injury, physical examination with the correlation of X-rays if needed, MRI (magnetic resonance imaging), CT scan (computed tomography), and ultrasound required for the confirmative diagnosis of the condition. MRI and CT with or without arthrocentesis (fluid sample collected from the knee for lab investigation) is the gold standard for diagnosing intra-articular conditions.

What Are the Treatment and Management of Knee Pain?

The standardized treatment with the minimally invasive to surgical intervention protocol is based on the condition's severity. The mild knee pain due to minor trauma often resolves on its own. Palliative care (symptomatic relief) is recommended for autoimmune diseases like rheumatoid arthritis and other moderate conditions. NSAIDs (non-steroidal anti-inflammatory drugs) play a vital role in symptomatic relief and inflammatory conditions. In severe infections, intra-articular injection (therapeutic injections are given directly into the joint space) is advised to reduce the inflammation and for quick pain relief. Surgery is indicated based on the severity of the injury. The other treatment methods are listed below:

• Arthroscopic Surgery: Arthroscopy is a process by which a fiber optic camera and the instruments are inserted into a knee through tiny incisions to repair damaged cartilage and reconstruct torn ligaments.

• Knee Replacement: The entire or partial knee is replaced by an artificial joint, which is made up of metal alloys, high-grade plastics, and polymers.

• Osteotomy: Removal of thigh bone from the thigh to reconstruct the knee and relieve pain.

• Physiotherapy: It improves joint function and relieves pain after surgery, and it is also recommended for nonsurgical patients to improve muscle strength, balance, and flexibility. In addition, the power training program is used in sports to help people regain their lost capacities to perform specific activities (running or jumping).

What Is Home Care For Knee Pain?

A mild injury usually does not require any treatment, and home care is sufficient to overcome the pain.

• Plenty of rest for two days with minimal physical activity.

• Wearing compression stockings reduces the unwanted movement of the joint and decreases inflammation.

• Cold compression with an ice pack reduces inflammation and gives a soothing effect.

• Leg elevation with the help of a pillow decreases the vascularity of the joint, which aids in swelling and inflammation.

What Are the Exercises for Knee Pain?

Exercise is strongly recommended for arthritis patients with knee and hip pain. The efficiency is based on the duration, intensity, and frequency of exercise. Walking and cycling are an individual's standard forms of physical activity. Using a weight machine and elastic bands, the strength training exercise addresses muscle weakness and reduces functional inability. Some studies show that being overweight is the primary cause of joint pain, and exercise is the only source to get rid of it.

Conclusion:

Knee pain is associated with chronic conditions that alter physical activities if not diagnosed and controlled on time. Life-threatening situations or complicated outcomes like suspected fractures and thrombosis (a blood clot that blocks blood vessels and veins) are rare. Physical activity and ice compression therapy decrease knee pain, develop bone density, flexibility, and muscular endurance, and decrease the risk of medical conditions.