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Fortunately, identifying the cause of knee pain is usually quite straightforward. This enables orthopaedic experts to recommend the most appropriate treatment to relieve the pain and mobility issues affecting the patient. The sooner the correct cause is identified, the quicker knee pain can be relieved.
Knee pain is a leading cause of visits to the orthopaedic team at Circle Reading Hospital.
“Knee pain can be extremely debilitating and can drastically affect the quality of life of patients who have chronic discomfort, particularly if it is accompanied by other symptoms.”
– Dr Tom Pollard, Consultant Orthopaedic Surgeon at Circle Reading Hospital
The main function of the knee is to work with the hips and ankles to carry the weight of the body, as well as to bend and straighten as part of the overall function of the legs.
The knee joint is a complex structure that contains three key parts. These are:
The end of each bone is covered with a layer of cartilage that absorbs shock and protects the knee from damage.
However, in addition to these structures, there are also tendons — tough cords of tissue that connect bone to muscle, and ligaments — highly elastic bands of tissue that connect one bone to another.
For the knee to function optimally, all of these different components — bones, muscles, cartilage, tendons and ligaments — need to be in good condition.
Here are some of the main reasons why patients experience knee pain and subsequently visit the orthopaedic team here at Circle Reading Hospital.
Osteoarthritis is the most common type of arthritis affecting the knee joint. Characterised by the degeneration of the cartilage covering the joint, osteoarthritis occurs when the ends of the bones rub together, causing friction, pain, inflammation and damage to the bone.
It is most often seen in older people, but can affect the younger generation too, particularly if a patient is overweight or performs repeated movements that accelerate the wear and tear on the joint.
This causes a range of debilitating symptoms, the most notable of which is pain. This pain may begin sporadically but often becomes persistent. The severity of your osteoarthritis pain may also vary, with many patients noticing that it is worse directly after a period of being still, and in cold weather.
Stiffness is another key symptom of osteoarthritis. This happens because as the cartilage wears away, the joint can no longer move as smoothly as before, causing it to stiffen.
People with moderate to advanced osteoarthritis of the knee will almost certainly find that their knee becomes increasingly stiffer until they undergo treatment. At this point, a knee replacement is usually recommended.
“There is little point waiting for the stiffness in your knee to increase before undergoing a knee replacement”, explains Dr Pollard, “particularly since a knee replacement will only restore your pre-operative range of movement and little more. It’s a highly effective treatment to prevent your symptoms from worsening and maintain your current mobility”.
Sprains and strains are also extremely common, and usually occur as a result of a minor accident or injury, such as a fall, sudden blow to the knee or it twisting incorrectly during a slip.
When this happens, the ligament experiences dozens of tiny micro-injuries that cause the symptoms most often associated with sprain or strain. These include:
Most sprains and strains will heal themselves, but patients will need to take extra care of the joint while this happens.
This may involve using a support bandage on the knee, avoiding physical activity as much as possible, controlling inflammation using heat/cold and anti-inflammatory medications, and getting plenty of rest.
If a ligament has been torn as a result of the accident, it will need to be repaired. Your orthopaedic surgeon will carry out a short surgery to stitch it back together. This is usually performed as keyhole surgery, or arthroscopically.
Arthroscopy is where a long, thin tube is inserted into a small incision in the knee and is used to repair the damage. The benefit of this type of surgery is that it is minimally invasive, helping patients to experience less post-operative pain and recover more quickly.
Once the ligament has healed, your knee pain should subside.
Tendonitis can occur anywhere in the body where there are tendons — the thick cords that attach bone to muscle — including in the knee. It can cause severe knee pain, particularly pain inside the knee.
This condition generally occurs when repetitive motion, such as running, squatting or jumping, causes the tendons to become irritated and inflamed. When this happens, it can cause joint pain, stiffness and affect how the tendon moves, which may limit the mobility of someone who experiences it.
The knee may also be swollen, hot, or red to the touch, and you may notice a creaking or crackling sensation when you try and move it.
Most cases of tendonitis in the knee affect athletes, and people who are physically active day-to-day, such as those who lift and carry as part of their job.
Although you can manage and treat the condition yourself at home, many people who experience chronic tendonitis seek the advice and support of an orthopaedic specialist. This referral is also essential if the damage to the tendon is severe enough for it to rupture.
At-home care for tendonitis can include methods like over-the-counter pain relief, hot/cold compresses, wearing a support on the affected knee, and plenty of rest.
However, if these do not provide enough relief from your knee pain, your orthopaedic consultant may recommend other treatments to help. These can include:
As with ligament repair, tendon repair can often be performed arthroscopically, which will help you to recover from knee pain quicker.
A dislocated kneecap is a fairly simple injury that occurs when the patella (kneecap) that usually sits over the front of the knee, comes out of the groove that usually keeps it in place. It is a key cause of knee pain, particularly pain on the outside of the knee.
Most dislocated kneecaps happen when there is a sudden trauma to the knee, such as blunt force applied to it, or you suddenly change direction while your legs remain in place, such as when playing sport.
The symptoms of a kneecap dislocation include:
A popping sensation in the knee at the time of the dislocation
While a kneecap can pop itself back into place, it’s still advisable to speak to an orthopaedic doctor, particularly if it has happened more than once. It could be that there is an issue with the groove that usually keeps the kneecap in place, or another type of weakness. Further investigation in the form of an x-ray may be necessary.
If professional intervention is needed to fix a dislocated knee, your doctor should be able to manipulate it back into place — something which is known as a reduction. If necessary, you may be given pain relief before this manipulation is carried out.
You may also need some physiotherapy to help accelerate your recovery. If any additional damage has occurred as a result of your dislocation, such as a fracture or a ligament tear, surgery may also be recommended, and your orthopaedic consultant will discuss this with you.
We’ve already discussed some of the knee pain treatments that you may be offered for specific knee injuries and problems.
However, it is also important to be aware that there are many things that you can do at home to help manage your knee pain day-to-day, and that could reduce your reliance on medications. There are also outpatient treatments that may be recommended.
Whenever the body experiences an injury, the first thing that it will do to try and protect itself is to trigger inflammation.
Also referred to as swelling, inflammation is a process where your body’s white blood cells and the things that they make protect you from infection, viruses and more.
Immediately following an injury, you’ll notice that the traumatised area becomes warm, red and painful, and begins to swell. This is inflammation and supports the healing process. However, it should be temporary.
If the area doesn’t heal quickly or properly, it is possible to develop chronic inflammation — a cycle of injury and repair that leads to continual or progressive knee pain in the back of the knee, front of the knee or affecting the area as a whole.
Treating inflammation is essential if you are to get relief from knee pain.
Here are our top tips for treating knee pain caused by inflammation:
Get plenty of rest, which reduces the strain placed on the knee
Protect the knee from further trauma, by using a support, bandage or splint
The main substance in steroid injections is hydrocortisone. These types of steroids should not be confused with anabolic steroids (the type that bodybuilders use to gain muscle) as they are quite different. Hydrocortisone injections are only available on prescription and can only be administered by trained professionals.
Steroid injections are delivered directly into the painful joint and work by releasing the medicine into it slowly.
The injection itself can be uncomfortable, and your knee may initially feel more painful for several days. However, patients report that their knee pain can subside for several months or more following their treatment, which makes it a highly effective treatment for chronic knee pain.
Nevertheless, steroid injections cannot be given long-term. This is because they can affect the effectiveness of your immune system, making you more likely to pick up infections, particularly things like chickenpox, measles and shingles.
Getting a serious infection could make you very ill, so it’s important to tell your orthopaedic care team if you think you may have come into contact with anyone with these diseases.
While steroid injections can be used by many patients, they are not automatically the safest or best treatment for everyone, and so you will need to have your suitability assessed by your orthopaedic care team before you start treatment.
You can read more about steroid injection therapy on our treatment page.
We’ve already talked a little about arthroscopic surgery to repair issues like a torn ligament or damaged tendon. However, it can also be used to address a wide range of other issues affecting the knee, including:
Your Circle Reading Hospital orthopaedic surgeon will talk to you about why each surgery is needed, what happens during the procedure and what to expect from your recovery.
This is where the existing joint is removed and replaced with a prosthetic alternative and is an immediate solution for most types of knee pain.
Nevertheless, it is a significant surgery and not something to be undertaken lightly. The recovery period following knee replacement surgery is extensive.
“The first six weeks after knee replacement take a physical and mental toll on the patient”, explains Dr Pollard. “Full recovery can take up to a year, but the actual knee pain disappears immediately. It is just post-surgery pain that you will experience, which should subside within a month or two”.
Whether you need a partial or full knee replacement will be advised by your orthopaedic surgeon, who will also explain in detail what you can expect from the procedure and recovery.
Knee pain may be debilitating, but there are treatments that can help relieve your discomfort and restore your quality of life. If you are suffering from knee pain, or you have any concerns about the health or mobility of your knees, please don’t hesitate to contact the orthopaedic care team at Circle Reading Hospital today.
If you would like to learn more about this procedure, book your appointment online today or call a member of our team directly on 0141 300 5009.
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