Spence Rehabilitation Center
1650 45th Ave. Suite 2C
Munster, IN 46321
Visit our Porter County location!
1620 Country Club Rd. Ste E
Valparaiso, IN 46383
Phone : (219) 513-2267
What are the types of knee pain?
Acute (immediate) pain commonly occurs from an injury
resulting from trauma or infection. Chronic (long-term) pain
typically occurs from arthritis, inflammatory conditions such
as rheumatoid arthritis, and can occur from infection.
What are some common causes of acute pain?
Acute knee pain
1. Fractures (broken bones):
Typically associated with tenderness, severe pain that
interferes with walking and weightbearing, as well as
bruising and swelling.
2. Sprained and torn ligaments:
Sometimes result from twisting activities and are
accompanied by swelling, knee instability, or locking.
3. Tendon ruptures:
Both the quadriceps and patellar tendons may rupture
partially or completely. Pain is typically present when
trying to kick or extend the knee. The patella (kneecap)
is also often out of place either upward (with patellar
tendon rupture) or downward (with quadriceps tendon
4. Knee dislocation:
A true limb-threatening emergency caused by a
powerful blow to the knee. The lower leg becomes
completely displaced with relation to the upper leg.
This displacement stretches and frequently tears not
only the ligaments of the knee but also arteries and
nerves. Untreated arterial injuries leave the lower leg
without a blood supply. In this case amputation may
be required. Nerve injuries, on the other hand, may
leave the lower leg viable but without strength or
sensation. The knee is severely painful and there
can be an obvious deformity of the knee.
5. Dislocated kneecap (patella):
Caused by direct trauma or forceful straightening of the
leg. If present, you will notice the patella being out of
place and may have difficulty flexing or extending your
What are some tests used to evaluate for knee pain?
1. X-rays of the knee:
To evaluate for fractures and dislocations of the knee as
well as arthritic changes and check for abnormally large
or small joint spaces that could indicate an effusion or
2. CT scan of the knee:
To precisely define a fracture or deformity.
3. Magnetic resonance imaging:
To evaluate the ligaments and tendons for injuries.
4. Joint Aspiration:
Fluid is sometimes removed with a needle to check for
infection or crystals.
5. Blood tests:
To evaluate for signs of infection or diseases such as
rheumatoid arthritis and diabetes.
6. Arthroscopy:
A fiber optic camera is placed in the knee joint to look
more closely at damaged menisci or cartilage. The
doctor may also be able to repair damage by shaving
down torn cartilage or removing particles from the knee
while the camera shows the inside of your knee.
What are some causes of chronic knee pain ?
1. Osteoarthritis:
Is caused by degeneration of cartilage in the knee.
The painful knee that is often more painful with
2. Rheumatoid arthritis:
Typically affects many joints often including the
knee. People who have this disease often have
family members who suffer from it as well. Patients
may also complain of morning stiffness greater than
30 minutes and pain in other joints.
3. Crystalline arthritis (gout and pseudogout):
Is arthritis caused by sharp crystals that form in the
knee and other joints. These crystals can form as a
result of defects in the absorption or metabolism of
various natural substances such as uric acid (which
produces gout) and calcium pyrophosphate
4. Bursitis:
A fluid filled sac in the knee gets inflamed as a result
of trauma, infection, or crystalline deposits. A
common bursitis is prepatellar bursitis and commonly
occurs in people who work on their knees. It is often
referred to as housemaid’s knee or carpet layer’s
knee. Another type of bursitis is anserine bursitis
which is located about 2 inches below the knee along
the inner side of the knee and is often worse with
bending the knee or at night with sleep.
5. Infection (infectious arthritis):
A common organism is Gonorrhea. Knee Infections
cause painful knee swelling, fevers and chills.
6. Patellofemoral syndrome and chondromalacia
Caused by patellar mistracking. In patellofemoral
syndrome, the patella rubs against the inner or
outer femur rather than tracking straight down the
middle. The knee pain is usually worse with activity
and prolonged sitting. As the condition progresses,
degeneration of the articular cartilage on the
underside of the patella occurs which is called
chondromalacia patella.
7. Jumper’s knee:
Quadriceps tendonitis or tendonitis of the patellar
tendon typically seen in basketball players, volleyball
players, and other jumping sports. Jumper’s knee
causes localized pain that is worse with activity. It
usually hurts more as you jump up than when you
land because jumping puts more stress on tendons
of the knee.
8. Osgood-Schlatter disease:
Occurs in adolescent athletes where repetitive
extension of the knee causes inflammation and
injury of the tibial tubercle. Pain is typically a couple
of inches below the knee where the patellar tendon
attaches and is worse when extending the leg. The
tibial tubercle is tender to touch and over time begins
to protrude more because the chronic inflammation
stimulates the bone to grow.
9. Iliotibial band syndrome:
Inflammation of a fibrous ligament that extends from
the outside of the pelvic bone to the outside of the
tibia. When this band is tight it may rub against the
bottom outer portion of the femur. This pain is
commonly seen in distance runners, is outside knee
pain, and will typically come on 10-15 minutes into a
run and improve with rest.
What are some treatment options for ACUTE knee
1. Protect:
The knee from further trauma. Consider a knee pad.
2. Rest:
The knee to allow time to heal and helps to prevent
further injury.
3. Ice:
The knee to reduce swelling and limit pain. Apply
cold packs 2-3 times a day for 20-30 minutes each
time. You can also use an ice bag or a bag of frozen
vegetables placed on the knee.
4. Compress:
The knee with a knee brace or wrap.
5. Elevate:
The knee to help reduce swelling.
6. Acetaminophen:
(Tylenol) can also be used to control knee pain but does
not have the anti-inflammatory properties of the
7. Nonsteroidal anti-inflammatory drugs (NSAIDs):
Such as naproxen (Aleve or Naprosyn) and ibuprofen
(Advil or Motrin) play a role in the treatment of knee
pain and can limit joint inflammation. You should not
use NSAIDs if you have a problem with bleeding,
stomach ulcers, or some types of kidney disease.
8. Physical Therapy:
Will depend on the diagnosis as well as patients
symptoms. However, in general, patients begin
working on progressive passive and active range
of motion exercises until normal range is obtained.
Therapies will then be upgraded to include stretching
and strengthening of the knee, hips, and ankle. If
patellofemoral pain is present, therapies may also
include tracking of the kneecap. Finally, therapies will
target a work or sport specific activity to minimize the
likelihood of reinjury. Therapies should be performed
at least two to three times a week for optimal results.
9. Glucosamine and Chondroitin:
Is an over-the –counter supplement that helps to limit
pain and inflammation as well as limit the destruction
of cartilage in the knee.
10 Corticosteroid injection of the Knee:
Allows a higher dose of steroid to be placed at the site
of injury. Knee injections are limited to every three to
four months.
11. Knee Braces:
Are sometimes prescribed for pain that is not
responding adequately to therapies and medication.
Patellar cutout braces can help to keep the kneecap in
line for patients with Patellofemoral syndrome and
Unloader Braces can help patients with osteoarthritis by
shifting weight away from the part of the joint with the
most arthritic narrowing. Medial Arch Supports can help
treat for foot disorders that can alter walking which is
subsequently leading to knee problems.
12. Hyaluronic acid:
Is derived from Rooster combs and has been found
to limit pain as well as inflammation of knees with
osteoarthritis. The injections are given intermittently
in a series and can last as long as six months.
13. Topical Pain Medications:
Lidocaine can be applied to the knee as an ointment or
patch to help limit pain. Capsaicin which is a medicine
derived from chili peppers is also sometimes tried.
14. Cane:
Is used to increase your base of support and help
unload the arthritic joint. The cane is typically used
on the opposite side as the painful knee.
15. Knee Surgery:
The types of procedures will depend on the extent of
arthritis. Arthroscopy is a procedure that uses a small
microscope to view inside the knee joint and can be
used to remove loose bodies and damaged cartilage.
If you have severe arthritis at one part of the joint but
some healthy cartilage still remains, surgeons may
elect to perform a Unicompartmental knee replacement
or partial knee replacement. The most damaged
portion of the knee is removed and replaced with a
metal and plastic prosthesis during a partial knee
replacement. In contrast, during a total knee
arthroplasty, the entire knee joint is replaced with a
metal a plastic prosthesis.
"Nothing contained on this website should be interpreted to be medical advice. This website is for general information only.
Please consult a physician for medical advice regarding any medical condition."
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