일상/건강&질병

Knee pain

진02Jin02 2025. 5. 27. 06:06
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Knee pain is a very common complaint that can arise from a variety of causes, ranging from acute injuries to chronic conditions. The knee is a complex joint, involving bones, ligaments, tendons, cartilage, and muscles, all working together to facilitate movement and bear weight. Because of its central role in mobility, knee pain can significantly impact daily activities and quality of life.

Common Causes of Knee Pain

  1. Injuries (Acute Trauma):
    • Ligament Tears:
      • ACL (Anterior Cruciate Ligament) Tear: Common in sports involving sudden stops, changes in direction, or jumps (e.g., soccer, basketball, skiing). Often accompanied by a "pop" sound, severe pain, and instability.
      • PCL (Posterior Cruciate Ligament) Tear: Less common, often due to a direct blow to the front of the knee while bent.
      • MCL (Medial Collateral Ligament) Tear: Injury to the ligament on the inside of the knee, often from a blow to the outside of the knee.
      • LCL (Lateral Collateral Ligament) Tear: Injury to the ligament on the outside of the knee, often from a blow to the inside of the knee.
    • Meniscus Tear: The meniscus (C-shaped pieces of cartilage that act as shock absorbers) can tear with twisting motions, especially if the knee is bearing weight. Can cause pain, swelling, and a "locking" or "catching" sensation.
    • Fractures: Breaks in the kneecap (patella), shinbone (tibia), or thighbone (femur) due to falls, accidents, or direct impact.
    • Tendinitis: Inflammation of tendons, often due to overuse. Examples include:
      • Patellar Tendinitis (Jumper's Knee): Pain below the kneecap.
      • Quadriceps Tendinitis: Pain above the kneecap.
    • Bursitis: Inflammation of the bursae (small fluid-filled sacs that cushion the joint). Can cause pain and swelling over the affected bursa.
  2. Mechanical Problems:
    • Loose Body: A piece of bone or cartilage can break off and float in the joint space, causing pain, catching, or locking.
    • Patellar Dislocation: The kneecap slips out of its groove.
    • IT Band Syndrome (Iliotibial Band Syndrome): Tightness or inflammation of the IT band (a tough band of tissue running along the outside of the thigh) causing pain on the outside of the knee, common in runners.
    • Foot or Hip Pain: Problems in the hip or foot can alter gait and put more stress on the knee.
  3. Types of Arthritis:
    • Osteoarthritis (OA): The most common type, a degenerative condition where the cartilage in the knee slowly wears away. Often causes pain, stiffness, and reduced mobility, especially with age.
    • Rheumatoid Arthritis (RA): An autoimmune disease that can affect any joint, including the knees, causing inflammation, pain, swelling, and joint damage.
    • Gout: A form of arthritis caused by uric acid crystal buildup, leading to sudden, severe pain, redness, and swelling, often in the big toe but can affect the knee.
    • Pseudogout: Similar to gout but caused by calcium pyrophosphate crystals.
    • Septic Arthritis: A painful infection of the joint, often with fever, redness, and severe swelling. Requires immediate medical attention.
  4. Other Problems:
    • Patellofemoral Pain Syndrome (Runner's Knee): Pain around or behind the kneecap, common in athletes, often due to overuse, muscle imbalance, or improper tracking of the kneecap.
    • Osgood-Schlatter Disease: A condition causing pain and swelling below the kneecap in growing adolescents, often related to athletic activity.
    • Baker's Cyst: A fluid-filled cyst behind the knee, often a result of another underlying knee problem (like arthritis or a meniscus tear).

Symptoms of Knee Pain

The symptoms you experience will depend on the cause of your knee pain. Common symptoms include:

  • Pain: Can range from dull ache to sharp, stabbing pain. It might be constant or only occur with certain activities.
  • Swelling and Stiffness: The knee might feel swollen or "full," and difficult to bend or straighten.
  • Redness and Warmth: Indicates inflammation.
  • Weakness or Instability: Feeling like your knee might buckle or "give out."
  • Popping, Clicking, or Grinding Noises: Sounds when you move your knee, sometimes accompanied by pain.
  • Inability to Fully Straighten the Knee: A common symptom with meniscus tears or significant swelling.

When to See a Doctor

You should seek medical attention for knee pain if you experience:

  • You can't bear weight on your knee.
  • You have severe swelling or redness.
  • You have significant pain, even when resting.
  • You notice deformity in your knee or leg.
  • You have a fever in addition to knee pain, redness, and swelling.
  • You cannot fully extend or bend your knee.
  • The pain persists or worsens despite rest and home care.

Diagnosis

A doctor will typically perform:

  • Physical Exam: Checking for swelling, tenderness, range of motion, and stability.
  • Imaging Tests:
    • X-rays: To check for bone fractures, arthritis, or other bone abnormalities.
    • MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues like ligaments, tendons, menisci, and cartilage.
    • Ultrasound: Can help evaluate tendons, ligaments, and fluid buildup.
  • Lab Tests: Blood tests may be ordered to check for inflammatory conditions like rheumatoid arthritis or gout, or infection.

Treatment

Treatment for knee pain depends on the underlying cause and severity.

  • Non-Surgical (Conservative) Treatment:
    • R.I.C.E. (Rest, Ice, Compression, Elevation): For acute injuries to reduce swelling and pain.
    • Medications: Over-the-counter pain relievers (NSAIDs like ibuprofen, naproxen) or prescription medications.
    • Physical Therapy: Exercises to strengthen muscles around the knee (quadriceps, hamstrings, glutes), improve flexibility, balance, and gait.
    • Injections:
      • Corticosteroid injections: To reduce inflammation and pain.
      • Hyaluronic acid injections (viscosupplementation): To lubricate the joint and reduce pain, primarily for osteoarthritis.
      • PRP (Platelet-Rich Plasma) or Stem Cell Injections: Newer treatments aiming to promote healing and regeneration.
    • Bracing: To provide support and stability.
    • Lifestyle Modifications: Weight loss (if overweight), avoiding activities that worsen pain, using proper footwear.
  • Surgical Treatment:
    • Arthroscopy: A minimally invasive procedure to diagnose and repair many knee problems (e.g., meniscus repair, ligament reconstruction, cartilage debridement).
    • Partial or Total Knee Replacement (Arthroplasty): For severe osteoarthritis or other extensive joint damage, where the damaged parts of the knee are replaced with artificial components.
    • Osteotomy: A procedure to realign the bones and shift weight off the damaged part of the knee.

Managing knee pain often requires a combination of treatments and a commitment to rehabilitation. Following your doctor's advice and physical therapy instructions is crucial for recovery and long-term knee health.

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