By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute
Pain in the knee is very common. The most common causes are overload, injury and osteoarthritis. By yourself, you can give relief to the knee, do exercises and strengthen you knee. If you cannot stand on the leg after an injury because of the pain, you must seek a doctor immediately. Usually, your general practitioner can help you if you suspect serious injury or lengthy nuisances refer you to a specialist.
More and more complain about pain in the knees. This is particularly due to the fact that more and more are injured when doing sports. In the course of a year, 30% of all women and 25% of all men complain about pain in the knee.
What can it be? Pain in the knee can have many causes. The most common causes are overload, osteoarthritis and injury after a twist or blow.
Overload injuries: Overload injuries in the knee are relatively common with athletes, especially with sports where jumping and take-offs are common (football, handball, volleyball and alpine skiing). Typically, increasing pain that is provoked by activity and disappear when you rest is experienced. The pain can be located both inside the knee, on the front, on the back and on the sides – depending on which structure (tendon, muscle or bursa) that is overloaded. Usually, there is soreness when you press the place where the structure is overloaded.
Distance runners frequently overload a tendon located on the outer side of the knee and therefore experience pain here. Some runners step is askew when they run so that the muscles on the back of the knee are overloaded followed by pain. With children 10 to 15 years old, activity related pain might arise below the knee cap. Swelling, soreness, warmth and redness on the front of the knee or right below the knee cap may arise following overload caused by lengthy work performed on the knees (washing and polishing of floors).
Osteoarthritis: Osteoarthritis in the knee is seen with people older than 40 that have experienced knee injury earlier in life. The pain is located in the front of the knee and is worsened by walking up and down hills and sitting with the knees bent. The knee can swell heavily and cause strong pain.
Injuries: Only in the case of very violent injuries to a knee (traffic or fall accident), the bones break. Smaller injuries to tendons and meniscus are seen far more often.
Injuries to the meniscus with young people often arise in connection with a strong twist of the knee where the meniscus is completely torn apart followed by strong pain and swelling of the knee. With older people, injuries to the meniscus often arise following smaller but more frequent twists where a tear in the meniscus arise that cause not as strong but lengthy and repeated pain. Injuries to the meniscus can lead to locking of the knee so that the knee is unable to either bend or stretch. The pain can be located on the outer side or inner side of the knee – depending on which meniscus is injured.
Injuries to the cruciate ligament are common sports injuries and appear as pain inside the knee, swelling of the knee together with a feeling of the knee failing. Most often, injuries to the cruciate ligament arise from twists to the knee where the foot is locked in place. Most often injuries to the tendons are seen with a twist of a stretched leg and appears as pain on the outer side or the inner side of a swollen knee.
Other conditions in the knee: Baker’s cyst is an enhanced bursa inside the knee. The bursa bulges to the back of the knee where you can feel a soft swelling. The Baker’s cyst is a sign of increased amount of fluid in the knee and is seen following injuries to the knee and in the case of Rheumatoid arthritis.
Osteochondritis dissecans is when small pieces of bone floats around inside the knee. The pieces of bone are torn following blows to or twists of the knee. This is often seen with people in the age of 15 to 20 years who experience incidents of locking of the knee, pain and swelling of the knee.