Knee Pain

Knee pain can be caused by a variety of conditions, including ligament tears, meniscus tears, cartilage injuries, fractures, tendonitis, bursitis, and arthritis. These conditions can all produce pain, swelling, and stiffness in the knee. Bursitis and tendonitis are usually due to overuse, a change in activity level or training, or a new exercise routine. The result is pain and inflammation in the knee. The pain is worse with activity and improves with rest. These conditions usually get better with anti-inflammatory medication and physical therapy. Sometimes a brace or a cortisone injection can be helpful.

Anterior cruciate ligament (ACL) tears and meniscus tears are the most common causes of knee pain and swelling after sports injuries in athletes. It may be a non-contact twisting injury or from a collision. The athlete will usually feel a “pop” with immediate swelling, and is unable to continue to play. Over the next several days, the swelling will improve, but pain, popping, and clicking will persist, and the athlete will not be able to return to play sports. Ligament tears and meniscus tears cause pain, swelling, popping, clicking, and feelings of instability.

Knee pain can also result from trauma, such as a car accident or fall from a height. This can result in a fracture, dislocation, or ligament tears. Finally, some knee pain develops slowly over time, from continued “wear and tear”. This is often caused by arthritis or degenerative meniscus tears. When the knee hurts, it may feel better not to move it and it can become stiff. Knee pain usually is worse with activities, such as running or sports, and improves with rest.

How can this be diagnosed?

The diagnosis of your knee pain is made by a physician by a combination of history (when the knee hurts, what makes it worse, and what makes it better) and examination of the knee. During your office visit, an examination of the knee will be performed to evaluate for ligament tears and meniscus tears, and X-rays will be obtained to evaluate for fractures or arthritis. Further imaging studies, such as MRI or CT scan, may be ordered to gain additional information.

How can this be treated?

Dr. Michael O’Brien treats knee pain of all varieties in all patients. The initial treatment often involves rest and anti-inflammatory medications (NSAIDs) that can be prescribed to decrease pain and inflammation. Certain injections can be useful for pain relief. Sometimes bracing or splinting is required, with rest from any sporting or aggravating activities. Physical therapy and home exercises are helpful to improve range of motion and strength. When non-operative treatment fails to provide relief, surgery may be an option. Surgery may also be necessary for certain fractures, ligament tears, or meniscus tears. Arthroscopic surgery (surgery through a scope) may be performed for certain conditions, while other conditions may require an incision.