อาการ สาเหตุ  การรักษาอาการปวดเข่า - Knee pain: Symptoms, Causes, Treatment

Knee pain

Knee pain can result from injuries or conditions like osteoarthritis, gout, or arthritis. Initial treatment includes knee braces and physical therapy. Severe cases may require surgery for improved quality of life.

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Knee pain

People of all ages and genders can develop knee pain typically due to an injury such as torn cartilage or ruptured ligament or medical conditions such as knee osteoarthritis, gout, arthritis, or infections. Doctors may recommend knee braces or physical therapy sessions to help relieve and manage mild knee discomfort. In severe cases, surgical treatment is an effective treatment modality that can promote patients’ quality of life.

What are the symptoms of knee pain

  • Your knee becomes stiff, swollen, and tender.
  • You cannot fully straighten your knee.
  • You develop knee weakness or instability.
  • You hear popping noises from your knee.

When to see a doctor

  • Your knee gives out or cannot bear any weight.
  • Your knee cannot be flexed or extended.
  • You notice some deformity in your knee or leg.
  • You have a fever accompanying swelling of the knee.
  • You experience severe knee pain due to injury.

อาการปวดเข่ามีสาเหตุเกิดจากอะไร - What causes of knee pain?

What causes of knee pain?

Injury A knee injury can impact various parts of your knee joint, including ligaments, tendons, bursae, bones, cartilage, and joint structures. Here are some common knee injuries.

  • Anterior Cruciate Ligament (ACL) injury occurs often in individuals who participate in sports like basketball and soccer or activities involving sudden changes in direction.
  • Fractures of knee bones and kneecaps from falls, accidents, or weakened bones due to osteoporosis.
  • A torn meniscus can occur from suddenly twisted while bearing weight.
  • Knee bursitis is an inflammation in the bursae caused by repetitive knee injuries, affecting the smooth gliding of tendons and ligaments over the joint.
  • Patellar tendinitis is prevalent in those who regularly engage in sports such as running, skiing, biking, or jumping.

Mechanical knee problems

  • Hip or knee pain can cause you to alter your gait to alleviate the discomfort in those joints. However, this modified gait can increase stress on the knee joint and result in knee pain.
  • The patella slips out of its normal position, usually to the outer side of the knee.
  • A loose body can hinder the movement of the knee joint.
  • Iliotibial band syndrome arises in distance runners and cyclists.
  • Knee osteoarthritis occurs when the knee meniscus sustains damage from long-term use and excessive body weight.

Types of arthritis

There are over 100 types of arthritis, and several types affect the knee. For example:

  • Gout can cause uric acid crystals to accumulate in a knee joint.
  • Pseudogout due to the precipitation of calcium-containing crystals in the joint fluid
  • Rheumatoid arthritis is an autoimmune condition that can affect any joint of the body, including the knee.
  • Septic arthritis with fever. It is crucial to seek medical attention promptly as it can rapidly cause significant damage to the knee cartilage.

Other problems

  • Patellofemoral pain syndrome is frequent in athletes or seniors with kneecap arthritis.

Risk factors that cause knee pain

  • History of knee injuries.
  • Engage in certain sports or occupations that can place more stress on your knees compared to others, such as skiing, basketball, running, or construction work.  
  • Being overweight can put extra stress on your knee joints while engaging in daily activities such as walking or climbing stairs. It also raises the risk of developing osteoarthritis by accelerating the deterioration of joint cartilage.
  • Lack of sufficient muscle strength and flexibility.

Complications

Knee injuries and medical conditions, such as osteoarthritis, can worsen over time if left untreated, which can result in escalating pain, joint damage, and decreased mobility. Additionally, individuals with a previous knee injury are more likely to develop future similar injuries.

How is knee pain diagnosed?

  • History taking and physical exam
    Your doctor will examine if you have visible bruises, pain, swelling, and tenderness in the knee. You will be asked to move your leg to assess the range of motion. Then, your doctor will push and pull your knee joint to determine the strength and stability of your knee.
  • Imaging tests
    • X-rays to detect bone fractures and degenerative joint disease.
    • CT scan: useful in diagnosing bone issues, subtle fractures, and gouty arthritis, even in an uninflamed joint.
    • Ultrasound while moving your knee in different positions to check for specific problems.
    • MRI to detect injuries to soft tissues such as ligaments, tendons, cartilage, and muscles.
  • Lab tests
    Blood tests and arthrocentesis may be ordered if there is an infection or inflammation in the knee.

How is knee pain treated?

Oral medications

Your doctor might recommend medications to alleviate pain and address the underlying conditions contributing to the knee pain, such as rheumatoid arthritis or gout.

Intraarticular injections

  • Corticosteroid injections can minimize the symptoms of an arthritis flare and provide pain relief that may last a few months. However, they may not be effective in every case.
  • Hyaluronic acid can help lubricate joints, improve mobility, and ease pain that may last six months.
  • Platelet-rich plasma (PRP) can reduce inflammation and promote healing.

Physiotherapy

Physical therapy can strengthen the muscles around your knee and make your knee more stable. A physical therapist would recommend exercises suitable to your requirements and the cause of knee pain. Athletes and those who regularly play sports will receive advice on proper exercise techniques and correct any movement patterns impacting their knees. You will learn how to exercise to improve your flexibility. Your physical therapist may suggest using arch supports or heel wedges to shift pressure away from the knee. Some knee braces can also help prevent further knee damage. 

Surgery 

  • Arthroscopy can remove loose bodies, repair damaged cartilage in case of knee locking, and reconstruct torn ligaments. 
  • Partial knee replacement involves replacing only the damaged portion of your knee. 
  • Total knee replacement entails removing damaged bone and cartilage from your thighbone, shinbone, and kneecap and replacing them with an artificial joint made of metal alloys, high-grade plastics, and polymers. 
  • Osteotomy is the surgical removal of your bone from the thighbone or shinbone to realign the knee and alleviate arthritis pain.  

Lifestyle and home remedies 

  • Take pain relievers such as ibuprofen or naproxen sodium or apply numbing creams containing lidocaine or capsaicin to ease your pain at home. 
  • Rest and take a break from regular activities to minimize strain on the knee, allow time for healing, and prevent further damage.  
  • Place a cold compress to decrease pain and inflammation. Limit ice therapy to 20 minutes per session to avoid nerve and skin damage. 
  • Use a warm compress as temporary pain relief. Apply a hot water bottle or heat pack on the affected knee. 
  • Use a compression bandage to prevent fluid buildup in injured tissues and maintain knee alignment. 
  • Elevate your affected leg while sitting or sleeping. Propp up the injured leg on pillows to reduce swelling. 

How to prevent knee pain?

  • Maintaining a healthy weight helps reduce knee pressure and lowers the risk of injuries and osteoarthritis. 
  • Before engaging in a sports activity, prepare or train your muscles to minimize the risk of knee injuries. 
  • Pay attention to the technique and movement patterns used in sports or activities. 
  • Build strength and flexibility of the muscles around your knees and practice regular stretching exercises to prevent muscle tightness, which can also contribute to injuries. 
  • Modify your exercise routine to suit your health conditions, particularly if you have osteoarthritis, chronic knee pain, or recurring injuries. Consider low-impact activities like swimming or aquatic aerobics as alternatives. 

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Published: 20 Jun 2024

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