The common causes of knee pain and how to treat them

Chronic knee and leg pain hurts about one-third of people who are 50 and older, according to the data from a Gallup-Healthways Well-Being Index. While knee pain is extremely common, among younger people as well, it sometimes warrants a doctor’s visit. But when depends on the patients’ pain tolerance, Dr. Armin Tehrany, board-certified orthopedic surgeon, says.

“Pain that does not subside in a week or so should be evaluated by a physician to rule out something that could worsen with running,” Dr. Tehrany adds.

We use our knees all the time but they somehow they stay strong. What weakens them is too much repetitive or high-impact activities over a long period of time. Some of the worst sports for the knee are football, basketball and track; and the best sports are low-impact such as swimming. “We make our knees vulnerable to injury; however, other causes of knee injury are not our fault. They are due to genetics,” he says.

The knee is the biggest and the most complex joint in the body, and it can get hurt in a lot of ways.

1. Foot pain

“Patients with flatfeet can alter the mechanics of the entire leg causing knee pain,” Dr. Tehrany says. Shoe inserts can sometimes help foot or gait problems that may be causing pain in the knee. If you are a runner, make sure you change your shoes often, before the cushioning gets worn out.

2. Sprained ligaments

A sprain happens when a ligament is stretched or torn. Most ankle ligament injuries are caused when the foot twists inwards. The ligaments connect bones to other bones around the joints. You can seriously injure the tissue if you quickly change direction, land wrong on your feet, or you hit it (or it gets hit) too hard. A good way to prevent this from happening is strengthening the muscles. Weakness and lack of coordination are like prerequisites to sprains. Depending on the severity of the sprain, you’ll have to wear a hinged knee brace, use a weight-bearing brace or just rest and ice the injury.

Preacher’s knee (knee bursitis)

This is bursitis (inflammation) of the bursa just under the kneecap. A bursa is a fluid-filled sac that reduces friction between the bones, tendon and muscles. When it fills with blood from injury and overuse, your mobility is affected and it hurts. You may be at risk if you have to kneel often or practice sports such as wrestling or football. You can take anti-inflammatory medication, ice and rest the injured area.

Extra weight

If you weigh more than you should, you’re putting too a lot more stress on your knees. The cartilage that covers the bones wears out faster because of the extra pressure. Also, being overweight leads to the release of leptin, also called “the starvation hormone,” which has been linked to the development of osteoarthritis.

Loose body

Loose bodies in the knee joint are small fragments of cartilage or bone that move freely around the knee in joint fluid. They can hinder the joint moment by getting caught in flexion and extension movements. The fragments can lead to damage to the articular cartilage, causing osteoarthritis, so it’s important to remove them early. Physical therapy and anti-inflammatory drugs can be used to help with the symptoms.

Meniscus tears

“Pain in the front of the knee is more likely to be from the knee cap,” Dr. Tehnary says. “Pain on the sides of the knee is more likely to be a meniscus or ligament issue.” Meniscus tears are a common injury and are usually caused by forced twists or hyper-flexing of the knee. Surgery is sometimes necessary, but the usual treatment is muscle strengthening to stabilize the joint.

“We cannot assume that the knee is healed simply because the pain has subsided,” Dr. Tehrany says. “Pain is a subjective thing. The patient should rely on the physician’s assessment of the exact diagnosis in order to feel that the problem has healed.”

Runner’s knee

Runner’s knee is damage to the cartilage, a semi-hard and flexible tissue that covers the end of your bones, under the kneecap. The stress on your knees from running for a long time can cause irritation where it rests on the bone. The pain gets worse if you’re running uphill or up and down stairs. There may even be some swelling. If you’re a runner, you, obviously, won’t stop running. Strength training can help, according to a study, in handling and reducing the pain. Gait retraining can help as well.


Over the counter medication can be taken for patients that need to mask the pain in order to function, Dr. Tehrany says. It is important to establish the proper diagnosis first in order to ensure that one is not avoiding the problem and making it worse.

“For [people] that want the medication right away, I prescribe it only after making the diagnosis and explaining the proper treatment. For those that refuse to take medication that should, I simply explain to them the risks and benefits of their actions. The choice is theirs.”

© Anat Baniel Method (image), MSN.

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