Every year, millions visit a doctor complaining of pain in the knee. In fact, knee pain is the most common reason to go see a bone and joint surgeon.
Specifically, the knee is where the thigh bone comes together with the tibia. The tibia bone is the largest bone in the lower portion of the leg. At the joint between the thigh bone and the tibia rests the patella or knee cap. The entire joint is covered by the synovial sac which produces a lubricant like fluid for the functioning of the joint. Of course, other body parts are involved in making up the entire knee joint: muscles, ligaments, cartilage, and tendons.
The Knee Joint.
The knee joint allows for rolling movements, rotating movements, and gliding actions. Because of the joint’s extreme versatility and complete range of motion and despite that the knee is able to support a person’s body weight two to three times over, the knee is highly susceptible to injury.
Knee pain, therefore, can be caused by many different factors and reasons. In general, pain in the knee is experienced as an aching feeling or as an on fire sensation.
What Causes Knee Pain?
A lot of different conditions and diseases are associated with knee pain. Knee pain lasting for a short amount of time may simply be caused by overexertion. The following list describes the ten most common reasons for knee pain.
Arthritis: Arthritis is probably the most common association with knee pain. There are three types of arthritis: osteoarthritis, rheumatoid, and septic. Osteoarthritis is joint degeneration. Rheumatoid is joint inflammation. Septic arthritis is caused by joint infection.
Bursitis: The bursae of the knee is a protective structure within the joint that protects from general friction. Bursitis is caused by inflammation. The inflammation of the bursae can be caused by larger existing issues such as rheumatoid arthritis or gout. Interestingly, bursitis was once known as “the house-maid’s knee,” because of the constant kneeling one did as a house maid to clean floors. Bursitis can simply be caused by an over-use of the joint in a particular movement—such as continued kneeling.
Cysts: Cysts are simply fluid-filled sacs. A cyst around the knee joint causes not only general knee pain, but can also be the central cause of swelling of the knee.
Fracture: Any kind of break or crack in the bones that make up the knee joint will cause knee pain. That means a crack or break in the patella, the tibia, or even anywhere in the thigh bone can cause pain within the knee.
Gout: Gout places an inordinate amount of uric acid within the blood. The uric acid is produced as a result of an internal bodily chemical process gone hay-wire. Besides joint pain in general, uric acid can leave deposits of a crystal like substance in and near joint areas. At it’s most benign, gout can cause rheumatoid arthritis. At it’s worse, gout can cause total joint destruction.
Ligament injury: Ligaments support the knee. Any injury or overuse to the knee ligaments can cause serious pain. This type of injury is most common with sports.
Loose bodies: Anything floating around the knee joint can cause pain. These loose bodies can be anything from ligament and/or cartilage fragments to crystal deposits caused by uric acid in the blood stream.
Meniscus related problems: At the top end of the tibia where it meats the thigh bone sits shock absorbers, much like what is found in a vehicle’s suspension system. Only this shock system is made up of cartilage and is called menisci. A meniscus related problem is another one of those sports associated injuries, though damage can be done to the menisci other than participating in sports. Damage happens normally as a tear. A meniscus tear can also happen due to old age too.
Osteonecrosis: Osteonecrosis is bone degeneration. Osteonecrosis can cause knee pain when the degeneration of the bone happens along the thigh bone or the tibia. The problem can not only lead to knee pain, degeneration of the particular bone in question, but can cause deformity. Osteonecrosis occurs when there is a decreased blood supply to the bone. The decreased supply can sometimes occur due to a fracture or break.
Patellofemoral pain: No one knows exactly what causes patellofemoral pain. The pain centers specifically around the knee cap or the patella, and does not seem to spread. There is some suspicion that the patellofemoral pain is caused by an unusual rapid growth of some sort, the bones repositioning themselves in an odd way, a weakening of the muscles around the patella, or decreased range of flexibility in the knee. Whatever causes the patellofemoral pain is pretty much just a good, educated guess though. The pain is also sometimes referred to as anterior knee pain syndrome.
Knee Pain Prevention
Knee Pain Symptoms Natural CuresWhether recovering from a knee injury or just trying to avoid knee injury and pain altogether, knee strengthening exercises are a great solution. Also, wear proper shoes with an adequate amount of foot support. If one is involved in a heavy exercise workout or knee-demanding sports such as basketball or skiing, be sure to warm up with stretches before engaging in such activities.
Improving the Support for Your Knees
It is easy to be skeptical on the efficacy of pads or braces, however for some people they can have a big impact at a low cost. When my mother had knee pain put on a Cho Pat dual action knee strap (available on Amazon.com here) her pain went away almost immediately. Many athletes can be seen wearing leg compression sleeves from companies like McDavid (also available on Amazon.com here).
Some people who stand for long periods of time on long work shifts (like nurses) use shoes with extra cushioning in their soles. New Balance and Crocs are popular choices.
Even low cost insoles like those provided by Dr. Scholl’s can help provide some pain relief starting around $10. A variety of higher cost insoles are available, though it is likely best to shop for them in person, as you will need to feel how the support fits your foot and arch. Some stores like Road Runner Sports offer a foot measurment service when you shop for new shoes.
Old shoes which are worn out can put extra stress on your knees and ankles. In some cases rotating between different pairs of shoes can help save you money while keeping your legs healthy. For example, if you engaged in a high impact sport like basketball you could use your new shoes for that use older shoes for leisurely walking. As the basketball shoes get worn down you could add insoles and turn them into your walking shoes, while using new shoes during your higher impact exercises.
Ideal Shoe Types?
For a significant period of time some sources have recommended shoe types for different pronation levels.
Normal Arch: for people with normal arches stability shoes have typically been recommended. These shoes have higher density midsoles to absorb the shock impact from feet slightly rolling inward.
Flat (low) Arch: for people with low arches motion control shoes and stability shoes have typically been recommended. These shoes compensate for overpronation by having firmer medial support and flatter soles to offset excessive inward roll of the feet when they strike the ground.
High Arch: for people with high arches neutral cushioning shoes are recommended. These shoes tend to have softer midsoles and do not have stability devices or medial posts.
While the above shoe type recommendations sound reasonable, numerous studies have shown people who use shoes which feel comfortable to them are less likely to get injured than people who select their shoe based on the alleged best practice based on their arch. Thus if someone recommends a certain shoe type for you and it doesn’t feel good, then pick a different shoe. Once you find a shoe which works well for you still feel great about it after an extended period of time, it can make sense to ensure you document the shoe model number and size and look to see if you can find the shoes on sale online in order to bulk purchase them.
Gretchen Reynolds’ The First 20 Minutes has an excellent section on shoe recommendations in chapter 7.
Recently running barefoot, or using shoes like Vibram Five Fingers which emulate running barefoot, has become a popular trend. However, even if barefoot running could potentially be better on your joints, your muscles become acclimated to what they are used to. Thus if a girl who frequently wore stiletto heels shifted to running barefoot she would likely be at an increased risk of injury. We are quite adaptive, but change to our muscular and joint structures take time significant shifts increase the risk of overuse injuries.
The following four exercises are designed specifically to strengthen the knee area, and strengthening any individual part of the body is a great prevention method to help avoid injury and pain to that body area.
Knee Pain Remedies
Exercise One: Stand approximately six to twelve inches away from a wall. Squat, then lean the upper body away from the wall until the hip comes against the wall. Do this for about twenty seconds, then switch sides.
Exercise Two: Standing, cross left foot over the right. Raise arms straight above the head. Lean to the left as far as possible without bending knees. After twenty seconds, switch feet around and lean to the right.
Exercise Three: Feet together, stand approximately twelve inches away from a wall. Stretch your arms out horizontally. Don’t bend the knees. With the right hand, bend at the waist and reach as far down as possible. Remain in this position for about twenty seconds, then repeat with the left hand.
Exercise Four: Lie on the right side of the body on the floor. The elbow should be resting on the floor as well. Lift the left leg approximately a foot high. Repeat twenty times or as much as could be tolerated until thirty reps are reached. Repeat the exercise lying on the left side of the body and lifting the right leg.
If you find yourself routinely hurting after exercise it may be due to overuse. If you exercise daily it can make sense to add an off day or two to your weekly routine, or to do lower impact exercises some days.
A number of supplements are recommended to improve bone and joint health.
Calcium and Vitamin D: Vitamin D helps us absorb calcium calcium helps keep bones strong and prevent bone mass loss.
Glucosamine and chondroitin: glucosamine sulfate and chondroitin sulfate help improve joint mobility and remove pain.
SAMe: S-adenosy-L-methioine helps improve joint strength by delivering sulfur to your cartilage.
MSM: can reduce muscle damage and other exercise-related stress markers may slightly reduce some symptoms of arthritis of the knee.
natural anti-inflammatories: turmeric, ginger and boswellia are natural alternatives to ibuprofen or asprin which may be used to treat osteoarthritis. Dr Weil recommends consulting your doctor before using ginger in combination with other blood thinning drugs or supplements like ginko biloba.
Previously stated all ready, many different conditions, symptoms, diseases, and conditions can cause knee pain. Certain individuals may be at higher risk for knee pain than others though. For instance, habitual runners have higher instances of knee pain. Because the knee does support at least the entire weight of the body and at least up to three times the weight of the body, those that are overweight are at higher risk to suffer from knee pain.
Those that are involved in high impact supports such as basketball, skiing, football, soccer, tennis and lacrosse are all more likely to find themselves suffering from knee pain. Anybody in a work related field that requires repetitive kneeling or crawling such as laying flooring and carpeting are more likely to develop knee pain symptoms. Lastly, with the onset of advance age, knee pain is almost a guarantee for the majority of the population.
Knee Pain Diagnosis
After going over a general medical history and then performing a physical exam of the person suffering from knee pain, an orthopedic (bone joint) physician or surgeon can make a diagnoses as to what is causing the knee pain. In general, the exam includes bending the knee to figure out the complete range of motion and flexibility left in the knee. The doctor will also feel the knee with his hands, looking for any strange growths, deposits, or other abnormalities. Other tests may be administered as well as X-rays. In extreme cases, the use of an MRI or a computed tomography is not unheard of.
Knee Pain Treatment
Once diagnosed and the exact cause determined, there are three main methods of treating knee pain: herbal and other natural remedies, over the counter and prescription drugs, and surgery.
Herbal Other Natural Remedies
At least twenty different herbs exist for knee pain relief. They can be categorized as topical treatments and herbs that can be ingested for the pain.
Basil: Use as an oil.
Comfrey: Use as an oil rub and will relief the symptoms of aching joints and joint stiffness.
Eucalyptus: An essential oil rub, the eucalyptus reduces swelling.
Ginger: Ginger reliefs arthritis, general joint stiffness, and pain from degenerative joint disease. Use as in a bath or as a hot compress.
Lavender: Another oil rub that can be used to alleviate aching joints and stiffness.
Mustard: For general knee pain, mustard can be used in a topical paste rub or in a bath.
Red Pepper: Helps with swelling and arthritic pain. Use as a lotion.
St. John’s Wart: Alleviates aching joints and stiffness. Use as an oil rub.
Wintergreen: For chronic, persisting pain in the knee, wintergreen can be used as an oil rub.
Celery: Treats gout and swollen joints. Used as a tincture—a mixture of infused alcohol. Vodka seems to work the best. Works as a decoction.
Chamomile: reduces swelling and spasms.
Deadly Nightshade: Alleviates swollen joints.
Devil’s Claw: Use in a tablet or pill form. Alleviates swollen joints.
Flaxseed: Works as a joint lubricant and is used in an oil form.
Geranium: Used against chronic and long-term, persistent pain.
Jamaican Dogwood: Works against swelling an general pain.
Lemon Juice: Helps with swelling.
Prickly Ash: Should be taken as a tea and relieves joint pain.
White Willow: Taken in a pill form or as a decoction. Helps joint swelling and pain.
Wild Lettuce: Reduces swelling and joint pain.
Various other natural remedies exist for relieving and treating knee pain. A few of the more traditional natural methods include: acupuncture, exercise, and massage.
Some of the more odd natural remedies for knee pain include acupressure, aromatherapy, magnetic therapy, and Rolfing. Acupressure is like acupuncture as in it utilizes pressure points on the body, but does not require the use of needles. Aromatherapy with the use of essential oil such as rosemary and peppermint seem to relax muscles in general and relieve pain as well.
Concerning magnetic therapy, it is believed that magnetic fields increase blood flow. Wearing a therapeutic magnet near the knee may also reduce pain by blocking the pain receptors. Rolfing is a painful, deep tissue massage technique believed to speed the healing process and help manage pain.
Over The Counter And Prescription Drugs
Knee pain can be self-medicated also with drugs such as ibuprofen, naproxen, or acetaminophen. These specific drugs can be found over the counter in name brands such as Advil and Motrin, Aleve, and Tylenol respectively.
Prescription treatments may include narcotics or pain reducers such as tramadol. Some drug treatments involve injecting the drug directly into the knee.
In the majority of cases of knee pain, patients do fine with the natural or over the counter treatments; however, with patients suffering from arthritis and osteoarthritis specifically, the only way to alleviate the pain is surgically replacing the knee altogether.
In a knee replacement surgery, the top portion of the tibia and the bottom portion of the thigh bone are replaced. Not all patients will need the entire knee replaced. Postoperative preparation is painful and recovery is also rather painful. Recovery involves six to eight weeks of intense physical therapy as well.