Knee Pain

What can cause knee pain?

Knee pain has a wide array of different potential causes that include both pathology within the knee joint itself as well as pathology that presents with pain referred into the knee and felt in and around the knee joint. Example of this includes hip pain, lower back pain, and less commonly, pelvic pain.

Causes from within the knee joint include arthritis, meniscal tears, osteochondral defects, osteonecrosis, patella maltracking, patellofemoral syndrome, cruciate ligament damage, collateral ligament damage, and other rare causes such as pigmented villonodular synovitis (PVNS).

How to diagnose knee pain

Any knee pain that is persistent and refractory to over-the-counter analgesia, exercise, rest or sustained physical activity should be brought to the attention of a healthcare professional. Our specialist orthopedic surgeons would be happy to see you in consultation for any knee pain that you may be having.

The process begins with a formal history and physical examination, which will include discussion of the knee pain and its duration, nature, characteristics and exacerbating or alleviating factors. We will then perform a physical examination of the knee joint and arrange for you to undergo plain film radiographs, x-ray studies that will give us more information about the anatomy of your knee and potentially give us the diagnosis at that point. If at this point the diagnosis is still unclear, then further imaging studies such as a CT or MRI scan may be ordered in order to ascertain exactly what is causing the underlying knee pain based on the clinical suspicion from the history and physical examination.

Depending on the cause, in some cases your knee pain may be able to be diagnosed in the office during your first visit, but for other causes that are less clear-cut it may require you to undergo a further scan of some kind and return to the office when the scan has been completed for us to discuss the results with you.

What can I do for knee pain?

The first line treatment for any type of joint pain should be rest of the affected joint for a short period of time. Over-the-counter analgesics such as Tylenol or nonsteroidal anti-inflammatory medications are also the first protocol for analgesia.

If neither of these strategies are effective then you may require a full course of dedicated physical therapy and if this does not work either then, at this point, consultation with a healthcare professional in regards to your knee pain is essential to investigate the underlying diagnosis so that appropriate treatment can be initiated.

Do knee braces help with knee pain?

Bracing of the knee is indicated in a number of conditions that include both osteoarthritis and patellofemoral causes. If your healthcare provider feels that you would benefit from a course of bracing, they will inform you as such as give you recommendations as to the best type of brace for you to purchase.

It is worth mentioning, however, that braces will only provide relief from knee pain for the duration that they are worn. Many patients find that with some of the bulkier braces, they are uncomfortable and find they are unable to tolerate them for significant periods of the day. This leads some patients to not wear their brace and if this is the case then clearly bracing is not the appropriate intervention for these patients, as not wearing the brace defeats the purpose of the bracing strategy for treating the patient’s complaint.

Can knee pain cause hip pain?

Although it is possible for alteration in a patient’s gait pattern as a result of knee pain to adversely effect other joints as part of the gait cycle (these do include both the hip, lower back and even in some cases the ankle) it is actually more common that pathology in the hip can present with knee pain.

This is well known to be the case in younger patients who sustain injuries known as a slipped capital femoral epiphysis (SCFE). These patients will often present with knee pain and have their knee extensively investigated only to reveal no major clinical abnormality responsible for the ongoing pain and these critical injuries can often go missed causing long-term problems with the hip and leading to surgical intervention much earlier on in life than it would have been necessary had the hip pain been investigated at an earlier stage.

Therefore it is important to bear in mind that while you may be feeling the pain in and around the knee joint it is the responsibility of your treating healthcare practitioner to investigate both the joint above and below and, if done properly, this will reveal pathology within the hip that is presenting as referred pain in the knee. This can also happen in certain cases with osteoarthritis.

What kind of doctor should I see for my knee pain?

Although many patients choose to begin with their regular family physician to investigate their knee pain, and this is entirely appropriate, our specialist orthopedic surgeons who have years of experience treating common and complex knee complaints will be more than happy to see you in consultation for any knee pain that you may be having. They will utilize their specialist expertise to achieve a definitive diagnosis for your knee pain and will be happy to explain all of your potential treatment options including any surgical procedure or if nonsurgical procedures are more appropriate, we will offer those or offer a referral to practitioners who provide them for you.