Knee Pain; Understanding Causes and Effective Treatment Options

What is Knee Pain?

Knee pain or discomfort around the knee joint is a common concern, especially for those who are elderly, athletes or experiencing chronic leg pain. Although knee pain can affect everyone, most elderly be it those inactive and active tend to experience prolonged knee pain. Knee pain is often associated with general wear and tear from daily activities like walking, bending, standing and lifting. Most often, wear and tear occurs with ageing and having repeated stress on the knee– mainly from sports / overworked knee joints from activities.

Anatomy of the Knee Joint

A knee joint is made up of muscles, ligaments, tendons, cartilage as well as synovial fluid. The knee joint is a connection between the bones of the lower and upper leg for movement and balance. This hinge-type synovial joint mainly allows flexion (bending) and extension (straightening) of the knee to assist in functions like walking, running, jumping, and bending.

As the knees are essential in everyday mobility and movement, keeping them strong and healthy is of paramount importance. The thigh bone (femur), the shin bone (tibia) and the kneecap (patella) articulate through tibiofemoral and patellofemoral joints. These three bones are covered in articular cartilage which is an extremely hard, smooth substance designed to decrease the frictional forces caused by everyday activities. The medial and lateral condyles of the femur articulate with the tibia to form the tibiofemoral joint. Similarly, the anterior and distal parts of the femur articulates with the patella to form a patellofemoral joint. The tibiofemoral joint is the weight-bearing joint of the knee which helps to cushion impact caused by activities.

The patella, also known as the kneecap, plays an important role in protecting the entire joint as it is located at the front of the knee joint to assist in movement and stability. However, when these joints are not held together by strong muscles or ligaments, the entire knee joint loses its stability and strength which leads to dull aching pain as well as inflammation around the knee joint.

The patella has a triangular shape, with anterior and posterior surfaces. The apex of the patella is situated inferiorly and is connected to the tibial tuberosity by the patellar ligament. The base forms the superior aspect of the bone and provides the attachment area for the quadriceps tendon.

The patella has two main functions:

Leg extension – Enhances the leverage that the quadriceps tendon can exert on the femur, increasing the efficiency of the muscle.
Knee Protection – Protects the anterior aspect of the knee joint from physical trauma.

Causes of Knee Pain

Knee pain can result from a wide range of issues, both acute and chronic. Here are some of the most common causes:

Knee Injuries:
- Ligament Sprains or Tears: The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are often injured in sports that involve sudden twists or impacts, like basketball, football, or skiing.
- Meniscus Tears: The meniscus, a cartilage cushion between the shin and thigh bones, can tear due to twisting movements or direct impact.
- Tendonitis: Inflammation of the tendons around the knee due to overuse or repetitive activity.
- Fractures: Direct trauma to the knee can cause bone fractures, often requiring urgent medical intervention.
Osteoarthritis:
The most common cause of knee pain in older adults, osteoarthritis occurs when the cartilage in the knee joint deteriorates, causing bones to rub together. This condition leads to pain, swelling and stiffness, especially after extended periods of activity.
Chronic Strain:
Overuse, lack of muscular strength, or improper alignment of the knees can cause chronic strain, often seen in younger individuals who engage in high-impact sports without proper conditioning.
Patellar Issues:
The patella (kneecap) plays a vital role in knee movement. When the patella is misaligned, it can lead to pain and instability in the knee.

Symptoms of Knee Pain

The location and severity of knee pain may vary, depending on the cause of the problem and how it was injured based on the trauma angle. Signs and symptoms that sometimes accompany knee pain include:

Diagnosis of Knee Pain

While many cases of knee pain can be managed at home with rest and over-the-counter treatments, there are times when you should consult a doctor. If you experience any of the following symptoms, it’s important to seek medical attention:

Inability to bear weight: If you cannot put weight on your knee or feel it is unstable or giving out, this may be a sign of a serious injury that requires medical evaluation.
Marked knee swelling: If your knee swells significantly or rapidly, it could indicate an underlying issue such as a ligament tear, meniscus injury, or infection.
Inability to fully extend or flex the knee: Difficulty moving your knee through its full range of motion, especially if accompanied by pain, may suggest a more severe injury or condition such as a torn ligament or cartilage damage.
Visible deformity: If you notice any visible deformity, misalignment, or abnormal positioning of the knee or leg, it’s crucial to seek immediate medical attention as this could signal a fracture or dislocation.
Fever with redness and swelling: If your knee is red, warm to the touch, and accompanied by fever, this could indicate an infection, which requires prompt medical treatment.
Severe knee pain from an injury: If you experience intense knee pain following an accident or fall, especially if it’s associated with a popping sound or a sudden loss of mobility, it’s essential to get evaluated by a healthcare professional.

Treatment for Knee Pain

Non-Invasive Treatments

1. Physiotherapy

Physiotherapy is a cornerstone for knee injury recovery and managing chronic pain. A physiotherapist can guide you through strengthening exercises to improve muscle stability around the knee and reduce pressure on the joint.

2. Medications

Over-the-counter pain relievers such as ibuprofen or acetaminophen can provide short-term relief from knee pain and inflammation. In some cases, doctors may recommend topical treatments or corticosteroid injections for inflammation.

3. Rehabilitation Exercises

Specific exercises that strengthen the quadriceps, hamstrings and gluteal muscles are key to knee pain relief. These exercises help stabilise the knee and improve overall mobility.

Alternative Treatments

When non-invasive treatments don’t bring sufficient relief, surgical intervention may be considered:

Chiropractic

Chiropractic adjustments can help alleviate knee pain by improving alignment and function in the spine and pelvis. Misalignments can affect posture and gait, putting stress on the knee joint. Chiropractors may also use joint manipulations and soft tissue therapies to improve mobility and reduce pain.

Acupuncture

Acupuncture involves inserting thin needles into specific points to relieve pain and promote healing. It can help reduce knee pain by stimulating the body’s natural pain-relieving mechanisms, improving blood circulation, and reducing inflammation, making it an effective treatment for conditions like osteoarthritis or tendonitis.

Arthroscopic Surgery

For joint damage or severe cartilage tears, minimally invasive arthroscopic surgery can be performed to remove damaged tissue or repair injuries.

Knee Replacement Surgery

For advanced osteoarthritis where other treatments have failed, partial or total knee replacement surgery may be recommended. This procedure involves replacing the damaged knee joint with an artificial one to restore mobility and reduce pain.

Regenerative Medicine

Treatments like platelet-rich plasma (PRP) injections are gaining popularity for stimulating tissue healing, particularly in cases of tendonitis, meniscus tears, and early-stage arthritis.

Preventing Knee Pain

To ensure that the knee joint does not compensate for other movements, start with a proactive approach to strengthening the surrounding muscles such as the hamstrings, quadriceps as well as gluteus medius and maximus are strong enough to support the hip joint.

Strengthening Exercises: Targeting the muscles that support the knee, such as the quadriceps, hamstrings, and calves, can provide essential stability to the joint. Exercises like leg raises, squats, and lunges help build strength in the muscles surrounding the knee, reducing the risk of injury.

Such exercises include:

Lying Knee Bend
Hamstring Stretch
Seated Knee extension
Chair Sit to Stand
Straight Leg Raises
Clamshells

2. Stretching: Keeping muscles flexible through regular stretching can alleviate tension in the surrounding muscles and prevent overuse injuries. Focus on stretching the quadriceps, hamstrings, and calf muscles to ensure proper mobility and avoid muscle imbalances.

3. Proper Posture and Gait: Maintaining good posture and proper walking or running techniques is crucial for knee health. Poor posture or incorrect movement patterns can place excessive stress on the knee joint, leading to discomfort or injury over time. Focus on maintaining a neutral spine and ensuring that your knees are aligned with your feet when walking or running.

4. Correct Walking/Running Technique: Pay attention to your form while walking or running. Ensure your feet land directly under your body, and avoid overstriding, which can place undue stress on the knees. Additionally, wearing properly fitted shoes designed for your activity can help reduce impact on the knees and prevent injury.

5. Maintaining a Healthy Weight: Excess body weight puts added stress on the knee joints, increasing the likelihood of pain or injury. Maintaining a healthy weight through balanced nutrition and regular physical activity can help reduce the strain on the knees, contributing to long-term joint health.

Our Patient Testimonials

The team at Kovan is friendly and approachable. Asyraaf and Dr Youssef are dedicated and sincere in helping you and your body feel better. They also give you practical ways to practice through the week exercises you can do to improve your posture and strengthen your muscles.

Enjoy the stretching there, the schedule is more flexible and possible to get the suitable time. They do provide recommendation of packages due to adjustments take times. If you don’t want you can just let them known, they won’t do hard sale. And you also can let them known your preferred professionals.

*Doctors/Chiropractors where very experience on their field, give advice and informed you on whats happening in your condition
*Staff here where all friendly and give you warm welcome, very accomodating and will notify you on the incoming schedule you make.
Thanks NATRAHEA Kovan🙏🙌🏻

The staffs there were very friendly and helpful. Dr Jason is a very professional chiropractor and he explained very clearly to me my x-ray results and what my conditions were. After only a few chiropractic sessions with him along with physiotherapy done by Cassandra, I felt that my lower back and neck stiffness has improved significantly. My experience with them have been great so far and I highly recommend this place for chiropractic treatment !

I had a constant knee pain and my shoulders always aches due to long hours facing the computer. Dr Loo, Sherry and Cassandra have been very helpful and they have relieved me of my pain. Definitely a great experience here where the staff are always very friendly and accommodating.

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