Knee Pain – Traumatic, Degenerative, and Inflammatory Causes

Knee pain is one of the most common musculoskeletal complaints, affecting both athletes and older individuals. It most often results from mechanical injuries, degenerative disease, or overuse, but it can also be a symptom of inflammatory diseases such as rheumatoid arthritis or gout.

• The most common are mechanical injuries to the knee.
• Meniscus damage and ACL tears cause instability.
• Degenerative disease predominates after the age of 50.
• Being overweight significantly increases the load on the joint.
• Rehabilitation and strengthening the quadriceps muscle are crucial.

See also: Hip pain – the most common degenerative, inflammatory, and neurological causes.

Are mechanical injuries the most common cause of knee pain?

Knee pain often results from mechanical injuries.

The most common include knee sprains, dislocations, and meniscus damage. Meniscus damage manifests as pain, joint locking, and swelling of the knee joint.

Tearing the anterior cruciate ligament (ACL) leads to a feeling of instability and the knee “giving way,” especially during changes in direction.

Does knee osteoarthritis cause chronic pain?

Knee pain in older individuals is most often associated with knee osteoarthritis.

The degenerative process of cartilage leads to stiffness, pain during weight-bearing, and limited mobility. Symptoms worsen when climbing stairs and standing up.

A risk factor is being overweight – every additional 5 kg of body weight significantly increases the load on the knee while walking.

Can inflammatory and metabolic diseases cause knee pain?

Knee pain can be a symptom of rheumatoid arthritis (RA) – an autoimmune disease leading to chronic inflammation of the synovial membrane.

Gout causes sudden, very intense pain attacks accompanied by swelling and redness.

Baker’s cyst is a fluid accumulation in the popliteal fossa, often coexisting with degenerative or inflammatory disease.

Are overuse and patellar chondromalacia common in active individuals?

In young and active individuals, knee pain is often associated with overuse of the periarticular structures.

Tendinitis and so-called runner’s knee (anterior knee pain syndrome) result from excessive loading.

Patellar chondromalacia involves softening and damage to the patellar cartilage, causing pain when going down stairs and prolonged sitting.

What does treatment and rehabilitation look like?

Knee pain can often be treated conservatively.

The foundation is rehabilitation that includes strengthening the quadriceps muscle, which stabilizes the knee joint.

In acute injuries, helpful measures include:

• Cold compresses.
• Elevation of the limb.
• Temporary unloading.
• Knee brace.

Non-steroidal anti-inflammatory drugs are also used in pain management according to the doctor’s recommendations.

Weight reduction significantly decreases the load on the joint and improves prognosis.

Q&A

Does every knee swelling require a doctor’s visit?
Yes, especially if accompanied by an injury or severe pain.

Does an ACL tear always require surgery?
Not always; the decision depends on age, activity level, and degree of instability.

Do exercises help with degeneration?
Yes, appropriately selected exercises reduce pain and improve function.

When should imaging studies be performed?
In the case of injury, joint locking, or persistent pain.

Sources:

1. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet.
2. AAOS Clinical Practice Guidelines. Management of knee osteoarthritis.
3. McAlindon TE et al. OARSI guidelines for knee osteoarthritis.
4. Firestein GS et al. Rheumatoid arthritis.
5. Arendt EA et al. Patellofemoral pain syndrome.