4 Questions That Help Solve Your Knee Pain Mystery

How doctors sort causes and culprits

knee pain

By: Scott Burg, DO

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Whether you’re walking, running, skiing, golfing, biking, going up stairs or simply rising from a chair, your knees do important work.

Sometimes that work leads to pain. As you age, and as you put strain on your knees through sports, knee pain becomes common. That’s partly true because it can come from so many different sources.

To get the relief you need, your doctors have to identify the right cause. Here are the few of the factors that go into that process.

Where is your pain?

The hunt for the cause of knee pain is like the search for a home: Location matters.

For example, pain below your kneecap might be a sign of patellar tendonitis, or inflammation in the tendon that connects the kneecap to the shinbone. Pain above the kneecap often means quadriceps tendonitis.

Pain on the inside or outside of your knee could has truly varied causes. It might be a sign of a torn ligament (the medial collateral ligament on the inside or lateral collateral ligament on the outside). But it also could indicate a torn meniscus. That’s the cartilage that lines and “cushions” your knee joint.

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Those are just a couple of causes, not including various types of arthritis. Location is important, but we also ask other questions, such as…

When do you feel better or worse?

You’ve probably heard the “RICE” acronym before. That’s rest, ice, compression and elevation, and it’s a decent guideline for conservative management of minor pain — at least as a starting point.

But nobody is at rest all the time. So when do you feel your pain the most?

For instance, does walking up or down a flight of stairs trigger pain behind your kneecap? That could be a sign of osteoarthritis. With osteoarthritis, pain also tends to get worse over the day as you’re more active.

On the other hand, pain that starts strong in the morning and gets better as you move during the day sounds more like an inflammatory condition, such as rheumatoid arthritis.

If you are seeing a doctor, make note of all of this. The smallest details — even the resting positions that bring you the most relief — will help in finding the right diagnosis.

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How do you describe your pain?

I know, it’s a tough question sometimes. But you probably can tell the difference between a dull, throbbing pain and a sharp, burning sensation.

That’s important. A sharp, burning (some say “knifelike”) sensation more often indicates an irritated nerve rather than a joint or ligament problem. On the other hand, you might describe pain from arthritis as more constant and achy.

Is anything strange happening?

Or really, “Is anything strange happening beyond your knee pain?”

For example, can you still flex your knee all the way? Most patients get frightened when their knee locks and can’t straighten anymore. Often the culprit is called Baker’s cyst, a fluid-filled sac behind the knee caused by inflammation.

A clicking sound also triggers concern for many patients. Nobody wants to hear a click with every step. Sometimes, it’s harmless, but if that clicking comes with pain, you might have a mechanical problem such as a torn meniscus.

These are just a few examples among many. The knee is a complicated — and critical — part of your everyday life. So when you have pain that comes with serious symptoms or lasts for more than a week or two, seek the right diagnosis by getting a physical exam and any necessary imaging that comes with it.

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