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Knees are complex, weight-bearing joints (junctions between 2 bones) that provide your body with flexibility, support, and a wide range of motion. Knees can be injured from trauma, arthritis, or everyday stress and strain. Knee pain is therefore a common complaint. Depending on the type and severity of joint damage, knee pain can be minor or can lead to severe discomfort and disability. There are a number of common causes for knee pain, and it is important to have an accurate diagnosis of the cause so that appropriate treatment can be undertaken. The April 18, 2007, issue of JAMA includes an article that discusses treatment options for individuals who have chronic knee pain.
Obesity—excess weight increases stress on the knee joints. It increases risk of accelerated osteoarthritis (degenerative collapse of the joint).
Overuse—can lead to muscle fatigue and excessive loading stresses across the joint. This causes an inflammatory response (increased blood flow and cell response) that damages tissues.
Instability—tight or weak muscles offer less joint support.
Mechanical problems—structural abnormalities, such as having one leg shorter than the other, abnormal alignment of the bones, or flat feet can increase risk of knee problems.
Initial care guidelines
Protection—a sleeve or brace to provide added joint stability and restrict range of motion
Rest—minor injuries may require only a day or two of rest but severe damage is likely to need a longer recovery time.
Ice—reduces pain and inflammation.
Elevation of the limb
Compression—a wrap around the knee prevents edema (fluid buildup within the joint).
Medications—nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen, or ibuprofen can help relieve swelling and pain.
When to seek medical advice
Difficulty bearing weight on the knee
Swelling of the knee
Obvious deformity in the leg or knee
Severe or persisting pain
Locking—inability to bend or straighten the knee joint
Infection—typically indicated by fever and a knee joint that is red, painful, and swollen
Screening and diagnosis
Pinpointing the exact reason for knee pain can be challenging because of the wide range of possible causes. Acute injuries may include fractures, ligament and cartilage tears, muscle strains, and contusions (blunt trauma). Conditions that generate chronic pain can include arthritis, tumors, and infection. A comprehensive medical history and a thorough physical examination are important. X-rays may be taken to detect bone injury and degenerative arthritis, but computed tomography or magnetic resonance imaging scans are often requested to help identify specific soft tissue injuries.
For more information
American Academy of Orthopaedic Surgeons (AAOS)http://www.aaos.com
American Academy of Family Physicians (AAFP) http://www.aafp.com
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on osteoarthritis of the knee was published in the February 26, 2003, issue.
Sources: American Academy of Orthopaedic Surgeons, American Academy of Family Physicians
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: BONE AND JOINT DISEASE
Zeller JL, Lynm C, Glass RM. Knee Pain. JAMA. 2007;297(15):1740. doi:10.1001/jama.297.15.1740