The arrival of longer days and warmer weather often acts as a catalyst for us to begin exercising again after the sedentary winter months. After all, it is a lot more enticing to pull on our running shoes or get on our bike if the sun is shining and there is a promise of summer on the horizon.
If you have chronic knee pain due to a long-term injury or condition, it can be more challenging, although not impossible, to exercise.
In this article, we look at some common long-term knee problems and offer simple advice on diagnosis and treatment, including self-care. Of course, nothing beats a face-to-face consultation with your doctor or orthopaedic surgeon so if you are experiencing pain, especially chronic pain, that should always be your first port of call.
Start with a diagnosis
The first step to dealing with knee pain should always be to understand why and get a diagnosis. There can be many different causes of knee pain and until the cause has been diagnosed you won’t know how to treat it effectively, combined with clinic consultation and examinations, we offer several different techniques to help us confirm an accurate diagnosis:
- X-rays can detect fractures and degenerative joint diseases like knee arthritis.
- CT scans produce cross-sectional images of the inside of your body. They can diagnose stress fractures and bone problems.
- Ultrasound scans use sound waves to produce real-time images. They are used to diagnose problems with the soft tissues around your knee.
- MRI scans create detailed 3D images of the inside of your knee and can be used to diagnose injuries to the ligaments, tendons, muscles and cartilage.
- Arthrocentesis (joint aspiration) involves taking a sample of the fluid from within your knee joint using a fine needle. It is sent to a laboratory to check the cause of swollen painful joints (for example, arthritis or Crystal Arthropathies such as Gout)
Common long-term knee conditions
Knee pain can affect people of all ages. It may be due to an injury or long-term condition like arthritis. The pain can vary in severity and location depending on the cause, and may be accompanied by stiffness, swelling, loss of function, instability and sometimes popping or crunching noises within the knee joint.
Injuries that can cause long-term knee pain include:
- Anterior cruciate ligament (ACL) tear. The ACL is one of four ligaments that connect the shinbone to the thighbone. ACL tears are common in sports that involve sudden changes of direction and jumping. There may be a popping sensation and the knee may swell and become very painful.
- Fractures which may include a fractured kneecap (patella). This is normally caused by falling onto your knee or a heavy blow or collision. A patellar fracture is a serious injury that may prevent you from bending or straightening your knee. In some cases, the patella may break in multiple places. If you have osteoporosis, which weakens the bones, fractures may occur from something as simple as missing your step.
- Dislocated kneecap. This is a very painful injury that results in the kneecap slipping out of place, normally to the outside of your knee. You will be unable to walk or straighten your knee. Often the kneecap will slip back into position by itself but you may need an X-ray to check for damage to the surrounding bones and advice of how to rehabilitate after this injury.
- Meniscus tear. The meniscus is the cartilage in between your shinbone and thighbone. A sudden twisting movement may cause it to tear.
Conditions that can cause long-term knee pain include:
- Iliotibial band syndrome. The iliotibial band runs from the outside of your hip to the outside of your knee. If it becomes very tight it can rub against part of your thighbone.
- Knee arthritis. You may develop osteoarthritis, which is when the cartilage in your knee joint deteriorates due to wear and tear, or rheumatoid arthritis, which is an autoimmune condition.
- Knee bursitis. The bursae are sacs of fluid that cushion the outside of the knee joint. If you injure your knee they can become inflamed.
Treatment for long-term knee injuries
The treatment will vary according to the type of injury and its severity. If you have a long-term knee injury it is important to rest the joint to allow it to heal fully. An ice pack can help to reduce pain and inflammation and compressing the joint with a compression bandage can help prevent fluid build-up. Elevating your injured leg with pillows or cushions can also help to minimise swelling.
Your orthopaedic surgeon will advise on the most effective treatment for your injury. In some cases, using a brace to support the knee is sufficient, or exercises recommended by a physiotherapist to strengthen the muscles around the joint. For more serious injuries, you may need surgery. Wherever possible, arthroscopic (keyhole) surgery will be used to minimise the risk of complications.
If you have long-term knee pain, why not find out about your treatment options? Contact us for information about diagnosis and treatment.
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Please be reassured that orthopaedic treatments are now again being routinely offered to patients. Having the vaccine does not mean that your treatment won’t go ahead. However, in some circumstances, such as for planned surgery, it is advisable to delay it by a couple of weeks to ensure your body responds in the optimum way to the vaccine. If in doubt, please talk to your orthopaedic consultant or contact us for more guidance to help get your orthopaedic treatment back on track.
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