Receiving an accurate diagnosis is vital in overcoming your knee pain, receiving the correct course of treatment and stopping it from returning. For example, if the knee is swollen you can treat the swelling with ice, but if you don’t treat the underlying cause, it will just keep coming back. The best way to receive an accurate knee pain diagnosis is to see your healthcare professional, but here is a guide to help you find out what your problem might be and some questions to think about:
- Specific symptoms: What are the main symptoms associated with your pain (e.g. popping noises, locking, etc.)?
- Location of the pain: where exactly is your knee pain (e.g. inner our outer knee)?
- How did the pain start: the mechanism of injury (e.g. sudden twisting or gradual onset)?
One of the most important parts of diagnosing knee pain is thinking about the specific symptoms that accompany the pain. These tend to be the most defining features in knee pain diagnosis, as the presence or absence of them quickly rule conditions/injuries in or out.
1) Knee Makes Unusual Noises
A sudden popping noise at the time of injury usually indicates a ligament injury or sometimes indicates a cartilage tear. Persistent clicking/grinding when the knee moves may indicate an ongoing knee problem affecting the joint surfaces or how the bones are moving such as chondromalacia patella.
2) Pain When Kneeling
Kneeling puts pressure through the front of the knee and primarily aggravates three conditions:
- Housemaids Knee: inflammation of the prepatellar bursa (fluid filled sac) at the front of the knee. It is a common problem for people who spend long periods kneeling (e.g. carpet layers)
- Osgood Schlatters: common in adolescents, particularly after a growth spurt. Tension on the tendon just below the kneecap damages the bone, often resulting in a hard lump on the front of the shin
- Arthritis: changes in the bone caused by wear and tear or sometimes inflammation. Most common over the age of 50
3) Locking (knee gets stuck)
This happens when something gets wedged in the joint, stopping you from moving the knee. You generally have to wiggle the knee around before it will then move. The most common cause of locking is a Meniscus Tear (a tear in the cartilage that lines the joint.) It can be caused by sudden twisting or a force through the knee, or can come on gradually due to wear and tear.
A less common cause of locking is Osteochondritis Dissecans, a condition where poor blood supply causes small bits of bone and cartilage to break off at the joint.
4) Running Knee Pain
Knee pain from running is hardly surprising when forces up to 550% of one’s body weight go through the joint when running. Running knee pain is usually due to either training errors or poor biomechanics.
5) Knee Gives Way
This is when the knee buckles underneath you without you being able to control it. The most common cause of this is a ligament injury, usually an ACL tear or sometimes a PCL injury. They are usually caused by sudden twisting, a force through the knee or the knee bending backwards the wrong way. Only 20% of ACL tears are caused by direct contact. It may be accompanied by a popping sound, swelling and extreme pain.
Meniscus tears often make the knee feel unstable and can occasionally cause the knee to give way, but this is much less common.
A great deal of force goes through the knee when we do any activities with a bent knee. For example, squatting down places a force seven times body weight through the knee. It may be caused by a problem inside the knee, such as a cartilage tear or arthritis, or one of the surrounding structures, such as a ligament tear or inflammation of the bursa.
7) Pain When Sitting for Long Periods
It is not just activity that aggravates knee pain. Some conditions tend to get worse with prolonged inactivity (e.g. office workers sitting for long periods.) The pain may start while you’re sitting or when you first get up. The most common causes are:
- Runners Knee: a problem in how the kneecap moves that causes pain and stiffness at the front of the knee
- Arthritis: changes in the bone caused by wear and tear or sometimes inflammation
- Osgood Schlatters: common in adolescents, particularly after a growth spurt. Tight muscles irritate the bone causing pain just below the knee
8) Pain Going Down Stairs
This usually indicates a problem with the kneecap, as the force going through the kneecap when you come down stairs is 3.5 times bodyweight.
If the swelling begins immediately or within the first 48 hours, it usually indicates a ligament or cartilage injury. If it comes on gradually with no specific cause, it usually indicates an underlying knee problem such as bursitis. If there is moderate to severe swelling, you should see your doctor immediately.
Knee stiffness may develop as a result of an injury or a medical condition. It may develop suddenly or gradually, and often fluctuates. Stiffness when you first wake up that settles once you’re moving about is a classic feature of Osteoarthritis, which is most common in people over age 50.
11) Bony Lump at Front of Knee
This is a classic sign of Osgood Schlatters, which is common in teenagers and young adults, particularly after a growth spurt. Tension on the tendon just below the kneecap damages the bone, often resulting in a hard lump on the front of the shin.
Remember, the best way to get an accurate knee pain diagnosis is to see your doctor. Contact Michigan Spine and Pain for an appointment to receive a proper diagnosis.