Knee Pain Introduction
Knee pain is the most common musculoskeletal complaint that brings people to their doctor. With today's increasingly active society, the number of knee problems is increasing. Knee pain has a wide variety of specific causes and treatments.

Types of Knee Pain
The nerves that provide sensation to the knee come from the lower back and also provide hip, leg, and ankle sensation. Pain from a deeper injury (called referred pain) can be passed along the nerve to be felt on the surface. Knee pain, therefore, can arise from the knee itself or be referred from conditions of the hip, ankle, or lower back. All of the following sources of knee pain arise from the knee joint itself.

In general, knee pain is either immediate (acute) or long-term (chronic). Acute knee pains can be caused by an acute injury or infection. Chronic knee pains are often from injuries or inflammation (such as arthritis) but can also be caused by infection.

Acute knee pain
Fractures (broken bones)

• Description: Fractures of any of the bones of the knee are traumatic injuries typically caused by moderate to high forces (such as car accidents or contact sports).
   

• Symptoms: Fractures may be accompanied by swelling or bruising but are almost always extremely painful and tender. The pain is typically so severe that people are unable to walk or even put weight on the knee.
   

• Evaluation: Fractures are an emergency and should be checked by a doctor. This evaluation will generally include x-ray and other relevant studies. A delay in evaluation can result in fracture fragments being moved and associated injuries.
   

• Treatment: Depending on the particular fracture, the doctor may either recommend immobilization (with a cast or splint) or surgery to repair it.
   

• Prognosis: Fractures often heal with no long-term problems. Some fractures, however, are complicated by arthritis or by injuries to arteries or nerves that can be serious.

Tendon ruptures

• Description: Both the quadriceps and patellar tendons may rupture partially or completely. Quadriceps tendon rupture typically occurs in recreational athletes older than 40 years (this is the injury President Clinton suffered while jogging), and patellar tendon rupture typically occurs in younger people who have had previous tendonitis or steroid injections to the knee.
   

• Symptoms: Rupture of either the quadriceps or patellar tendon causes pain (especially when trying to kick or extend the knee). Those people with complete ruptures are unable to extend the knee. The patella is also often out of place either upward (with patellar tendon rupture) or downward (with quadriceps tendon rupture).
   

• Treatment: Tendon ruptures should be evaluated urgently. Tendon ruptures generally require surgical repair. A partial rupture may be treated with splinting alone.

Meniscal injuries

• Description: Injuries to the meniscus are typically traumatic injuries but can also be due to overuse. Often, a piece of the meniscus will tear off and float in the knee joint
   

• Symptoms: Meniscal injuries may cause the knee to lock in a particular position, or either click or grind through its range of motion. Meniscal injuries may also cause the knee to give way. Swelling typically accompanies these symptoms although the swelling is much less severe than with an ACL injury.
   

• Treatment: Meniscal injuries often require arthroscopic surgical repair. A locking knee or a knee that "gives" should be evaluated for arthroscopic repair.
   

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Knee Pain



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