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
The knee joint’s main function is to bend, straighten, and bear the weight of the body along with the ankles and hips. The knee, more than just a simple hinged joint, however, also twists and rotates. In order to perform all of these actions and to support the entire body while doing so, the knee relies on a number of structures including bones, ligaments, tendons, and cartilage.
Inflammation (which is felt as pain by the patient) is the body’s normal response to an injury. In treating many types of knee pain, a common goal is to break the inflammatory cycle. The inflammatory cycle starts with an injury. After an injury, substances that cause inflammation invade the knee to assist in healing. However, if the injury and subsequent inflammation is not resolved, inflammation can become a chronic issue, leading to further inflammation and additional injury. This cycle of inflammation leads to continued or progressive knee pain. The cycle can be broken by controlling the substances that cause inflammation, and by limiting further injury to tissue.
Some common home care techniques for knee pain that control inflammation and help to break the inflammatory cycle are protection, rest, ice, compression, and elevation. This regimen is summarized by the memory device PRICE.
PROTECT the knee from further trauma.
- This can be done with knee padding or splinting.
- A pad over the kneecap, for example, helps to control the symptoms of some knee injuries (an example is a form of bursitis sometimes called housemaid’s knee) by preventing further repetitive injury to the prepatellar bursae.
REST the knee.
- Rest reduces the repetitive strain placed on the knee by activity.
- Rest both gives the knee time to heal and helps to prevent further injury.
ICE the knee.
- Icing the knee reduces swelling and can be used for both acute and chronic knee injuries.
- Most authorities recommend icing the knee 2 to 3 times a day for 20-30 minutes each time.
- Use an ice bag or a bag of frozen vegetables placed on the knee.
COMPRESS the knee with a knee brace or wrap.
- Compression helps accomplish two goals:
- First, compression is another way to reduce swelling.
- Second, in some knee injuries, compression can be used to keep the patella aligned and to keep joint mechanics intact.
ELEVATE the knee.
- Elevation also helps reduce swelling.
- Elevation works with gravity to help fluid that would otherwise accumulate in the knee flow back to the central circulation.
- Prop your leg up when you are sitting, or use a recliner, which naturally elevates the legs. Elevation works best when the knee — or any other injured body part — is higher than the level of the heart.
If your symptoms have not gone away after trying a week of PRICE therapy and over-the-counter anti-inflammatory pain meds, you should set up an appointment with your doctor. If you cannot put weight on your knee, feel sick, or have a fever or if your knee is red and hot, you should consider going to the ER to be evaluated by a doctor because of the possibility of a fracture or infection.
Other signs and symptoms that demand emergency evaluation:
- Unbearable pain
- Pain that does not improve with rest
- Pain that wakes you
- Drainage
- Large wounds
- Puncture wounds
- Swelling, if you are on a blood thinner (Warfarin or Coumadin) or have a bleeding disorder (such as hemophilia)
Article by: Dr. Alexis Dominic Xavier, Specialist in Orthopaedic Surgery at Aster Hospital, Mankhool.
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