Chronic Knee Pain

What is Chronic Knee Pain?

Chronic knee pain is a persistent pain lasting over three months. Various factors, including injury, overuse, arthritis, or other medical conditions, can cause it.

How Does Chronic Knee Pain Impact Your Anatomy and Health?

Chronic knee pain can lead to decreased mobility, flexibility, and strength, making it challenging to perform daily activities. Chronic knee pain can also cause swelling, stiffness, and instability of the knee joint, making it difficult to maintain balance and coordination. Additionally, it can lead to psychological distress, such as anxiety, depression, and reduced quality of life.

What are the Types of Chronic Knee Pain?

Chronic knee pain can be classified into three types based on the underlying cause and the pain experienced. These types are nociceptive, neuropathic, and centralised pain.

• Nociceptive Pain is the most common type of chronic knee pain caused by tissue damage or inflammation in and around the knee joint. Nociceptive pain can be further classified into two types: somatic and visceral. Somatic nociceptive pain occurs when pain receptors in the tissues and joints are stimulated, causing sharp, throbbing, or aching pain. Visceral nociceptive pain occurs when pain receptors in the organs, such as the knee joint, are stimulated, causing deep, dull, or pressure-like pain.
• Neuropathic Pain occurs due to nerve damage, which can result from an injury, a medical condition such as diabetes, or other causes. Neuropathic pain is often described as a burning, tingling, or shooting pain, sometimes accompanied by numbness or weakness.
• Centralised Pain is caused by an abnormality in the central nervous system, which can result in chronic pain in multiple parts of the body, including the knee joint. Centralised pain is often associated with fibromyalgia or chronic fatigue syndrome. It can be described as a constant, widespread pain often accompanied by fatigue, sleep disturbances, and mood changes.

Risk Factors for Chronic Knee Pain

Individuals who are overweight or obese, athletes who engage in high-impact sports, and older adults are at higher risk of developing chronic knee pain. Additionally, people with knee injuries, such as a torn ligament or meniscus, are more likely to develop chronic knee pain.

Chronic Knee Pain Causes

• Knee Arthritis or Osteoarthritis is the most common cause of chronic knee pain in older adults. Osteoarthritis occurs when the cartilage that cushions the knee joint wears away, causing the bones to rub against each other, leading to pain and stiffness.
• Rheumatoid arthritis is an autoimmune disease that causes joint inflammation, including the knee joint, leading to pain and swelling.
• Knee injuries, such as a torn ligament or meniscus, can cause chronic knee pain.
• Tendinitis is the inflammation of the tendons that connect the muscles to the knee joint.
• Bursitis is the inflammation of the bursae, small fluid-filled sacs that cushion the knee joint.
• Patellofemoral pain syndrome is a condition that causes pain and discomfort in the front of the knee, often due to overuse or improper alignment of the patella (kneecap).

Symptoms Related to Chronic Knee Pain 

Chronic knee pain can manifest in various ways, depending on the underlying cause. Some common symptoms of chronic knee pain include:

• Knee inflammation or swelling, 
• Knee cracking or popping sounds,
• Knee buckling and locking
• Poor range of motion or knee stiffness, 
• Loss of joint space, and
• Knee Deformities

Knee Inflammation

Periodic inflammation, swelling or tenderness in your knee can cause pain. This may be caused by the formation of bone spurs (osteophytes) or extra fluids in the knee. 

Swelling may be more pronounced after prolonged activities, such as in the morning. The skin on your knee may look red or feel warm when you touch it. 

Over time you may experience chronic inflammation of the knee that does not improve with over-the-counter medications or anti-inflammatory drugs.

Knee Buckling and Locking

Over time, the muscles in your knee may weaken, and the entire joint structure can become unstable. 

The overall weakness in the knee can cause your knee to give way or buckle. The joint can also stick or lock up, so you can not bend it or straighten it out when you want to. 

These symptoms and pain can come and go for no apparent reason.

Knee Cracking or Popping Sounds

A grinding feeling or sensation in your knees can arise as you move. You might even hear cracking or popping sounds from your knees. These can be a sign of arthritis. 

These symptoms can occur with the loss of knee cartilage. This smooth covering helps with your knee's smooth range of motion. Loss of cartilage can cause significant pain.

If you have arthritis of the knee, the disturbing noises and the grinding feeling result from rough surfaces and bone spurs rubbing over each other as you move your joints.

Poor Range of Knee Motion

Pain can arise from arthritis challenging knee joints to glide as they should, making previously simple movements increasingly tricky. 

Patients notice a restricted range of motion, difficulty climbing stairs or more challenging activities.

As osteoarthritis progressively wears away the knee cartilage, the pain worsens. As the knee joint movement no longer functions normally, simple tasks such as walking become difficult. 

Loss of Joint Space

X-ray diagnosis of the knees can help understand the loss of joint space that causes pain, poor range of motion and those unsettling sounds.

The space that usually allows freedom of movement is lost to bone spurs and other rough surfaces on the ends of bones. Bone spurs can occur when the cartilage is worn through or from calcification. These spurs are a common sign of osteoarthritis.

Knee Deformities

Knee appearance, such as a thinning or sunken muscle surrounding the knees, can weaken and cause pain.

The knees can begin to point toward each other, creating a knock-kneed effect. They can also bend outward, creating a bow-legged look. Deformities of the knee can range from barely noticeable to quite severe.

Chronic Knee Pain Diagnosis

To diagnose chronic knee pain, your doctor will conduct a physical examination, review your medical history, and perform diagnostic tests, such as X-rays, MRI scans, or blood tests. Your doctor may also recommend joint aspiration, which involves removing fluid from the knee joint to test for infection or other underlying conditions.

Chronic Knee Pain Treatment

The treatment for chronic knee pain depends on the underlying cause, the severity of the pain, and the patient's overall health. Some standard treatment options for chronic knee pain include:

• Pain medication: Over-the-counter pain medication, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), can help relieve mild to moderate chronic knee pain.
• Physical therapy: Physical therapy can help improve knee function and reduce pain through exercises that strengthen the muscles around the knee joint.
• Injections: Corticosteroid injections can relieve chronic knee pain by reducing inflammation in the knee joint.
• Surgery: Surgery may be necessary to manage severe chronic knee pain caused by injuries, arthritis, or other underlying conditions. Knee replacement surgery is a common procedure involving replacing the damaged knee joint with an artificial joint.

What if Chronic Knee Pain is Untreated?

Untreated chronic knee pain can lead to several complications, including reduced mobility, decreased quality of life, and increased risk of falls and injuries. Chronic knee pain can also lead to psychological distress, such as anxiety and depression, and may interfere with daily activities, including work, socialising, and exercise. 

In some cases, chronic knee pain can lead to permanent joint damage. It is essential to seek medical attention if you experience persistent knee pain, as early diagnosis and treatment can help prevent complications and improve your overall health and well-being.