Orthopaedic Surgeon

Consultations:

Randwick: 02 9399-5333

Concord: 02 9744-2666

Knee Pain

Pain can be present at rest or with activity. Sometimes it is only present at night time or with specific activities such as climbing stairs.

The nature or type of pain as well as it's location are very useful when trying to make a diagnosis.

Pain can also be acute or chronic

Acute pains are present at the time of an injury or intermittent with certain activities and chronic pains are often there with day to day life. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage or meniscus. Medical conditions — including arthritis, gout and infections — also can cause knee pain. There are more rare causes of knee pain such as pigmented villonodular synovitis, osteochondritis dissecans, tumours and infections. Typically acute pain can be treated with ice, compression, elevation and gentle range of motion through physiotherapy.

Chronic arthritis pain requires a stepwise approach which is discussed here. Treatment involves first making a careful diagnosis to determine the cause of the pain and stiffness. Simple remedies such as panadol, ice, cycling, and pool exercises can often relieve the symptoms. A detailed history, physical examination,  x-ray and/or MRI scan almost always results in an accurate diagnosis.

What kind of pain is it?

  • Sharp, catching pain which you can point to usually indicates a mechanical problem in the knee such as a meniscus tear or cartilage injury. This may be less serious like pinching of an inflamed joint lining but more often than not does require an arthroscopy to treat it.

  • A 'headache' or throbbing sensation usually indicates chronic overload of the joint. This is usually from tight muscles or poor balance between the muscles. This usually responds to a physiotherapy programme. In some cases it can be caused by arthritis so it best to get it checked out if the pain is not responding to physiotherapy. 

  • Burning pain is not always from the knee. While is can be from an inflamed joint it can also be referred pain from a pinched nerve or a lack of blood circulation to the area.

Meniscal pain is usually felt at the joint line (between the tibia and femur) and is worse with activity. Most people with a medial meniscal tear complain of pain when their knees touch when they are in bed. Locking and swelling are less consistent signs.

Kneecap or patellofemoral pain is either felt deep inside the knee or behind the kneecap. It is worse with walking down slopes or stairs and with activities such as squatting or keeping the knee still for a long period of time (like at the movies or driving a long distance).

"Overuse" of the knee happens over a long to medium length of time. There is usually no swelling of the knee and it typically settles with rest. With close history taking you often find that there has been a change in shoe wear, technique, or training schedule. 

  • Overuse injuries include:
  • Patella tendonitis (Jumper's Knee)
  • Pes anserinus bursitis
  • Semimembranosus bursitis
  • Quadriceps tendonitis
  • ITB (Iliotibial band) friction syndrome
  • Popliteus tendonitis
  • Biceps femoris tendonitis
  • Sindig Larssen Johanssen Syndrome
  • Prepatellar bursitis

A careful history combined with a careful examination will allow an accurate diagnosis of your knee injury and pain.