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Chronic Knee Pain

Written by Kimberly Holland
Medically Reviewed by George Krucik, MD

What Is Chronic Knee Pain?

Chronic knee pain is long-term pain, swelling, or sensitivity in one or both knees. The cause of your knee pain can determine the exact signs and symptoms you may experience. Chronic knee pain is a broad condition; many conditions can cause it or contribute to it, and many treatments exist for it. Each person’s experience with chronic knee pain may be different.

What Causes Chronic Knee Pain?

Temporary knee pain is different from chronic knee pain; many people may experience temporary knee pain as a result of an injury or accident. Chronic knee pain rarely goes away without treatment, and it isn’t always attributable to one incident. It’s most often the result of several causes or conditions.

Physical conditions or diseases that can cause knee pain:

  • osteoarthritis–pain, inflammation, and joint destruction caused by degeneration and deterioration of the joint
  • tendinitis–pain in the front of the knee that is made worse when climbing, taking stairs, or walking up an incline
  • bursitis–inflammation caused by the repeated overuse or injury of the knee
  • chondromalacia patella–damaged cartilage under the kneecap
  • gout–arthritis caused by the buildup of uric acid
  • Baker’s cyst–a buildup of synovial fluid (fluid that lubricates the joint) behind the knee
  • rheumatoid arthritis–a chronic autoimmune inflammatory disorder that causes painful swelling and can eventually cause joint deformity and bone erosion
  • dislocation of the kneecap
  • meniscus tear–a rupture in one or more of the cartilage in the knee
  • a torn ligament
  • bone tumors

Factors that may make chronic knee pain worse:

  • injury–injuries to the structure of the knee can cause bleeding and swelling, and over time, if the injury is not treated properly, it can create a chronic problem.
  • a sprain or strain
  • overuse
  • infection
  • bad posture and form when doing physical activity
  • not warming up or cooling down before or after physical activity
  • not stretching the muscles properly

Who Is at Risk for Chronic Knee Pain?

People who are overweight or obese are at a greater risk for knee problems. For every pound that you are overweight, your kneecaps must absorb an extra 5 lbs. of pressure when you walk, run, or climb stairs. Other factors that increase your risk for chronic knee pain include:

  • age
  • previous injuries or trauma
  • athletic activity or physical exercise

What Are the Symptoms of Chronic Knee Pain?

The symptoms of chronic knee pain are different for each person, and the cause for the knee pain often affects how the pain feels. Chronic knee pain may present as:

  • a constant ache
  • a sharp, shooting pain when in use
  • a dull burning discomfort

You may also experience chronic swelling or pain when the knee is touched.

Diagnosing Chronic Knee Pain

Each possible cause of chronic knee pain requires different tests for diagnosis. These include blood work, physical examination, X-rays, CT or MRI scans, and other imaging tests. The types of diagnostic tests you will undergo depend on the condition your doctor thinks is causing your chronic knee pain.

Treating Chronic Knee Pain

Each cause for chronic knee pain has specific types of treatments, including physical therapy, medication, surgery, and injections. The most common cause of chronic knee pain, bursitis, is treated in the following ways:

  • Ice the knee for 15 minutes once an hour for three or four hours. Do not apply the ice directly to the knee; instead, cover your knee with a cotton towel. Place ice in a plastic zip-top bag, and then place the bag on the towel.
  • Wear flat shoes that support your feet, are cushioned, and do not exacerbate your pain.
  • Avoid sleeping on the side of your body where you’re having knee pain. Wedge a pillow on that side of your body to prevent turning onto it. Keep a pillow between your knees when lying on your side.
  • Stay seated as much as possible. If you have to stand, avoid hard surfaces and keep your weight equally divided on both legs.
  • Lose weight if you are overweight or obese.

What Is the Long-Term Outlook for Chronic Knee Pain?

Some knee pain, especially pain caused by osteoarthritis, will likely be permanent (unless you have a joint replacement). That’s because the structure of the knee is damaged, and without surgery or another type of extensive treatment, your knee will continue to create pain, inflammation, and swelling. The long-term outlook for chronic knee pain involves managing pain, preventing flare-ups, and working to reduce irritation to the knee.

How Can Chronic Knee Pain Be Prevented?

You can only prevent the possible causes of knee pain, not chronic knee pain itself. However, you can help prevent severe pain or problems once you do have chronic knee pain.

If your chronic knee pain is made worse by overuse or tends to be most painful after physical activity, you can use home care or lifestyle changes to help treat the pain. These approaches include:

  • Warm up before exercise. Stretch your quadriceps and hamstrings before and after exercise.
  • Try low-impact exercises. Instead of tennis or running, give swimming or bicycling a shot. Or mix low-impact exercises with high-impact exercises to give your knees a break on occasion.
  • Lose weight.
  • Walk down hills. Running puts extra force on your knee. Instead of running down an incline, walk.
  • Stick to paved surfaces. Rough roads or pocked walkways may be hazardous to your knee’s health. Stick to smooth, paved surfaces like a track or walking arena.
  • Get support. Shoe inserts can help treat foot or gait problems that may be contributing to knee pain.
  • Replace your running shoes frequently to ensure they still have proper support and cushioning.
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