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Chronic Knee Pain

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 symptoms you experience. Many conditions can cause or contribute to chronic knee pain, and many treatments exist. Each person’s experience with chronic knee pain will be different.

What causes chronic knee pain?

Temporary knee pain is different from chronic knee pain. Many people 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 can cause knee pain. These include:

  • 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 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 (RA): a chronic autoimmune inflammatory disorder that causes painful swelling and can eventually cause joint deformity and bone erosion
  • dislocation: dislocation of the kneecap most often the result of trauma
  • meniscus tear: a rupture in one or more of the cartilage in the knee
  • torn ligament: tear in one of the four ligaments in the knee — the most commonly injured ligament is the anterior cruciate ligament (ACL)
  • bone tumors: osteosarcoma (second most prevalent bone cancer), most commonly occurs in the knee

Factors that may make chronic knee pain worse:

  • injuries to the structure of the knee can cause bleeding and swelling and can create a chronic problem over time if not treated properly
  • sprains and strains
  • overuse
  • infection
  • bad posture and form when doing physical activity
  • not warming up or cooling down before or after physical activity
  • improperly stretching the muscles

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 knee must absorb an extra 4 pounds 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
  • sharp, shooting pain when in use
  • dull burning discomfort

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

Diagnosing chronic knee pain

Each possible cause of chronic knee pain requires different diagnostic tests. These include blood work, physical examination, X-rays, CT scan or MRI, and other imaging tests. The condition your doctor thinks you have will determine the types of tests you will undergo to see what’s causing your chronic knee pain.

Treating chronic knee pain

Each underlying cause of chronic knee pain has a specific type of treatment. These treatments may include:

  • physical therapy
  • medication
  • surgery
  • injections

Bursitis, a common cause of knee pain, 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-close bag, and then place the bag on the towel.

Wear cushioned, flat shoes that support your feet and don’t exacerbate your pain.

Avoid sleeping on your side. Use pillows positioned on either side of your body to prevent you from rolling onto your side. When lying on your side, keep a pillow between your knees.

Stay seated when 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. That’s because the structure of the knee is damaged. Without surgery or another type of extensive treatment, you’ll continue to feel pain, inflammation, and swelling in your knee.

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 prevent some, but not all, of the possible causes of knee pain. But you can’t prevent chronic knee pain. There are things you can do to alleviate the pain.

If your chronic knee pain gets worse because of overuse, or tends to be the most painful after physical activity, you can make 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.
  • 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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