Dr. M.J. Bazos, Patient Handout
KNEE PAIN
About Your Diagnosis
Knee pain is a relatively vague diagnosis. If you are referred to an orthopedic surgeon, he or she attempts to define whether the pain is located in the anterior (front) part of the knee just beneath the kneecap or is deep within the knee joint itself. The many causes of knee pain include a sprained or torn ligament, torn cartilage, or arthritis of the kneecap or entire joint. Inflammatory conditions such as rheumatoid arthritis or osteoarthritis also may manifest themselves with knee pain. Knee pain is extremely common and is usually self-limiting. In other words, when the offending activity is discovered and discontinued, the knee pain usually resolves. Depending on the particular cause of knee pain, it is often curable.

Living With Your Diagnosis
Knee pain is usually accompanied by swelling and sometimes by a clicking or popping sensation. Sometimes the knee can actually catch and lock. In that situation, a torn piece of cartilage has become trapped within the joint and is preventing bending or straightening of the knee.

Treatment
Initially, with knee pain, the most important aspect is to determine the cause, particularly if the activity has been initiated recently, such as aggressive walking or jogging. Many persons who participate in court sports that require lateral movement experience knee symptoms, and when these activities are eliminated for 2 to 6 weeks, the symptoms gradually subside. The use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, which can be obtained over the counter, helps to decrease inflammation and pain. These medications should be used with caution; they can cause stomach problems and should be taken with meals. Patients with a history of ulcers or bleeding ulcers should consult their physician before initiating the use of these medications. Kneecap pain usually can be managed with physical therapy to aggressively strengthen the quadriceps muscles in the front of the thigh and stretch the hamstring and calf muscles on the back of the thigh and lower leg. Sprained ligaments often heal with rest and time. However, torn ligaments around the knee sometimes necessitate immobilization followed by aggressive physical therapy for rehabilitation. A surgeon may recommend surgical reconstruction. As with any surgical procedure, there can be risks and complications, which are usually discussed with you before the actual surgical procedure. Once the symptoms have subsided, activities can be resumed gradually, beginning with straightahead activities such as walking or cycling. Working back into the preferred activity can be attempted with caution.

The DOs
• Take your medications as prescribed.
• Consult your primary care physician when beginning new medication if you take other prescription medications.
• Eliminate the activity that causes the pain.
• Resume activity gradually; resume the offending activity with extreme caution.

The DON’Ts
• Do not use nonsteroidal anti-inflammatory medications if you have a history of bleeding ulcers.
• Do not continue the offending activity, such as running, in the belief that you can “run it off.” This can cause additional injury to the knee, which may worsen or damage the joint itself.

When to Call Your Doctor
• If you have attempted conservative measures on your own and the symptoms persist.
• If you are undergoing a prescribed physical therapy or rehabilitation program and your symptoms worsen. Physical therapists usually offer to contact the physician, but do not hesitate to ask if you notice that the therapy seems to be worsening the symptoms.
• If you have side effects from the medication.

Websites:
http://www.mayo.ivi.com/mayo/9312/htm/kneepain.htm