Knee Pain: Causes by the Site of the Pain and When to See a Doctor
Knee pain has many causes, from overload after running to osteoarthritis and a meniscus injury. What says most about the cause is where the pain sits, how it began and whether the knee swells, locks or gives way. This article has a table of causes by the site of the pain, the signs that call for a prompt appointment, what you should know about osteoarthritis and injuries, and the treatment options.
The site of the pain and the most common causes
| Where it hurts | The most common causes and typical signs |
|---|---|
| The front, around and below the kneecap | Pain in the kneecap joint, inflammation of the kneecap tendon. It gets worse on stairs, in a squat and after sitting for a long time. |
| The inner side | Damage to the inner meniscus, a strain of the inner ligament, osteoarthritis, bursitis below the knee. Pain on twisting; with osteoarthritis, pain after walking and brief morning stiffness. |
| The outer side | Damage to the outer meniscus, iliotibial band syndrome. Common in runners and cyclists, with pain after a certain distance. |
| The back | A Baker's cyst, an injury to the hamstrings. A feeling of fullness and tightness behind the knee. |
| The whole knee, with swelling | Osteoarthritis, injury, gout and other forms of arthritis. Swelling that recurs calls for an examination and an ultrasound. |
Signs that call for a prompt appointment
- the knee is suddenly swollen, red and hot, especially with a fever: that can be an infection of the joint and calls for emergency care;
- after an injury you cannot put weight on the leg, or you heard a pop followed by rapid swelling;
- the knee locks and cannot be straightened fully;
- the knee gives way and buckles when you walk;
- pain at night and at rest, with no injury;
- swelling and pain in the calf alongside the knee pain, which means vein thrombosis has to be ruled out.
Osteoarthritis of the knee
Osteoarthritis is the most common cause of long-standing knee pain after the age of 50. Typical features are pain at the start of movement that eases once the knee has “warmed up”, pain after a longer walk, morning stiffness that usually lasts less than half an hour, creaking and occasional swelling. An X-ray shows narrowing of the joint space, but the degree of change on the image does not always track the severity of the pain. Longer morning stiffness and swelling of several joints point to inflammatory joint disease and to a rheumatology appointment.
Meniscus and cruciate ligament injuries
The meniscus is most often damaged by twisting the knee while the foot is on the ground, in younger people during sport and in older people even in an ordinary squat. Typical features are pain on one side of the knee, swelling the next day and sometimes locking. The anterior cruciate ligament tears on sudden stopping and changing direction, often with a sense of a pop and rapid swelling. Ultrasound shows tendons, bursae and fluid in the joint well, while the meniscus and the cruciate ligaments are best seen on an MRI scan.
Treating knee pain
Most knee pain is treated without surgery. The foundation is adapting your activity rather than resting completely, ice briefly after exertion when there is swelling, exercises for the thigh and hip muscles and losing weight where there is osteoarthritis, because every kilogram lost reduces the load on the knee when walking. Physical therapy helps to reduce pain and restore movement. In osteoarthritis, injections into the joint are used in selected cases, including platelet-rich plasma (PRP); results differ from person to person, so the decision is made after an examination and imaging. Surgery comes into consideration with a locking joint, larger ligament and meniscus injuries and advanced osteoarthritis.
What an appointment at Miren Medic looks like
The orthopedic appointment at the Miren Medic clinic is carried out by Dr Nikola Pješčić, specialist in orthopedic surgery and traumatology, and the orthopedic appointment can also be booked together with an ultrasound. Joint ultrasound is also performed by the radiologist Dr Oliver Radmili. With swelling of several joints, long morning stiffness or suspected gout the appointment is with the rheumatologist Dr Marko Vorkapić. Physical therapy is provided at the clinic, and PRP of a joint is performed by Dr Džihan Abazović, a specialist in regenerative medicine. All of it without a referral.
Prices
| Service | Price |
|---|---|
| Orthopedic appointment (Dr Nikola Pješčić) | 8.000 RSD |
| Orthopedic appointment + ultrasound (Dr Nemanja Bosančić) | 10.500 RSD |
| Joint ultrasound (Dr Oliver Radmili) | 6.000 RSD |
| Rheumatology appointment (Dr Marko Vorkapić) | 6.000 RSD |
| Rheumatology appointment + ultrasound of the joint/tendons | 10.000 RSD |
| Tecar (up to 30 minutes) | 4.000 RSD |
| Package of 5 (Tecar + massage + kinesitherapy) | 18.000 RSD |
| PRP of one joint (Dr Džihan Abazović) | 65.000 RSD |
Frequently asked questions
Why does my knee hurt without an injury?
Most often because of overload, pain in the kneecap joint, osteoarthritis or inflammation of a tendon or bursa. With swelling and no injury, gout and other forms of arthritis are checked too, and pain that wakes you at night calls for an appointment without delay.
When is knee pain an emergency?
When the knee is suddenly swollen, red and hot with a fever, when you cannot put weight on the leg after an injury, and when the calf swells and hurts alongside the knee pain. In those cases you do not wait for a routine appointment.
What does pain on the inner side of the knee mean?
Most often damage to the inner meniscus, a strain of the inner ligament, osteoarthritis of the inner part of the joint or bursitis below the knee. The examination tells them apart, with an ultrasound or an MRI scan if needed.
Is it better to rest or to keep moving?
For most pain it is better to adapt your activity than to rest completely: avoid what causes strong pain, but keep walking and doing exercises that do not make the symptoms worse. After a fresh injury with swelling, brief rest and ice are justified until the appointment.
Which scan is best for the knee?
It depends on what is suspected. An X-ray shows osteoarthritis and bone, ultrasound shows tendons, bursae and fluid in the joint, and an MRI scan shows the menisci and the cruciate ligaments. The doctor decides on the scan after the examination.
Which doctor do you see for knee pain?
For pain after an injury, osteoarthritis and meniscus problems, an orthopedic surgeon. For swelling of several joints, long morning stiffness or suspected gout, a rheumatologist.
Book an appointment
If your knee has been hurting for more than a few days, swells or gives way, book an orthopedic appointment at the Miren Medic clinic. The examination, the ultrasound and a treatment plan come from one place, without a referral.
