When Should I See a Provider For My Knee Pain?

Knee pain can come from a large variety of conditions including:

1) acute pain caused damage to the soft tissue/ligaments supporting the knee joint (acl, meniscus, protective cartilage)
2) chronic pain caused by osteoarthritis (slow-developing damage to the bones that make up the knee joint over time)
3) flare ups of an auto-immune disorder that affect the knee joint

Today we're going to highlight these 3 causes, outline general knee pain treatment options, and recommend which type of provider to see based on your situation. However, remember that you should ALWAYS seek a medical provider's advice before pursuing any treatment options. The purpose of this article is not to recommend a treatment option, it is to provide information about how knee pain is diagnosed, and educate you on what types of options you can ask your provider about.

Acute Pain from Injury:

When the knee joint twists, or bends inwards/outwards too much, it stresses the ligaments that support the knee joint resulting in tears that cause pain, swelling, and reduced mobility. Smaller tears/injuries are typically referred to as "sprains" while severe injuries are typically labeled as "tears". The supporting ligaments in the knee joint are:

-the menisci (plural for meniscus)
-the anterior cruciate ligament (ACL) across the front of the knee joint
-the posterior cruciate ligament (PCL) across the back of the knee joint
-the medial collateral ligament (MCL) supporting the medial side of the knee joint (close to the midline)
-the lateral collateral ligament (LCL) supporting the lateral side of the knee joint (away from the midline)

The type of activity/range of motion that caused the injury is typically indicative of which ligament (s) were affected. The severity of the ligament damage is classified using a scale called "grades". Grade I indicates a small tear (less than 1/2 way thru the ligament) that should heal in about 6-8 weeks with proper rehab and rest. Grade II indicates a tear of at least 1/2 way thru which is reflected in the rehab time and rest time typically about 10-14 weeks. Grade III indicates that a ligament has torn all the way through and most likely requires surgery.

If you are experiencing knee pain resulting from an acute injury you'll want to have it evaluated by a medical professional ASAP. The way that joints heal is very important to your health later down the road. If the joint heals the wrong way now, you'll be paying for it "double" later on in life in the form of limited range of motion and chronic osteoarthritis. If you do  not have a primary care physician, you can contact an urgent care near your, or a physical medicine office near you to have your knee evaluated.

Chronic Pain from Osteoarthritis:

When knee joints don't heal properly (sometimes as a product of the acute injuries outlined above), the joint starts to carry stress/weight in uneven amounts. When the weight/stress is being carried in uneven amounts, this causes certain areas of the joint to wear down faster than the other portions. As this process (called "degeneration) occurs, the cartilage supporting the knee joint wears down which allows for more irritation, swelling, and pain within the bones that make up the knee joint. IF left untreated, this degeneration process becomes irreversible, and with it, so does the pain.

There are a lot of treatment options available for chronic degeneration and osteoarthritis of the knee joint in the form of physical therapy/rehab, hyaluronic acid injections, and regenerative medicine. However, because we all have different histories that led to our knee pain, it's important to consult a physician so they can recommend the best treatment option for your history and symptoms.

Acute Flare Ups from Autoimmune Disorders:

Believe it or not, your immune system and genetics could also be an underlying cause of your knee pain in the form of an autoimmune disorder. Furthermore, your pain could be a product of all 3 causes listed in this article. Maybe you had a sports related injury in high school, that got worse overtime because it healed the wrong way, AND you have an autoimmune disorder that's making it worse. Let's hope not, but it's certainly possible.

An autoimmune disorder is when your body's immune system (immune) doesn't recognize it's own cells (auto) and triggers and immune response against those cells. For example, let's say your body's immune system doesn't recognize the cells that make up the bones in your knee joint. The immune system will attack these cells as if they were a bacteria or virus which causes swelling, pain, and changes to the shapes of the bones. OUCH.

If you already have osteoarthritis in the knee, a history of knee injuries, AND now your body's immune system is attacking your knee joint, that's going to cause a lot of pain for you. Because this can be a very complex cause, you must consult a physician to see if autoimmune disorders might be playing a factor in your knee pain.

Hopefully this information helps you decide which one of these knee pain causes best describes your situation. Stay tuned for more Modern Concepts health and wellness tips!