What You Need to Know about Knee Pain

Knee pain is a really common pain and complaint for many people. There are several factors that can lead to pain in one’s knees, so having awareness and knowledge of their causes can lead to a more accurate diagnosis.

Knee joint

Our knee joints are made of four bones connecting – the femur (thigh bone), the tibia and fibula (the two bones of the calves) and the patella (the kneecap). The knee is divided into four compartments: medial and lateral tibiofemoral compartments, the patellofemoral compartment and the superior tibiofibular joint. Each of these compartments’ components can suffer from repetitive strain injury or disease.

What are the common injuries that cause knee pain?

Some of the injuries that causes pain in our knees include the following:

• Sprain (Ligament sprain)
• Medial collateral ligament
• Lateral collateral ligament
• Anterior cruciate ligament
• Posterior cruciate ligament
• Tear of meniscus
• Medial meniscus
• Lateral meniscus
• Strain (Muscle strain)
• Quadriceps muscles
• Hamstring muscles
• Popliteal muscle
• Patellar tendon
• Hamstring tendon
• Popliteal tendon

What are the common diseases that cause knee pain?

Some of the diseases of cause of knee pain include:

• Knee osteoarthritis
• Chondromalacia patella
• Baker's cyst
• Meniscal cyst
• Discoid meniscus
• Osgood-Schlatter disease
• Larsen-Johansson disease
• Knee rheumatoid arthritis
• Osteochondritis dissecans disease
• Synovial chondromatosis disease
• Tumors
• Ankylosing spondylitis
• Reiter's syndrome
• Tuberculosis arthritis
• Septic arthritis (Pyogenic arthritis)
• Osteomyelitis
• Hemophilic arthritis
• Gout (Gouty arthritis)

What are the common inflammations that cause knee pain?

• Bursitis of the knee
• Prepatellar bursitis - Housemaid's knee (most common)
• Infrapatellar bursitis - Clergyman's knee (Superficial infrapatellar bursitis and Deep infrapatellar bursitis)
• Semimembranosus bursitis
• Tendinitis
• Patellar tendinitis (Jumper's knee)
• Hamstring tendinitis
• Popliteal tendinitis
• Synovitis of the knee

What are the common deformities of the knee?

• Genu varum
• Genu valgum
• Genu recurvatum (Knee hyperextension)
• Knee flexion deformity
• Bipartite patella

Syndromes

• Patellofemoral pain syndrome (Runner's knee)
• Plica syndrome
• Iliotibial band syndrome

Fractures

• Femoral fracture
• Tibial fracture
• Patella fracture

Dislocations

• Patella dislocation
• Knee joint dislocation (Tibiofemoral joint dislocation)

Referred knee pain

Referred pain is pain perceived at a location other than the site of the painful stimulus. An example is where if a patient has a heart attack but feels the pain in his neck, shoulders and back instead of his heart. Likewise, there can be pain that is referred to the knee that is related from another part of the body – the pain can come from one’s ankle, foot, hip joints or even lumbar spine (lower back).

Cold-induced Pain In Knees

A study in China concluded that knee pain is significantly more prevalent in people working in cold stores than in those in normal, non-cold temperature.

Another study concluded that 17% of adolescents with anterior knee pain (a common condition though mildly self-limiting) reported that their pain is associated with cold temperatures and cold weather. In the same study, the main activities that are associated with pain are sporting, stair climbing, walking and sitting. Some people also reported pain in their knees when it’s colder…and they also wear extra tights and warm pants in winter.

Cold-induce pain in the knee can also be caused by tenosynovitis of knee tendon, where exposure to cold can be either a causative or contributing factor. To add to this, there is also a known hereditary disease, which is the FCAS which is the familial cold autoinflammatory syndrome which often demonstrates pain in the knee. Cold weather may also aggravate pain in the knee which already has osteoarthritis, rheumatoid arthritis and fibromyalgia.

Pain due to immobility/lack of movements

People who are more sedentary or involved in lesser physical activity and work environment is yet another reason for developing pain in the knees. What happens is that decreased activity and movement weakens one’s knee muscles, and the lax muscles are unable to support the knee structure, causing increased bone-to-bone impact. Blood vessels may be compressed as well, causing painful conditions in the knee. As we grow older, the movement of the knee joint causes higher friction with nearby tissues and cartilages.

As age progresses the movement of the knee joint involves higher friction with adjacent tissue and cartilages.

Other causes of pain in the knees

• Ligamentous laxity
• Fat pad impingement
• Knee effusion
• Deep vein thrombosis
• Peripheral vascular disease

Implications for Physiotherapy and Deep Tissue Release / Sports Massage Therapy

It’s important that an accurate diagnosis is made for all knee-related pain and injuries, and physiotherapy and deep tissue release therapy to start as soon as possible. Treatment techniques may include specific strengthening to correct muscle imbalance, soft tissue massage, joint mobilization and ultrasound therapy. Other electrotherapy procedures such as heat therapy may also be used to accelerate healing and provide pain relief.

This article was contributed to Tab A Doctor by,

Ms Louise Yow, Hon. in Physiotherapy
Urbanrehab Pte Ltd
22 Malacca Street, Royal Brother Building,
#03-03 (RB Capital Building), Singapore 048980

Elbow Pain and Aches: Tennis Elbow

Any repetitive motion of the wrist can cause tennis elbow, including tennis, hedge clipping, excessive use of a hammer or screwdriver, painting, or any activity that requires constant gripping or squeezing. This is according to an article at eMedicineHealth.com.

The elbow is one of the most used joints of the human body. If it does not function properly, a person's ability to complete tasks and care for self is restricted, wrote Wanda Thibodeaux in an article at eHow.com.

Tennis elbow, known clinically as lateral epicondyle, is a condition caused by inflammation of the tendons on the outer bony prominence of the elbow. It can occur in anyone who strains the tendons of the forearm and is not limited to tennis players, according to medical author William C. Shiel Jr., MD, FACP, FACR in another article at eMedicineHealth.com.

Symptoms and Signs

Common symptoms of tennis elbow mentioned in the article by Shiel Jr. are:

• Tenderness on the outer bony part of the elbow
• Morning stiffness of the elbow with persistent aching
• Soreness in the forearm
• Pain worse when grasping or holding an object

When to Seek Medical Care

While tennis elbow does not usually lead to serious issues, if the condition continues and is left untreated, loss of motion or loss of function of the elbow and forearm can develop, wrote Shiel Jr. Professional help is advised if the following conditions develop:

• Pain that limits daily activity
• Pain that lasts despite ice, resting, and over-the-counter anti-inflammatory pain relievers
• Any weakness or numbness in the hand, as this may mean there is another type of injury in the wrist or elbow

Diagnosis

In taking the patient’s medical history, the doctor may ask questions about activity level, occupation, recent recreational activities, medications, and other medical problems.

During the physical exam, the doctor will feel the elbow and possibly other joints, wrote Shiel Jr. in his article. The nerves, muscles, bones, and skin may also be examined. X-ray images may be required if the symptoms suggest another problem in the elbow joint.

Self Care at Home

Some home remedies mentioned by Shiel Jr. in the article include:

·       Icing the area with a wrapped towel for 20 minutes twice a day to help decrease inflammation and relieve pain

·       Rest the sore area to prevent further injury and decrease pain

·       Over-the-counter anti-inflammatory medications such as ibuprofen, aspirin, or naproxen, which can help decrease the pain and possibly speed up the healing

Medical Treatment

A second line of therapy may be recommended by the doctor if home care treatment does not produce the desired result. This may include physical therapy involving different exercises to increase flexibility and strength.

According to Sheild Jr. in his article, while steroid injections are safe, they are usually limited to two to three times a year. Steroid injections if done too frequently can weaken the tendon and make it more likely to rupture. If positive results are not seen after the first injection, additional injections are unlikely to work.

Surgery is usually a last resort, but successes are known to help relieve 85 to 95 percent of pain. The operation for tennis elbow involves a small incision over the elbow to trim the tendon or sometimes to release and then reattach the tendon to the bone. It can usually be performed within several hours as an outpatient procedure.

Prevention

The best way to prevent tennis elbow is to stretch and strengthen the arm muscles so they are flexible and strong, according to advice from an article at WebMD.com. Try warm up, stretching and strengthening exercises.

Other approaches to prevent tennis elbow include:

• Staying in good overall physical shape
• Using the correct techniques and movements during activities
• Using equipment appropriate for a person’s ability, body size, and body strength
• Not overusing arm with repeated movements that can injure tendon
• Strengthening the muscles of the arm, shoulder, and upper back to help take the stress off the elbow
• Wearing a counterforce brace during activities that require grasping or twisting arm movements

Elbow Pain Causes and Treatment

by Dr. Nabil Ebraheim

Physiotherapy Management of Tennis Elbow

by SingHealth

For professional help with tennis elbow, please consult a doctor or an orthopedic specialist.

Muscle Aches and Pain

“So I am only 24 and almost a month ago my upper back became very sore, mostly on the right side,” wrote a member of a community forum at AnxietyZone.com. “It felt like sore muscle knots and I figured it was because of stress and sitting hunched at the computer too much.”

Muscle aches, pain, and soreness can be due to many reasons. According to an article at MedlinePlus, a muscle pain can involve ligaments, tendons, and fascia or the soft tissues that connect muscles, bones, and organs. Often, it relates to tension, overuse, or muscle injury from exercise or physically-demanding work, where the pain tends to involve specific muscles and starts during or just after an activity. In such situations, usually it is obvious which activity is causing the pain.

Many people tend to confuse soreness with pain, which are actually very different, according to Jennipher Walters, a certified personal trainer and fitness instructor. In an article at SparkPeople.com, Walters wrote that soreness is more of a dull, slightly uncomfortable ache in the muscle, whereas pain is a very uncomfortable or sometimes sharp sensation in the bones, joints, or sometimes muscles. While some muscle soreness is normal, pain is not. If pain is felt at any point during a workout, it is important to stop whatever activity a person is doing. Seeing a healthcare professional immediately is advised if there is one or more of the following:

• sudden pain
• severe pain
• swelling
• extreme tenderness
• weakness in a limb
• inability to place weight on a leg or foot
• inability to move a joint through its full range of motion
• visible dislocation or broken bone
• numbness or tingling experienced

Muscle Ache Relief

When looking for muscle ache relief, one of the first things a person should do is to isolate and identify the source or cause of the pain. This is the advice given in an article at PainRelief.FactExpert.com. It is absolutely important to know if a pain is resulting from simple strain and overuse or it is a serious problem that requires a doctor’s treatment. If there is a torn muscle, dislocation of a disc or joint or some other similar problem, pain relief treatments should not be used to alleviate the pain as it will only temporarily mask the real problem.

A few things can be done to relief muscle pain or ache once it has been determined as not a medical condition that needs to be treated right away. In the case of muscle pain from overuse or injury, rest for that part of the body is advised, as stated in the MedlinePlus article. Apply ice to reduce pain and inflammation for the first 24 to 72 hours of an injury. After that, use heat which should feel more soothing.

Massage usually helps with muscle aches that are due to overuse or long term body-wide pain. Gentle stretching exercises after a long rest period are also helpful. Regular exercise can help restore proper muscle tone. Walking, cycling, and swimming are good aerobic activities to try as well.

When doing a workout, always begin slowly and increase gradually. Avoid high-impact aerobic activities and weight lifting when injured or while in pain. Get plenty of sleep and try to reduce stress. If these measures do not help, seek professional help from a doctor who may prescribe medication or physical therapy or refer you to a specialized pain clinic.

In cases where muscle aches are due to specific disease, patients should follow the instructions of the doctor or specialist on treatment of the primary illness.

How to Get Rid of Sore Muscles

by eHow

Aging: The Pains and Aches

It is not uncommon to have to deal with certain ailments as we age. Some of such ailments include joint pain, fading eyesight, weak bones, and memory glitches. By understanding the changes in the body and learning how to adapt to a healthy lifestyle, managing unwelcome aches and pains to continue to live happily is possible, according to an article at EverydayHealth.com.

Common Aches and Pains

The wear and tear of the body is the biggest culprit causing pain to senior citizens, said Dr Tan Kian Hian, director of Singapore General Hospital's Pain Management Centre, in an article by The Straits Times. The article which is reproduced at the HealthXchange.com.sg states that about four in five of the centre's older patients suffer from degenerative pain, mainly from arthritis or joint damage.

Arthritic Knee

The most common form of arthritis among the elderly is osteoarthritis. As a result of progressive degeneration of cartilage lining, when the bones rub against one another, pain and swelling occur. Such pain can arise after prolonged standing or walking or when carrying something heavy, said Dr James Low, a senior consultant and the head of the Department of Geriatric Medicine at Alexandra Hospital in The Straits Times article. The pain, which may be sharp or dull, can be accompanied by swelling, stiffness and crepitus or the crackling sound in the knee. In severe cases, the pain can come even when the person is resting, said Dr Low.

Frozen Shoulder, Slipped Disc

Another common condition of older adults is the frozen shoulder, characterized by a dull ache and stiffness. According to The Straits Times article, frozen shoulder occurs when the joint becomes inflamed, scarred or shrinks. Everyday activities like combing one’s hair or putting on a T-shirt can be difficult for those with this ailment.

Carrying too much weight and having a back injury can also lead to the faster degeneration of the spinal discs which act as cushioning for the vertebral bones. Commonly known as slipped disc, this condition may press onto the surrounding spinal nerves, causing a sharp pain radiating from the lower back all the way to the feet.

Injuries and Nerve

Risk from sports injuries and nerve pain are other aging pains mentioned in The Straits Times article. People active in sports may be more prone to aches and pains later in life if they have had injuries.

Nerve pain caused by shingles is a type of pain that commonly afflicts the elderly. Anyone who has had chickenpox can develop shingles. The virus which causes chicken pox in a young person can lurk in the body and cause painful shingles rash when the person is older. This pain, often described as stinging or stabbing, can last for weeks and months even after the rashes have subsided. People above 50 years of age are more susceptible to nerve pain when their immune system weakens.

Guidelines for Pain Management

No matter how old we are or what is our ailment, we need to heed guidelines when we feel pain. This is the advice from an article by Lisa Zamosky at WebMD.com. These guidelines include:

• Dealing with pain head on. Denying pain is never a good idea.
• Getting treatment. Acute pain—the kind that comes on suddenly—should be treated as quickly as possible to prevent it from becoming a chronic pain condition or pain that lasts longer than three months.
• Checking on vitamin D. Vitamin D helps prevent micro factures and alleviating pain that stems from fractures associated with osteoporosis. Ask the doctor to check vitamin D levels to ensure no deficiency.
• Avoiding obesity. Extra pounds put tremendous strain on the body and increase the chance of experiencing chronic joint and lower back pain.
• Getting enough sleep. A lack of sleep can worsen pain and contribute to muscle tightness and depression. If not sleeping well, check with the doctor for any sleep disorder and find out what can be done to get a good night's rest.
• Watching out for depression. Chronic pain is frequently accompanied by depression, making it more difficult to deal with physical pain, which often goes unrecognized. When in chronic pain, let the doctor know how’s the emotional state of mind as well.

Steps to Healthy Aging

Some tips on healthy aging by Diana Rodriguez in her article at EverydayHealth.com:

• Stay physically active with regular exercise.
• Stay socially active with friends and family and within your community.
• Eat a healthy, well-balanced diet—dump the junk food in favor of fiber-rich, low-fat, and low-cholesterol eating.
• Don't neglect self: Regular check-ups with the doctor, dentist, and optometrist are very important.
• Take all medications as directed by the doctor.
• Limit alcohol consumption and cut out smoking.
• Get the sleep the body needs.
• Tend to emotional health as well and reap the rewards of long life in enjoying each and every day and by savoring good health and happiness.

Tips for Healthy Aging

by BeWellDoc.com


For professional help with prevention and treatment of older adults, please consult a geriatrician.