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Knee Pain Overview

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Chronic Knee Pain continued...

Infection (or infectious arthritis)

  • Description: Many organisms may infect the knee. Gonorrhea, a common sexually transmitted disease, can infect the knee, as can common organisms residing on normal skin.
  • Symptoms: Infection of the knee causes painful knee swelling. In addition, people who develop such infection typically complain of fevers and chills. Less severe infections may not have associated fevers or cause this ill feeling.
  • Treatment: New swelling and pain in the knee must be evaluated for infection based on your doctor's opinion. Treatment usually includes intensive antibiotic therapy and may include aspiration of the joint, or surgical drainage of the infection.

Patellofemoral Syndrome and Chondromalacia Patella

  • Description: These 2 conditions represent a spectrum of disease caused by patellar mistracking.
  • Symptoms: The condition typically occurs in young women and also in athletes of both sexes and elderly people. In patellofemoral syndrome, the patella rubs against the inner or outer femur rather than tracking straight down the middle. As a result the patellofemoral joint on either the inner or outer side may become inflamed causing pain that is worse with activity or prolonged sitting. As the condition progresses, softening and roughening of the articular cartilage on the underside of the patella occurs, and the syndrome is referred to as chondromalacia patella.
  • Treatment: Home care with PRICE therapy, NSAIDs, and exercises (such as straight leg raises) that balance the muscles around the patella work for most people. Physical therapy to assess factors that may contribute to the disease process guides management to include exercise, bracing or taping of the patella, commercial arch supports (for the arch of the foot), or orthotic supports that correct foot mechanics and may reduce abnormal forces on the knee. Severe cases of patellofemoral syndrome or chondromalacia may be treated surgically through a variety of procedures.

Jumper's Knee

  • Description: Tendonitis (inflammation of the tendon) of the quadriceps tendon at the upper point of the patella, where it inserts, or tendonitis of the patellar tendon either at the lower point of the patella, or at the place where it inserts on the tibia (called the tibial tuberosity, the bump about 2 inches below the knee on the front side), is termed jumper's knee. Jumper's knee is so named because it is typically seen in basketball players, volleyball players, and people doing other jumping sports.
  • Symptoms: Jumper's knee causes localized pain that is worse with activity. It usually hurts more as you jump up than when you land because jumping puts more stress on tendons of the knee.
  • Treatment: Home therapy with the PRICE regimen together with anti-inflammatory drugs is the basis of treatment to manage the acute phase. Particularly important are rest, ice, and NSAID drugs, which will help stop the pain and break the cycle of inflammation. After controlling the pain, you should slowly start an exercise regimen to strengthen the quadriceps, hamstrings, hip, and calf muscles before resuming your sport of choice a few weeks down the line. Also, bracing of the extensor mechanism may help remove stress from the tendons.

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