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Knee Pain Clinic

Are you frustrated with your knee pain that is not getting better? Are you experiencing Knee discomfort after prolong walking, squatting or running? You are in the right place! We certainly able to help with our innovative and non-invasive (non-surgical) form of treatment. Get your knee check today. Call us at (65) 64712744 or SMS to (65) 92357641 to schedule for an appointment

Knee Pain

Knee pain refers to pain that occurs in and around your knee joint. Knee pain can be caused by problems with the knee joint itself, or it can be caused by conditions affecting the soft tissues, ligaments, tendons, or bursae that surround the knee.

The severity of knee pain can vary widely. Some people may feel only a slight twinge, while others may experience debilitating knee pain that interferes with their day-to-day activities. In most cases, self-care measures can help you cope with knee pain.

The knee consists of two long leg-bones held together by muscles, ligaments, and tendons. Many knee problems are a result of the aging process and continual wear and stress on the knee joint. Other knee problems result from injury or a sudden movement that stiffens the knee.

Some common conditions of Knee Problem include:

  • ARTHRITIS – Knee pain is a common problem in Asia, especially in individuals above the age of 40. The most common cause of knee pain is degenerative osteoarthritis. Women are more prone to the disease. It is characterized by mild to debilitating pain.

  • LIGAMENT INJURIES – Ligament injuries in the knee; such as an anterior cruciate ligament (ACL) are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change your lifestyle.

  • MENISCAL TEAR – The meniscus is a small “c” shaped cartilage that acts as a cushion in the knee joint. They sit between the femur and the tibia bone, one on the outside and one on the inside of the knee.

  • PATELLAR TENDONITIS – Patellar tendinitis is a common overuse injury. It occurs when repeated stress is placed on the patellar tendon. The stress results in tiny tears in the tendon, which the body attempts to repair.

  • CHONDROMALACIA PATELLA – Chondromalacia patella is a common cause of kneecap pain or anterior knee pain. Often called “Runner’s Knee,” this condition often affects young, otherwise healthy athletes.

  • DISLOCATING KNEECAPS – Kneecap dislocation occurs when the triangle-shaped bone covering the knee (patella) moves or slides out of place. The problem usually occurs toward the outside of the leg.

  • BAKER’S CYST – A Baker cyst is swelling caused by fluid from the knee joint protruding to the back of the knee. The back of the knee is also referred to as the popliteal area of the knee

  • BURSITIS – A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.

  • PLICA SYNDROME – Often called “synovial plica syndrome,” this is a condition that is the result of a remnant of fetal tissue in the knee. The synovial plica are membranes that separate the knee into compartments during fetal development.

  • OSGOOD-SCHALLATER DISEASE – Osgood-Schlatter disease is a disorder of the lower front of the knee where the large tendon under the kneecap (patellar tendon) attaches to the bone of the leg below.

  • OSTEOCHONDRITIS DISSECANS – Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone.

  • GOUT – Gout is a rheumatoid form of arthritis that causes the inflammation, joint pain and swelling especially in the toe, knee and ankle, also reducing their mobility.

  • SHIN SPLINT – Shin splints are a member of a group of injuries called “overuse injuries.” Shin splints occur most commonly in runners or aggressive walkers

When do you need to call us about your knee pain?

If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of knee pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

  • Inability to walk comfortably on the affected side

  • Injury that causes deformity around the joint

  • Knee pain that occurs at night or while resting

  • Knee pain that persists beyond a few days

  • Locking (inability to bend) the knee

  • Swelling of the joint or the calf area

  • Signs of an infection, including fever, redness, warmth

  • Any other unusual symptoms

Treatments for Knee Pain

Treatment of knee pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.

Read more about patient guide to knee pain

Read more about knee pain while running

Read more about knee pain causing by heavy weight

Read more about 9 tips to avoid knee pain and injuries

Read more about Meniscus Cartilage Tear

Who is Knee Specialist?

Knee specialist is an orthopaedic surgeon specialise in disorders of the knee. They deal with conditions such as knee arthritis, and damage to the knee ligaments. The operations and treatments that knee specialists offer include total and partial knee replacement, arthroscopic knee surgery, and knee ligament reconstruction (including anterior cruciate ligament reconstruction).

CURE YOUR KNEE PAIN TODAY. GET A KNEE SPECIALIST TO RULE OUT THE CAUSES AND CURE OF YOUR KNEE PAIN. CALL US +65 64712744 OR EMAIL INFO@BONECLINIC.COM.SG TO SCHEDULE FOR AN APPOINTMENT

Osteoarthritis (Knee Pain Clinic)

Are you looking for effective way to manage and cure Osteoarthritis? You are at the right place. Stop your Knee Pain today! Call us at +65 6471 2744 or SMS to +65 92357641 to schedule for an appointment.

The most common form of arthritis, Osteoarthritis (OA) affects an estimated 40% of the adult population. Of these, only 10% seek medical advice and only 1% are severely disabled.

Knee Osteoarthritis

Knee Osteoarthritis

Causes

Osteoarthritis (OA) means inflammation of the joints although it is better known as a degenerative disease due to the inflammation of the joints with thinning of the articular cartilage. The cartilage in our joints allows for the smooth movement of joints. When it becomes damaged due to injury, infection or gradual effects of ageing, joints movement is hindered. As a result, the tissues within the joint become irritated causing pain and swelling within the joint.

Symptoms

In OA, you will have no problem in the morning on arising but as the day progresses your discomfort will increase.

In the evening, there will be a dull ache in the area of the affected joint.

Other symptoms include:

  • Pain
  • Swelling of the affected joints
  • Changes in surrounding joints
  • Warmth – The arthritic joint may feel warm to the touch
  • Crepitation – A sensation of grating or grinding in the affected joint caused by the rubbing of damaged cartilage surfaces
  • Cysts – In OA of the hand, small cysts may develop, which may cause the ridging or dents in the nail plate of the affected finger

The changes associated with degenerative arthritis tend to involve similar joints. Whereas in post-traumatic degenerative arthritis where there is a history of acute or chronic trauma, the changes tend to be isolated to the specific joints injured.

Risk Factors

Old age
As a person grows older, it becomes more likely that the cartilage may be worn away. OA is uncommon in people below 40 years of age.

Gender
Women are more likely to suffer from OA, especially after menopause.

Previous joint injury
Someone with a previous injury to the cartilage within the joint, e.g. after a fracture involving the joint or after a sporting injury to the joint will have a higher risk of developing OA later in life.

Weight
A greater than normal body weight puts more stress on the weight-bearing joints such as the hip and knee, increasing the likelihood of developing OA in these joints.

Bone deformities
People born with deformed joints or abnormal cartilage have an increased risk of OA.

Other diseases that affect the joints
Bone and joint diseases that increase the risk of OA include other arthritic conditions such as rheumatoid arthritis and gout.

Genetics
Genetic factors may predispose to the development of OA.

Diagnosis

The specialist will begin by taking a detailed history of your problem and past medical problems, followed by a physical examination. He may then proceed to other tests, such as:

X-rays
This is the most commonly performed test to evaluate the status of the affected joint and the alignment of the joint. Normal x-rays are safe, simple and pain-free.

Blood tests
Depending on the clinical findings, blood may be drawn for special testing, to rule out other causes of joint pain, e.g. due to rheumatoid arthritis, gout or infection.

Joint aspiration
Occasionally, especially when the joint is very swollen, the doctor may choose to suck some fluid out of the swollen joint for special testing. Removal of joint fluid also sometimes relieves pain.

Treatment Options

The goals for treatment for osteoarthritis are:

i. Pain relief
ii. Maintenance of function
iii. Prevention of associated deformities
iv. Patient education

The treatment for OA depends on the severity of the disease and the patient’s own lifestyle expectations.

Early cases of OA can generally be treated with:

  • Rest and lifestyle modification, such as weight loss and cessation of smoking
  • Use of aid (e.g. a walking stick). Use of good shoes is also helpful for relieving symptoms in some
    cases of OA
  • Exercise and physiotherapy to strengthen muscles and improve joint flexibility
  • Medication

In OA of the hand, rest can be accomplished by selectively immobilising the joint in a splint. Splinting is initially done for a period of 3 – 4 weeks, during which the splint is worn continuously.

This is usually combined with non-steroidal anti-inflammatory medication (NSAIDs) taken at the same time. If there is improvement in symptoms, use of the splint during the day is progressively diminished over the course of the coming month/s.

Use of NSAIDS
Gastrointestinal intolerance remains one of the major factors limiting the prolonged use of NSAIDs and may require temporary or permanent discontinuation of the anti-inflammatory agent. Concomitant use of H2 blockers, omeprazole, or misoprostol, a prostaglandin analogue that counteracts the mucosal effects of NSAIDs, may mitigate some of the gastrointestinal effects. Nephrotoxicity is a well-known complication of NSAIDs, and patients with pre-existing renal insufficiency should not take NSAIDs for extended periods.

Types of medication
There is presently no medication that can cure OA or regrow the cartilage in osteoarthritic joints.

The most commonly prescribed medications are painkillers. The type of painkiller prescribed depends on
the severity of the pain. For early disease with mild and occasional pain, simple painkillers, although more severe pain may require the use of non-steroidal anti-inflammatory drugs (NSAID’s) for relief. Analgesic (painkillers) creams and adhesive patches can also be used.

Glucosamine, with or without chondroitin, has also become a popular drug treatment in recent
years. It can be purchased without a doctor’s prescription.

However, it is ineffective in many patients, especially those with severe OA. The duration of its symptomatic relief also tends to be temporary. There is no evidence that glucosamine or chondroitin is able to result in cartilage repair.

Injections
For the treatment of OA, your doctor may sometimes recommend a lubricant injection to coat the cartilage and stimulate the healing process.

Surgery
Surgery is usually only offered for severe disease that has not responded to conservative treatments mentioned. Both the type of surgery and the decision for surgery are made following careful discussions between you and your doctor.

For many joints in the hands, arthodesis or fusion of the joint is the method of choice. In joint fusion, the arthritic surface is removed and bones on either side of the joint are fused to eliminate movement from the problem joint.

There may be some loss of movement but the pain ablation and stability may functionally improve the joint that is severely affected by the degenerative joint disease.

STOP YOUR KNEE PAIN TODAY. CALL US AT +65 6471 2744 Or SMS TO +65 92357641 FOR APPOINTMENT

Knee Ostearthritis

Osteoarthritis (OA) of the Knee is one the most common knee joint disorder, which is due to aging and wear and tear on the knee joint.

Causes, incidence, and risk factors

Osteoarthritis of the knee is a normal result of aging. It is also caused by constant ‘wear and tear’ on the knee joint.

  • Cartilage is the firm, rubbery tissue that cushions your bones at the joints, and allows bones to glide over one another.
  • If the cartilage breaks down and wears away, the bones rub together. This causes pain, swelling, and stiffness around your knee.
  • Bony spurs or extra bone may form around the knee joint. The ligaments and muscles around the knee joint become weaker and stiffer which cause discomfort.

Often, the cause of Osteoarthritis of the knee is unknown. It is mainly related to aging.

The symptoms of Osteoarthritis of the knee usually appear in middle age. Almost everyone has some symptoms by age 70. However, these symptoms may be minor.

Before age 55, Osteoarthritis of the knee occurs equally in men and women. After age 55, it is more common in women.

Other factors can also lead to Osteoarthritis of the knee

  • Osteoarthritis of the knee tends to run in families.
  • Being overweight increases the risk of Osteoarthritis of the knee joints because extra weight causes more wear and tear.
  • Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and cruciate ligaments in your knee joints.
  • Jobs that involve kneeling or squatting for more than an hour a day put you at the highest risk. Jobs that involve lifting, climbing stairs, or walking also put you at risk.
  • Playing sports that involve direct impact on the joint (such as football), twisting (such as basketball or soccer), or throwing also increase the risk of arthritis.

Medical conditions that can lead to Osteoarthritis of the knee include:

  • Bleeding disorders that cause bleeding in the joint, such as hemophilia
  • Disorders that block the blood supply near a joint and lead to avascular necrosis
  • Other types of arthritis, such as chronic gout, pseudogout, or rheumatoid arthritis

Symptoms

Pain and stiffness in the knee joints are the most common symptoms. The pain is often worse after exercise and when you put weight or pressure on the joint.

If you have Osteoarthritis of the knee, your knee joints probably become stiffer and harder to move over time. You may notice a rubbing, grating, or crackling sound when you move the knee joint.

The phrase “morning stiffness” refers to the pain and stiffness you may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that “warms up” the joint.

During the day, the pain may get worse when you’re active and feel better when you are resting. After a while, the pain may be present when you are resting. It may even wake you up at night.

Some people might not have symptoms, even though x-rays show the changes of Osteoarthritis of the knee.

Signs and tests

A physical exam can show:

  • Joint movement may cause a cracking (grating) sound, called crepitation
  • Joint swelling (bones around the joints may feel larger than normal)
  • Limited range of motion
  • Tenderness when the joint is pressed
  • Normal movement is often painful

No blood tests are helpful in diagnosing Osteoarthritis of the knee.

An x-ray of affected joints will show a loss of the joint space. In advanced cases, there will be a wearing down of the ends of the bone and bone spurs.

Treatment

Osteoarthritis of the knee will most likely get worse over time. However, your Osteoarthritis of the knee symptoms can be controlled.

You can have surgery, but other treatments can improve your pain and make your life much better. Although these treatments cannot make the arthritis go away, they can often delay surgery.

MEDICATIONS

Over-the-counter pain relievers, which you can buy without a prescription, can help with Osteoarthritis of the knee symptoms. Most doctors recommend acetaminophen (Tylenol) first, because it has fewer side effects than other drugs. If your pain continues, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include aspirin, ibuprofen, and naproxen.

Other medications or supplements that you may use include:

  • Corticosteroids injected right into the joint to reduce swelling and pain
  • Over-the-counter remedies such as glucosamine and chondroitin sulfate
  • Capsaicin (Zostrix) skin cream to relieve pain
  • Artificial joint fluid (Synvisc, Hyalgan) can be injected into the knee to relieve pain for 3 – 6 months

LIFESTYLE CHANGES

Staying active and getting exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.

Other lifestyle recommendations include:

  • Applying heat and cold
  • Eating a healthy, balanced diet
  • Getting rest
  • Losing weight if you are overweight
  • Protecting the joints

As the pain from your Osteoarthritis of the knee becomes worse, keeping up with everyday activities may become more difficult or painful.

  • Sometimes making changes around the home will take some stress off your joints, and relieve some of the pain.
  • If your work is causing stress in certain joints, you may need to adjust your work area or change work tasks.

SURGERY

Severe cases of Osteoarthritis of the knee might need surgery to replace or repair damaged joints. Surgical options include:

  • Arthroscopic surgery to trim torn and damaged cartilage
  • Changing the alignment of a bone to relieve stress on the bone or joint (osteotomy)
  • Surgical fusion of bones, usually in the spine (arthrodesis)
  • Total or partial replacement of the damaged joint with an artificial joint (knee replacement, hip replacement, shoulder replacement, ankle replacement, elbow replacement)

Expectations (prognosis)

Every person with Osteoarthritis of the knee is different. Pain and stiffness may prevent one person from performing simple daily activities, while others are able to maintain an active lifestyle that includes sports and other activities.

Your movement may become very limited over time. Doing everyday activities, such as personal hygiene, household chores, or cooking may become a challenge. Treatment usually improves function.

STOP YOUR KNEE PAIN TODAY. CALL +65 6471 2744 or SMS to +65 92357641 for Appointment.

About Knee

How is the knee designed, and what is its function?

The knee is a joint that has three compartments. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third compartment called the patellofemoral joint. The thigh bone (femur) meets the large shinbone (tibia) forming the main knee joint.

The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint (collateral ligaments) as well as crossing within the joint (cruciate ligaments). These ligaments provide stability and strength to the knee joint.

The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for motion and absorbs the load of the body above the knee when standing. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. Below the kneecap, there is a large tendon (patellar tendon) which attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee (referred to as the popliteal space). The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend the knee joint. In the back of the thigh, the hamstring muscles flex the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.

The knee functions to allow movement of the leg and is critical to normal walking. The knee flexes normally to a maximum of 135 degrees and extends to 0 degrees. The bursae, or fluid-filled sacs, serve as gliding surfaces for the tendons to reduce the force of friction as these tendons move. The knee is a weight-bearing joint. Each meniscus serves to evenly load the surface during weight-bearing and also aids in disbursing joint fluid for joint lubrication.

What injuries can cause knee pain, and what other symptoms may accompany knee pain? How is knee pain diagnosed?

Injury can affect any of the ligaments, bursae, or tendons surrounding the knee joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones forming the joint. The complexity of the design of the knee joint and the fact that it is an active weight-bearing joint are factors in making the knee one of the most commonly injured joints.

Ligament injury

Trauma can cause injury to the ligaments on the inner portion of the knee (medial collateral ligament), the outer portion of the knee (lateral collateral ligament), or within the knee (cruciate ligaments). Injuries to these areas are noticed as immediate pain but are sometimes difficult to localize. Usually, a collateral ligament injury is felt on the inner or outer portions of the knee. A collateral ligament injury is often associated with local tenderness over the area of the ligament involved. A cruciate ligament injury is felt deep within the knee. It is sometimes noticed with a “popping” sensation with the initial trauma. A ligament injury to the knee is usually painful at rest and may be swollen and warm. The pain is usually worsened by bending the knee, putting weight on the knee, or walking. The severity of the injury can vary from mild (minor stretching or tearing of the ligament fibers, such as a low grade sprain) to severe (complete tear of the ligament fibers). Patients can have more than one area injured in a single traumatic event.

Ligament injuries are initially treated with ice packs, immobilization, rest, and elevation. It is generally recommended to avoid bearing weight on the injured joint, and crutches may be required for walking. Some patients are placed in splints or braces to immobilize the joint to decrease pain and promote healing. Arthroscopic or open surgery may be necessary to repair severe injuries.

Surgical repair of ligaments can involve suturing alone, grafting, and synthetic graft repair. These procedures can be done by either open knee surgery or arthroscopic surgery (described in the section below). The decision to perform various types of surgery depends on the level of damage to the ligaments and the activity expectations of the patient. Many repairs can now be done arthroscopically. However, certain severe injuries will require an open surgical repair. Reconstruction procedures for cruciate ligaments are increasingly successful with current surgical techniques.

Meniscus tears

The meniscus can be torn with the shearing forces of rotation that are applied to the knee during sharp, rapid motions. This is especially common in sports requiring reaction body movements. There is a higher incidence with aging and degeneration of the underlying cartilage. More than one tear can be present in an individual meniscus. The patient with a meniscal tear may have a rapid onset of a popping sensation with a certain activity or movement of the knee. Occasionally, it is associated with swelling and warmth in the knee. It is often associated with locking or an unstable sensation in the knee joint. The doctor can perform certain maneuvers while examining the knee which might provide further clues to the presence of a meniscal tear.

Routine X-rays, while they do not reveal a meniscal tear, can be used to exclude other problems of the knee joint. The meniscal tear can be diagnosed in one of three ways: arthroscopy, arthrography, or an MRI.

Arthroscopy is a surgical technique by which a small diameter video camera is inserted through tiny incisions on the sides of the knee for the purposes of examining and repairing internal knee joint problems. Tiny instruments can be used during arthroscopy to repair the torn meniscus.

Arthrography is a radiology technique whereby a contrast liquid is directly injected into the knee joint and internal structures of the knee joint thereby become visible on X-ray film.

An MRI scan is another radiology technique whereby magnetic fields and a computer combine to produce two- or three-dimensional images of the internal structures of the body. It does not use X-rays and can give accurate information about the internal structures of the knee when considering a surgical intervention. Meniscal tears are often visible using an MRI scanner. MRI scans have largely replaced arthrography in diagnosing meniscal tears of the knee. Meniscal tears are generally repaired arthroscopically.

Tendinitis

Tendinitis of the knee occurs in the front of the knee below the kneecap at the patellar tendon (patellar tendinitis) or in the back of the knee at the popliteal tendon (popliteal tendinitis). Tendinitis is an inflammation of the tendon, which is often produced by a strain event, such as jumping. Patellar tendinitis, therefore, also has the name “jumper’s knee.” Tendinitis is diagnosed based on the presence of pain and tenderness localized to the tendon. It is treated with a combination of ice packs, immobilization with a knee brace as needed, rest, and anti-inflammatory medications. Gradually, exercise programs can rehabilitate the tissues in and around the involved tendon. Anti-inflammatory injections, which can be given for tendinitis elsewhere, are generally avoided in patellar tendinitis because there are reports of risk of tendon rupture as a result of corticosteroids in this area. In severe cases, surgery can be required. A rupture of the tendon below or above the kneecap can occur. When it does, there may be bleeding within the knee joint and extreme pain with any knee movement. Surgical repair of the ruptured tendon is often necessary.

Fractures

With severe knee trauma, such as motor vehicle accidents and impact traumas, bone breakage (fracture) of any of the three bones of the knee can occur. Bone fractures within the knee joint can be serious and can require surgical repair as well as immobilization with casting or other supports.

What are diseases and conditions that can cause knee pain, and what is the treatment for knee pain?

Pain can occur in the knee from diseases or conditions that involve the knee joint, the soft tissues and bones surrounding the knee, or the nerves that supply sensation to the knee area. In fact, the knee joint is the most commonly involved joint in rheumatic diseases, immune diseases that affect various tissues of the body including the joints to cause arthritis.

Arthritis is inflammation within a joint. The causes of knee joint inflammation range from noninflammatory types of arthritis such as osteoarthritis, which is a degeneration of the cartilage of the knee, to inflammatory types of arthritis (such as rheumatoid arthritis or gout). Treatment of the arthritis is directed according to the nature of the specific type of arthritis. Many people suffer from arthritis; the pain and discomfort can be so limiting that some patients may require a total knee joint replacement. Knee replacement surgery often allows the patient to regain much of their mobility.

Swelling of the knee joint from arthritis can lead to a localized collection of fluid accumulating in a cyst behind the knee. This is referred to as a Baker cyst and is a common cause of pain at the back of the knee.

Infections of the bone or joint can rarely be a serious cause of knee pain and have associated signs of infection including fever, extreme heat, warmth of the joint, chills of the body, and may be associated with puncture wounds in the area around the knee. These infections are often diagnosed by aspirating joint fluid accumulations with a needle (joint aspiration) and examining the fluid microscopically and with microbial culture techniques. Treatment is done with antibiotics.

Tumors involving the joint are extremely rare (for example, synovial sarcomas, and giant cell tumors). They can cause ambulatory problems with local pain. Treatment usually involves surgery; a few individuals may require amputation of the knee and lower leg. Treatments and surgery depend on the tumor type.

The collateral ligament on the inside of the knee joint can become calcified and is referred to as Pellegrini-Stieda syndrome. With this condition, the knee can become inflamed and can be treated conservatively with ice packs, immobilization, and rest. Infrequently, it requires a local injection of corticosteroids.

Chondromalacia refers to a softening of the cartilage under the kneecap (patella). It is a common cause of deep knee pain and stiffness in younger women and can be associated with pain and stiffness after prolonged sitting and climbing stairs or hills. While treatment with anti-inflammatory medications, ice packs, and rest can help, long-term relief is best achieved by strengthening exercises for the quadriceps muscles of the front of the thigh.

Bursitis of the knee commonly occurs on the inside of the knee (anserine bursitis) and the front of the kneecap (patellar bursitis, or “housemaid’s knee”). Bursitis is generally treated with ice packs, immobilization, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) or aspirin and may require local injections of corticosteroids (cortisone medication) as well as exercise therapy to develop the musculature of the front of the thigh.

STOP YOUR KNEE PAIN TODAY! CALL +65 6471 2744 or Email to info@boneclinic.com.sg for Appointment

Knee Pain in Sports Injury

One of the top sports injuries today is a knee injury. Athletes commonly suffer from knee injuries because their knees are unfortunately not protected and therefore more susceptible to injury. Sadly, for some athletes, knee injuries are not only painful they are also career ending. Therefore, protecting the knees becomes a priority. Those that suffer from knee problems understand the frustration of this and they sympathize with anyone that has knee pain. And athletes are actually not the only ones that suffer from knee related injuries. This type of knee pain affects many individuals. Therefore, read the following information for a guide on the basic knee problems that could affect those around you.

Where It Starts And What It Feels Like

Any pain in or around the knee can be very difficult to deal with. Stabbing pains are hard to ignore when trying to walk or move around, and dull, achy pains can wear a person down quickly. Whether a person is young or old, heavy or thin, an athlete, knee pain can strike. And when it does, it is a pain that no one wants to suffer from. It is aggravating, irritating, and often hard to treat.

Sometimes people get just pains from a ‘catch’ in a muscle or a nerve momentarily misfiring. Most of the time, though, the pain comes from something that is already a problem or could develop into one. That being said, it may not be a serious problem and a little bit of extra care could easily take care of it.

List Of Common Causes And Conditions of Knee Pain

The most common causes of knee pain are listed here, so anyone who’s suffering with this kind of problem can get some insight into what might be causing their discomfort. Hopefully this will aid individuals as they seek to understand why they are suffering from knee trouble. They are definitely not alone in their pain. There are a wide variety of knee problems that affect many.

Cartilage injuries – when a person damages the cartilage in his knee, it can sometimes cause the bones to actually grind together rather than rest on the cartilage cushion that was originally there. Obviously, that can cause a lot of pain and discomfort, and it’s not something that can be easily adjusted or corrected. However, because of sports, exercise, and an active lifestyle, it’s becoming more common today.
Arthritis – because arthritis can strike in any joint, one of the main areas that people often notice it in is the knee. It can cause both pain and stiffness, and it can also keep a person from doing all the activities that he wants to do, simply because it’s just so very uncomfortable. It can also get worse and cause serious debilitation.
A sprain or strain – it’s possible to injure the knee in such a way that it will heal and doesn’t do damage to the cartilage. In other words, there isn’t any permanent damage done but the pain and discomfort from it is very real. It can also take a long time to heal up, especially because the knee is such an integral part of the body
Patellar Tendonitis – this is tendonitis around the knee joint. It happens to the patellar tendon, which is the large tendon over the front of the knee
Chondromalacia patella – this condition causes knee pain under the kneecap. It usually occurs because the cartilage begins to soften. Most of the people who suffer from this condition are between the ages of 15 and 35.
Dislocating Kneecap – when the kneecap has been dislocated the individual can experience acute symptoms of pain during the dislocation. However, this condition can lead to chronic knee pain.
Baker’s Cyst – this usually occurs because of the result of a meniscus tear. It causes swelling in the back of the knee joint, resulting in knee pain.
Bursitis – this condition affects people that kneel for work (i.e. gardeners or carpetlayers), and it affects the joint above the kneecap.
Plica Syndrome – this is an uncommon cause of knee pain and it is difficult to diagnose, however it can happen and cause knee pain.
Osgood Schlatter Disease – this knee problem occurs in many adolescents and happens because of the irritation of the growth plate in the front of the knee joint.
Osteochondritis Dissecans – this is another growth related problem that causes problems in the knees of adolescents.
Gout – although not usually a cause of knee pain, the symptoms of gout can spread to the knees.

List Of Common Treatment Options for Knee Pain

Treating knee pain can be difficult, largely because a lot of people just try to live with it. They aren’t sure what’s causing it, and they worry that it might be something serious. Because they worry, they avoid going to their doctor and trying to get it corrected, when it could actually be something simple. Here are some of the most common treatment options for knee pain.

• Surgery – while not something a lot of people want to think about, surgery for knee injuries is quite common. Because of doctors’ ability to go in laproscopically through small incisions, knee surgery is much easier than it’s been in the past. The recovery is faster and there is a lot less pain while the knee heals.
• Medications – arthritis can be treated with medications more easily now than it could in the past. That’s great news for anyone who’s dealing with knee pain as a result of arthritis and who doesn’t really know what else to do in order to feel better.
• Knee braces and over-the-counter pain relievers are also good choices for knee pain.
• Rest is a common treatment for knee pain. One of the only ways that knee pain will heal is if the individual decides to stay off their knees. This might mean that they have to take it easy for a while.
• Physical Therapy is extremely important for many knee injuries because it will build back the strength in the knee area. There are a variety of different techniques that physical therapists use, however most of them are useful at allowing the sufferer to overcome knee pain and be able to walk again without pain.
• Ice and heat are also recommended to reduce inflammation in the knee area. Often, this is the best treatment for knee pain and many patients forget this simple procedure.
• Injections are a powerful medication that will help reduce and even treat inflammation. They are used commonly with people that suffer from knee problems. It is important to talk to the doctor concerning this option before proceding.

Holistic Approach

There are also alternative forms of treatment that may prove beneficial with specific knee pain. Many people choose to go this route, especially because knee pain is a constant problem that often does not disappear overnight. Here are some suggestions.

• Glucosamine and chondrotitin and two substances that aid in knee pain problems. They occur naturally in cartilage and can be purchased over the counter as supplements. They help relieve pain for a wide variety of conditions and can even reduce inflammation. Both are an effective natural remedy.
• Acupuncture is also a top holistic approach for knee pain. Research suggests acupuncture is one of the leading methods to treat knee pain. The needles actually help several people that are suffering with this issue. Most people believe that the pain relief comes from the release of endorphins. It’s always a good idea to ask the doctor about acupuncture possibilities. It is a good option for many cases of knee pain.

When To See A Doctor for Knee Pain

At certain times a doctor’s help may be required to treat knee pain. This is important to recognize. While some knee injuries are basic sprains or bruises that require rest or ice, others may need to be evaluated by the proper medical expert. The sooner it is evaluated the sooner healing will begin. Here are some guidelines to help individuals assess whether or not a doctor is necessary.

• Visit the doctor when it becomes difficult to walk comfortably on the leg that has knee pain.
• See the doctor if the knee pain is combined with a deformity around the joint. This is not normal and should be addressed quickly.
• Go to the doctor for knee pain that happens during the knee or during rest.
• Visit the doctor if the knee locks or becomes difficult or impossible to bend.
• See the doctor if the joint or calf area begins to swell.
• Let the doctor check out the knee if there are signs of infection such as fever, redness, and warmth.
• Go to the doctor if anything unusual occurs with knee pain or if it persists for a long time.

Managing Knee Pain

Since knee pain is difficult to treat unless the injury requires surgery, pain management must be kept up individually. This means that each person should listen to the advice of his or her doctor. What activities do they knee to avoid? What stretches and activities should they incorporate to promote healing? These types of questions will guide them as they seek to overcome the pain they experience from knee issues.

Lastly, pain management can be hard and overlooked. Do not overdo it. Try to avoid activities that place too much pressure on the knees to promote healing and avoid further pain.

Stop your Knee Pain Today. Call us at +65 6471 2744 / Email to: info@boneclinic.com.sg

Patient Guide to Knee Pain

Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions  including arthritis, gout and infections also can cause knee pain.

Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. In some cases, however, your knee may require surgical repair.

The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:

  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • “Locking,” or inability to fully straighten the knee

When to see a doctor
Call your doctor if you:

  • Can’t bear weight on your knee
  • Have marked knee swelling
  • Are unable to fully extend or flex your knee
  • See an obvious deformity in your leg or knee
  • Have a fever, in addition to redness, pain and swelling in your knee
  • Fall because your knee “gives out”

Knee pain can be caused by injuries, mechanical problems, types of arthritis and other problems.

Injuries
A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:

  • ACL injury. An ACL injury is the tearing of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play basketball or go downhill skiing, because it’s linked to sudden changes in direction.
  • Torn meniscus. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.
  • Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.
  • Patellar tendinitis. Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous cords that attach muscles to bones. Runners, skiers and cyclists are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

Mechanical problems

  • Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement — the effect is something like a pencil caught in a door hinge.
  • Knee ‘locking.’ This can occur from a cartilage tear. When a portion of cartilage from the tear flips inside the knee joint, you may not be able to fully straighten your knee.
  • Dislocated kneecap. This occurs when the triangular bone (patella) that covers the front of your knee slips out of place, usually to the outside of your knee. You’ll be able to see the dislocation, and your kneecap is likely to move excessively from side to side.
  • Hip or foot pain. If you have hip or foot pain, you may change the way you walk to spare these painful joints. But this altered gait can interfere with the alignment of your kneecap and place more stress on your knee joint. In some cases, problems in the hip or foot can refer pain to the knee.

Types of arthritis

  • Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It’s a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
  • Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.
  • Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
  • Pseudogout. Often mistaken for gout, pseudogout is caused by calcium pyrophosphate crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
  • Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. There’s usually no trauma before the onset of pain. Septic arthritis often occurs with a fever.

Other problems

  • Iliotibial band syndrome. This occurs when the ligament that extends from the outside of your pelvic bone to the outside of your tibia (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome.
  • Chondromalacia patellae (patellofemoral pain syndrome). This is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It’s common in young adults, especially those who have a slight misalignment of the kneecap; in athletes; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.
  • Osgood-Schlatter disease. This condition affects the softer area of bone near the top of the shinbone, where bone growth occurs. It’s most common in boys who play games or sports that involve running or jumping. The discomfort can last a few months and may continue to recur until the child’s bones stop growing.
  • Osteochondritis dissecans. Caused by reduced blood flow to the end of a bone, osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone. It occurs most often in young men, particularly after an injury to the knee.

A number of factors can increase your risk of having knee problems, including:

  • Age. Certain types of knee problems are more common in young people — Osgood-Schlatter disease and patellar tendinitis, for example. Others, such as osteoarthritis, gout and pseudogout, tend to affect older adults.
  • Sex. Teenage girls are more likely than are boys to experience an ACL tear or a dislocated kneecap. Boys, on the other hand, are at greater risk of Osgood-Schlatter disease and patellar tendinitis than girls are.
  • Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.
  • Mechanical problems. Certain structural abnormalities, such as having one leg shorter than the other, misaligned knees and even flat feet, can make you more prone to knee problems.
  • Lack of muscle flexibility or strength. A lack of strength and flexibility are among the leading causes of knee injuries. Tight or weak muscles offer less support for your knee because they don’t absorb enough of the stress exerted on the joint.
  • Certain sports. Some sports put greater stress on your knees than do others. Alpine skiing with its sharp twists and turns and potential for falls, basketball’s jumps and pivots, and the repeated pounding your knees take when you run or jog all increase your risk of knee injury.
  • Previous injury. Having a previous knee injury makes it more likely that you’ll injure your knee again.

Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and even disability if left untreated. And having a knee injury even a minor one makes it more likely that you’ll have similar injuries in the future.

Read more about Knee Pain

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Knee Injuries

There are many different structures inside and outside your knee. These include ligaments, which connect your bones together, articular cartilage, which covers the end of your shin bone and thigh bone in your knee joint, and a crescent-shaped disc called a meniscus. This is made from cartilage and acts as a shock absorber and helps to stabilise your knee. Injury to your knee may damage any one of these structures.

Knee ligament injuries

Your knee ligaments help to keep your knee stable.

The medial collateral and lateral collateral ligaments are found on either side of your knee joint, and act to limit the amount it can move from side to side. You can sprain or tear your medial collateral ligament if you twist your leg while it’s straightened, for example, when being tackled in rugby. Your lateral collateral ligament isn’t usually damaged on its own, but you may need to have it repaired if you have damaged other ligaments.

Your anterior cruciate ligament and posterior cruciate ligament form a cross (cruciate) inside your knee. They help to keep your knee stable when the joint is moving backwards and forwards. Anterior cruciate ligament injuries are one of the most serious types of knee injury.

If you have injured your medial collateral or lateral collateral ligaments, your doctor may grade your injury according to how severe the damage is.

  • Grade 1 is a stretch of the ligament without tearing.
  • Grade 2 is a partial tear of the ligament.
  • Grade 3 is a complete tear of the ligament.

Other soft tissue injuries

Apart from ligaments there are other soft tissues around your knee that can be injured. Soft tissue means any tissue in your body that isn’t bone.

You may tear the meniscus in your knee. You can damage it if you play a sport that involves twisting your upper leg while your foot is planted on the floor. As you get older, your meniscus may become slightly thinner or have micro tears (degenerates). This makes it more likely to tear after a very minor injury.

If you use your knee a lot, for example if you run, you can irritate or tear the tendon that connects your kneecap (patella) to your thigh muscle. This tendon is called the patella tendon and the condition is patella tendonitis.

Symptoms of knee injuries

You may feel or hear a popping or snapping sensation at the time of the injury. You may also find that you can’t stand properly on the affected leg, or put your full weight on it.

The symptoms for most ligament injuries will be similar, no matter which one has been damaged. These may include:

  • pain
  • swelling
  • instability – you may feel like your knee is giving way

You may feel a tearing sensation and severe pain if you injure the meniscus in your knee. Pain may develop towards the inside, outside or back of your knee joint (depending on which menisus you injured) and you may see some swelling.

If you have any of these symptoms, visit your GP or physiotherapist for advice.

Causes of knee injuries

You may injure your knee if:

  • an impact moves your knee beyond its usual range of movement, for example if you have a fall or land awkwardly
  • you play a sport that combines running, jumping and stopping with quick changes of direction, such as football
  • you have a condition such as arthritis or gout, which can affect your joints, or are very overweight, which can put pressure on your knees
  • your knees hit the dashboard in a car accident – posterior cruciate ligament damage is sometimes called the ‘dashboard injury’ as this is often how it occurs
  • you wear footwear that doesn’t match the shape of your feet or have poor training methods or flexibility, which can lead to overuse injuries of your knee

Diagnosis of knee injuries

Your doctor or physiotherapist will ask about your symptoms and examine you. This may include feeling for fluid in your knee joint by pressing gently around your kneecap. He or she will also ask you to describe how your injury happened, where your pain is and what type of pain it is.

Your doctor or physiotherapist may ask you to walk, sit or lie down so he or she can test for injury to your knee ligaments or soft tissues. He or she will bend and flex your knee and move your leg into different positions. Your physiotherapist may also ask you to step, squat or hop.

Your doctor may refer you for other tests in a hospital or clinic. These may include an MRI or ultrasound scan, and occasionally an X-ray. These tests can help to diagnose more complicated or severe injuries.

Treatment of knee injuries

There are different types of treatment that your doctor or physiotherapist may suggest, depending on the type and severity of the damage to your knee. It’s important to be patient when recovering from a knee injury. Your injury may take time to fully repair itself, so you may not be able to do all the things you are used to doing for some time.

Self help

You should follow the PRICE procedure to manage any type of soft tissue injury to your knee. PRICE stands for the following.

  • Protection. Protect your injury from further harm.
  • Rest. Rest the injury for the first two to three days, then reintroduce movement so you don’t lose too much muscle strength.
  • Ice. Apply a cold compress such as ice or a bag of frozen peas wrapped in a towel to help reduce swelling and bruising. Do this for 15 to 20 minutes every two to three hours. Don’t apply ice directly to your skin as it can damage your skin.
  • Compression. Compress the joint by bandaging it to support the injury and help decrease swelling. Don’t leave this on while you sleep.
  • Elevation. Elevate your knee by resting it above the level of your heart and keeping it supported.

There are certain things you should not do in the first three days after your injury so you don’t damage your knee further. These can be remembered as HARM.

  • Heat. This includes having a hot bath or using a heat pack.
  • Alcohol. Drinking alcohol can increase bleeding and swelling in the affected area.
  • Running or other forms of exercise.
  • Massaging the injured knee. This can cause more swelling or bleeding.

If you’re having difficulty bearing weight on your knee, you may need to use crutches or wear a brace to make sure that you keep weight off the affected knee.

Medicines

You can buy over-the-counter painkillers such as paracetamol to treat mild and moderate pain. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and ketoprofen can help to reduce inflammation and swelling, as well as relieve pain. NSAIDs are available as gels, creams and sprays that you can put directly onto your skin and gently massage in, as well as tablets or capsules that you take by mouth.

Your doctor may prescribe stronger painkillers if your pain is severe. Always read the patient information that comes with your medicine and if you have questions, ask your pharmacist or doctor for advice.

Physiotherapy

If your injury is more severe or complex, your doctor may refer you to a physiotherapist (a health professional who specialises in movement and mobility). You can also choose to see a physiotherapist privately. He or she will develop a programme of rehabilitation exercises to gradually strengthen your knee and stretch your muscles. These exercises will vary depending on the type of injury you have and how severe it is. Your physiotherapist may also use various techniques to help speed up the healing of your knee.

Braces or strapping to support your knee are occasionally used during rehabilitation, usually when an injury has been severe.

Surgery

For some types of knee injury, our doctor or physiotherapist may recommend that you have surgery to repair the injury to your knee – especially if other forms of treatment haven’t worked. Your doctor will refer you to an orthopaedic surgeon for assessment.

The surgeon is more likely to suggest surgery if you have one of the following injuries.

  • You have torn your anterior cruciate ligament and you do a lot of sport or have also torn the meniscus or your medial collateral ligament. Anterior cruciate ligament reconstruction involves taking a piece of tendon (usually from your hamstring) to replace the damaged ligament.
  • Your knee remains painful or locks after an injury to your meniscus.

Rarely, surgery may involve opening up your knee joint to repair it, or you may be able to have a type of keyhole surgery called knee arthroscopy to access the damaged area of your knee.

Prevention of knee injuries

There are some precautions you can take to try to reduce the risk of damaging your knee ligaments.

  • Exercise regularly to maintain a good level of fitness. This will mean your muscles are stronger and better able to support your joints, including your knees. If you haven’t been active for a while, start gently and gradually increase the intensity.
  • Spend five to 10 minutes warming up before exercise to increase blood flow to your muscles and reduce the chance of an injury. Many sports professionals advise stretching your muscles after warming up and again after cooling down; however, the benefit of stretching before or after exercise to prevent soft tissue injuries is unproven.
  • Wear correct footwear. There are many different models of trainers available, but the best is one that matches the shape of your feet. If you’re not sure, it’s a good idea to go to a specialist sports shop and ask for advice.

To Check on Your Knee, Call us at +65 6471 2744 (24 Hours) / info@boneclinic.com.sg