A 2015 study found out that about 90% of Indians suffer from knee pain by the time they are 60-65 years old. But this was not the alarming part of the study, the fact that most Indians considered it as a common side-effect of age was.
The human knees are like the parts of a machine, which require care and undergo wear and tear with age. But there are ways to delay that onset of pain and alleviate it. Let us first begin by understanding the anatomy of the knee so that the next time the doctor holds up your x-ray, you know exactly what he is talking about.
The knee has three bones. The femur or thigh bone (top portion of the joint), the tibia (below the calf muscle) and the patella or kneecap (the front portion of the femur). The fibula is not directly involved with the knee joint but is close to the outer portion of the joint that stabilizes the ankle and supports the muscles of the lower leg.
The knee has four ligaments, which connect the femur to the tibia. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) provide front, back and rotational stability to the knee. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) located along the inner (medial) and outer (lateral) sides of the knee provide stability to the knee.
Tendons connect muscles to bones. The two important tendons in the knee are the quadriceps tendon, which connects the quadriceps muscle, which lies on the front of the thigh, to the patella and the patellar tendon, which connects the patella to the tibia.
Cartilaginous structures called menisci line the top of the tibia and lie between the tibia and the two knuckles at the bottom of the femur. They provide space and cushion for the knee joint.
Bursae are fluid-filled sacs that help to cushion the knee.
Causes of Knee Pain
A fracture occurs when one of the bones which make up the knee is broken either due to external force like an accident or due to osteoporosis (weakened bones), which often results from a deficiency in calcium and vitamin
A dislocation is when an external pressure forces a part of the knee structure to come out of its place. In a few cases, the knee can correct itself. In other cases, the doctor needs to be called in.
Any type of knee twisting beyond the capacity of the body can result in a meniscus tear. This can also occur due to age.
Tendon tears, like meniscus tears, can occur when it is stretched beyond its capacity. A bad landing after a jump is the most common cause of a tendon tear.
When a ligament is injured, it has been stretched too far from its normal position. Depending on the seriousness of a ligament injury it is divided into Grade I, II and III.
Some knee injuries cause inflammation in the bursae that can cause pain.
Tendinitis is irritation and inflammation of one or more tendons due to strenuous activity leading to pain.
Sometimes injuries or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off, and floats in the joint space and ends up interfering with the knee movement.
Iliotibial Band Syndrome
This occurs when the band of tissue, which extends from the outside of your hip to the outside of your knee (iliotibial band) becomes tight and rubs against the outer portion of your femur.
If you have hip or foot pain, it may affect the way you walk. This may, in turn, put more stress on your knee joint leading to knee pain.
While there are about 100 different kinds of arthritis, there are 6 common ones that affect the knee especially.
Nerves At Play
There is only one nerve that goes through your knee. It is a branch of the sciatic nerve called the peroneal nerve. This nerve goes around the outside of your knee before travelling down the outside of your lower leg and at the bottom of your knee; it lies between the bone and the skin, which makes it vulnerable to compression.
The saphenous nerve is the longest branch of the femoral nerve and is purely a sensory nerve. Irritation or entrapment of the saphenous nerve may mimic common conditions of knee pain.
When To See The Doctor
While some symptoms of knee pain can effectively be treated at home, it is imperative that you visit a doctor if any of the following symptoms occur.
- If you are unable to put the least amount of pressure on your knee.
- If the knee joint is inflamed and swollen.
- If there is redness.
- If fever accompanies pain.
- If you feel the pain is starting to spread to other parts of the body.
- If it refuses to go even after a few days.
- If trying a week of PRICE (protection, rest, ice, compression and elevation) therapy fails.
- If pain is accompanied by lesions on the body.
- If the joint looks deformed.
Perhaps the first mistake people make with knee pain is associating it only with age. Knee pain can affect anybody irrespective of age. While the aged and the athletes are more prone to it, day to day strenuous activities, incorrect footwear can also lead to knee pain. Do not ignore it. Rather, evaluate the kind of pain that you are feeling; try PRICE, natural-pain-killers or even simple exercises. But if you realise that your knee looks or feels like any of the above-mentioned cases, it is best to seek doctor’s intervention.