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Where is your knee pain? And what does this mean?

23rd June 2022

Knee osteoarthritis is one of the main causes of knee pain, but it is not the only reason. Knowing where your pain is coming from can help to identify the cause so you can consult with a medical professional to help you find the best possible treatment plan.

Knee osteoarthritis can be due to physical changes which affect the joint function, which may be from birth or has developed due to excess weight placing pressure on the joint. OA can also develop from an injury.

We hope this article will help guide you to understand your knee pain, possible causes and help you find a treatment solution as soon as possible.

Knee pain

Front of the Knee:

Knee Osteoarthritis: Also called “wear-and-tear” arthritis, knee OA is caused by the disintegration of cartilage, causing bones to rub against each other. Upper knee pain might be caused by osteoarthritis in the patellofemoral part of the knee. In other words, the cartilage between the patella (knee cap) and femur (thigh bone) might be degraded.

Bursitis: Bursae are fluid-filled sacs between the bones of the knee joint and are responsible for reducing friction. Bursitis can be described as the inflammation of these sacs. This is usually caused by acute injuries and overuse, but it can also be triggered due to an underlying inflammatory condition, such as rheumatoid arthritis.

Chondromalacia: Commonly known as the runner’s knee, this condition causes the cartilage between the patella and femur to disintegrate. Although it sounds similar to knee OA, it mainly affects people with high levels of physical activity, unlike knee OA, which comes with age, genetic background, and various other factors.

Patellar Tendinitis: This condition is associated with an injury to the tendon between the patella and tibia, leading to tendon inflammation. It is often referred to as the jumper’s knee and commonly occurs in sports that involve jumping, such as basketball and volleyball.

Osteochondritis Dissecans occurs due to insufficient blood flow to the meniscus. Over time, the cartilage separates from the bone. It might be caused by traumatic injury or prolonged stress.

Medial (Inner) Knee Pain

Pes anserine bursitis: Inflammation occurs on the bursa between the tibia (shinbone) and the hamstring tendons crossing the medial part of the joint. The swelling of the bursa creates added pressure on the joints, triggering pain.

Medial Plica Irritation: Medial Plica is a group of folds in the membrane protecting the medial part of the knee joint. When these folds are irritated, they can get swollen and create pressure on the inner knee. Besides pain and stiffness, this condition is characterized by the popping sound heard when the knee is bent.

Knee Osteoarthritis: In most knee OA cases, the wear-and-tear starts at the medial compartment because the medial part bears more body weight than the lateral.

Medial Collateral Ligament Tear occurs when the inner ligament connecting the tibia and femur is injured. It is often caused by injury during sports or falls.

Meniscus Tear: Injury on the medial side of the meniscus, often due to sudden twisting.

Location of your knee pain

Lateral (Outer) Knee Pain

Iliotibial band syndrome is the result of an injury to the iliotibial, the fibrous tissue running along the outer thigh, connecting the hip joint to the outer part of the tibia. It commonly occurs in long-distance runners and cyclists, who might be putting too much strain on the iliotibial.

Knee Osteoarthritis can occur on the outer knee in advanced stages of knee OA or if there is more weight burden in the lateral compartment than the medial.

Lateral Tibial Plateau Fracture: The tibial plateau fracture has a significant role in carrying body weight and absorbing shock. A fracture occurs when the outer knee receives a direct impact during a motor vehicle accident or a sports accident.

Lateral collateral ligament injury: This condition is characterized by a sprain on the main ligament that connects the femur and tibia on the outer side. It is often the result of excessive stretching of the ligament. For example, if there is an accompanying medial knee condition, a person might be tempted to put more weight on the outer knee.

Back Knee Pain

Baker’s Cyst is a fluid sac that forms due to the leakage of excess synovial fluid through the back of the knee capsule. It can cause pain in the calf, swelling, and tenderness in the back of the knee. Baker’s Cyst often accompanies a form of arthritis that damages the knee capsule.

Posterior cruciate ligament injury: PCL is the ligament that connects the femur and tibia and prevents the two bones from sliding against each other. Injuries occur due to hyperflexion during an accident or a sudden strike to the shin from the back.

Hamstring Tendonitis is the inflammation of the tendons connecting the hamstrings to the knee.

The Hamstring itself might experience tears due to excessive exercise and overuse.

Systemic Knee Pain

Rheumatoid Arthritis (RA): Rheumatoid arthritis is an autoimmune disease where the immune system tissue around the knee causes inflammation in the knee joint lining. This brings on pain, swelling, burning sensation, and stiffness. Severe cases often cause fatigue, poor appetite, and weight loss. Unlike the other knee-specific conditions outlined above, RA in the knee is more symmetric and less localized. In other words, one can feel almost equal pain in all parts of the knee.

Takeaway

While knee osteoarthritis is one of the more common conditions, the knee can suffer from various types of injury. Each part of the knee joint and its surroundings can form a different defect with different outcomes. However, many knee conditions show similar symptoms, such as pain, swelling, and stiffness. Furthermore, one knee condition can pave the way for the others to occur. For example, some studies suggest that people with OA or RA have higher risks of bone fracture (1). This makes sense because a malfunction in one part of the knee can hamper overall knee function.

If you experience persistent pain in the knee, you should consult a healthcare professional as soon as possible for a diagnosis.

  • Jacob, Louis, and Karel Kostev. "Osteoarthritis and the incidence of fracture in the United Kingdom: a retrospective cohort study of 258,696 patients." Osteoarthritis and Cartilage 29.2 (2021): 215-221.

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