Understanding Knee Pain

Understanding Knee Pain

From an article by Simon Curtis MSc, BSc  (Hons) DO MIOA that appeared in the Spring 2009 issue of Sláinte, Ireland’s Health Magazine.

Knee problems can have all sorts of funny nicknames: Housemaid’s Knee, Clergyman’s Knee, Runner’s Knee – among other more daunting terms like Osgood-Schlatter’s disease and Chondromalacia Patella. But whatever we call it, one in five of us will experience knee pain at some time. Osteopath Simon Curtis explains what causes it and what we can do about it.

“In our osteopathic clinics, we see many patients with knee problems, often associated with sports injuries, but frequently as part of normal wear and tear on these joints which take a lot of strain throughout a normal life. And around one in five Irish people will experience knee problems, with women suffering slightly more frequently than men...

Image of Knee Joint from Wikimedia Commons

Knee Diagram from Wikimedia Commons

Common causes

There are a number of causes of knee pain:

Ligament strains and sprains are usually caused by trauma or a fall. For example, you may often hear them saying on TV that a football player has torn his ligaments in a tackle, or twisted them while running.

Osteoarthritis, which is a degenerative joint disease often affecting the knee joint. This is more common in elderly patients.

Patello-femoral syndrome (pain in the front of the knee to do with the knee cap).

Overuse syndromes tendinitis and bursitis, which refer to inflammation of the tendon and bursa (fluid-filled bags that reduce friction) respectively. Wear and tear can damage these structures and cause inflammation.

Osgood-Schlatter’s disorder, an overuse problem where the quadriceps (thigh muscle) tendon causes inflammation due to excessive traction on the tibial tubercle (below the knee) where it attaches. This is more common in athletic adolescents.

Referred pain from the hip, femur, or spine.

When patients come to an osteopath with a knee problem, the osteopath will examine the local area, but also look at the structural mechanics throughout the patient’s body in order to understand how and why the knee problem is being maintained. Sometimes, pain in the knee can be coming from the hip. At other times, hip stiffness or foot/ankle mechanics can be increasing the load on the knee and causing the knee to be painful.

For example, I recently treated a triathlete for knee problems which came on after he fell off his bike and onto his hip. He had tried several different approaches to his problem, but his knee did not get better until I worked to improve the function in his hip!

Getting professional help to look at your knee mechanics and work to assist in the healing process could be crucial and, in some cases, surgery on the knee can be of benefit.


You can help yourself

There are many things you can do. As we understand more about the natural treatment of joint inflammation processes, more and more scientific studies are discovering the benefits of dietary interventions to help stifle jointdamaging inflammation. For example, experiments have shown that when people with stiff, sore, osteoarthritic knees took a ginger extract for six weeks, they felt significantly better!

Fish oil supplements, rich in omega-3 oils, have also been claimed as beneficial in arthritis, while some other oils of marine origin (such as from the green-lipped mussel), and a range of vegetable oils (such as olive oil and evening primrose oil), have indirect anti-inflammatory actions.

Overall, there is growing scientific evidence supporting the use of dietary supplements to complement the treatment of inflammatory disorders such as osteoarthritis.

Equally, there are measurable benefits to taking berries, avocado, flaxseeds and soy to help reduce pain and swelling in sore knees.

The recent medical buzz is the use of glucosamine sulphate and chondroitin sulphate both of which have been shown to be beneficial in reducing the symptoms of arthritis in the knee. Interestingly, they also appear to slow down the progression of osteoarthritis in the knees.


Careful exercise is crucial

Almost all the cases of knee pain I have treated, I have followed up the treatment by recommending exercises. Exercise really benefits knee problems strong leg muscles support the knee and absorb shock before it gets to the knee. Exercising the quad muscles (at the front of the thigh) increase circulation in the knee joint and has been shown to stimulate beneficial biochemical changes in the joint fluid of the knee, improving its lubricating properties. Exercise also improves the range of motion of the knee.”

Generally, easy exercise which does not cause pain, will help strengthen the knees. But it is always a good idea to seek professional guidance to determine the diagnosis of the problem and a suitable management plan.