Advice and information for patients
The knee is a hinge joint that allows the leg to bend (flex) and straighten (extend). It is surrounded by “soft tissues” - muscles, ligaments and tendons. A muscle is a band of fibrous tissue that has the ability to contract, producing movement or maintaining the position of parts of the body. A tendon is a flexible but inelastic cord of strong fibrous collagen tissue attaching a muscle to a bone. A ligament is a short band of tough, flexible fibrous connective tissue which connects two bones, holding together a joint. Within the knee there are two horse shoe shaped cartilage structures called “menisci” which help with shock absorption and the smooth running of the knee.
Knee pain often results from a simple strain or sprain. "Strains" are injuries to muscles or tendons and "sprains" are injuries to ligaments. Such 'soft tissue injuries' may be caused by a specific injury or may gradually build up over time. The patella (kneecap) can sometimes become painful during activities such as sitting-to-standing or climbing stairs. Sometimes a tear can develop to one of the menisci. Again this may occur after a specific injury or it may develop from middle age as the meniscus ages. Meniscal tears may cause pain and locking, but often they do not cause any trouble and many of us have no idea if we have one! As we get older, or after a previous injury, osteoarthritis may develop in the knee, which can cause pain and stiffness. Most knee pain has a simple cause and clears up within a few days; sometimes it lasts a few weeks. However, even more persistent problems, such as a meniscal tear or osteoarthritis can be self-managed successfully.
How can I help myself to get better?
Minor injuries, such as mild sprains and strains, can often be initially treated at home using a protection, rest, ice regime for the first two or three days after onset:
- Protection – protect the affected area from further injury; for example, avoid the painful activities that may have caused the injury if this is easily traced. However do not stop moving altogether as this will likely cause your knee to stiffen further.
- Rest – rest the knee for two or three days only. Resting the leg for a short time may help any inflammation or discomfort to settle. However resting beyond two to three days may lead to the surrounding muscles becoming weaker which will not be helpful in the longer term.
- Ice – should you notice any swelling or tenderness around the joint, apply an ice pack to the affected area for about 15 minutes every two to three hours. This may help to reduce the swelling and give some pain relief. A bag of frozen peas, or similar, will work equally as well.
- NB please be sure to wrap the ice pack / frozen peas in a moist towel or similar to avoid direct contact with the skin.
Contrary to many people’s beliefs, it is good to stay active when you have pain in your soft tissues or joints. As we have said, pain can be the result of overuse or overtraining. If this is the case, try to reduce the amount of activity (rather than stopping it altogether) that may be exacerbating your symptoms for a short period, until the pain settles. You should then aim to slowly work back up to your previous activity level. If exercising does not affect your symptoms or improves them, try to stay as active as possible.
- Some basic exercises can be useful in easing your knee pain and to help it move better. These simple knee exercises from ARC UK may be a useful starting point. ARUK knee pain exercises
- Pain relief through medication may be useful – however it is essential that prior to using pain-relieving medication that you check with either your GP or pharmacist that you are OK to use them - even if they are “over-the-counter” type medications such as paracetamol, ibuprofen or creams that you can buy at the chemist.
When should I see my doctor or physiotherapist?
Knee pain usually gets better or improves on its own, or with the self-management approaches as discussed above.
However you should seek medical advice for the following:
- After a sudden traumatic injury such as a fall onto a hard surface, a high impact injury or a sudden twisting injury
- If the pain is severe or knee is hot or very swollen
- If you have tingling or numbness in the leg
- If you develop acute knee pain at the same time as feeling unwell or if you develop a fever similarly to the onset of your knee pain, it is possible you may have developed and infection of the joint, so you should see your doctor immediately/the same day. If you are unable to see your doctor you may need to attend at your local Walk in Centre or A+E.
The Healthy Living Teams in provide tailored support and guidance to local people who would like to be more physically active. To find out more about the programmes available, please click on the link below for your Borough: