Dr. Mandelbaum for U.S. News & World Report: Navigating Knee Pain: the Inside, Outside, Front and Back
Posted on Jun 17, 2019 4:39pm PDT

KNEE PAIN IS ONE OF those common complaints, like back pain, that affects
just about everyone at some point in their lives. While it's true
that some form of pain in the knee will befall most of us eventually,
knowing the type of pain you're experiencing can go a long way toward
getting the right treatment and finding relief. Some types of knee pain
are harder than others to pinpoint, feeling "generalized" to
the entire knee versus precisely located – so many of the conditions
described below can cause the person experiencing them to feel
pain all over the knee and not just in one spot. Although many knee pain conditions resolve on
their own with minimal intervention and at-home treatments, not all of
them do. It's essential to know what to watch out for if the pain
you're experiencing warrants a trip to a doctor for proper evaluation and care.
Osteoarthritis, or OA, is among the most common causes of knee pain, especially in older
adults. Though this type of pain can "radiate" to the entirety
of the knee, the pain is often initially described as occurring on the
inner side of the knee. OA is considered a degenerative disease –
which means it breaks down the cartilage of the knee over time, resulting
in a bone-on-bone grinding of the knee. Especially if the inner knee pain
worsens over the course of the day with pressure from walking, climbing
stairs or sitting in a chair, for example, these are clues that may indicate
OA. If the above describes your knee pain experience, a visit to the doctor
is essential. Though there is currently no cure for osteoarthritis, there
are many treatment options that can help people maintain otherwise active
and healthy lives while managing their OA symptoms. Other causes of inner
knee pain may include rheumatoid arthritis, an MCL ligament tear or injury,
a meniscus injury or bursitis.
When knee pain seems to be coming from the outer side of the knee, it could
be a sign of an
IT band injury or
Iliotibial band syndrome – an issue that commonly occurs in people who do a lot of cycling
or running. The IT band is a ligament that runs along the outer part of
the thigh. When the IT band tightens or becomes otherwise irritated, it
can rub against the thigh bone and cause pain between the hip and knee
of the affected sign. This pain often worsens with increased activity.
Treatment for IT band syndrome does require a medical diagnosis from a
physician, but the good news is it usually resolves with proper physical
therapy, and in some cases, steroid injections that can provide temporary
relief while the inflamed band heals.
Beyond the pain being felt on the inner or outer sides of the knees, it
can also seem to arise from the front or back of the knee. When knee pain
is felt predominantly on the front of the knee, around the knee cap, this
can be a sign of a condition known as
runner's knee. Though the name would have you assuming that this is a condition experienced
only by runners, the truth is that it's one that can be experienced
by anyone and is commonly brought on by overuse, a fall or blow to the
knee, foot problems or thigh muscle weakness. Medically referred to as
patellofemoral pain syndrome, the associated pain with this condition is frequently felt on the front
of the knee surrounding the knee cap and can worsen when you bend, squat,
jump, run or kneel. The best treatments for this type of knee pain are
rest, ice and wrapping the knee to create additional support, without
constricting blood flow. NSAID medications can also help for a short time
but always talk to your doctor first before starting these. Runner's
knee often heals on its own without medical intervention but the time
it takes is very much influenced by the individual who is experiencing the pain.
Jumper's knee is a condition characterized by pain that's frequently felt on the
back of the knee, though it can become generalized to the entire knee.
This condition commonly involves tendinopathy what is referred to as "functional
stress overload" due to jumping. Jumper's knee often affects
athletes and can occur in as many as 20% of the athletes who frequently
engage in jumping (basketball players, for example). The condition is
classified in four stages, and treatment is commonly based on the stage.
Though jumper's knee requires a clinical diagnosis, treatment can
include non-invasive options such as
physical therapy and stretching exercises. In more severe cases or at later stages, steroid
injections or surgery to repair the underlying issue may be necessary.
No matter where it hurts, knee pain can put a damper on active daily living.
If you're suffering from knee pain that keeps you from living the
life you want, it's essential to have a conversation about it with
your doctor. Some lifestyle adjustments can make a world of difference
for many people – strengthening exercises and
weight loss for those who are overweight are among the options your doctor may ask
you to consider. Our knees are critical to just about every human function
required of us on a day-to-day basis, so giving them the TLC they deserve
is crucial, whether or not they're causing you pain.