Evaluation can determine cause, guide treatment for knee pain

Dear Mayo Clinic: One year ago, I fell and broke my arm. While my arm has healed, my knees also have been bothering me since I fell. I have arthritis in both knees and a slight tear in the meniscus on one knee, but both knees are extremely painful when I walk. Is it possible that arthritis is causing this much pain, or could there be another reason, perhaps related to my fall? I am 59.

A: It’s possible that your knee pain could be traced back to your fall. You may have injured your knees without realizing it when you fell, or the trauma of the fall could have caused your arthritis to flare. Either way, you should make an appointment to have your condition evaluated. That evaluation will guide treatment going forward.

Any time you experience physical trauma, such as a fall, and it results in a serious injury, such as a broken bone, there’s the possibility of something called a “distracting injury.” That means the severity of one injury —in your case, the broken arm —masks the urgency of other damage that occurred due to the trauma. So you may have injured your knees when you fell, but the extent of those injuries didn’t become apparent until after your arm healed.

The arthritis in your knees adds complexity to the situation because, in some cases, an acute injury can trigger mild arthritis to become more intense. Once that happens, the arthritis pain is unlikely to return to the level it was before the injury without treatment.

Based on the symptoms you describe, the meniscus tear you have in one knee is not likely to be contributing significantly to your knee pain. Meniscus tears involve damage to the cartilage that acts as a cushion between your shinbone and thighbone. These tears are common with age. About half of people older than 50 have a meniscus tear. In patients with arthritis in the knee, the percentage of people who have a tear is even higher. Minor tears may not cause any symptoms. When they do, they tend to affect the mechanics of the knee —often causing pain or symptoms such as locking, catching or buckling of the knee.

To investigate the source of your knee pain, see your primary care physician. X-rays can show the nature of the injury to your knees and reveal the extent to which your arthritis may be contributing to the pain.

If your arthritis is fairly severe, it is likely the main culprit, and there are various treatment options available. A knee brace can be used to take pressure off the section of the knee joint most affected by arthritis and reduce pain. Medications for pain relief often are useful, too. They may include nonprescription or prescription nonsteroidal anti-inflammatory drugs, such as ibuprofen, naproxen sodium, diclofenac sodium and celecoxib. In some people, acetaminophen may ease arthritis pain.

When those measures aren’t enough, an injection of a corticosteroid medication into the knee to reduce inflammation or hyaluronic acid to provide lubrication may offer relief. In about 75 percent of patients, either type of injection may reduce symptoms, but the amount of time it lasts varies considerably. Some people only need injections once every two years to keep symptoms at bay. Others see a return of pain in less than a month. The response to these injections often dictates the next steps needed.

New treatments are under investigation, too, such as platelet-rich plasma injections and stem cell treatments. These therapies are available at some academic medical centers, including Mayo Clinic, and may be worthwhile to explore when other options for reducing arthritis knee pain have been unsuccessful.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Kenney pledges $100M toward Red Deer hospital improvements

Premier Jason Kenney has committed $100 million toward improvements at Red Deer… Continue reading

RDC athlete apologizes for racist slur

A Red Deer College athlete has apologized for using a racial slur… Continue reading

Innisfail man killed in single-vehicle collision

RCMP said car hit a pole just northwest of Innisfail early on Wednesday

Central Albertans should plan ahead in case of coronavirus pandemic, advises health expert

Dr. Deena Hinshaw said the local risk is still low, but the situation is rapidly changing

Oilsands project’s demise sends ripples through central Alberta

Concerns raised about lost jobs and message sent to potential investors

VIDEO: Grumpy sea lion resists help back to water in Washington state

Crews were able to coax her into a crate to carry her back to water

Your community calendar

Feb. 19 A Liberation of Holland event is being held at the… Continue reading

Police intervention in Kahnawake would be act of provocation, First Nation says

Protesters reinforced a rail blockade on the Kahnawake Mohawk territory south of… Continue reading

Alberta must juggle sluggish economy, big deficits, lost jobs in upcoming budget

EDMONTON — Alberta is to bring in its new budget Thursday while… Continue reading

Prepare for new coronavirus like an emergency, health minister advises

OTTAWA — Health Minister Patty Hajdu is encouraging Canadians to stockpile food… Continue reading

New Brunswick maintains position on abortions and Canada Health Act

FREDERICTON — The New Brunswick government is standing firm in its position… Continue reading

Bolder actions, words from protesters behind Quebec and Ontario rail blockades

Protesters behind rail blockades in Quebec and Ontario ramped up their actions… Continue reading

Renovation forces Canada Day party off Parliament Hill this summer

OTTAWA — Canada’s biggest annual birthday bash is moving away from Parliament… Continue reading

Kenney warns cancelled energy projects stand in the way of Indigenous prosperity

CALGARY — A $1-billion fund established last year to support Indigenous participation… Continue reading

Most Read