Evaluation can determine cause, guide treatment for knee pain

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

Although B.C. has not made masks mandatory in public indoor spaces, some business owners are requiring all customers to wear them before entering their store. (Ashley Wadhwani/Black Press Media)
Mandatory indoor mask wearing starts Monday in Red Deer

A municipal bylaw requiring masking in public indoor places takes effect Monday… Continue reading

A pedestrian makes their way through the snow in downtown Ottawa on Wednesday, Nov. 25, 2020. THE CANADIAN PRESS/Sean Kilpatrick
Wild winter, drastic swings in store for Canada this year: Weather Network

Wild winter, drastic swings in store for Canada this year: Weather Network

In this Saturday, Nov. 21, 2020, photo taken through a camera lens the word "pandemic" in seen in a dictionary in Washington. Dictionary.com declared “pandemic” its 2020 word of the year. (AP Photo/Jenny Kane)
Dictionary.com picks ‘pandemic’ as its 2020 word of the year

NEW YORK — On Dec. 31, China reported a cluster of pneumonia… Continue reading

NDP Leader John Horgan, left, speaks as local candidate Ravi Kahlon listens during a campaign stop at Kahlon's home in North Delta, B.C., on April 18, 2017. THE CANADIAN PRESS/Darryl Dyck
B.C.’s economic recovery minister says getting through pandemic will be team approach

VICTORIA — The British Columbia cabinet minister appointed to lead the province’s… Continue reading

In this photo released by the official website of the Iranian Defense Ministry, military personnel carry the flag draped coffin of Mohsen Fakhrizadeh, a scientist who was killed on Friday, in a funeral ceremony in Tehran, Iran, Monday, Nov. 30, 2020. Iran held the funeral service for Fakhrizadeh, who founded its military nuclear program two decades ago, with the Islamic Republic's defense minister vowing to continue the man's work "with more speed and more power." (Iranian Defense Ministry via AP)
Iran says Israel remotely killed military nuclear scientist

TEHRAN, Iran — A top Iranian security official on Monday accused Israel… Continue reading

Idyllic winter scenes are part of the atmosphere of the holiday season, and are depicted in many seasonal movies. How much do you know about holiday movies? Put your knowledge to the test. (Pixabay.com)
QUIZ: Test your knowledge of holiday movies and television specials

The festive season is a time for relaxing and enjoying some seasonal favourites

FILE - In this Feb. 11, 2019 file photo, George Clooney participates in the "Catch-22" panel during the Hulu presentation at the Television Critics Association Winter Press Tour at The Langham Huntington in Pasadena, Calif. In a Sunday, Nov. 29, 2020, interview on “CBS Sunday Morning,” Clooney said he's been cutting his own hair for more than two decades with a Flowbee device. (Photo by Willy Sanjuan/Invision/AP, File)
George Clooney’s secret to cutting his hair, as seen on TV

LOS ANGELES — George Clooney is just like us, maybe. The star… Continue reading

Gold medallists in the ice dance, free dance figure skating Tessa Virtue and Scott Moir, of Canada, pose during their medals ceremony at the 2018 Winter Olympics in Pyeongchang, South Korea, Tuesday, Feb. 20, 2018. THE CANADIAN PRESS/AP-Charlie Riedel
Ice dance star Tessa Virtue happily out of her comfort zone in Queens EMBA program

TORONTO — Tessa Virtue doesn’t feel the same sense of exhilaration or… Continue reading

Conservative MP Pierre Poilievre speaks during a news conference Monday, Nov. 16, 2020 in Ottawa. Poilievre says building up the Canadian economy post-pandemic can't be achieved without a massive overhaul of the tax system and regulatory regime. THE CANADIAN PRESS/Adrian Wyld
Conservatives attack Trudeau’s ‘reset’ but they have ideas for their own

‘We don’t need subsidized corporate welfare schemes that rely on endless bailouts from the taxpayer’

In this undated photo issued by the University of Oxford, a volunteer is administered the coronavirus vaccine developed by AstraZeneca and Oxford University, in Oxford, England. Pharmaceutical company AstraZeneca said Monday Nov. 23, 2020, that late-stage trials showed its coronavirus vaccine was up to 90% effective, giving public health officials hope they may soon have access to a vaccine that is cheaper and easier to distribute than some of its rivals. (University of Oxford/John Cairns via AP)
Moderna chairman says Canada near head of line for 20 million vaccine doses

Trudeau created a firestorm when he said Canadians will have to wait a bit to get vaccinated

There were 47 new COVID-19 cases in Alberta Tuesday. (THE CANADIAN PRESS/Paul Chiasson)
Spread of COVID-19 in Brampton, Ont., linked to systemic factors, experts say

‘We’re tired. We’re numb. We’re overworked. We’re frustrated, because it’s not our rules’

The courthouse in Iqaluit is shown on Wednesday, Oct. 7, 2020. Three Nunavut judges, including the chief justice, are at odds over whether prison conditions caused by the COVID-19 pandemic should be considered when sentencing offenders in the territory. THE CANADIAN PRESS/Emma Tranter
Nunavut judges disagree on how to sentence offenders during pandemic

IQALUIT — Three Nunavut judges, including the territory’s chief justice, are at… Continue reading

A corrections officer opens the door to a cell in the segregation unit at the federal Fraser Valley Institution for Women during a media tour, in Abbotsford, B.C., Thursday, Oct. 26, 2017. Independent reviews of the hundreds of inmates placed in segregation over the past year found only a handful were inappropriate, new government data indicate. THE CANADIAN PRESS/Darryl Dyck
Few federal inmates moved from solitary after external reviews, new data show

‘There can be rare cases where the removal may not be immediate’

A couple embrace during a ceremony to mark the end of a makeshift memorial for victims of the Toronto van attack, at Yonge St. and Finch Ave. in Toronto on Sunday, June 3, 2018. THE CANADIAN PRESS/Cole Burston
‘I’ve been spared a lot,’ van attack survivor says as she watches trial alone

Court has set up a private room for victims and families of those killed in the Toronto van attack

Most Read