Question 1

What are the common causes of knee pain?

Accepted Answer

Common causes include osteoarthritis, or wear of the knee, which is the most frequent with age; meniscal (cartilage) tears, which can follow a twist or develop gradually; ligament injuries such as to the anterior cruciate ligament, which tend to cause instability; and problems at the front of the knee around the kneecap, known as patellofemoral pain. Less commonly, pain is referred from the hip. Identifying the cause is the key to effective treatment.

Question 2

Where is knee pain usually felt?

Accepted Answer

The site of the pain is a useful guide. Pain along the inner or outer joint line often suggests a meniscal tear or wear in that compartment. Pain at the front of the knee, around or behind the kneecap and worse on stairs or after sitting, points to a patellofemoral cause. Generalised, load-related pain with stiffness is common in osteoarthritis. Pain or swelling behind the knee can be due to a Baker's cyst. Mr Kosuge will examine the knee to localise the problem.

Question 3

How do the symptoms of a meniscal tear differ from arthritis?

Accepted Answer

A meniscal tear typically causes joint-line pain, swelling that comes and goes, and sometimes clicking, catching or locking of the knee. Osteoarthritis tends to cause a more constant, load-related ache with stiffness and gradual loss of movement. The two can coexist, particularly in older patients. Because the treatment differs, an accurate diagnosis, usually with examination and imaging, matters.

Question 4

When should you see a specialist about knee pain?

Accepted Answer

It is worth seeing a specialist when knee pain is disturbing your sleep, limiting your activities, or not settling with simple measures over a few weeks, and promptly if the knee locks, gives way, or swells significantly after an injury. Seeing a specialist does not commit you to surgery. It provides a clear diagnosis and options.

Question 5

How is the cause of knee pain diagnosed?

Accepted Answer

Diagnosis starts with a history and examination, including specific tests for the ligaments and menisci. Plain X-rays show the joint and any arthritis. An MRI scan is the best test for the soft tissues, including the menisci and ligaments. Together these usually identify the cause and guide treatment.

Question 6

What can be done to treat knee pain?

Accepted Answer

Treatment depends on the cause, and Mr Kosuge favours non-surgical measures first where appropriate, including physiotherapy, activity modification, weight management where relevant, simple pain relief and, in some cases, an injection. Where a specific problem such as a mechanically significant meniscal tear or advanced arthritis is responsible and non-surgical measures are not enough, options range from knee arthroscopy to partial or total knee replacement. The right treatment follows the right diagnosis.

Question 7

Can knee pain come from the hip or back?

Accepted Answer

Yes. Pain can be referred to the knee from the hip in particular, and occasionally from the lower back. This is why a knee that does not fit the usual pattern, or that examines normally, prompts Mr Kosuge to assess the hip and spine as well, so that treatment is directed at the true source.

Knee Pain