It is estimated that the average, moderately active person will walk about 110,000 miles during their lifetime.[1] That’s the equivalent of eight round-trip walks from Houston to Alaska.[2]
Although most people will never make that trek once, yet alone eight times, they will still put their knees to work walking, running, bending, kicking, kneeling, etc. It is no wonder then that knee pain is one of the most common complaints doctors hear from their patients.
Basic Knee Anatomy
The knee joint is where many of the body’s major muscles, tendons, ligaments, blood vessels and bones meet. To accurately treat knee pain, the physician must first determine if the pain is coming from:
- Bones: The knee is where the major bones of the upper (femur) and lower (tibia and fibula) leg meet. They are protected by the kneecap (patella).
- Cartilage: The menisci (lateral and medial) are the rubbery tissues that provide a cushion between the thigh (femur) and shin (tibia) bones that meet in the knee joint.
- Ligaments: The cruciate ligaments (anterior and posterior) and the collateral ligaments (lateral and medial) help stabilize the knee joint.
- Muscles: The major muscles of the upper leg (the hamstring and quadriceps) and the lower leg (calf) meet at the knee.
- Tendons: The connective tissues that join muscle to bone in the knee are the quadriceps tendon, which connects the quadriceps muscle to the patella, and the patellar tendon, which joins the patella to the tibia.
Main Causes of Knee Pain
Usually, the reason for knee pain can be attributed to three main causes:
- Injury: Ligament and tendon injuries are some of the most common sports-related knee injuries since they occur when the knee is hit or twisted unnaturally. But these injuries can also occur on the job, especially for those who work in construction and warehouses.[3] Accidents, including falls and vehicle crashes, can result in broken leg bones. The patella is often the primary source of impact for drivers involved in accidents.
- Over-use: Weekend warriors who fail to properly warm up their leg muscles and tissues prior to any unusual strenuous activity such as hiking, biking, gardening, etc., risk straining, inflaming or perhaps even tearing the soft tissues in the leg. Frequent, repetitive motions may lead to bursitis and tendonitis, which occur when the small, fluid-filled sacs (bursae) that help cushion the bones, tendons and muscles in the knee become irritated and inflamed. But even dedicated athletes risk injury from overuse or in some cases, poor biomechanics that put strain on the knee’s anatomy.
- Age-Related Degeneration: Over time, the knee cartilage begins to wear out and the upper and lower leg bones begin to rub against each other. Known as knee osteoarthritis, this leads to pain, inflammation, stiffness and decreased mobility in the joint.
Options for Treating Knee Pain
Patients who suffer from painful knees have options for treatment that can provide long-term relief. These include:
- Steroid injections to relieve swelling and reduce pain..
- Nerve blocks to numb pain.
- Human allograft tissue injections that provide powerful anti-inflammatory agents to reduce the swelling associated with osteoarthritis.
- Radio Frequency Ablation to denervate (deaden) the genicular nerves that contribute to knee pain.
- Dorsal Root Ganglion stimulation to interrupt pain messages from the dorsal root ganglia that contain sensory nerves that carry sensory information from the peripheral nervous system to the central nervous system.
Specialists in pain medicine can provide the best options based on the source of the pain and the degree of injury or degeneration.
Dr. Skaribas is fellowship-trained and double board certified in Pain Medicine and Anesthesiology. He has extensive experience in using fluoroscopic (x-ray) guidance to direct epidural steroid injections and nerve blocks to the source of chronic knee pain.
Sources:
[1] https://snowbrains.com/brain-post-how-far-does-the-average-human-walk-in-a-lifetime/
[2] Houston to Anchorage 8,266 miles (round trip)
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553424/
