What causes stiffness after knee surgery

Knee pain: injury, osteoarthritis, or overload?

Content on knee pain

  1. What is knee pain?
  2. Symptom check: which of these knee pains do you suffer from?
  3. Knee Joint Anatomy: Why Is It So Prone To Pain?
  4. Causes and Risk Factors of Knee Pain
  5. When should you see a doctor immediately if you have knee pain?
  6. How does the doctor examine your knee pain?
  7. Home remedies and self-help for knee pain
  8. Surgery for knee pain
  9. Acute knee pain after an accident or trauma
  10. Chronic knee pain in runners after overload
  11. Knee osteoarthritis and joint wear as a cause of knee pain
  12. Knee pain due to metabolic disorder, immune disorder, hereditary disease
The anatomical structure of the knee joint is a complex interplay of bones, cartilage, ligaments and muscles. This illustration shows the muscles, tendons, and ligaments as the knee joint moves. The kneecap is freely suspended on four ligaments. Injuries to these structures can lead to different types of knee pain. © MedicalArtInc @Istockphoto

Knee pain can manifest itself through a wide variety of symptoms. You should tell the doctor as precisely as possible so that he can make the correct diagnosis and recommend a suitable therapy. Since the knee joint is very complex, various structures such as ligaments, muscles, cartilage and bones can cause the pain. It is therefore important to precisely describe the type, location, timing and situation in which the knee pain occurs (e.g. in the morning after getting up). If the knee is reddened or overheated, swollen, unstable, or if you hear cracking or grinding noises, you should consult a doctor immediately. Even if you can no longer put weight on the knee due to severe pain, a specialist should examine the knee joint.

Knee pain, what to do?

Knee pain is a biologically important warning sign that can indicate overload, acute injuries, joint wear, metabolic disorders or entrapment of nerve tracts.

They affect the bones (femur, tibia, and fibula or patella) of the knee joint, or the muscles around the knee joint, the ligaments (cruciate ligaments or collateral ligaments), cartilage, or meniscus of the knee joint.

Pain-free trauma to the knee joint is much more dangerous than severe knee pain because the patient is not warned if the knee is not damaged. So he does not have the opportunity to react in time and seek medical help.

If you have knee pain, you should describe the symptoms as precisely as possible: The circumstances, the type, the exact location and the triggering movements of your knee pain help in the necessary diagnosis of the causes of the pain.

Anatomy of the knee joint: why is the knee joint so susceptible to pain?

The knee joint is one of the most injury-prone joints in the human body due to its complicated structure and great mobility. A finely tuned apparatus made up of ligaments, tendons and muscles stabilizes the knee.

The knee joint is made up of three bony joint partners: femur (thigh), tibia (lower leg) and the patella (kneecap). The leverage of the patella is very important for the transmission of force from the thigh muscles into the joint.

Understanding the anatomy of the knee joint is essential to understanding knee pain: The knee joint is dependent on the functions of the outer ligament, inner ligament and the two cruciate ligaments that run inside the knee. In addition, the structure as a whole is dependent on strong muscles in which it is embedded. Different types of knee pain can arise from this complex interplay of bones, ligaments and muscles.

The knee is very complex. The thigh and lower leg are movably connected to one another in the inner and outer compartments (area) of the knee joint. As a third partner, the patella (kneecap), which is freely suspended from four ligaments, is articulated to the femur (thigh bone) (femoropatellar joint) © MedicalArt @istockphoto

What can be causes of knee pain?

Most injuries are the result of stabbing knee pain, which is accompanied by swelling of the knee joint. Knee osteoarthritis or rheumatic diseases of the knee joint cause inflammatory changes or wear and tear.

Risk factors for developing knee pain

Knee pain can occur for many reasons. However, there are certain circumstances that make it much more likely to occur. One also speaks of specific risk factors for knee pain.

Overweight or overload of the knee joint

Overweight puts stress on the joints with every step, for many years. On average, people who are overweight suffer from knee pain or knee osteoarthritis many years earlier than people of normal weight. The additional weight puts a greater strain on the articular cartilage. In addition, the knee joint is stressed by inflammation-promoting metabolic products (adipokines), which occur more frequently when people are overweight.

Lack of muscle strength, stiffness, or muscle pain

Very often the cause of knee pain lies in the function of the joint-guiding muscles and tendons in which the joint is embedded. Hardened muscles and poor flexibility cannot guide the knee joint well. Chronic pain in the muscles, which are often already hardened and have little vitality, become more likely.

Contact sports with high impacts put stress on the knee joint

Sports with a lot of start-stop movements, sprints or bumps put a lot of strain on the knee joint. This includes almost all ball sports (football in particular), but also tennis, badminton and squash. Even skiing puts a lot of strain on all structures of the knee joint through repeated impacts.

Knee pain when jogging and doing other endurance sports

Endurance sports - especially jogging or marathon training - place special demands on the knee joint. The forces acting during jogging are not as high as in contact sports, in which sprints, duels and changes of direction are very demanding on the knee. For this, the tendons, cartilage and muscles around the knee joint are stressed over and over again in the same way - i.e. monotonously - over many hours. This places particularly high demands on the tendon attachments (enthesis or enthesis organ), the tendon sheaths (covering tissue of the tendons) and the bursa responsible for the mobility of the tissue in the knee joint (bursa). Previous injuries or disorders of the leg axis in the knee joint (bow leg or knock knees) exacerbate these complaints.

Symptoms of knee pain and knee joint injuries

Knee pain and symptoms

  • Sharp pain
  • Burning pain
  • Dull knee pain
  • swelling
  • Redness of the knee joint
  • warming
  • Crunching or cracking
  • stiffening
  • Pain on exercise

Knee pain can manifest itself in very different ways because different symptoms can trigger it. To determine the cause of your knee pain, it is always helpful if you can identify and name as many of these symptoms as possible. This will help the doctor diagnose and find appropriate treatment for you.

In the knee joint, bones, tendons, ligaments and cartilage form a functional unit with the muscles. Any of these components of the knee joint can contribute to acute or chronic knee pain. Knee pain is often multifactorial, so it has several causes. So z. B. Osteoarthritis pain in the knee joint is often not caused by cartilage wear, but rather by contracted, hardened muscles. For the therapy of knee pain, this means: not only analyzing X-rays, but also taking into account all functional aspects of the muscles and the mobility of the knee joint. © bilderzwerg @ fotolia

See a doctor immediately with knee pain?

With knee pain, you don't always have to see a doctor straight away. The symptoms often go away on their own after a few days with a little rest and gentle care. However, you should consult a doctor if you have the following symptoms:

  • Redness and overheating of the knee joint
  • Acute swelling of the knee joint or the soft tissue covering around the knee.
  • Weakness, sudden loss of strength and instability, and problems with coordination.
  • Grinding and cracking noises in the knee joint.
  • The knee is so painful that it cannot be subjected to loads, immediately gives way under load, or can no longer be moved.
  • The knee loses its external shape.
  • Knee pain occurs along with a fever.

How does the specialist examine your knee pain?

At the beginning of every medical examination, a conversation with the patient (anamnesis) and a description of the pain sensation belong. This is followed by a clinical examination with external inspection of the knee joint. Based on the findings from the patient interview and the clinical examination, further examinations such as imaging or the laboratory can result.

Patient survey and clinical examination

The examination begins with the anamnesis (patient survey) and the clinical diagnosis of your knee pain through a physical examination. When taking the medical history, the specialist asks about the medical history and the exact circumstances of your pain perception. He inspects the knee joint and pays attention to visible signals such as bruising, swelling, redness or overheating. Touching is used to check for pressure pain. The mobility of the knee joint is examined in every direction of movement to identify possible blockages.

The leg axis can already be checked by inspecting the bare leg. The X-ray completes the examination of the leg axis. The specialist inspects the gait pattern and determines whether there are evasive movements or pain-related limping. The drawer test (pulling the lower leg forward) checks whether the knee is overmovable, for example due to accidental damage to the cruciate ligaments (cruciate ligament tear).

Examination of knee pain with the help of imaging

Various imaging techniques can show bones, ligaments and soft tissues around the knee joint:

  • X-ray examination:
    The X-ray examination mainly shows the condition of the bones and the bone metabolism. The function and integrity of the tendons, ligaments and cartilage is also indirectly checked in the case of stressed images where the patient stands with full weight on the joint.
  • Ultrasound examination:
    The sound waves sent into the organism during the ultrasound examination mainly show the condition of the soft tissues: tendons, ligaments and cartilage can be made visible in the ultrasound even when the joint is moved. The orthopedic surgeon identifies tendon defects, swellings and fluid deposits in the knee joint in this way.
  • Computed Tomography (CT):
    The CT scanner combines X-rays from different directions to produce sectional images. The state of the bone can be represented three-dimensionally in this way. The CT image shows fractures of the bone with regard to their entire course.
  • Magnetic resonance imaging (MRI):
    The MRI generates strong magnetic fields to influence the oscillation of hydrogen atoms in the body. In this way, all water-containing soft tissue is made visible in great detail. Above all, cartilage, tendons, ligaments and water retention can be evaluated for changes and injuries in sectional images.

Role of laboratory tests

A laboratory test of the blood or synovial fluid provides information about metabolic disorders or disorders of the immune system that can be the cause of knee pain. The blood test provides crucial information about the medical causes of the disease in the following diseases of the knee joint:

  • Gout (disorder of uric acid metabolism)
  • Rheumatoid arthritis (autoimmune disease)
  • Bacterial arthritis

Knee pain: effective treatment through conservative procedures

Knee misalignment (above) can promote knee osteoarthritis (gonarthrosis). Below in comparison a healthy knee with a clearly visible joint gap on both sides. If the cartilage is damaged, the gap on the X-ray becomes increasingly narrow: The joint gap narrowed in the X-ray (see picture above) is a clear diagnostic sign of knee osteoarthritis. In the case of severe knee osteoarthritis on the X-ray, however, it is not a matter of course that knee pain can always be eliminated with an endoprosthesis. Muscles, tendons and soft tissues often have to be accompanied by therapy in order to achieve the treatment goal of pain-free resilience. © Joint Clinic

Osteoarthritis of the knee - also known medically as osteoarthritis of the knee - is one of the most common diseases that orthopedists see in their everyday work.

Osteoarthritis is often a side effect of getting older. Nevertheless, knee pain is all too quickly attributed to joint wear and tear caused by cartilage degradation. Often, knee pain is only a side effect of cartilage wear, but not a direct consequence of osteoarthritis. There may also be other causes.

This means: therapies for knee osteoarthritis are not always suitable for treating chronic knee pain. Many patients only feel after using a knee prosthesis that even the replacement of the joint surfaces as a therapy for osteoarthritis has not eliminated the actual cause of the knee pain.

At this point, at the latest, the knee specialist must examine what he should have seen with a careful diagnostic work-up before the operation: The muscles and the condition of the tendons, muscles and fasciae must be precisely assessed.

When diagnosing and treating knee osteoarthritis, the specialist must take into account all of the patient's living conditions - age, occupation, and special stresses.

He must also fully assess all tissues in the knee joint. Shortening and hardening of the muscles as well as the condition of the tendons are important indicators to be able to recommend targeted therapy in terms of pain reduction. Regardless of the x-rays, every knee joint must be understood holistically.

Cell biological regulation therapy (ZRT® matrix therapy) against knee pain

Knee pain caused by osteoarthritis should not only be seen as a result of cartilage wear. Many patients still feel severe pain in the knee joint even after a successful prosthesis operation. The metabolic situation of the muscles is therefore one of the things that an orthopedic surgeon should examine. The close cooperation between the knee specialist and physiotherapist in every stage of knee osteoarthritis is therefore a matter of course for us.

Knee pain is often caused by an unfavorable metabolic situation and shortening and hardening in the surrounding soft tissue - muscles, tendons and fasciae. Biomechanical stimulation (cell matrix therapy) can treat this pain causally. It is often shown that the joint pain can decrease even with radiologically severe knee osteoarthritis. © Jointreha.de

In many cases of muscle stiffness and painful tension, it is not possible to use physiotherapy to treat knee pain with the help of muscle strengthening and improving coordination. The tissue can often not be trained. Cell biological regulation therapy (ZRT®) is therefore a necessary therapy phase before strengthening physiotherapy can have an effective effect.

We see a particularly effective application of cell biological regulation therapy after every knee operation, but especially after the operation of a knee prosthesis, in the occurrence of arthrofibrosis: the excessive formation of scar tissue with constant knee pain and signs of inflammation. Arthrofibrosis is a widespread, painful complication after knee surgery (knee arthroscopy or knee prosthesis).