Knee pain or soreness is a common complaint. It can be caused by a sudden injury, gradual wear-and-tear, or chronic overuse. Most forms of knee pain aren’t serious and can be treated at home. In some cases, however, knee pain can be caused by an acute injury needing immediate medical attention, or it’s from age-related damage requiring medical supervision.

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A quick overview of knee anatomy

The knee is one of the most stable joints in the body. It’s also the most stressed joint, supporting the entire body and undergoing immense stresses as we walk or run. There are three bones in the knee:

1. Femur (thigh bone)

2. Tibia (shin bone)

3. Patella (knee cap)

Together these bones form two separate joints – encased within the overall knee joint. This is called a compound joint. The tibiofemoral joint is a hinge joint held by several tendons and ligaments. The surfaces are covered in cartilage and the menisci – which act as shock absorbers. Meanwhile, the patellofemoral joint increases leverage as the knee extends straight.

Causes and symptoms of knee pain

Knee pain causes include injuries, arthritis, and mechanical dysfunction.

Injuries

Knee injuries can occur to any knee structure, including:

• Anterior cruciate ligament (ACL) tears are among the most common ligament tears. It’s caused by a sudden change in direction. You’ll likely hear a “pop”, followed by pain and swelling.

• Fractures of the kneecap are most common, particularly in osteoporotic individuals. 

• Torn meniscus often presents with knee pain and a feeling of the knee getting “stuck”.

• Knee bursitis involves the inflammation of the fluid-filled sacs, which cushion and lubricate the knee.

• Patellar tendinitis is the inflammation of the surrounding tendons. The knee may appear hot, painful, and swollen.

Arthritis

Here are the arthritis types most likely to affect the knee:

• Osteoarthritis is a degenerative disease caused by wear and tear. You may feel the rubbing of bone-on-bone during movement.

• Rheumatoid arthritis 

• Gout is caused by uric acid crystals in the joint space.

• Pseudogout is like gout, except it’s a build-up of calcium-containing crystals. Knees are most commonly affected.

• Septic arthritis is an infection of the knee. Symptoms include fever, swelling, pain, and redness. See a doctor urgently.

Mechanical problems and other causes

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Not all knee pain causes fit neatly into other categories.

• Patellofemoral pain syndrome is the most common type of knee pain. It occurs gradually and worsens with sitting, climbing, or descending stairs. The exact cause is unknown, but it is common in runners.

• Iliotibial band syndrome presents with pain from the outside of your hip to your knee. 

• Dislocated kneecaps are quite rare.

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Treatment

Standard treatment strategies for mild to moderate injuries involve RICE: Rest, Ice it, Compress your knee, and Elevate your Knee. You can also take NSAIDs (like Ibuprofen or Naproxen) and practice stretching and strengthening exercises.

Tears or fractures will need medical or even surgical intervention – as will any infection or arthritic causes.  Chiropractic care depends on the pathology, working effectively for inflammatory or arthritis causes. They would typically perform a full assessment of the pelvis because if the pelvis is not correctly aligned the knee joints may compensate for the malalignment and become overworked and painful. 

By adjusting and correcting the pelvis, hips, or lumbar spine, knee pain can be alleviated and reduced over several sessions. Techniques such as dry needling are commonly used by Chiropractors, an acupuncture needle is used to stimulate blood flow into the knotted muscle to release tightness.