Knee Pain

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DEFINITION

• Pain in the knee.

Causes of Knee Pain

• Arthritis (e.g., degenerative, gouty, infectious, inflammatory, traumatic)
• Baker's Cyst - This is a fluid collection in a cyst that bulges out from the knee joint. Symptoms include painful or painless swelling in the area behind the knee.
• Bursitis - Prepatellar bursitis is a fluid filled sack localized on the inferior aspect of the anterior knee.
• Cellulitis – Medical term for skin infection
• Overuse injury, tendonitis
• Trauma (e.g., contusion, dislocation, fracture, sprain, strain)

Some Signs and Symptoms That Could be SERIOUS

• Severe pain and unable to walk
• Knee swelling with fever (possibility of infection of knee joint)
• Unilateral calf pain and/or swelling (possibility of blood clot in leg)

See More Appropriate Topic (instead of this one) If

• Knee pain after a KNEE INJURY

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• You feel weak or very sick

• Severe pain (can't stand or walk)
• Fever and swollen knee joint
• Redness of skin around knee
• Pain or swelling in one calf

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think you need to be seen

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Swollen knee joint
• Fluid-filled sack just below knee cap
• Limping
• Symptoms interfere with work or school
• Knee pain persists longer than 7 days
• Knee pain is a recurrent problem
• Knee giving way (or buckling) when walking, is a recurrent problem 
• Knee locking (i.e., joint gets stuck, catching), is a recurrent problem

Self Care at Home If

• Mild knee pain and you don't think you need to be seen

HOME CARE ADVICE FOR A MILD KNEE PAIN

1. Knee Pain after Overuse: Muscle strain and joint irritation are very common following vigorous activity. Such activities include sports like tennis and basketball, jogging, and certain types of work.
   • Local Cold: Apply a cold pack or ice bag (wrapped in a moist towel) to the area for 20 minutes. Repeat in 1 hour, then every 4 hours while awake. Continue this for the first 48 hours after an overuse injury. (Reason: reduce the swelling and pain)
   • Local Heat: Beginning 48 hours after an injury, apply a warm washcloth or heating pad for 10 minutes three times a day to help increase circulation and improve healing.
2. Rest Your Knee for the next couple days. Avoid activities that worsen your pain. Reduce activities that put a lot of strain on the knee joint (e.g. deep knee bends, stair climbing, running).
3. Pain Medication:
   • For pain relief, take acetaminophen or ibuprofen.
   • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
   • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
   • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
   • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid  this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
   • CAUTION: Do not take acetaminophen if you have liver disease.
   • Read the package instructions thoroughly on all medications that you take.
4. Expected Course: If your knee pain does not get better during the next week or if it recurs, then you should make an appointment with your doctor.
5. Call Your Doctor If:
   • Knee pain persists longer than 7 days
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.