Do You Feel Knee Pain Going Up Stairs

 

The knee joint is the largest joint in the body, joining the two longest bones, (the bottom of the femur and the top of the tibia), with the knee cap in between. It plays a huge role in movement and weight-bearing, hence it is one of the most active and stressed joints. It is no surprise, therefore, that the knee is more prone to injury. There is an estimated number of 2.5 million sports-related injuries among adolescent athletes yearly (1).

As a hinge joint, it performs the following functions:

  • – Enables you to walk efficiently
  • – Supports your body to maintain a good posture
  • – Acts as a shock absorber
  • – Allows flexing and twisting of the leg.
  • – Provides stability during movement

Apart from the bones, the knee comprises other components such as:

  • – Strong tendons and ligaments that hold the bones together and aid stability.
  • – Cartilages that cushion the bones and promote smooth movement over one another.
  • – The quadriceps muscles that straighten the legs, and the hamstring muscles that bend the legs at the knee.
  • – Joint capsule that is filled with synovial fluid and lubricates the joint.
  • – Bursa that reduces friction and prevents inflammation.

They all work together, promoting the easy movement of your body. But when any of these components is damaged or gets infected due to one reason or another, it can result in knee pain.

Knee pain is a common musculoskeletal condition that can limit movement and reduce your quality of life. Although it can occur at any age, its prevalence increases with age (2). It may present immediately after an injury or begin as mild discomfort, growing worse over time.

Symptoms Of Knee Pain

Depending on the cause or location of the pain, signs, and symptoms may include:

  • – Pain that lasts for more than 48 hours
  • – Swelling and stiffness
  • – Decreased movement
  • – Inability to strengthen your knee fully
  • – Inability to put your weight on the knee
  • – Instability or weakness
  • – Redness and warmth of the knee
  • – Constant popping or crunching sounds

Causes Of Knee Pain

There are several causes of knee pain. It can result from injuries due to trauma, medical conditions, mechanical problems, and other factors.

Traumatic Causes

You can even feel pain from an old injury that was not properly treated. Some of them include:

  • – Injuries due to trauma

Most injuries are gotten during sports, exercises, a fall, or a misstep. They can affect either the ligaments, tendons, or bursae surrounding the knee. They often lead to fractures of the kneecap, tibia or femur, meniscus tear, or torn ligament. Below are some examples:

  • – Sprains and Strains

A sprain or strain in the knee is more common among athletes or those who exercise regularly. It affects the ligaments and/or muscles surrounding the knee, and can occur due to overstretching or sudden twisting of the knee. This can cause severe knee pain in front of the knee. Other symptoms may include swelling and difficulty when walking(3). You could also get a sprain when you have an accident such as bumping into an object or falling on the floor.

You are at risk of developing knee pain under kneecap due to strains also if you don’t warm up before exercising, engage in sports without using protective gear, or work too hard in an activity.

  • – Knee Ligament Injury

There are four major ligaments in your knee, attaching the femur (thigh bone of the upper leg) to the tibia (shinbone of the lower leg). They include the Posterior Cruciate Ligament, the Medial Collateral ligament, Anterior Cruciate Ligament,and the Lateral Collateral ligament.

Injuries affecting the anterior cruciate ligaments are the most common and occur majorly in people who engage in activities that require a sudden change in direction such as dancing, football, basketball, running, etc (4).

The knee feels like it’s popping or giving out. On some occasions, you feel knee pain upon leg extension. Injury to the posterior cruciate ligament is the least common and is caused by a high-energy impact such as a car accident. It usually presents as knee pain in back of knee. It could also lead to instability while walking or standing.

A medial collateral ligament injury makes one feel pain inside the knee. It can be caused by a direct blow to the front of the knee. A lateral collateral ligament injury can be caused by a blow to the inside of the knee while the pain presents on the outside (5).

  • – Torn Meniscus/Cartilage

The meniscus refers to the tough rubbery C-shaped cartilage that cushions the joint and acts as a shock absorber. When a meniscus tears, the edges can get stuck inside the joint, causing swelling and knee pain side of knee. Tearing of the meniscus can occur when you twist your knees suddenly. You may hear a pop sound and feel a “catching” sensation or knee pain upon extending the leg. Your knee could also give way or fail to straighten up when you want to stand.

  • – Fracture

The kneecap as well as other bones in the knee can get broken when you fall or have auto accidents. The elderly whose bones have been made weak by osteoporosis are prone to develop knee pain and cracking of the bones by missing a step.

  • – Patellar Tendonitis

Refers to inflammation of the tendon in the patellar, a large tendon that joins your kneecap to the upper end of your shinbone. This tendon allows one to run, jump and kick your leg. Athletes such as cyclists, runners, and people who engage in activities that require jumping are commonly affected. Veterans are given knee pain VA rating of 0 to 60%. It is also known as “jumper’s knee”. This is because jumping repeatedly can cause it. Around knee pain usually starts with a throbbing dull pain that grows severe when you become active.

There are cases where a weak patellar tendon may tear and cause inflammation of the knee and knee pain top of knee. If the tear is bad, it appears as a small dent and causes knee pain under kneecap.

Mechanical Causes

Knee pain can arise as a result of our body’s mechanical malfunction when we perform regular daily activities. Some conditions are:

  • – Bursitis

The joints contain small fluid-filled sacs known as bursae that help to cushion the bones and prevent friction as one moves. Constant kneeling and bending, falls or overuse of the knee can irritate the bursa. Inflammation occurs, leading to swelling and knee pain top of kneecap. This is also called ‘prepatellar bursitis” or preachers knee’. Symptoms include redness, warm knees, and pain and swelling that grows worse when you bend or kneel.

  • – Dislocation

This occurs when the kneecap slides out of its position as a result of a sudden change in direction, collision, or sharp blows to the knee. It presents as extreme pain knee pain in front of knee, swelling, slipping, and/or buckling during activity. Knee pain lunges can also be experienced as you perform some exercises

  • – Iliotibial Band Syndrome

A bunch of thick fibers called iliotibial band run from outside your hips to the outside of the knees. When this band becomes too tight, it can rub against the rear end of the femur, causing swelling and knee pain at side of knee.

  • – Loose Body

Some types of injury or bone degradation can make a piece of bone or cartilage disintegrate and find its way inside the joint. This can interfere with movement and can result in knee pain going up stairs. Knee pain due to loose body is often caused by overuse; engaging in activities that require you to continually bend your knees.

  • – Patellofemoral Pain Syndrome

This is a condition characterized by muscle imbalance and other alignment issues of the legs. It starts between the kneecap and the femur and is commonly experienced by young athletes whose kneecap fails to track properly in its socket. It also occurs in older adults with prior arthritis and is more common in women (6).

Sometimes, drivers experience knee pain from driving as a result of keeping their legs bent in a car or bad posture while driving. Symptoms include knee pain comes and goes and occasional giving out of the knee (buckling). Knee pain going up stairs can also be felt, growing worse with frequent bending or after sitting for a long time.

Medical Causes

Some medical conditions such as different types of arthritis can cause knee pain. They include:

  • – Osteoarthritis

This is the most prevalent type of arthritis-causing knee pain and is more likely to develop as one grows older. It is also known as degenerative arthritis. It occurs as a result of wear-and-tear of the cartilage that is associated with aging. Knee pain due to osteoarthritis is characterized by joint pain that increases over time and stiffness of the joint.

  • – Rheumatoid Arthritis

Refers to an autoimmune disease where the immune system fights its own body, attacking the joints, including the knee joint. It causes debilitating pain, redness, warmth, and swelling of the knees.

  • – Gout

Occurs when high levels of uric acids build up as sharp crystals in the joint. Although the big toe is the most common part affected by gout, it sometimes affects the knees too. Knee pain gout can be very intense.

  • – Osgood-Schlatter Disease

Also referred to as Osteochondrosis, this condition happens in young immature children as their bones and other components of the knee undergo some growth changes. It is associated with anterior knee pain and tenderness of the patellar tendon region. This knee pain comes and goes, and usually occurs due to frequent exercises that involve the knee (7).

  • – Cancer

You can experience extreme knee pain as a result of cancer that either starts at the knee bones or spread to them from another site.

Other risk factors of knee pain are:

  • – Obesity

Excess weight can put pressure on the knees, straining them and leading to pain and inflammation. Knee pain postpartum can also be experienced by pregnant women who put on extra weight during pregnancy.

  • – Baker’s Cyst

Refers to a fluid-filled swelling that develops behind the knees. Also known as “popliteal cyst”, it forms when the tissue at the back of the knees becomes inflamed and swells up. This can lead to knee pain in back of knee and occasional locking of the knee joint (9).

  • – Plica Syndrome

Sometimes, the plica (a membrane fold in the knee joint) becomes irritated. This gives rise to knee pain in front of knee and the middle. The knee also swells up and becomes unstable.

  • – Genetic Factors

Genetic factors can predispose one to have conditions that revolves around knee pain.

Diagnosis of Knee Pain

Knee problems can be diagnosed by either of the following:

  • – Physical Examination: The physician checks for swelling, popping, or cracking sounds, stability of the knee, if the knee is locked, and how well you can move your knees.
  • – Medical History: The physician may ask questions to augment the findings from the physical examination. Such questions include; the location of the pain, at what time it hurts more, how long does the pain last, and any other accompanying symptoms.
  • – Imaging Scans: imaging studies such as X-ray, Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and Arthroscopy can be carried out to view the bones and evaluate the surrounding tissues of the knee.

Treatment Of Knee Pain

Treatment options are dependent on the cause of the knee pain. Sometimes, it can stop on its own. But cases like injuries and unidentifiable causes will require you to see a doctor.

For mild pain, you can take care of it at home by applying these knee pain natural remedies:

  • – Rest: Resting the knee helps to reduce inflammation.
  • – Heat and cold therapy: A heating pad is effective in relieving swelling and associated pain. You can also alternate by placing an ice pack on your knee for 15 to 20 minutes every few hours. Avoid placing the ice directly on your skin or leaving it on your skin for a long time to avoid frostbite.
  • – Keep your knees elevated as much as you can. Try sleeping with a pillow under your knees to ease knee pain lying down.
  • – Application of herbal pain relief ointment on the knee.
  • – Use support devices such as braces, tapes, casts, or elastic bandages.
  • – Perform mild exercises that stretch and strengthen your muscles.

For moderate to severe pain or as required by your doctor, the following is recommended:

  • – NSAIDs: Non-Steroidal AntiInflammatory Drugs are medications used to relieve pain and inflammation. Examples include Naproxen and Ibuprofen.
  • – Steroids: in some occasions, steroids such as prednisolone and cortisone are given to reduce inflammation and knee pain. This is very effective in osteoarthritis-induced pain.
  • – DMARDS: Disease Modifying AntiRheumatoid Drugs: These medications are given majorly in cases of knee pain caused by rheumatoid arthritis.
  • – If seen fit by the doctor, you may be referred to a physiotherapist who can provide physical therapy to aid in the relief of symptoms.
  • – Complementary and Alternative Therapies like yoga and tai chi and acupuncture have been found to be effective in relieving pain. They work to improve flexibility and activate several processes in the body that reduces pain (10). It is particularly beneficial in osteoarthritis.
  • – Surgery: This is usually performed the above treatment options fail to be of help. Arthroscopy is the most common type of knee surgery. It can be carried out to repair or remove a torn meniscus, remove an inflamed synovial tissue, trim a damaged articular cartilage or reconstruct a torn anterior cruciate ligament. Knee Replacement can also be performed to remove the damaged parts of the knee joint and replace them with materials such as pieces of ceramic, plastic, or metal (11).

If you are lucky, experiencing knee pain can be only temporary. For some people, it can occur frequently and persists with activity or old age. To help prevent knee pain or decrease the symptoms, you should adopt a healthy lifestyle by maintaining your weight, quitting smoking and excessive alcohol intake, exercising regularly, and use of protective gear during sports (for athletes).

References

  1. 1. https://www.medicalnewstoday.com/articles/299204
  2. 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408027/.
  3. 3. https://www.hopkinsmedicine.org/health/conditions-and-diseases/knee-pain-and-problems
  4. 4. https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849
  5. 5. https://www.verywellhealth.com/knee-pain-symptoms-2549628
  6. 6. https://www.webmd.com/pain-management/knee-pain/knee-pain-causes
  7. 7. https://www.ncbi.nlm.nih.gov/books/NBK441995/
  8. 8. https://medlineplus.gov/ency/article/003187.htm
  9. 9. https://www.nhs.uk/conditions/bakers-cyst/
  10. 10. https://www.healthline.com/health/osteoarthritis/knee/acupuncture-for-knee-osteoarthritis#procedure.
  11. 11. https://www.asahq.org/madeforthismoment/preparing-for-surgery/procedures/knee-surgery/#:~:text=The%20most%20common%20knee%20surgeries,knee%20problems%20%E2%80%94%20or%20knee%20replacement.&text=Arthroscopy%20is%20a%20type%20of,wide%20range%20of%20knee%20problems.