Pain and Swelling In Knee

 

Pain and swelling are two cardinal signs of inflammation and they are a pointer that there is a disorder in certain parts of the body. Both can coexist together as in inflammation, and they can also exist independently.

Overview Of Pain

The unpleasant feeling or sensation from the nervous system as a result of tissue damage in the body is referred to as pain, and the feeling of pain can be physical or emotional (2). Pain sometimes serves as damage control to help the body prevent further damage to the tissues. The character of pain can either be a sharp pain, dull aching pain, or throbbing pain and sometimes, pain can be described as throbbing or pulsatile (1).

Classification Of Pain

Generally, pain is described as either acute or chronic.

  • – Acute pain: Pain is described as acute when the onset is sudden and the cause is secondary to an underlying disorder causing the pain. Acute pain usually lasts for about six months, and once the underlying cause is solved, the pain is over and such individuals can go on with their normal activities, Some causes of acute pain are; surgery, fracture, burn accident, labor pain, and dental caries (3).
  • – Chronic pain: Chronic pain is any pain that has lasted beyond six months in the body and most times the pain usually continues even after the underlying cause or illness has been dealt with. The nerves sending pain signals to the appropriate part of the brain remain active for a very long time beyond months or years. Most times, chronic pain occurs without an underlying disorder. Some of the conditions responsible for chronic pain are; Cancers, rheumatoid arthritis, and headache. Others are backache, fibromyalgia, and nerve pain.

Some of the effects of chronic pain on the body are:

  • – Body weakness
  • – Anorexia or loss of appetite
  • – Inability to freely move around
  • – Loss of function
  • – Others are anxiety, anger, and post-traumatic stress disorder, especially for pain with an underlying trauma (3).

Overview Of Swelling

Swelling also refers to as edema occurs when there is an enlargement of the body’s organs or tissues, most times it occurs as a result of inflammation, infection, or accumulation of fluid within the organs and tissues. Swelling can affect any part of the body both internally and externally (12).

Pain and swelling can affect any part of the body at the same time. For example, pain and swelling in knee can be a result of arthritis, and pain and swelling eyelid can be a result of an infection affecting the eyes. Pain and swollen gums, medically known as gingivitis can occur as a result of dental caries.

Causes Of Pain And Swelling In Different Parts Of The Body

Pain and swelling affect different parts of the body both internally and externally depending on the underlying cause. The following are the causes of pain and swelling in different parts of the body:

  1. 1. Joint Pain And Swelling

Pain and swelling affecting the joint vary and most times they occur as a result of inflammation, infection, or trauma to the affected limbs. Below are some of the causes of pain and swelling in the joints.

  • – Gout

Gout occurs as a result of the accumulation of excess uric acid in the body, medically known as hyperuricemia. Gout mostly occurs when there is a problem with the excretion of uric acid from the body which mostly occurs as a result of chronic kidney disease (4).

When it is not properly excreted, it leads to accumulation of the uric acid in the joint forming needle-like crystals, and when this occurs, it leads to joint pain and swelling. Pain and swelling in hands can be a result of gout because most times, gout has a predilection for small joints of the hands. Pain and swelling top of foot can also result from gout because the metatarsophalangeal joint of the foot is a popular area of gout.

  • – Rheumatic heart fever

Rheumatic heart fever is an infection of the heart valves that occurs as a result of infection from group a of beta-hemolytic streptococcus microorganisms, which manifests as a throat or skin infection. One of the major clinical manifestations of rheumatic heart fever is migratory polyarthritis which affects the big joints of the body.

Joint pain and swelling are not all the time from osteoarthritis, hence the need to always investigate thoroughly. Pain and swelling in legs, pain and swelling foot, pain and swelling in ankle all can be a result of migratory polyarthritis from rheumatic fever.

  • – Osteoarthritis

One of the commonest types of arthritis is osteoarthritis. Osteoarthritis usually results due to wear and tear of the protective cartilage serving as a cushion between the bones. This causes the joint to be very painful, stiff, and swollen. Pain and swelling elbow can be a result of osteoarthritis, same with pain and swelling in ankle.

Osteoarthritis develops gradually and reaches its full peak in middle age women and adults. It should be identified and treated early before complications arise, and it is worthy of note that osteoarthritis damage to the joint is not reversible but it can be halted to prevent further damage and complications (7).

  • – Rheumatoid arthritis

Rheumatoid arthritis is a chronic autoimmune disorder that affects joint linings. It affects several joints of the body but it spares the distal interphalangeal joints. When it affects the joints, it results in swelling, and pain, and it can also cause redness of the overlying skin of the affected joint. And on examination, sponginess around the affected knee is felt when palpated.

Rheumatoid arthritis has a predilection for the joints in the hands, wrists, and feet, and it often affects joints symmetrically. Hence, pain and swelling in hands can be a result of rheumatoid arthritis, also pain and swelling of legs can be manifestations of rheumatoid arthritis. Because it is symmetrical, pain and swelling foot of the right limb may also lead to pain and swelling foot of the left limb.

Aside from joint swelling and pain, there are other clinical manifestations of rheumatoid arthritis such as weakness, a fever described to be low-grade, and malaise. Prompt diagnosis and management of the symptoms and disease are significant to prevent long-term complications from it (8). Other causes of joint pain and swelling are Infections such as septic arthritis, joint injury from trauma, fracture, and covid-19 (5).

  1. 2. Eye pain and swelling

Pain and swelling in the body are not limited to the joints alone, certain things also cause pain and swelling eyelids, and pain and swelling under eye are caused by certain conditions. Common conditions associated with eye pain and swelling are:

  • – Cellulitis

Cellulitis refers to the inflammation of soft tissues located under the skin. When there is cellulitis of the eyes, it is either preseptal or orbital cellulitis. preseptal cellulitis commonly affects children, and it affects the skin of the eyelids, while orbital cellulitis is an inflammatory disease of the eyes socket and it causes pain and swelling eyelids which further makes the movement of the eye or the eyelid difficult. It can also manifest as pain and swelling under eye (9).

  • – Corneal abrasion

Abrasion to the corneal refers to a scratch on the corneal surface. Corneal abrasion can be a result of a corneal ulcer or due to laceration to the corneal. Corneal laceration refers to a cut by an object hitting the eye or from punch trauma with force.

It can result in either a partial or full tear of the eyeball in severe trauma. A corneal ulcer is secondary to an infection, dry eye, or other underlying disorder causing the cornea to develop an open sore. Corneal abrasion most often than not results in pain and swelling under eye and in severe trauma, it can lead to pain and swelling eyelids (9).

  • – Irritants

Another cause of pain and swelling under eye and eyelids is irritation of the eyes and associated structures by irritants from smoke especially cigarette smoke, air pollution from industrial exhausts, and excessive chlorine in pools. When this happens, it leads to inflammation of the muscles surrounding the eyes which if not properly taken care of can result in complications (9).

  1. 3. Gum pain and swelling

Gingivitis is a medical term defining the inflammation of the gum, which most often than not presents as pain and swollen gums. Swollen gum almost always is a sign of an underlying pathology such as infection, some of the causes are:

  • – Food particles

The presence of a food particle stuck in between the teeth or at the gum will manifest as pain and swollen gum, but many times, the symptoms resolve once the food particle is removed (10).

  • – Pregnancy

Interestingly, studies have shown that pregnancy is responsible for gum swelling and such has been traced to hormonal changes happening in pregnancy causing vasodilatation that makes blood flow to the gum increase, and this is independent of whether they have good oral hygiene or not. Pain and swollen gum in this case are because they are more sensitive to the swelling (10).

  1. 4. Envenomation

Envenomation occurs when the body tissue is exposed to certain toxins and poisons from the stings or bites of animals such as snakes, scorpions, and bees. When envenomation occurs depending on how toxic it is, it can manifest as swelling and pain around the surrounding tissues. For instance, a snake bite around the leg will lead to pain and swelling leg. It is worthy of note that envenomation can get severe to affect internal organs.

  1. 5. Pain and swelling of internal organs

Most times, pain and swelling radiating from internal organs is usually a pointer to an acute or chronic disease. For example, pain and swelling of the right side of the abdomen might be a pointer to an infection of the liver causing its inflammation, an example of such infection is the popular viral hepatitis. Colitis is pain coming from the colon, which is either the small or large intestine.

Where would pain be for appendix? Ever wondered where appendicitis pain is felt in the body, most times appendix pain is felt at the right lower abdomen, medially called the right iliac fossa. Appendix pain sometimes radiates to the left lower abdomen and the groin regions, these are the signs tested clinically by medical practitioners before making a diagnosis of appendicitis.

When an inflamed appendix ruptures, it can lead to peritonitis with the fluid splashing in the entire abdominal wall, pain from such is usually felt in the entire abdomen (11).

Treatment Of Pain And Swelling

The treatment of pain and swelling will be dependent on the individual condition, if both symptoms exist independently or if they coexist together as in inflammation.

Different types of pain will be treated differently because depending on the severity and location of the pain, the treatment of one may not work well for another. Below are some of the measures in management:

  • – Acetaminophen: This is a pain relief medication usually prescribed for mild to moderate types of pain, and it can be gotten both as a prescribed medication and over the counter. Tylenol, a brand of acetaminophen is well known for its ability to relieve pain, fever, and the common cold. Precautions should be taken while using acetaminophen as over-dose of it can result in liver damage (2).
  • – Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are stronger forms of analgesic and they help to relieve both pain and swelling. They are suitable for both acute and chronic pain and there are grades of NSAIDS available depending on the level of pain and edema. They are suitable for relieving local inflammation and the pain that occurs as a result of swelling in any part of the body (2). Other pains relieving measures available are acupuncture, nerve block, transcutaneous electrical nerve stimulation (TENS), and surgery (2).

In addition to the treatment of pain and using medications to solve the underlying cause of such pain and swelling, other measures should be taken to relieve swelling such as:

  • – Elevate the foot of the bed
  • – Avoid sitting in the same position for a long time without taking breaks
  • – Avoid risk factors for internal organ pain and swelling, such as low salt intake.
  • – Low alcohol consumption
  • – Compression socks help reduce fluid accumulation on certain parts of the body.
  • – Seek medical help and follow your doctor’s prescription (6).

References:

  1. https://www.healthline.com/health/pain
  2. https://www.medicalnewstoday.com/articles/145750#diagnosis
  3. https://my.clevelandclinic.org/health/articles/12051-acute-vs-chronic-pain
  4. https://www.healthline.com/health/joint-swelling
  5. https://www.healthdirect.gov.au/joint-pain-and-swelling
  6. https://my.clevelandclinic.org/health/diseases/12564-edema
  7. https://my.clevelandclinic.org/health/symptoms/17752-joint-pain
  8. https://www.arthritis-health.com/types/general/what-causes-swollen-knee-water-knee
  9. https://my.clevelandclinic.org/health/symptoms/17796-eye-pain
  10. https://www.medicalnewstoday.com/articles/swollen-gums#causes
  11. https://my.clevelandclinic.org/health/diseases/8095-appendicitis
  12. https://www.healthline.com/health/swelling