Introduction
The knee is the largest joint in the body, and the medial compartment of the knee is the inner side of the knee. It is important because it is the weight-bearing compartment, and the knee is vulnerable to degenerative and traumatic conditions that produce pain and discomfort. Inner knee pain is often a debilitating problem that affects people’s mobility and impairs their activities of daily living. There are various causes of inner knee pain, and treatment will depend on an accurate diagnosis. The common cause of inner knee pain is an injury to the medial meniscus. This is a C-shaped piece of cartilage in the knee that acts as a cushion and provides a smooth surface for the knee joint. The meniscus can be torn or degenerated over time. Damage to it can result in pain at the joint line, and if a piece of the torn meniscus gets stuck in the joint, it can result in locking of the knee. The piece of meniscus can be removed by keyhole surgery, resulting in resolution of symptoms.
Overview of Inner Knee Pain
Proper treatment of an injury is based on a correct diagnosis. If an injury has occurred within the first 48 hours it is best to follow the PRICE formula – Protection, Rest, Ice, Compression, Elevation. The RICE method (or PRICE for protection, rest, ice, compression) is a common treatment for soft tissue injuries. Protection involves using a support or in this case reducing activities that may increase pain or swelling. Phase two treatment is aimed at improving range of motion and strength of the injured limb. Usually it is best to exercise the muscle at both the above and below the knee since the inner knee muscle primarily helps to adduct the knee in toward the other knee. A strong, well stretched out muscle will help to prevent future injuries. In severe injury cases or injuries to ligament it is best to consult a physician or physical therapist. High grade ligament injuries or injuries which involve the cartilage are often best treated by a physician.
After undergoing an unfortunate incident where an individual hurts or injures their inner knee, it is important to acquaint themselves with symptoms and treatment options to alleviate their injury. The inner part of the knee is made up of soft tissue and is a common location of pain, but the issues are often undiagnosed due to overlapping pain symptoms or pain elsewhere in the knee. Inner knee pain may derive from a variety of injuries and medical conditions and pinpointing the location and symptoms of the pain can help to determine the proper diagnosis and treatment of the injury. Some common causes of inner knee pain consist of muscle injuries or strains, torn ligaments, cartilage injuries or arthritis. Usually the onset of an injury is due to an innocent increase in activity (e.g., walking, cycling, dancing, etc.) or increase in weight bearing, or a direct blow to the inside of the knee. Individuals will often identify a specific point in time when the injury occurred. Inner knee pain can also occur in various activities of daily living that involve bending or straightening the leg. Patients may report a catching, locking, or giving way sensation. Since these symptoms overlap on many conditions, proper diagnosis of the injury is imperative.
Importance of Seeking Treatment
Some people consider knee pain a common sign of aging. Sometimes, that’s all it is. An overuse injury such as tendonitis is more likely to affect younger people. Bad or overaggressive surgical technique can also result in inner knee pain. But because the knee can also be affected by arthritis, it is important to have it evaluated by a doctor if the pain hasn’t subsided within 5-7 days. At the very least, an evaluation can provide peace of mind. In some instances, early diagnosis and treatment may improve the prognosis for the long-term functional health of the knee. This is especially true in the case of an acute injury such as an anterior cruciate ligament tear. If an individual has an anatomic abnormality predisposing them to arthritis, for example, knowing this and treating the associated factors (i.e. malaligned knees) can sometimes slow or halt the arthritic process. This may delay the onset of painful degenerative joint disease for many years and/or allow the individual to maintain activity levels.
Causes of Inner Knee Pain
The causes of inner knee pain can vary widely. It is helpful to understand a bit about the structure of the knee and how each of these structures can be injured. This isn’t always obvious, as pain can be referred from one structure to another. For example, tears of the meniscus (cartilage pads in the knee) are often not felt as pain directly over the torn area. Instead, the pain is often felt on the inner side of the knee and somewhat towards the back of the knee. It is the position of this pain that often leads to an incorrect diagnosis of a knee ligament injury, rather than a problem with the meniscus. Similarly, pain from the patellofemoral joint – the joint between the kneecap and underlying thighbone – often causes pain around the kneecap. This can be quite diffuse and difficult to localize. If the cartilage on the inner side of the patellofemoral joint is damaged, the pain will often be felt on the inner side of the kneecap. This pain can be missed if focus is entirely on the location of the damaged cartilage, rather than the referred pain. So as can be seen, accurate diagnosis in the case of knee pain can be quite challenging. This information is intended as a guide only and not a substitute for professional medical advice.
Knee Injuries and Overuse
In short, an injury can affect any of the ligaments, bursae or tendons surrounding the knee joint. Injuring the anterior cruciate ligament is one of the most common injuries in the knee. Often people who experience an ACL injury feel a tearing sensation, and the knee may give out from under them. It can be difficult to tell the severity of how bad an ACL injury is without seeing a doctor. An ACL tear is a severe injury that usually occurs when pivoting or changing direction. Often this injury is seen in athletes. A torn ligament is accompanied by a feeling of looseness or instability in the knee. Sometimes there is swelling, but often the only sign something is wrong is the inability to sustain an activity in competition. Another type of sprain is called the posterolateral sprain. This is an injury to the ligaments that stabilize the knee joint. A grade one sprain will only stretch the ligament, a grade two sprain will partially tear the ligament, and a grade three sprain will fully tear the ligament. This type of sprain occurs when the knee is forced to twist, or has a blow to the front of the tibia while the foot is in a pointed position. It often occurs with damage to the cruciate ligaments or the meniscus.
Arthritis and Joint Degeneration
When the smooth articular cartilage found in the knee joint is damaged or worn away, it becomes difficult for the bones to move along each other the way they are supposed to. This can lead to restriction of movement and pain due to rough, exposed bone surfaces. This is the leading cause of disability in the older population, and occurs in younger individuals as a result of acute trauma to the knee. There are several different types of arthritis that can affect the knee joint, some of the common types include: – Osteoarthritis: a degenerative joint disease in which the cartilage that covers the ends of bones in the joint deteriorates, and over time may progress to the point where the bones rub together. It is often a result of natural wear and tear on the knee or can be due to an injury. – Rheumatoid Arthritis: an autoimmune disease that affects the function of the synovial membrane which can consequently lead to a decrease in the production of lubricating synovial fluid. This makes movement of the joint difficult and painful. RA also causes the thin layer of cells that covers the joint surface (articular cartilage) to thicken and wear away. – Post-traumatic Arthritis: can follow a serious knee injury such as a dislocation or severe fracture. The cartilage may become damaged or menisci torn leading to the joint no longer moving smoothly. It is this irregularity of the joint surface which can lead to arthritis.
Alignment and Biomechanical Issues
Alignment is a frequently overlooked cause of knee pain, particularly in women. The Q angle – an angle formed by a line drawn from the ASIS to the center of the patella and a second line drawn from the center of the patella to the tibial tubercle – is greater in women than in men. This increased angle leads to an increase in lateral force on the patella, which leads to an increased risk of patellofemoral problems or pain. Coxa vara or coxa valga deformities of the hip may alter the neck shaft angle and create an angle of abduction or adduction of the femur which increases stress on the knee. Internal tibial torsion or a decreased Q angle are associated with increased risk of ACL injuries. High levels of static varus (bowleggedness) and dynamic varus are often associated with medial compartment pain. Static varus alignment has been identified as a strong and independent risk factor in the development of knee OA but it also may contribute to pain in young athletes. Dynamic valgus was clinically observed in female athletes with PFPS and may represent a potential risk factor in the development of PFPS. Iliotibial band syndrome is often associated with a varus malalignment of the knee.
Treatment Options for Inner Knee Pain
Rest, ice, compression, and elevation. These four steps are usually the first line of treatment for most minor injuries. If a person is unsure of the severity of his or her inner knee pain, implementing these four steps and staying off the affected leg for a couple of days will usually clear up any minor discomfort that he or she may be experiencing. Along the same lines as the R.I.C.E. approach, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are commonly used to treat minor pain or discomfort in the inner knee. These two options are intended to reduce swelling, manage pain levels, and expedite the healing process from whatever harm the knee has sustained. If the pain is more severe and limits a person’s ability to walk or partake in his or her regular activities, visiting a healthcare professional for a more individualized treatment plan would be beneficial. Physical therapy is often the next step healthcare professionals take in treating persistent inner knee pain. A physical therapist will assess and come up with a specific plan to correct any mechanical dysfunction and eliminate pain in the knee. This plan may consist of muscle strengthening exercises, addressing and correcting faulty postural or movement patterns, or flexibility work to correct or prevent the development of any biomechanical irregularities within the knee. Physical therapy is intended to improve the overall function of the knee and leg and allow patients to return to their regular activities without pain or restriction.
Non-Surgical Approaches
When we speak about taking time off from our activities, one must ask what is it about the activities that is causing my pain. This is helpful information as it can direct us to a health professional who can help evaluate and treat the conditions that may be causing our pain. For example, if pain is caused by pressure on the kneecaps as a result of vigorous sports such as basketball, this may indicate that some form of biomechanical problem exists. This would be good information for someone like a physiotherapist to know, as they can then assess and treat the problem to help prevent it from recurring in the future.
A period of rest, ice, compression, and elevation is advisable when one is experiencing any sort of knee pain or injury. Rest usually entails avoiding activities that provoke pain, like walking, going up or down stairs, or sitting with the knee bent for long periods of time. Using a cane to avoid limping is also advisable. The duration of rest depends on how severe the symptoms are. If one is having pain at night, then it is a signal that the condition is more severe and will likely need more rest.
Rest, Ice, Compression, and Elevation (RICE)
Physical Therapy and Rehabilitation
Medications for Pain Management
Surgical Interventions
Magnetic resonance imaging is useful in determining the type of meniscal tear and whether there is a chance for healing. If it is determined that the tear is repairable, surgery may involve a meniscal repair with suture of the torn edges together. This is done in attempts to avoid meniscectomy and thus to preserve the meniscus and its function in the knee long term. On occasion where meniscal preservation is not an option, a total or partial meniscectomy will be performed. This procedure is often very effective in reducing pain; however, it is associated with increased rates of osteoarthritis.
Surgical intervention to inner knee pain treatment is reserved for severe cases. By and large, it is recommended that patients exhaust all non-operative options before entertaining the idea of surgery. It is advised that patients continue in activity modification and strengthen the muscles around the knee as surgery may exacerbate symptoms if the muscles are weak. The type of surgery recommended will depend on the severity and the specific cause of the pain. For acute trauma resulting in specific injury, there may be a need for reconstructive surgery, i.e., to repair a torn ligament. Meniscal tears are often dealt with arthroscopically with a partial meniscectomy. Studies have shown that patients with mechanical symptoms such as clicking, catching, or locking of the knee in association with a meniscal tear have higher rates of success with partial meniscectomy as opposed to conservative management.
Arthroscopy
Knee Replacement Surgery
Other Surgical Procedures
Seeking Knee Pain Treatment in Singapore
If you’ve been to your GP for treatment, but your knee pain still persists, it would be wise to seek a referral to a specialist. Orthopedic specialists are doctors who specialize in treating bone and joint problems. Many people are hesitant to see a specialist as they feel that their condition is not that serious. However, the sooner you see a specialist the better. As knee pain becomes more chronic, it can lead to other complications such as joint deformities. Seeing a specialist can help to accurately diagnose the cause of your knee pain and prevent it from worsening. In Singapore, you can find orthopedic specialists practicing in both private and public healthcare sectors. Some specialists choose to work in private hospitals, while others opt for government restructured hospitals. The choice of specialist and type of hospital usually depends on the nature of your knee problem and whether you are covered by health insurance.
Seeking for the knee pain at night treatment in Singapore? To most people, it’s just a matter of hopping down to the nearest GP and getting some anti-inflammatories. But what happens when the pain becomes chronic and the pills stop working? When do you need to seek the next level of medical care? To help you along on your journey to recovery, we’ve put together a guide on knee pain treatment in Singapore.
Overview of Healthcare Facilities in Singapore
Public (government) healthcare services are heavily subsidised while private healthcare services are comprehensive, but expensive. Most Singaporeans used the public healthcare services, from the primary care all the way to the quarternary care in government restructured hospitals. The more affluent or those with private insurance arrangements tend to choose from a large variety of private medical practitioners and specialists, many of whom also have admitting rights to private hospitals. Physiotherapy and rehabilitation services are also available in public and private institutions. For expatriates and tourists, medical services are also available from the private sector and a number of general and medical practitioner clinics in the heartlands who are registered with the Singapore Medical Council.
Before seeking any kind of treatment, we must first understand the facilities and services that are available to us. In Singapore, you will find that the healthcare system is fast gaining international recognition. It is known for its safe and effective services in a clean and green environment. This is juxtaposed against the high cost, which may be partially offset by medical insurance, and a subvention system for the needy.
Top Orthopedic Specialists in Singapore
Seeking Knee Pain Treatment in Singapore Overview of healthcare facilities in Singapore Top orthopedic specialists in Singapore Singapore is renowned for its advanced healthcare system. In the 2000s, the government had a vision of turning Singapore into a global healthcare city. The ultimate aim was to offer services of this industry with the public healthcare division leading that would be recognized internationally. To achieve this, the government had allocated S$3 billion and has since implemented this initiative. With the state-of-the-art medical and clinical research facilities, it is a hotspot for medical tourism for both regional and international patients. At present, there are 11 Joint Commission International (JCI) accredited hospitals and the number of private hospitals and medical facilities is steadily increasing. The government introduced the concept of medical hubs, where different clusters of healthcare services cater to different groups of patients. This includes the heart center, focusing on heart-related diseases, and the cancer center, an upcoming project that will be completed by 2012. When it comes to treating knee pain in Singapore, you have the option of choosing to get treated at private or public hospitals, or private specialist clinics. A referral from a general practitioner is needed if you were to choose to seek consultation in the public sector.
Availability of Advanced Treatment Options
This concludes our 5 part essay on “Inner Knee Pain: Causes and Treatment Options”. The intent of this essay is to provide readers with a comprehensive understanding of the causes behind their knee pain and the available treatment options. It is important to note that the treatment options discussed are general in nature and may vary in different countries and individual medical centres. It is our hope that our readers are better informed about their knee problem and are able to make the best choices for their care.
For patients with advanced knee arthritis, treatment options have become diverse ranging from joint preserving procedures such as high tibial osteotomies, unicondylar knee replacements and autologous chondrocyte implantation, to minimally invasive total knee replacements with computer navigation and patient specific instrumentation. Patients seeking treatment in Singapore can be assured that they have access to the full array of advanced treatment options for all knee conditions. It is essential that patients have a good understanding about their knee problem and the treatment options available to make informed decisions about their care. This requires an open discussion with their doctor and information that is reliable and easy to understand.
The availability of advanced treatment modalities is a crucial factor in seeking quality care for any condition. As patients become increasingly more informed about healthcare and take a proactive role in medical decision making, it is imperative that physicians are able to educate and guide patients to make the best choices for their care. Presently in Singapore, advanced treatment options for meniscal tears and ligament injuries are available. These include anatomic meniscal repairs and meniscal transplants, as opposed to the traditional meniscectomies, and ligament repairs with graft reconstructions. These procedures are offered by a select group of orthopaedic surgeons who have undergone subspecialty training in sports orthopaedics and are usually only available in larger medical centres.
