- When to See a Doctor for Knee Pain
- Interview Transcript
- Knee Doctor
- Possible Treatments for Knee Pain
- Knee Pain: Do You Need a Doctor’s Care?
- How Inflammatory Arthritis Affects Your Gut, and 3 Ways to Ease GI Symptoms
- How Inflammatory Arthritis Affects Your GI System
- How Arthritis Medications Affect GI Problems
- How to Ease GI Symptoms
- Keep Reading
When to See a Doctor for Knee Pain
Knee pain is a very common condition. There can be a variety of causes of your knee pain. These can range from a simple strain, to a ligament tear such as an ACL tear, or even a condition such as osteoarthritis. Depending on the condition, you can get knee pain with bending or knee pain when walking. The pain can be in the inside of the knee or in the back of the knee. Since it is so common, it is often difficult to know when to see a doctor for knee pain.
The first line treatment for knee pain should include avoiding activities that aggravate the knee. This, along with over-the-counter anti-inflammatories, can help reduce inflammation which is causing pain and allow your body to heal the injury. Chronic knee pain that has failed these treatments is one indication that you should seek the advice of a medical professional. Some other symptoms that should steer you towards seeing an orthopedic surgeon include sharp, severe pain in the knee or sense of instability in the knee.
When thinking about your knee pain, try to remember if there was a certain injury that caused it. What does the pain feel like, and what aggravates your knee pain? These are important questions that will help your orthopedic surgeon to determine the cause, and appropriate treatment plan for your knee pain.
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Interviewer: When should you have your knee pain checked out? Dr. Matheau Eysser is an orthopedic surgeon. What advice do you have for patients?
Dr. Eysser: Well, I tell my patients to look for two things: number one, pain. Acute pain or pain that interrupts your sleep could indicate a torn tendon, meniscal tear, or arthritis. Second, symptoms. If your knee locks up on you or you are unable to fully straighten your knee, it could indicate a torn meniscus. Feelings of instability, a painful clicking or popping, or sharp stabbing pain are also some of the complaints or symptoms of a meniscal tear.
However, if your symptoms are a dull ache, pain when standing from a sitting position, or pain that improves after walking a couple of steps, this could indicate arthritis. If you are experiencing these types of symptoms, it is a good idea to have your knee checked out by your doctor.
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Some of the most common causes of knee pain include:
- Broken bones or sprains, perhaps due to sports-related accidents
- Knee arthritis, or osteoarthritis of the knee
- Meniscus tears
- Osgood-Schlatter disease
- Other knee conditions that cause pain or restricted movement
When Is It Time to Consider Knee Surgery?
In some cases, a primary care doctor may be able to diagnose and treat your knee pain, but in most instances, it’s best to speak with surgeons who specialize in the treatment of the joints, ligaments, and cartilage. In particular, you should visit with trained and certified knee surgeons when you experience any of the following symptoms:
- Difficulty walking
- Difficulty walking up or down stairs
- Limping or physical discomfort
- Redness or swelling in or around your knees
- Trouble bending your knees
- Trouble extending your knees
What Are the Most Common Treatments for Knee Pain?
When you visit a doctor who specializes in knee pain, you will be given a treatment recommendation that corresponds to the nature and extent of your knee injury. The treatment method could be as minor as physical therapy or as major as a total knee replacement.
One common form of treatment is arthroplasty, which essentially means replacement of all or part of the knee joint. Total or partial joint replacement can be an especially effective means of treatment for those who deal with arthritis. ACL reconstruction is also a common surgical treatment.
What Is the Recovery Time for a Knee Replacement?
The most extensive form of knee treatment is knee replacement surgery or knee arthroplasty. This treatment is usually recommended for those patients whose knees have been deformed due to chronic conditions such as osteoporosis or arthritis.
Knee replacement surgery comes in different forms; depending on the extent of the deformity, you may require either partial knee replacement or total knee replacement. During the procedure itself, you will be administered anesthesia, ensuring that you are pain-free. Recovery from a knee replacement surgery can last for roughly six weeks and typically requires physical therapy. Pain medications can also be administered as needed.
If you deal with knee pain or limited motion, it’s important to visit with a surgeon as soon as possible. Learn more about the possibilities of evidence-based knee treatments by contacting a knee doctor today.
For more information on different knee replacement procedures our knee doctors perform, click the buttons below.
Partial Knee Replacement Total Knee Replacement
The Region’s Most Comprehensive Knee Care
At the Orthopedic & Sports Medicine Center, our experienced doctors and staff are proud to offer exceptional orthopedic care to people throughout the communities of northwest Missouri and northeast Kansas. Our doctors are available at our office in St. Joseph, Missouri, as well as at the Mosaic Medical Center in Maryville, Missouri, the Northwest Medical Center in Albany, Missouri, the Wright Memorial Hospital in Trenton, Missouri, the Benedictine College in Atchison, Kansas, and the Hiawatha Community Hospital in Hiawatha, Kansas.
Our board-certified orthopedic surgeons, Dr. Daniel Smith, Dr. Brett Miller, Dr. Corey Trease, Dr. Brian Duncan, Dr. Blake Peterson, and Dr. Michael Smith, have years of experience in treating patients with a variety of knee injuries or conditions. Our orthopedic knee surgeons have the knowledge and skills to perform a thorough evaluation and provide an accurate diagnosis and viable treatment options. Conservative methods will always be recommended first, but there are some cases when knee surgery is required to help eliminate pain and restore proper function.
If a knee injury or condition is keeping you from living the life you love, schedule an appointment with one of our specialty-trained knee surgeons by requesting an appointment online or calling (816) 233-9888.
For those urgent injuries that require immediate attention and can’t wait for an appointment, visit our OSMC Today Walk-In Clinic.
Possible Treatments for Knee Pain
Because knee pain has so many different causes, there is no single treatment that can help bring relief. However, there are several options your doctor may suggest.
- Rest your knee. If your pain is the result of an injury or overuse, the doctor may ask you to rest your knee for a period of days or weeks. This will help inflamed areas return to normal so that your pain will subside.
- Ice your knee. Similar to resting, ice can help swelling subside and hasten healing from certain injuries.
- Compress your knee joint. Your doctor may prescribe a knee brace or other elastic bandage to reduce swelling and increase support for your joint.
- Take anti-inflammatory pain medicine. Certain pain medicine can also reduce swelling and hasten healing. Medicines containing ibuprofen are the most well-known. You will want to be sure to follow dosages carefully to avoid side effects.
- Strengthening and stretching exercises. Your doctor will likely prescribe exercises to help you strengthen your knee and prevent future injuries. Be sure to follow the regimen so that you can avoid future pain.
- Medical procedure. In some cases, you may need a medical process to help relieve your knee pain. If you have bursitis, you may need fluid drawn off the joint. Surgery may be needed if you have bone fragments or a dislocated knee cap. Finally, in extreme cases, knee replacement surgery may be recommended.
Knee pain can be very frustrating and painful, but fortunately there are a variety of treatments for this common ailment. Be sure to see your doctor for an appropriate diagnosis, and follow the treatment plan given. Most of all, don’t resume your normal level of activity until you are pain-free. Being too active too soon can cause permanent damage.
Here’s to your health!
(Please note: this article is not intended as medical advice or to take the place of proper doctor’s care. Please see a physician for any questions or concerns you have about your health.)
Knee Pain: Do You Need a Doctor’s Care?
When knee pain occurs, it’s tempting to just live with the discomfort — and in many cases, that’s an acceptable course of action. “Eighty percent of the knee problems people have will resolve by themselves within a period of time,” says Robert Gotlin, DO, director of orthopedic and sports rehabilitation at Beth Israel Medical Center in New York City.
But in some cases of knee pain, it’s better to seek medical advice than to tough it out. If you’re aching but unsure whether to see the doctor, check out our list of signs that your knee pain needs professional help.
Knee Pain Symptoms: Difficulty Walking
It seems obvious, but if the pain in your knee is preventing you from walking — or causing you to walk with a pronounced limp — then it could be a sign of a serious condition like a bone injury. A good rule of thumb is to consider how many lifestyle changes you’re making to accommodate the pain. “You should see a doctor when the knee is running your life, instead of you running the knee’s life,” Dr. Gotlin says.
Knee Pain: Sudden Onset of Other Symptoms
If you notice that your knee pain is accompanied by sudden swelling, redness, or a warm feeling on the affected area, you should seek a doctor’s care. “That could be a sign of infection or something we call a ‘septic joint,’ meaning the fluid in your knee is not right,” Gotlin says. The bursa — the fluid-filled sac in the knee that helps cushion your joint — might be infected. Certain factors, like previous joint injuries or a wound on the knee, can increase one’s risk for this kind of infection. Infections can also cause fever, chills, and nausea, so be on the lookout for those symptoms, too.
How Inflammatory Arthritis Affects Your Gut, and 3 Ways to Ease GI Symptoms
Joint pain comes with the territory. So does stiffness, swelling, and fatigue. Those well-known symptoms of inflammatory arthritis you expect. Stomach cramps and constipation, however, you may not.
But research shows tummy troubles are common among people with inflammatory arthritis: A study published in the Journal of Rheumatology found that rheumatoid arthritis patients have a 70 percent greater chance of developing a gastrointestinal (GI) problem compared to people who don’t have RA.
“Pretty miserable reflux” — that’s what how CreakyJoints member described it on Facebook. Another has what she calls “tortuous gastroparesis,” a condition where the stomach muscles that propel food through your digestive tract slow down or stop working, which prevents your stomach from emptying properly. Some CreakyJoints members have been diagnosed with inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease; others with irritable bowel syndrome (IBS) — like Nikki Perkins-Miller who gets from long bouts of diarrhea, followed by severe constipation.
How Inflammatory Arthritis Affects Your GI System
First, a brief anatomy lesson: Your GI system has an upper and lower section. The upper GI goes from your mouth to your stomach; the lower GI runs from the start of the small intestine to the end of the large intestine. Studies show that inflammatory arthritis can affect both. Researchers at the Mayo Clinic found people with RA report higher rates of stomach ulcers, bleeding, and esophagitis (inflammation and swelling of the esophagus) in the upper GI tract, and perforations (holes), bleeding, bowel inflammation, and infections in the lower GI tract. People with inflammatory arthritis also have higher rates of abdominal pain, bloating, trouble swallowing, and nausea.
What’s the potential link? There may be several factors:
The same chronic inflammation that targets your joints in arthritis may also affect other parts of your body, including your digestive system. Several gastrointestinal conditions that are common in patients with arthritis are directly related to an active inflammatory condition, explains Dana Lukin, MD, gastroenterologist at Weill Cornell Medicine and member of the American College of Gastroenterology. For example, rheumatoid vasculitis — a condition that causes blood vessels to be inflamed and can impact the GI tract — may affect up to 10 percent of patients with RA, he says: “The most frequent symptom is abdominal pain, but RV may also present with weight loss, nausea, vomiting, and/or diarrhea.” Controlling your RA and reducing inflammation can improve symptoms.
Impaired Immune Response
A depressed immune response from inflammatory arthritis may also play role, as might the everyday stresses of coping with a chronic illness, adds Joseph E. Huffstutter, MD, a rheumatologist with Arthritis Associates PLLC, in Chattanooga, Tennessee. “The stress has to come out in some way,” he says. This may be in the form of an ulcer or bowel issues.
Another potential factor: fibromyalgia. This chronic pain condition often occurs with RA, as well as other types of inflammatory arthritis, says Dr. Huffstutter. If you have fibromyalgia, you likely also have IBS — the two often occur together, with symptoms including abdominal pain, bloating, gas, and alternating spasms of diarrhea and constipation.
Celiac disease is also associated with RA, says Dr. Lukin. With this digestive disorder, eating gluten leads to damage in the small intestine.
Inflammatory bowel disease (IBD) is also more common in people with RA, as well as in those with ankylosing spondylitis and psoriatic arthritis. IBD is an umbrella term for two conditions — Crohn’s disease and ulcerative colitis — that are characterized by chronic inflammation of the digestive tract, which leads to GI symptoms. Common genetic and environmental factors may be related to the development of both inflammatory arthritis and IBD, says Dr. Lukin.
Scientists are also looking into the microbiota of the GI tract, and how it relates to different illnesses, including rheumatologic disorders. Your body hosts communities of harmless bacteria known as the microbiota, which help keep us healthy. When one of these bacterial colonies is altered, or becomes unbalanced, it’s called dysbiosis. “Dysbiosis has been associated with the development of inflammatory arthritis, including RA, spondyloarthritis, and SLE, the most common type of lupus,” says Dr. Lukin. Read more about lupus and gut bacteria here.
How Arthritis Medications Affect GI Problems
Yes, GI problems are common side effects for many drug classes used in the treatment of inflammatory arthritis, says Justin Owensby, PharmD, PhD, research pharmacist with the department of clinical immunology and rheumatology at the University of Alabama at Birmingham. In fact, most GI problems in RA patients are related to their medications, says Dr. Huffstutter. “Side effects for RA drugs range from minor, such as nausea, to severe, like GI bleeding. They depend on the specific drug, dose, duration of therapy, and other meds you’re taking,” says Dr. Owensby.
Arthritis meds that can cause GI symptoms include:
NSAIDs: Nonsteroidal anti-inflammatory drugs reduce compounds called prostaglandins, which protect the lining of the stomach, explains Jared J. Vanderbleek, PharmD, pharmacist at the Kirklin Clinic at the University of Alabama at Birmingham. “If the lining of the stomach is exposed to stomach acid, irritation or an ulcer may occur.” The most common complication associated with NSAIDs are gastritis and peptic ulcer disease, says experts. If you take steroids along with these meds, or take NSAIDs for a long period of time, you may be at an increased risk of side effects, adds Dr. Vanderbleek. (Read more about NSAIDs and your GI health here.)
Steroids: These meds play an important role in how our digestive tracts work. A hormonal imbalance due to drug therapy is most likely the cause of side effects, says Dr. Owensby. High doses of steroids for prolonged periods may be associated with gastric ulcer, adds Dr. Lukin. They are also linked to GI perforation and pancreatitis.
DMARDs: Disease-modifying antirheumatic drugs such as methotrexate have been shown to cause diarrhea and nausea, as well as abdominal pain, indigestion, and vomiting. (Read more about tips for taking methotrexate here.)
Biologics: Many drugs can cause milder GI issues, such as nausea, diarrhea, or cramps. But some can be associated with serious problems, such as GI bleeding, GI perforations, and bowel obstruction.
You and your doctor should discuss all the possible risks and benefits of taking any of these medications as part of your shared decision-making process.
How to Ease GI Symptoms
Most important: Work with your doctor to keep your arthritis under good control, and report any signs of GI problems to your doctor right away.
With the multitude of potential GI issues associated with RA and other rheumatologic conditions, as well as the interplay between the gut and joints, says Dr. Lukin, it’s important to consult your rheumatologist, and if necessary, a gastroenterologist, to get any new or unusual GI symptoms under control. More tips to ease GI issues:
1. Review your meds with your doctor
To help minimize GI side effects, you and your doctor should evaluate how well you are tolerating your drug therapy on a routine basis, says Dr. Owensby. “The use of proton pump inhibitors may help negate some GI problems caused by NSAID therapy, and medications like ondansetron (Zofran) may help relieve nausea and vomiting caused by DMARD therapy,” he says.
“Adjusting a dose or dosage form, such as switching from a tablet to an injection, may also be an option,” adds Dr. Vanderbleek. And always tell your doctor about any over-the-counter meds, supplements, and vitamins you are taking: “Your doctor needs to know everything you put into your mouth,” says Dr. Huffstutter.
2. Stop smoking
As if you need another reason, but here it is anyway. Research shows smoking was associated with lower GI problems in people with RA. Plus, it can make many rheumatologic and GI conditions worse, says Dr. Huffstutter.
3. Consider your diet
“A careful diet review may help you identify potential triggers of symptoms,” says Dr. Lukin. If you notice eating certain foods seem to cause diarrhea, bloating, or abdominal pain, for example, tell your doctor; he or she may tell you to avoid that food, says Dr. Huffstutter.
That’s what one CreakyJoints member does: “I have full-body spondyloarthritis and as I flared up a couple years ago, I also was getting increasingly bad reflux and gastritis that became more crippling than the arthritis,” shared Anita Marie Poupa. She noticed if she ate inflammatory foods like sugar, processed meats, alcohol, or caffeine, it would trigger reflux. Now she focuses her diet on healthy, natural foods to help ease joint and stomach symptoms.
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- WEBINAR: The Latest Thinking on Managing Inflammatory Bowel Disease
Part of managing lupus is preventing flares — times when the disease gets worse. During a flare-up, a person with lupus may feel much more tired, sick, feverish, and achy than usual. Almost all lupus patients take medication to control inflammation and reduce the risk of flares.
Doctors often prescribe corticosteroids to control inflammation. These aren’t the same steroids some athletes take. If a doctor prescribes one of these medicines, the dosage and any side effects will be carefully monitored.
For day-to-day muscle and joint pain, patients can take acetaminophen or any of a variety of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen.
Almost all patients with lupus take antimalarial drugs (medicines first developed to prevent and treat malaria that also have proved helpful with lupus). Antimalarial drugs often help treat skin rashes and joint pain, and help prevent coronary artery disease and the involvement of other organ systems in lupus.
Some children who also have kidney disease, very low blood cell counts, or other organ involvement, may require more aggressive treatment with immunosuppressive drugs, which lower the body’s immune system responses.
In 2011, belimumab was approved by the U.S. Food and Drug Administration (FDA) for the treatment of lupus, especially for arthritis, rashes, and fatigue.
Making Lifestyle Changes
Though the course that lupus takes cannot be predicted, certain lifestyle changes may help minimize flare-ups. Patients should avoid too much sun exposure by wearing sunscreen and protective clothing when outside.
Regular exercise can help prevent fatigue and joint stiffness. A balanced diet and sufficient rest also are important for maintaining general health and well-being.
When to Call the Doctor
Kids and teens with lupus are prone to the usual childhood illnesses, such as a viral infection or diarrhea. However, a fever, rash, or mouth sore might indicate the beginning of a flare. As you and your child become more familiar with the disease, you may learn to recognize signs that a flare-up is around the corner.
Call the doctor immediately if any of these symptoms appear:
- bloody stools
- easy bruising (with or without nosebleeds)
- chest or abdominal pain
- new or high fever
The Outlook for Lupus
The outlook for lupus patients is constantly improving. Over the past few decades, better tools to diagnose and treat lupus have remarkably improved the lives of those who live with the disease.
Reviewed by: AnneMarie C. Brescia, MD Date reviewed: July 2014