Hi jjj,
How nice of you to inquire about your mom?s health!
Knee pain of any kind can have a wide variety of causes, depending on
your mom?s age and activity level. The location of the pain is
important in diagnosing the cause and treatment as well. I found the
following differential diagnostic chart of knee pain by location on
The American Academy of Family Physician?s web site (There is also a
good illustration on the left side of the page that can help you
understand ?knee terminology?:
Anterior knee pain
Patellar subluxation or dislocation
Tibial apophysitis (Osgood-Schlatter lesion)
Jumper's knee (patellar tendonitis)
Patellofemoral pain syndrome (chondromalacia patellae)
Medial knee pain
Medial collateral ligament sprain
Medial meniscal tear
Pes anserine bursitis
Medial plica syndrome
Lateral knee pain
Lateral collateral ligament sprain
Lateral meniscal tear
Iliotibial band tendonitis
Posterior knee pain
Popliteal cyst (Baker's cyst)
Posterior cruciate ligament injury
http://www.aafp.org/afp/20030901/917.html
Some usual causes of knee pain are osteoarthritis,bursitis, infection,
gout, a cyst or a trauma(injury) such as a sprain. According to your
description, and using the chart above, your mom?s pain may be lateral
knee pain, specifically iliotibial band tendonitis. The description on
the above site states: ?The patient with iliotibial band tendonitis
reports pain at the lateral aspect of the knee joint. The pain is
aggravated by activity, particularly running downhill and climbing
stairs. On physical examination, tenderness is present at the lateral
epicondyle of the femur, approximately 3 cm proximal to the joint
line. Soft tissue swelling and crepitus also may be present, but there
is no joint effusion. Radiographs are not indicated.
Noble's test is used to reproduce the pain in iliotibial band
tendonitis. With the patient in a supine position, the physician
places a thumb over the lateral femoral epicondyle as the patient
repeatedly flexes and extends the knee. Pain symptoms are usually most
prominent with the knee at 30 degrees of flexion. Popliteus tendonitis
is another possible cause of lateral knee pain. However, this
condition is fairly rare?
The I-Med Review web site explains iliotibial band syndrome thus:
?The iliotibial band is a band of tough, fibrous tissue running from
the side of the hip to the side of the knee along the entire length of
the upper leg. Irritation occurs if the band is stretched beyond its
normal length, causing friction as it rubs along the outside of the
knee at its insertion to the tibia (lower leg bone). The friction
causes a bursitis (inflammation of the bursa) that normally cushions
the bone from the iliotibial band. The usual symptoms are knee pain
over the lateral (outside) aspect, where the band inserts. The
syndrome is notorious in distance runners and is usually caused by
overstriding, running downhill, or running on the cantered edge of a
road. Treatment includes correcting the running form, resting, icing
the area, stretching, and taking anti-inflammatories.?
http://www.i-medreview.com/articles_html/sportsmed/overuse.html
The Knee Guru web site has some knee diagnostics at the bottom of this
page and says pain upon walking downhill could be a kneecap problem:
http://www.kneeguru.co.uk/html/step_01_basics/step_01_symptoms.html
Treatment of IBS:
The Sports Injury Bulletin recommends cutting back on physical
activities, icing the afflicted area, avoiding hilly terrain and
steps, and taking NSAIDs (Non-steroidal anti-inflammatory drugs sug as
Advil/ibuprofen or Naproxen/Naprosyn).According to this site, the
disorder may last 6 months. There are some stretches on this page that
are recommended, but I urge your mom to see a doctor before attempting
any stretching. The idea is to avoid further injury, which could occur
with improper stretching.
http://www.sportsinjurybulletin.com/archive/1026-knee-injuries.htm?1
Walking with poles is one way to strengthen the knee ?Who can benefit
most from walking with poles? Dr. Steadman believes people with early
to advanced degenerative joint disease could benefit most by using
poles, but people who suffer from patello-femoral pain or those
rehabilitating from knee surgery may also benefit. We also recommend
using walking poles as a preventative measure of knee pain. Reducing
the repetitive impact magnitude of the vertical forces may be a good
way to prevent overuse injuries and a trip to the doctors office.
Walking with poles may also improve a persons balance when walking
over uneven terrain and assist in preventing abrasions and minor
twisting of the knee?
http://www.shsmf.org/main/Reports/WalkingWithPoles.htm
The University of Iowa site suggests that Runner?s knee
(chondromalacia of the patella ? or softening of the knee cartilage)
may be the cause of knee pain when walking downhill, or going
downstairs. ?The main symptom of runner's knee is a dull, aching pain
under or around the kneecap. It is felt when the kneecap repeatedly
grinds against the thigh bone (femur), the bone behind the kneecap.
This causes the cushioning behind the knee cap to break down. The
break down of this cushioning is progressive. First, it softens. Then,
it might fray, crack, crater, or tear. The pain is most noticeable
going down stairs or hills. To avoid injury when running, never run
straight down a steep hill. Walk down it. If walking downhill is out
of the question, then run down in a zigzag pattern. Lean forward and
keep the knees bent. This technique will reduce the risk for knee
injury.?
The same site recommends avoiding high heeled shoes, shoes with cleats
and not doing deep knee bends. (This sounds as if it would be too
painfulyou?re your mother anyway!)
http://www.uihealthcare.com/topics/sportsmedicine/spor3208.html
http://www.redhillroadrunners.freeserve.co.uk/knee.htm
Arthritis of the knee is more common in women, probably because women
often work in jobs (such as childcare!) that require a lot of lifting,
kneeling and bending. Smoking and being overweight seem to contribute
to knee arthritis. Participating in sports seem to have little or no
bearing on whether a woman develops knee arthritis. Seems the way we
walk does have an effect on our chances of developing arthritis!
Knock-kneed and bow-legged people suffer from arthritis more than the
general population.
The Australian National Broadcasting Corporation Health Report site:
http://www.abc.net.au/health/minutes/stories/s961369.htm
http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s337909.htm
http://orthopedics.about.com/cs/generalinfo1/a/kneearthritis.htm
From an About web site: Symptoms of knee arthritis:
· Pain with activities
· Limited range of motion
· Stiffness of the knee
· Swelling of the joint
· Tenderness along the joint
· A feeling the joint may "give out"
· Deformity of the joint (knock-knees or bow-legs)
http://orthopedics.about.com/cs/generalinfo1/a/kneearthritis.htm
The American Academy of Orthopedics says post-traumatic arthritis can
develop after an injury.
http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=177&topcategory=Knee
Treatment of knee arthritis depends on severity, and usually includes
NSAIDs or prescriptions such as Vioxx or Celebrex. Some people rely on
glucosamine and chondroitin, both over-the-counter for relief of
arthritis pain. Some patients like placing a small pillow under the
affected knee for sleeping. Injections cortisone or a gel made from
rooster combs (Synvisc) or can temporarily replace some of the lost
cushioning. Surgery (Arthroscopy or in severe cases,knee replacement)
may even be considered, if your doctor deems this necessary. Weight
loss if needed, is helpful.
http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=177&topcategory=Knee
http://orthopedics.about.com/cs/generalinfo1/a/kneearthritis.htm
About Synvisc:
http://www.synvisc.com/
http://orthopedics.about.com/cs/treatment/a/synvisc.htm
About arthroscopy:
http://orthopedics.about.com/cs/arthritis/a/athroscopy.htm
To summarize, jjj, only your mom?s physician can make an accurate
diagnosis. The doctor can order x-rays and other tests to determine
the cause of your mom?s pain, and take appropriate action, possibly
preventing an aggravation of her condition. I hope my explanations
have helped you understand knee problems!
Kindly read the ?Important Disclaimer? at the bottom of this page.
If any part of my answer is not clear, or I have duplicated
information you already had, please request an Answer Clarification,
before rating, and I will be glad to assist you further!
Wishing your mom the best!
Regards,
crabcakes-ga
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