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Question:


I have pain and tenderness in the front of my knee that's worse when I sit for long periods and when I climb or descend stairs.

Which are the best treatments and the main causes if I didn't have any accident or trauma?

Matthew

Answer:

Dear Matthew,

Repeated stress or overuse and degeneration from aging are some common causes of your knee pain.

Chondromalacia of the patella, or patellofemoral pain syndrome or Runner's Knee, is a general term that refers to pain arising between your patella and the underlying thighbone (femur).

It's common in young adults, especially those who have a slight misalignment of the kneecap; in athletes; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

The best treatments for this kind of knee pain are:

-Rest.

Taking a break from your normal activities reduces repetitive strain on your knee, gives the injury time to heal and helps prevent further damage. A day or two of rest may be all that's needed for minor injuries. More severe damage is likely to need a longer recovery time.

-Elevation.

Because gravity drains away fluids that might otherwise accumulate after an injury, elevating your knee can help reduce swelling. Try propping your injured leg on pillows or sitting in a recliner.

-Ice.

A staple for most acute injuries, ice reduces both pain and inflammation. Some doctors recommend applying ice to your injured knee for about 20 minutes three times a day. A bag of frozen peas works well because it covers your whole knee. You can also use an ice pack wrapped in thin fabric to protect your skin. Although ice therapy is generally safe and effective, don't leave ice on longer than recommended because of the risk of damage to your nerves and skin.

-Glucosamine and chondroitin.

These substances, found naturally in cartilage, are also available as over-the-counter dietary supplements. Both may help relieve the pain of osteoarthritis of the knee in some people. One U.S. government-sponsored study found that although glucosamine and chondroitin aren't effective for everyone, a subgroup of people with moderate to severe arthritis pain reported relief from taking this combination supplement.

-Acupuncture.

Research suggests that acupuncture may help relieve pain for some people. Traditional beliefs hold that acupuncture needles, accurately placed along meridians in the body, help to unblock the vital life force known as qi (pronounced "che"). Most medical experts believe that pain relief from acupuncture comes from the release of neurotransmitters and endorphins. If you'd like to try acupuncture, ask your doctor for a recommendation or check with the National Certification Commission for Acupuncture and Oriental Medicine or the American Academy of Medical Acupuncture, which is an organization of physicians with additional training in acupuncture.

-Be smart about exercise.

If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. That doesn't mean you have to stop being active, but it does mean being smart about when and how you work out. If your knees ache after jogging or playing basketball or other sports that give your joints a real pounding, consider switching to swimming, water aerobics or other low-impact activities - at least for a few days a week. Sometimes simply limiting high-impact activities will provide relief.

-Optimize your technique.

If you're involved in a sport or activity on a regular basis, it's important to have the best technique possible so that proper movement patterns are trained.

-Physical therapy.

Normally, the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Depending on your injury, training is likely to focus on the muscles in the back of your thigh (hamstrings), the muscles on the front of your thigh (quadriceps), and your calf, hip and ankle. You can do some exercises at home. Others require the use of weight machines, exercise bicycles or treadmills, which may mean visits to an athletic club, fitness center or clinic.


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