Identifying the Causes of Knee Pain

Knee pain can wax and wane without any apparent reason. For some people, it begins as a stabbing sensation which resolves over time; for others, the pain is dull but chronically escalating. And as we have recently learned, knee pain can be a harbinger of referred pain that spreads throughout the body.

Naming and describing knee pain properly is one of the keys to making a good diagnosis. The Chicago Tribune recently tackled this topic, reviewing some of the common questions you are likely to hear when you visit your doctor:

Faced with a painful knee, doctors will take a history: Did you injure yourself? Did you change your exercise regimen? “All can lead to inflammation of the knee,” says Damle, who has a private practice in Wakefield, R.I.

Your doctor will examine the knee. “You might see fluid buildup, a decrease in the range of motion or difficulty bearing weight,” Damle says. These symptoms may indicate a serious injury such as a ligament tear, which may prompt an MRI scan and a referral to an orthopedic surgeon.

That’s where I come in. As a leading San Diego orthopedic surgeon, I see a number of patients complaining of knee pain. Taking a history can help to dispel the mystery, but sometimes the onset is gradual and subtle enough that no one can pinpoint an immediate point of origin. That’s why I endeavor to learn as much as I can about each patient’s habits, lifestyle choices, and vocation to make a good diagnosis.

Orthopedic knee pain is a widespread problem; visiting an effective orthopedist can help. Reach out today to get the best treatment for knee pain in San Diego.

Knee Pain Leads to Pain Everywhere

Referred pain is a phenomenon where pain in one part of the body can spread, almost by osmosis, to affect unrelated joints and tissues. Referred pain accounts for a number of common headaches, as well as some cases of arm, elbow, and wrist pain which may in fact originate in the shoulder.

The mechanisms behind referred pain are still being studied, but there is no question that it’s real, and often immobilizing. So it is newsworthy that a recent study found that knee pain may be behind all sorts of related complaints too:

“We found that the severity of knee pain and having pain present in both knees were significant risk factors for the development of widespread pain. In contrast, having only structural changes on X-ray indicative of knee osteoarthritis was not.”

Needless to say, “widespread pain’ is exactly what you think it is. Treating the source of referred pain can often resolve its offshoots downstream, as it were, so knee pain doctors such as myself are always looking for new ways to rip this problem out by the roots through careful knee treatment and knee surgery.

Knee Surgery? Not For Everyone

Demographic data can be a double-edged sword in the world of medicine. In the wrong hands, it may be treated as evidence of an underlying health liability, or poor lifestyle choices. In the right hands, it can guide us toward more responsible medical decisions predicated on the idea that not every patient population is precisely the same.

Consider this recent study of total knee replacement (TKR) surgeries, which resulted in a startling set of findings, including:

In comparison to the white population, minorities had lower rates of TKR utilization.
Minorities were less likely to undergo TKR in high-volume hospitals.
The risk for in-hospital mortality, and the complication rate following TKR, were significantly higher for blacks, Native Americans and mixed-race individuals.

In other words, minorities underwent fewer knee replacement procedures, but experienced a higher rate of complications and mortality for them.

Does this mean that knee replacement is inappropriate or ill-advised for nonwhites? Not necessarily; this is an observational study, not a controlled or randomized study, which means it is entirely possible that other socioethnic factors may be pushing the figures in one direction or another, independent of the medical facts.

Still it is a worthy reminder that medicine must take into account the whole patient, and that surgery is not always the first or best answer for knee pain.

When to See a San Diego Orthopedic Surgeon

Anyone who has ever dealt with chronic pain knows it can hard to assess when the treatment should escalate. After all, we’ve gotten pretty good at managing chronic pain with therapy, steroids and painkillers. But each of these approaches has serious limitations: in the case of drugs, for instance, there are very real dangers to maintaining a high dose of powerful narcotics.

Orthopedic surgery is the next logical step for most patients. Unlike ongoing medication designed to manage the pain, surgery gets at the root of the problem, relieving the primary issue. If damage to your muscle, cartilage or tendons has become so advanced that the body can no longer heal itself, then it’s time for orthopedic surgery.

As a San Diego orthopedic surgeon, I see many patients complaining of shoulder pain, elbow pain, hand and wrist pain, or knee pain. Each of these may be caused in turn by any of several dozen causes, from arthritis to cancer. The only way to know for sure where the is to conduct a full diagnostic assessment here in the office.

If your chronic pain has graduated to something you can no longer simply manage, it’s time to visit an orthopedic surgeon. Call Dr. William Holland to get a full evaluation today.

The Experience of Knee Surgery

Sports medicine is a discipline where numbers count: how long does a shoulder procedure take? How many years does a patient have left on that ailing knee? But numbers alone cannot account for the whole experience of surgery, which is why I field a lot of questions about what orthopedic surgery feels like – before, during, and after the procedure.

This article offers a quick look at some of the experiences you can expect following orthopedic knee surgery. It includes common issues such as swelling and pain, and throws in some numbers about how long you should expect to be laid up. But the real meat of the piece is its emphasis on recovery as an active process:

We will initially focus on regaining your range of motion (ROM) and then strengthening you through your available ROM. Especially after a total knee replacement, you will want to gain full extension. Do not stay in bed all day, and more importantly do not lay with a pillow under your knees!

Many people want to rest after surgery, and there’s no question that sleep is an essential component of recovery. But to truly regain function and reclaim an active life, you will also need to get up frequently and work at your healing process.

To learn more about orthopedic knee surgery in San Diego, please contact our orthopedic surgeons today.

New Insights on Knee Pain

Knee pain is often a persistent nuisance, but for some people, it’s devastating. Because our knees drive nearly every motion we make while standing, chronic pain in this joint can have lasting and systemic effects on everything we do.

For many years, the conventional wisdom held that knee pain should be treated at the source – namely, the knee. But a new study recently found that knee pain can be relieved by focusing “upstream” as well, on the hip, thereby strengthening the entire leg as a system:

British and Australian scientists analyzed 14 previous studies of people with patellofemoral pain, the official name for the ache in the front of the knee that strikes many runners. Participants whose programs included moves to build strength, endurance, and activation in the muscles around the hip had less knee pain and improved joint function when compared with those whose therapy focused on the quadriceps muscles alone.

It is an interesting finding that underscores the simple fact that our bodies are full of interdependent pieces, and that no orthopedic issue ever arises in a vacuum. My San Diego orthopedic practice offers effective therapy, treatment and surgery for chronic knee pain, and takes care to treat entire patients young and old.

Want to learn more? Contact the orthopedic surgeons today.

The Connection Between Knee Pain and Knee Surgery

As a San Diego orthopedic surgeon in practice for many years, I hear from many patients who don’t fully understand the different types of knee surgery, especially which ones are indicated for which kinds of knee pain.

Visit these pages on my site and you’ll find some quick primers, but what if you want more in-depth definitions? Try this piece, which includes a succinct and accurate rundown of the most common knee surgery procedures:

Arthroscopic surgery. Depending on your injury, your doctor may be able to examine and repair your joint damage using a fiber-optic camera and long, narrow tools inserted through just a few small incisions around your knee. Arthroscopy may be used to remove loose bodies from your knee joint, remove or repair damaged cartilage, and reconstruct torn ligaments.

Partial knee replacement surgery. In this procedure (unicompartmental arthroplasty), your surgeon replaces only the most damaged portion of your knee with parts made of metal and plastic. The surgery can usually be performed with a small incision, and your hospital stay is typically just one night. You’re also likely to heal more quickly than you are with surgery to replace your entire knee.

Total knee replacement. In this procedure, your surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

My San Diego orthopedic knee surgery practice offers industry standard approaches to imaging, surgery and aftercare. If you’re experiencing knee pain and want to visit an experienced team today, I urge you to reach out to us here.