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The question
I'm 30-years-old and in pretty good shape but I occasionally get bad knee pain, seemingly unprompted. Should I be concerned?
The answer
Knee pain is a common concern that affects people of all ages. Because it takes the full weight of the body and is regularly stressed by activities such as walking, running and jumping, the knee is a vulnerable joint and has a high risk of injury and age-related wear and tear.
Risk factors for knee pain include:
• Excess weight: Being overweight can increase stress on joints and increases the breakdown of cartilage in joint spaces that can lead to arthritis.
• Structural abnormalities: Flat feet, misaligned knees and different leg lengths can increase the risk of knee problems.
• Sports/physical activities: Some activities put a high level of stress on the knees such as basketball, skiing and running, which can lead to increased wear and tear damage.
• Previous injury can increase the risk of re-injury and degeneration of cartilage.
• Limited strength and flexibility of muscles surrounding the knee: These muscles protect the knee and if they are weak, the joint will take on more stress which can increase the risk of injury.
There may be a variety of reasons for your knee pain, which can include conditions of the joint, tendons, ligaments, menisci or surrounding muscles. Consider these questions when preparing to see your doctor:
1. When did you start having pain?
2. Are your symptoms constant or do they happen intermittently?
3. Where specifically does it hurt on your knee (i.e. deep inside/on one side or the other/front or back)?
4. How severe are your symptoms and how does it affect your function?
5. What, if anything, seems to trigger or worsen your symptoms (i.e. walking, stairs, at rest)?
6. What, if anything, helps to ease your symptoms (i.e. rest, medications)?
7. Do you exercise or play sports?
8. Do you have any instability or locking of the knee?
9. Are you experiencing symptoms in other part of your body, or just in your knee?
10. Have you ever had pain, injury or surgery on your knee before?
11. Are you having any other symptoms other than pain (i.e. fever, swelling)?
The answers to these questions can help guide your doctor in diagnosing the possible cause of your knee pain and can help to direct the next steps in management, which may include investigations, medical and non-medical therapy, and possible referral to specialists.
Your concern is valid and while occasional knee pain is common and often resolves on its own, it's important to listen to your body. If you are experiencing any of the following more serious symptoms such as difficulty weight bearing, unable to fully extend/flex your knee, redness/pain/swelling of knee with a fever, your knee gives out or locks, or your symptoms get worse, I would recommend seeing your doctor to rule out more serious causes.
Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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