In my last post, I provided some background about Knee Arthroscopy and the injury and illness that may cause someone to need this type of surgery. In this post, I am going to outline the examination and non-surgical treatment process for knee pain from acute or chronic conditions.
Treatment of Knee Pain
Every knee problem will not require interventional treatment by an orthopaedic specialist. Perhaps after a visit to the ER or Family Physician, pain and swelling from an acute incident can be managed using the old standby for injury treatment, RICE (Rest, Ice, Compression and Elevation). Adding an over-the-counter anti-inflammatory medication, such as Ibuprofen or Aleve, can help most problems resolve without clinical intervention.
Many people, who have chronic knee pain from conditions like arthritis, are well-versed at managing the “ups-and-downs” of their pain and stiffness. They take over the counter anti-inflammatory medications, like Aleve, use heating pads, warm baths, muscle rubs – like Icy Hot or BioFreeze, and find other ways to manage their discomfort, through exercise and paying attention to their bodies.
However, some patients will not respond to conservative home treatment or have a condition that has progressed to the point where more intensive therapy is needed. That is when they come to see me and ask for my help with the problem.
What is Involved in a Knee Examination
When visiting my office, patients will complete a history form that will tell me about any knee problems they have had and any other medical conditions about which I need to know. I will order x-ray studies of the patient’s knee to show whether or not any bone damage or fracture exists. I will review those images with the patient while we are together in the examination room.
When I conduct an examination of the patient’s knee, I am going to do the following:
- Check the knee for swelling, discoloration, tenderness and pain
- Assess the patient’s range of motion in the knee joint and if movement causes pain
- Ask the patient to point to the area of the knee that hurts
- Ask questions about the pain, when it started, how did it start, when is it better or worse
- Ask them what kind of home treatment they have tried
- Evaluate whether physical therapy has been ordered and how successful it was
Once I conduct a thorough check of the patient, I will review their x-ray images with them and explain what I see. I will point out any fractures or bone damage that may show up on the x-ray. I will tell them my diagnosis and what treatment that I recommend for them. If I do not see a serious problem that needs immediate surgical intervention, I can provide a prescription for strong anti-inflammatory drugs, pain medications, or physical therapy in order to help with the pain, swelling and lack of strength and range of motion in the knee. Sometimes, I will provide a brace to support and keep the knee immobile while it heals.
In my next post, I will detail why a patient would consider knee arthroscopy and how I do the procedure.
Robert J. Snyder is an Orthopaedic Surgeon who specializes in the treatment of knees, hips and shoulders. A graduate of and former Chief-of-Surgery at the United States Military Academy at West Point, Dr. Snyder’s specialty focus is Total Joint Replacement and the treatment of Sport Injuries.
Dr. Snyder currently practices at Orthopaedic & Spine Center in Newport News, Virginia.