Fire Fighter with painful right knee...

[renoir911]

Hello. I'm a 54 year old Fire Fighter and new here. I looked over the threads that deal with painful knee here but none match my symptoms.

My left knee causes me moderate to severe pain while driving my small truck. It started suddenly. When it hurts, I can make it worse by applying hand or finger pressure to the medial aspect of the knee. When it does not hurt, there are no pressure painful pressure points. The pain quickly goes away when I exit the vehicle and start walking. I have full function of the knee. There is no swelling. I've tried Advil, Tylenol Extra strenght, Aleve and even anti-inflamatories. Nothing helps a great deal.

I am athletic, and the only injury I ever suffered to this knee was when I was 6 years old in a car accident (laceration but no other injury to the front of the knee). I have skydived, hiked. As a Fire Fighter I occasionally put stress on my legs, knees. However I do not remember ever doing anything to cause me this pain so suddenly.

I have not yet seen a doctor.

Does anyone here suffer from these same symptoms ?
Your thoughts on what it may be ?
Thanks.

Wishing you all a great day.

RM

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[gcoe]

Hi Renoir111

As the pain with tenderness comes and goes and started suddenly my guess is that you have an internal derangement problem of the knee and that it is most likely something to do with the medial meniscus. Did it start with the truck driving? What were you doing at the time when it first started?

The truck driving is a relatively trivial stress on the knee but with the knee in a bent position and where rotation of the knee joint can occur and the meniscus is in a vulnerable position. It may be that you have some degenerative changes in the meniscus (cartilage) and the particular angle and movement of the knee was more of a case of the last straw that broke the camels back. A common pattern is that part of the meniscus has torn loose from it's "moorings"

If the knee sometimes locks on you or gives way on you this can add weight to such a possible diagnosis

When you are in the mid years, often with a quite physical history like your own, degenerative changes in the cartilage are not uncommon

However this is all guess work, Renoir111. You really should get it checked out. In your work you want your knees in top condition. A physio can help with the diagnosis but you may be better seeing an orthopaedic surgeon for a definitive diagnosis.

If by chance I am right and the problem is quite minor conservative management of working on building up the knee muscles it can sometimes settle down and some adequate repair can occur. However often the problem doesn't settle down and you need a surgical opinion. Arthroscopic surgery is then the surgery of choice.

As I said this is all speculation and it could be a number of things. Only a taking a full history a proper examination and possibly some imaging will really give you a definitive answer. So get it checked out

[renoir911]

Thank you for your message GCOE.

My pain came suddenly and was moderate at first. It came while driving my small truck. First it was a sort of soreness which is difficult to describe. Over a couple of weeks it developed into real pain but not incapacitating. I really do not recall anything I've done to bring this on this quickly. I do have periods of relief when I stand up and / or walk. It is when I sit with "pedal pressure) that it hurts the most. However, there is now always residual pain when I feel good, so it does not really go away anymore. Actually today was the worst pain I have had while driving my small truck. Today the pain involves the whole knee, front and back. The pain is usually at the front and also medially and I do have sore spots medially made worst by palpating the medial area of the knee. Today it is everywhere and sharp in front, dull at the medial side.

I know you're right about getting it checked out by an MD. I've procrastinated because I am not looking forward to what the results may tell me. Knee surgery will take me off work for a while and I don't like booking off work as it is as I can function at work. At work I drive fire engines and I sit way higher so relatively no pain.

My knee has never locked up and never given me any problems. I am in good shape. I have however had to lift heavy things and people over the years and at times not in the best way.

You sound very knowledgeable and I will take your suggestion seriously.
Thank you so much for the input.
Respectfully,
R. May

[gcoe]

Hi R. May

Glad you found it useful. Just thought I would add a bit:

*Arthroscopic knee surgery has greatly improved over the years. and there are a variety of new techniques such as biological implants that may improve knee function when a problem that is chronic as it seems now in your case. So if it is a meniscus problem and surgery is required it might all be more good news than bad news

*putting it off might do more harm than good (not saying it will but it is something you should consider). The abnormal forces and tissue may predispose your knee to osteoarthritis later.

*It sounds like it is getting worse not better anyway so might be worth doing something now before your knee gets in worse condition.

You could just get a no commitment consultation. Just find out what is going on, find out the treatment options and ask about prognosis. If the surgeon does indicate that surgery is warranted you could ask him about the prognosis of doing surgery vs the prognosis of doing nothing or doing and exercise programme. And you can always get a second opinion. Then you can make an informed decision.

By the way a good surgeon would always recommend an intensive rehab programme in a job like yours but don't go for the surgery without the rehab. With an ongoing problem like yours you are bound to have muscle weakness and a rehab programme could get you back to work quicker and safer.

[renoir911]

Update! It is now April 12 and my knee feels 90% better. I took Tylenol Xtra strenght, ani inflamatories and it did nothing. I Tried Aleve at full dose ( 2 per day at once) and the problem is now resolving itself.
RM