Terrible knee pain...Doctors have no answers...please help!

[juseasy]

Hello,

For about the past 6 months I have had this terrible pain in my right knee. At first I would feel the pain maybe 4 days a week. Most often the pain would be most severe at night. Around 2 months ago I decided to grind it out and begin exercising again. Now the knee hurts everyday.

Symptoms
-------------
The although the entire knee seems to hurt it is most painful on the upper inside(superior medial). The second most painful would be just opposite on the superior lateral side of the knee. These are also the two areas that have swelling. Sometimes the swelling on the upper outside of my knee looks as though its not even part of my knee!?!? Occasionally at night the pain is so bad that I cannot sleep. When I'm awake at night it hurts for me to straighten or bend my knee. Yet I always have this terrible urge to change to either position once the pain builds up in the other position (ie straight leg hurts so I bend. Bent leg begins to hurt so I straighten. Repeat). The knee is always swollen and tight.


What I Have Tried
----------------------------
I have tried resting, icing and heating. Although maybe I have not been consistent enough. After reading about runner's knee I went and bought a foam roller. I'm not sure I'm doing the exercises correctly.

History
-------------------------
I should point out that when I was 9 years old (I'm now 29) I began having terrible knee pain in both knees. They would hurt a lot and get hot and swollen with any physical activity. At the age of 17 I would get the same type of pain I'm experiencing now. But at 17 the pain was in both knees and it was about 3 times worse. From the age of 20 until 27 I had the usual aches and pains, but nothing too bad. I have been to several doctors and specialists....no one has ever been able to offer a cause let alone a remedy (I'd jump on a partial remedy!). Right now I am on the waiting list to see another knee specialist.

Me
-----------------
Age: 29
Height: 6'4"
Weight: 234lbs


I've read a few interesting things on this forum (eg lumbar alignment). I was really hoping someone could shed some light on my problem or even just offer a suggestion on how I may be able to help the situation.

Sorry to write such a long post. I just didn't want to leave out any information (I hope I didn't leave anything out) that may be helpful.

Any help would greatly appreciated.


Thanks

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[specialisedsofttissue]

hmmm seems as if no-one wants to touch this post, I have a couple of questions for you:

1. Was there an incident you remember that kicked off this last episode of pain (6 months ago)?

2. Do the symptoms appear only after physical exertion, or can they appear at anytime, randomly?

3. Are there any other areas on your body that get painful to a lesser or greater extent, or change in their appearance, i.e dryness, itching or lumps and bumps etc which coincide with the onset of pain in your knee/s?

You have done the right thing by booking in with a specialist. Seeing as though you have seen a few docs already I guess they would have already looked into things like Gout and Rheumatoid arthritis and the normal musculoskeletal possibilities for the source of your pain. although from my knowledge your symptoms don't fit perfectly with RA or Gout but there is always an exception to the rule. maybe do some research on these two and if it seems to fit bring it up at your next appointment. I'm an early stage student still so I may be way off but I could see you were left hanging there so I thought I'd give it a crack.

all the best,

SST

[tonywoodall]

Knee pain without known trauma is either a condition like Rheumatoid Arthitis, internal infection or refered pain from the spine. In general, pain at the Superior Medial location is from the lower Thoracic spine and upper Lumbar area. Pain at the Lateral Superior aspect is from the Lumbo Sacral spine. If you have pain distally, including down to the foot, it is usually from the Lateral Gluteal muscles which have become inflammed over time and are in spasm.
These comments may be disputed by some. Good luck.

[quorthon]

hi everyone....I have no reason to disagree with all the above comments....The first thing i would check out in a screening procedure is the LUMBAR SPINE as tony correctly noted....But the only thing that really concernes me and there is no reason to conceal it is the NIGHT PAIN which is worse at night, it maybe -sometimes and sometimes not- a warnign sign for a more serious patholgy...My recommendation is juseasy to consult her GP and highlight this particular symptom

[juseasy]

Thank you so much for the replies.

specialisedsofttissue
1. There was no incident the at kicked this off. It was really weird because I wasn't exercising or doing anything stressful (just being lazy!).
2. They symptoms can appear at any time. It always slightly hurts.
3. I do have other areas on my body that hurt but I don't think it coincides with the pain. My lower back gets sore easily. My left heals sometimes just hurts terribly and then stops hurting. The right foot is dry and cracked.

tonywoodall & quorthon
are there any exercises or stretches for the lumbar that I should look into?
When I see the specialist in may I'll definitely bring it up (if he doesn't) as well as the possibility of other serious problems.

Again I want to say thanks to you guys. This has been quite stressful for me and your consideration and response is really appreciated.

[Dr Damien]

Dear Juseasy

I will be agreeing with my colleagues to say this is probably a systemic problem. As you are having localised signs in both knees, swelling etc its probably not related to the spine...you described night pains, with some description that indicates probably stiffness (feeling like you want to move it to ease the pain, swollen and tight)...any family history of this type of problem? any morning stiffness? have you done any blood tests to screen for R.A? your issue sounds like a connective tissue disease of some sort?

Maybe you want to shed some light on the exercises you were doing that you feel aggravated the problem?

[alophysio]

Hi - i agree with the above...I am thinking the L/S.

I have had some patients who had definite knee swelling but we couldn't find anything wrong with the knee...found stuff wrong in the back though...Anyway, treated the back and the dysfunctions we found and within a few days the swelling subsided The superomedial knee pain can be a Saphenous nerve irritation.

Otherwise just make sure all things in the back, pelvis, hip, knees and ankles are all ok.

Cheers!