Knee Pain Management: When Is The Right Time To See A Doctor? Expert Tells
Knee pain has become a common condition these days. It may affect different age groups. Read here to know possible causes of knee pain and when to see a doctor.
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Knee pain is a common orthopaedic problem. It has been observed that it affects different age groups. These age groups can be broadly divided into three categories. The broad three categories of parents include - children from 0 to 18 age group, adults from 19 to 50 age group, and senior citizens from 50-year plus.
Small children presenting with knee pain and swelling is different from those who are college-going students. If a 10-year-old child is suffering from knee pain and swelling without any history of falls or accidents, parents usually get panic. If suddenly the knee is swollen or a child is witnessing difficulty in walking then parents start doubting that could it be arthritis (Juvenile Arthritis). But 90 percent of the time these problems are benign.
These are known as 'growth pain'. When a child is in a growing age that is typically 10 to 12 years of age, they go through a process known as 'growth spurt'. In this phase, the length of the bone increases which at the same time leads to stretching of the tissue around the bones which gives rise to bouts of knee pain and swelling. In the lower limbs, the growing end of the leg is around the knee. Hence the length of the leg increases around the knee and so these children go through knee pain.
But in this phase, parents need not worry. A doctor's reassurance to the parents helps a lot in such cases. There is no need for investigations like MRI or any blood tests. Parents should get it evaluated if there is any other cause of knee pain. Once the doctor confirms that it is just a 'growth pain', parents need not worry as this settles on its own.
Another age group is adult people. The aetiologies in this age group are different, they vary from domestic falls, road traffic accidents - bike accidents, sports injuries, which this age group of people commonly suffer from and then they witness knee pain. They might complain that they cannot hog, jog, jump, and sometimes they find it difficult to walk, loss of knee balance. These people generally have ligament injuries in their knees.
It may require a surgical cure at times in addition to medical management, and the person can become all right. Arthroscopic or keyhole surgeries lead to faster recovery and early return to their day to day household activities. Some subsets of these patients also are diagnosed to be suffering from arthritis (rheumatoid arthritis, seronegative arthritis), these also should do well with early confirmation of diagnosis and appropriate medical management.
It is the senior citizens' age group that often does not understand when to visit a hospital and patients usually tend to hide their issues. Initially, the pain is occasional, people from this age group might say that when they walk more they get knee pain, and once they take rest the pain settles down or increasing pain with an increase in exertional activity. So in this case, you should not ignore the knee pain as this might be early signs of arthritis. If one is witnessing these symptoms that were not present before then one should definitely visit the doctor. At this stage reassurance from doctors, exercises, and lifestyle changes can be helpful in controlling it in the early stages.
Senior citizens with advanced arthritis are the ones who do not have a normal walking pattern, complete restriction of household activities. In this case, such patients are hesitant to face surgical procedures and it is hence they do not wish to visit a doctor. Because of this many people spend their entire life with bad arthritis. Such patients who are disabled with knee pain, crippling deformity and are unable to perform day to day household tasks, surgery in the form of knee replacement is the best option for them.
All the above mentioned are the commonest presentations that are observed, right from pediatric to geriatric. Apart from these three categories, there is a growing incidence of knee arthritis in one more new group called 'middle-age females'. Many women around 40 are coming up with knee issues and arthritis. Among them, many are overweight women. They do not fall into the ligament injury group, neither they fall into the elderly group. For such age groups again reassurance from a doctor helps. The doctor suggests some exercises and lifestyle changes, which then prevent further wear and tear of the knee thus preserving the productive years of their lives.
(Dr. Sunny Gugale, Consultant Arthroscopy & Arthroplasty Surgeon at Sancheti Hospital, Pune)
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