Inner Side Knee Pain – Causes, Symptoms, Diagnosis, Treatment

Inner Side Knee Pain

Inner side Knee pain is one of the most common causes of knee pain and osteoarthritis that are seen middle in late-stage of life due to wear and tear of the tendon, cartilage, ligament, and associate structure of knee joint. In research is found that there are a hundred causes of inner side knee pain. It is basically found in postmenopausal women, overweight, lake enough nutrition from food and lake of regular exercise with unhealthy food habit that is causing arthritis to the affected joints, tissue surrounding joints, and other connective tissue.

Causes of Inner Side Knee Pain

There are many causes of inner side knee pain that are described bellow

  • Knee injuries – it is one of the most common causes of inner side knee pain for example, due to meniscus damaged permanently or partially, tearing of the cruciate ligaments, dislocation of the kneecap, or a bone fracture near the middle knee joint.
  • Being very overweight – Inner knee joint pain with people who have a BMI of over 30 and more are considered to be very overweight (obese). The higher the BMI, the more the change of strain on the joints, tendons, cartilage, ligament
  • A repeated major micro trauma and strain on the knee – It is one of the most basic causes of inner side knee pain with people who have jobs where they knee or squat a lot or lift heavy objects every day are more at risk of osteoarthritis and inner side knee pain.
  • Anatomy abnormality of knee – Congenital or abnormal knee structure that may be Having legs of different lengths or knee problems such as knock knees or bow legs for the best example of inner side knee pain.
  • Lake of healthy cartilage – It has a smooth gliding surface that allows low-friction movement in knee joints and  Osteoarthritis of the inner side develops if the cartilage softens and becomes cracked and thinner. Cartilage can’t repair itself as well as other types of tissue can, so any major damage is lasting.

Possible Causes of inner side Knee pain

  • Posttraumatic
  • Postsurgical
  • Congenital or malformation of the limb
  • Malposition (Varus/Valgus)
  • Scoliosis
  • Rickets
  • Hemochromatosis
  • Chondrocalcinosis
  • Ochronosis
  • Wilson disease
  • Gout
  • Pseudogout
  • Acromegaly
  • Avascular necrosis
  • Rheumatoid arthritis
  • Infectious arthritis
  • Psoriatic arthritis
  • Hemophilia
  • Paget disease
  • Sickle cell disease
  • Articular trauma
  • Occupation – prolonged standing and repetitive knee bending
  • Muscle weakness or imbalance
  • Weight
  • Health – metabolic syndrome
  • Gender – females more common than males
  • Age
  • Genetics
  • Race

Symptoms of Inner Side Knee Pain

The number of characteristics associated with knee inner side pain varies depending on whether a diagnosis is being made using clinical criteria only, using clinical symptoms are

  • The onset of symptoms – and pain gradually increases due to the bending of the knee
  • The specific location or inner side of pain – Pain in the inner side of knee pain may be a limited area or whole knee joint
  • Duration of pain and symptoms – It may be increased in the morning or working
  • Characteristics of the pain – It may be a tingling sensation and restriction of range of motion
  • Alleviating and aggravating factors – It may be an increased pain bedding knee during  prayer
  • Any radiation of pain – It may be localized acute pain in the inner side of the knee in a localized area
  • The specific timing of symptoms – It may be increased in the morning or noon or evening
  • The severity of symptoms – Pain in the inner side of the knee may be acute or chronic
  • Pain particularly when you’re moving your knee or at the end of the day – this usually gets better when you rest)
  • Stiffness especially after rest – It is this usually erases after a minute or so as you get moving)
  • Crepitus, a creaking – It may be felt crunching, the grinding sensation when you move the joint
  • Hard swellings – It may cause inflammatory arthritis caused by osteophytes)
  • Soft swellings – It may be caused by accumulated extra fluid in the joint.
  • Loss of flexibility – You may not be able to move your joint through its full range of motion.
  • Grating sensation – You may hear or feel a grating sensation when you use the joint.
  • Bone spurs – These extra bits of bone, which feel like hard lumps, may form around the affected joint.
  • Instability is one of the knee joints, or feeling like your knee joint is “giving way”
  • Limitations in the range of movement of your knee
  • Inability to continue working or with activities, whether they involve day-to-day tasks or sports

Knee pain is mostly  for most days of the prior month or year, plus have the radiographic evidence of osteophytes on joint margins in addition to 1 of the following

  • Crepitus may be felt on active motion
  • The morning stiffness or multiplejoint pain less than 30 minutes’ duration or more times
  • Age older than 50 years is the most common causes of inner side knee pain

Knee pain in the medial side for most days of the prior month, in addition to at least 5 of the following

  • Crepitus on active joint motion or movement
  • Morning stiffness less than 30 minutes’ duration or more
  • Bony tenderness to palpation of inner side knee pain
  • Bony enlargement may be felt in the inner side knee joint
  • Worm or abnormal temperature during palpitation
  • Erythrocyte sedimentation rate below 40 mm/h or maybe an increase
  • Rheumatoid factor less than 1:40 or may increase
  • Synovial fluid was consistent with OA (white blood cell count < 2000/ÎĽL).

Inner Side Knee Pain

Diagnosis of Inner Side Knee Pain

Other knee tests may be performed, depending on may be the clinical suspicion based on history.

Special knee tests

  • Patella apprehension – patellar instability
  • J-sign – patellar maltracking
  • Patella compression/grind – chondromalacia or patellofemoral arthritis
  • Medial McMurray – a medial meniscus tear
  • Lateral McMurray – lateral meniscus tear
  • Thessaly test – a meniscus tear
  • Lachman – anterior cruciate ligament (ACL) injury
  • Anterior drawer – ACL injury
  • Pivot shift – ACL injury
  • Posterior drawer – posterior cruciate ligament (PCL) injury
  • Posterior sag – PCL injury
  • Quadriceps active test – PCL injury
  • Valgus stress test – MCL injury
  • Varus stress test – LCL injury

Treatment of Inner Side Knee Pain

Non-Surgical Treatment Options

  • Patient education
  • Activity modification or a specific person
  • Physical therapy – It very helps full for treatment of old age people
  • Weight loss – As early as possible
  • Rest, ice, compression, elevation (RICE) to control pain. Heat, cold, pressure, light, and even electricity have been used for thousands of years to accelerate healing and decrease pain.
  • Knee bracing – It is essential during movement, walking, traveling
  • Glucosamine and chondroitin sulfate
  • Sitting or lying down –  It is done in order to take the weight off the leg. It may help to erase the inner side knee pain.
  • Keeping the knee joint – as still as possible to prevent further injury.
  • Cooling the knee – It is very important in case of an accident in the inner side knee pain to reduce swelling and relieve the pain a little (to avoid harming the skin, wrap cool packs or bags of ice in a towel before using them). Many scientific studies show that regular strength and mobility exercises can relieve pain and improve joint function movement.
  • Reduce overweight, losing weight – can reduce stress gradually on the joints. Studies have shown that weight loss of more than 5% can improve the range of motion and slightly relieve joint pain. People often recommend wearing well-fitting special shoes with shock-absorbent soles that can help to remove knee pain. Shoes should support the arch of your foot and leave enough space for your toes.
  • Insoles, orthotics, and special “unloading” shoes – are low-risk options that can be tried out, but their effect hasn’t been well studied yet. On scientific study showed that unloading shoes that are designed to reduce pressure on the knee joint pain also relieve knee inner side pain any better than normal, well-fitting, impact-absorbing shoes when worn regularly for several months.

Medication

  • Antibiotic – Cefuroxime or Azithromycin, or  Flucloxacillin, or any other cephalosporin/quinolone antibiotic must be used to prevent infection or clotted blood removal to prevent furthers swelling and edema of inner side knee pain.
  • NSAIDs – Pain medicines and anti-inflammatory drugs help to relieve pain and stiffness, allowing for increased mobility and exercise. like diclofenac, ibuprofen, and etoricoxib are also proven to relieve osteoarthritis pain. Acetaminophen (paracetamol) doesn’t work in osteoarthritis of the knee. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They include and Ketorolac, Aceclofenac, Naproxen, Etoricoxib.
  • Corticosteroids – Also known as oral steroids, these medications reduce inflammation with pain and swelling.
  • Muscle Relaxants –  These medications provide relief from associated muscle spasms and muscle spasticity. It is best to prescribe muscle relaxants are tolperisone eperisone etc.
  • Neuropathic Agents – Drugs are commonly prescribed are antiepileptic drugs are pregabalin & gabapentin that address neuropathic—or nerve-related—pain. This includes burning, numbness, and tingling.
  • Opioids – Also known as narcotics are strong pain medication for the inner side knee pain, these medications are intense pain relievers that should only be used under a doctor’s careful supervision.
  • Topical Medications – These drugs are prescription-strength creams, gels, ointments, patches, and sprays that help relieve pain and inflammation through the skin.
  • Calcium & vitamin D3 – It is an essential medicine for healthy bone and joints are used to improve bone health and healing fracture. As a general rule in medical science, men and women age 50 and older should consume 1,200 milligrams of calcium a day, and 600 international units of vitamin D a day must be taken for healthy bones.
  • Dietary supplement – It is very helpful to remove general weakness & improved health. Many studies have shown that nutritional supplements help to reduce inner side knee pain. The same is true for endoscopic lavage (washing) of the knee and smoothing of the cartilage (arthroscopy).
  • Antidepressants – It is a drug that blocks pain messages from your brain and boosts the effects of endorphins (your body’s natural painkillers).
  • Glucosamine & Diacerein, Chondroitin sulfate – can be used to tightening the loose tension, cartilage, ligament, and cartilage, ligament regenerates cartilage or inhabits the further degeneration of cartilage, ligament. They are structural components of articular cartilage, and the thought is that a supplement will aid in the health of articular cartilage. Glucosamine and chondroitin are produced within the body and are used in the manufacture or repair of cartilage.
  • Hyaluronic acid (HA) Injections – It is the late-stage treatment for the regeneration of cartilage. The injection is pushed in the knee joint directly to stimulate the glycosaminoglycan and hyaline cartilage in osteoarthritis joints. Intra-articular hyaluronic acid has a long history of injections into the joints of arthritic to improve their performance (therapy is called viscosupplementation). Hyaluronic acid is the lubricating substance within the joint that may be lost during osteoarthritis.[]
  • Joint injections – It’s very helpful steroid injections that are push in knee joints help better than injections of saline solution (a mixture of water and table salt), and there have risks associated with using them. Hyaluronic acid injections are the subject of debate. In the best-quality studies so far, they were hardly any better than saline solutions. Plus, you have to pay for them yourself. Injections with autologous blood products (using processed blood plasma taken from your own body) haven’t been proven to work.
  • X-ray therapy – It is the latest type of treatment that (or orthovoltage therapy) involves treating the joint with low-energy X-rays 6 to 12 times over several weeks. There are no comparative studies on this treatment, so it’s not clear if it helps or has controversy in some scientific journals.
  • In radiosynoviorthesis (RSO) – It is a weak radioactive substance is injected into the knee for the treatment of inner side knee pain. Studies haven’t shown it to be effective, and there are reports of complications like bone and joint inflammations.
  • Cartilage restoration surgery – It is for osteoarthritis of the knee it may even make the pain worse and has no proven benefits. This kind of surgery includes, for example, Pridie drilling, microfracture, cartilage grafts, and cartilage and bone grafts.
  • Joint Replacement  Surgery – It is basically the end stage of treatment options in the knee’s inner side pain may be an option. An artificial knee joint can considerably relieve the pain of advanced osteoarthritis in most people. After surgery, it’s important to have active rehabilitation treatment – and patience because it takes time to get used to your new knee.

Herbal or other treatment

Many other products and therapies that don’t have a proven benefit are also offered to treat osteoarthritis of the knee:

  • Herbal supplements like devil’s claw
  • Foods or food extracts, for example, based on soy or avocado
  • Ultrasound treatments
  • Transcutaneous electrical nerve stimulation (TENS)
  • Leech therapy
  • A special kind of electrotherapy (“high tone power therapy”)
  • Magnetic field therapy
  • Microwave therapy

References

  1. https://www.ncbi.nlm.nih.gov/books/NBK544982/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802101/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704066/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851845/
  5. https://www.ncbi.nlm.nih.gov/books/NBK507884/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153568/
  7. https://www.ncbi.nlm.nih.gov/books/NBK544983/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC403855/
  9. https://www.ncbi.nlm.nih.gov/books/NBK561511/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943847/
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612336/
  12. https://www.ncbi.nlm.nih.gov/books/NBK507780/
  13. https://www.ncbi.nlm.nih.gov/books/NBK333078/

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