Dear Ask The Doctor: Hello, I have had awful knee pain in both knees for over 6 months now. There is also some inflammation behind the knees as well. I have been seen by an Orthopedist( said its not arthritis)also had knees x-rayed and had many blood tests taken as well. My hands were also X-rayed because of some pain, I constantly drop things, can't open things, etc. X-rays on hands show some bone loss, However this does not solve the problem with my knees. It really hurts while sitting, standing, going up or down stairs, etc. I'm very frustrated now, need help.
Dear Lisa: The most common cause of knee pain is the chondromalacia patella or Patello femoral syndrome, in the case that you have history of a traumatism in the knee, some other causes must be rule out, for example: ligament, meniscus, muscle or capsule lesions. As you see, it depends on several factors to determine the nature of the knee pain. In the Patello Femoral Syndrome the pain typically is located behind the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (ei, during squats, ascending/descending stairs or pendants). Pain may be worsen by sitting with the knee flexed for a long period of time, such as while watching a movie, hence leading to the terms "theatre sign" and "movie-goer's knee." The causes are diverse: Overuse (repetitive use or activity), overloading, and misuse of the patellofemoral joint. I do not recommend at this point Hicking because that kind of activity may worsen your condition.The suggested strategy for conservative treatment should be as follows: Physical therapy program (exercises and pain control with TENS, ultrasound, ice packs after exercises), anti-inflammatory drugs (i.e.: “Aleve”, “Advil”), education so you understands which activities avoid because those can aggravate patellofemoral syndrome. Also, and very important, remark the need for extended adherence to the exercise regimen. The physical therapist should educate you about a home exercise program Allow time for these conservative measures (ei: exercise program) to have an effect , usually 4-6 weeks is adequate for some resolution of symptoms.