Knee pain episodes at night

Patient

Q: Ever since I was young I've suffered from knee pain at night. As a kid my parents atttibuted it to growing pains however I'm 22 now and still suffer from them. They tend to start arond 10-12oclock and usually peak at around 3 or 4 in the morning, waking me up, and are usually in the left knee but can occur in the right. Usually the dont happen more than 2 or 3 times a year but in the last few months they've become more common.

Doctor

A:   According to your description of the knee pain episodes, most likely you may be experiencing a Patellofemoral Syndrome. Knee pain is the most common presentation of patellofemoral syndrome. The pain typically is located behind/below /around the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (ei, during squats, bicycle, ascending/descending stairs, jogging or pendants, prolonged kneeling). Pain may be worsen at night, 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. 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 medication (i.e.: “Aleve”, “Advil”), wear a neoprene knee sleeve, education  so  you understand 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.

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