Knee Pain While Sleeping

Patient

Q: I was informed by my doctor that I have a torn meniscus in my right knee. I can tolerate the occasional pain but I notice the my knee tends to hurt more (sometimes waking me) while I sleep. Is there any exercise or strenghting program I can use. I really don't want surgery. I'm 45 years old. Thanks in advance!

Doctor

A:    The menisci are C-shaped wedges of fibro cartilage located between the tibia and femur, and very close related to knee ligaments and attached also to the joint capsule. They are susceptible to get injured with leg rotation movements or rotational forces applied to them, and the lesion produced can be partial or complete tear. A reliable indicator of meniscus lesion is a click or snaps after the joint unlocks, it can be or not associated with pain. A sensation of giving way may occur when the loose fragment becomes lodged for a moment in the knee joint, causing a sense of buckling. Spontaneous healing is common because of the rich blood supply in the menisci periphery. Successful recovery from a meniscal tear is helped by a gradual resolution of symptoms over 6 weeks with a return to normal activity by 3 months. Many meniscal tears heal spontaneously, hopefully this might be your particular case if  your lesion is partial and small tear. With time the symptoms tend to improve. If there is no significative improvement you should get a clinical (orthopedic surgeon) and Imaging (MRI) re-evaluation of your knee. The suggested strategy for conservative treatment should be as follows: Physical therapy program (exercises of range of motion and quads strengthening, along with pain control with TENS, ultrasound, ice packs after exercises), you can also use anti-inflammatory medication (i.e.: “Aleve”, “Advil”). And avoid rotational movements of the knees.

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