Pain in the knee caps since I was nine

Patient

Q: I have had aching knee pain since I was a little girl. The earliest memory I have of this is at the age of 9. I've noticed bending my knees for long periods of time bring this pain on and sometimes I just wake up with it. Most of the time the aching seems to be accompanied with a cold burning sensation (if that makes sense) and is located around my knee cap. This pain occurs in both knees but seems predominant in my right. Ibuprofen seems to help but not always takes the pain away completely. For the past two weeks it seems to be happening daily and I don't know why it has increased. Nothing in my lifestyle has changed. I'm just looking for some possible answers as I've researched on the internet and everything I find seems to be injury or running related. I haven't found anything that could be a lifelong condition.

Doctor

A:    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 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”), 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. Allow time for these conservative measures (ei: exercise program) to have an effect, usually 4-6 weeks is adequate for some resolution of symptoms.

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