Severe knee pain in an active teenager

Patient

Q: So for almost a year i've had this knee pain...it is quite severe and the pain is almost unbearable. it is on my left knee and its a sharp shooting pain on both sides of the knee cap, i also have a numbness in my shin because of this. the pain shoots all the way up my leg and into my lower back, and it gets worse when i lay down flat on my back. i played softball for a couple of years but have been unable to for the past 2 years. the pain comes around when i walk too much, excersise, sleep, or just out of no where. i've worn a knee brace whenever the pain comes back around and take several pain killers but no matter what i do the pain is still there. it is hard for me to walk and sit down properly because of it. but i dont have it ALL the time, it comes and goes...my question is, what do i have? what can i do for the pain? and what should i do when the pain comes back? oh and p.s. i've seen an actual doctor for this, but it's become worse....so i need some help:) thank you

Doctor

A:   According to your age and description of the symptoms, most likely you may have a Patellofemoral Syndrome, which basically is an unbalanced muscle pull that produced excessive pressure or leverage forces on the knee joint surfaces. The difficulty in flexing/ extending the knee that you described is a common presentation of the Patellofemoral Syndrome, and this generates a change in the gait that might be affecting your lumbar spine. The suggested strategy should be: strengthening and stretching the main muscle of the thigh: quadriceps, to restore the muscle balance around the knee joint, for this is indicated physical therapy for 6 to 8 weeks, using ice packs at the end of the exercise routine to decrease pain and swelling. The use of soft knee braces helps to control patella position and restrict full knee flexion which is good to ease the pain. Also, and very important, you have to stretch the hamstring muscles and the activities or sports that require frequent squatting must be avoided until the pain is under control. If there is a limited response to the treatment and locking or instability of the affected knee is noticed, then an orthopedic surgeon evaluation must be considered.
 

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