WHAT CAUSES KNEE SWELLING?
A swollen knee is a common problem which can affect people of all ages. There are many reasons why the knees can become swollen which can cause huge pain and disability.
It is very important to determine what is causing the knee to swell. It may an acute condition caused by a traumatic injury like in sports or activities, or a chronic condition which has progressively developed over time. It is also important to determine the location of the swelling, as it can often vary. Knee swelling can sometimes occur within the knee joint itself, or in the soft tissues surrounding the knee, like tendons or bursea.
The first step in treating knee pain and swelling is to diagnose the cause, we do this by examining the appearance. When the swelling is within the knee joint, the kneecap is usually easy to feel as the fluid pushes the kneecap outwards slightly. When the swelling is in the soft tissue, for example tendinitis or bursitis, the kneecap may not be visible, or there may be prominent swelling over the top of the kneecap.
Fluid over the top of the knee cap
When there is excessive fluid in the soft tissue over the top of the kneecap, this is often a condition know as pre-patella bursitis - inflammation of a fluid-filled sac (called the bursa) which cushions the top of the kneecap.
Fluid Inside the Knee Joint
If the knee joint is the region with the pain and swelling, it is often due to 3 possible causes:
1) acute traumatic injury (ie sports injury)
2) chronic condition (osteoarthritis or rheumatoid arthritis)
3) acute condition not related to an injury (gout)
Acute Injuries are those related to trauma. This could either be after a few days or even a few weeks. This often results in rapid swelling of the knee. Possible causes are usually related to either a torn knee ligament (ie an ACL tear) or a tearing of the joint cartilage (ie meniscus tear of the knee). In some cases a mild sprain or a mild tear can cause intermittent periods of swelling a few weeks on from either a traumatic injury or repetitive irritation, thus, causing effusion (inflammation) of the knee joint. The knee joint itself has a very large capsule. This meaning, that the capsule can be filled with fluid causing high amounts of pressure within the joint. This pressure causes extreme pain and poor mobility.
Chronic knee swelling is often a gradual progressive onset of swelling. The swelling can often fluctuate as the symptoms come and go, and are often in relation to age-related degenerative changes which cause irritation and inflammation, often excessive swelling.
Osteoarthritis is a condition whereby the cartilage has reduced cartilage over time, due to degradation. This causes excessive pressure and weight-bearing on the bone, which is not able to deal with excessive forces. This can cause the body to produce excess fluid in response to the underlying inflammation. People with knee arthritis often notice that the affected knee is larger than the other.
Rheumatoid arthritis (RA) is a form of inflammatory arthritis and is a systemic autoimmune form of arthritis. Rheumatoid arthritis will most often affect multiple joints accompanied by a greater persistence of swelling due to the ongoing, underlying systemic inflammation. Rheumatoid arthritis has caused from increased inflammatory markers in your blood.
Gout is associated with periodic acute painful swelling of a joint which is caused from increased uric acid levels in the blood.
More severe cases not mentioned above can be as a result of infectious synovitis. All the things mentioned above can cause swelling of the knee. But it is important to find out the exact cause of the swelling so it can be dealt with affectively, without causing further damage.
Treatment options often comprise of normal conservative management, joint aspiration (drainage) and anti-inflammatory injection.
Knee joint aspiration (draining fluid off the knee)
In some cases of acute swelling and pain, the knee joint may be drained to relieve joint pressure and pain. This is done by extracting fluid from the joint and a sterile conditions. extracting fluid off the joint usually gives immediate relief to the patient. In most cases, if safe to do so, and anti-inflammatory is injected back into the joint to calm inflammation.
Following joint aspiration, the fluid is examined for blood (hemarthrosis) or infection. If there appears to be blood inside the joint, this could possibly indicate ligamentous damage with inside the joint. If infection is suspected, this can be extremely serious, and the fluid needs to be sent off for analysis, at the same time as the patient admitted themselves into hospital for further examination immediately. This may require intravenous antibiotics.
GET IN TOUCH TO FIND OUT MORE OR SCHEDULE A CONSULTATION
Don’t let pain, joint damage, sports injuries or arthritis get in the way of allowing you to do what you want. Schedule a consultation at Dynamic Osteopaths & Regenerative Medicine today, and let us treat your injury, provide pain relief and get you back to your full and active lifestyle. We have clinics operating out of Solihull (Henley-In-Arden), Birmingham (Harborne/Edgbaston) & Bromsgrove (Barnt Green).
Call us today 01564 330773