Orthopedics-Online

Knee pain - pain that affects the whole knee

Anatomy of the knee joint

Synonyms in a broader sense

Knee pain, knee joint pain, meniscus damage, cruciate ligament tear, knee osteoarthritis

introduction

Knee joint pain can have very different causes. When looking for the correct diagnosis, the following are important:

Age
gender
Accident event
Type and quality of pain (stabbing, dull, etc.)
Pain development (slowly, suddenly, etc.)
Onset of pain (at rest, after / during exercise)
Location of pain (inside, outside, etc.)
external aspects (swelling, redness, etc.)
and much more

In the following descriptions of diseases we will try to address as many characteristics as possible that make up a certain clinical picture.

Unfortunately there are a lot of deviations from the norm, so the assumed self-diagnosis does not necessarily have to be correct. But we hope through our Self-diagnostic just to be able to help the patient on the internet organ or symptom related look for a disease.

Ultimately, only one can medical examination and, if necessary, imaging procedures (X-ray image, MRI of the knee etc.) lead to the correct diagnosis.

Appointment with a knee specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Causes of back knee pain

Pain in the back of the knee can have a number of causes. The definition of this pain describes the location of the pain sensation, but not necessarily also the location of the pain. The pain is usually felt on the back of the knee, but it can also radiate to the thigh and lower leg. The following article looks in detail at various causes of back knee pain.

Pain in the back of the knee caused by a vascular disease

Deep vein thrombosis, also called phlebothrombosis, can cause severe pain in the hollow of the knee. In combination with the pain in the hollow of the knee, there is also pain and a feeling of tension or a pulling in the groin area or the sole of the foot. Expanded skin veins, so-called varices, can be seen externally. In most cases, the left leg is affected. Such thromboses are often silent and symptom-free for a long time until the person affected really feels pain in the hollow of the knee. The popliteal vein is found in the depth of the knee. It carries venous blood from the lower leg and the hollow of the knee into the femoral vein, a large vein in the thigh.

Thromboses in the area of the popliteal vein or its supplying vessels can therefore cause severe pain in the hollow of the knee. So-called thrombolytics such as streptokinase and urokinase are used therapeutically to loosen the thrombus. This treatment takes about 5-7 days. Thereafter, thrombosis prophylaxis with heparin or acetylsalicylic acid is carried out. There is also the option of a thrombectomy. This is the surgical removal of a thrombus from a blood vessel. This is done using a catheter.

Please also read:

Drawing in the hollow of the knee
chronic knee pain
Periosteum inflammation on the knee
Twisted knees - you have to pay attention to this

Pain in the hollow of the knee caused by the calf / base of the calf

Calf pain often feel like a piercing pain that comes from below. However, these pains, especially chronic ones, are often of a superficial nature. They mostly result from tension in the muscles, their fasciae or the connective tissue. This tension can be felt from the outside as hardening. The calves then feel hard. The pain increases with certain movements, such as kneeling or jogging. Movement restrictions can almost always be observed.

Stretching the knee is difficult, but also rolling the feet, bending and stretching the toes, bending and stretching the ankle and the Per- such as Supination of the foot. The pain in the hollow of the knee can be explained by the course of the calf muscles. The big one is important here Triceps surae musclethat forms the arch of the calf. It consists of a superficial one Gastrocnemius muscle and a deep Soleus muscle. The gastrocnemius muscle is a two-headed muscle that is attached to the lower edge of the thigh bone, at the so-called epicondyles of the Femur, rises and in the Achilles tendon starts. With its two heads it limits the hollow of the knee to the right and left. Pain in this muscle or even at its origins quickly radiates into the hollow of the knee or even arises in it.

Pain in the back of the knee with tendon disease

Pain in the hollow of the knee can also originate from an overload of the Biceps femoris muscle to have. This muscle is located on the Dorsal side (Back) of the thigh and belongs to the so-called hamstring muscles. It has two heads and its long head rises from a protrusion of the pelvic bone, the Sciatic tuberosity. The short head arises from the thigh bone itself. After the two heads have been united, the muscle attaches to the fibular head of the fibula, thus limiting the knee to the outer edge.

There is also a bursa between the muscle tendon and the knee joint. A stress-related disease of this tendon, which one Biceps tendon tendinosis calls can be extremely painful. The pain is localized in the hollow of the knee and is felt to be stabbing and pulling and develops slowly. People who are very active in sports are particularly affected. There are other synonyms for this tendon disease. These are: Insertion tendopathy and Myotendinosis. The term insertion tendopathy describes the localization of the disease very nicely. This is the transition from the tendon to the bone, the attachment. The cause is almost always an incorrect load in people who have not been adequately trained or an overload in the case of athletes without adequate rest breaks. The attachment of the tendons is then swollen and degenerated in a fatty manner. This can also be seen from the outside.

The pain then mainly occurs under stress. But there is also pressure and stretching pain. For pain relief, it is advisable to avoid incorrect and excessive strain. Conservative is then still with heat therapy, tape bandages, Shock wave and Electrotherapy, as well as the injection of Glucocorticoids worked. If conservative therapy does not work, surgery can be performed. During this operation, the diseased tendon is cut. Since this always leads to functional restrictions, an operation should only be considered after any conservative method. Each type of therapy is accompanied by a Physiotherapy and physiotherapy recommended.

Read more on the subject at: Calf pain

Pain in the hollow of the knee in the child

Children can complain of leg pain, especially when they are in kindergarten or primary school. The pain is then mostly localized in the back of the knees, calves or in the hips. In many cases this is Growing pains. But how do you differentiate whether it is growing pains or a serious illness? A clear distinction is not possible without a doctor. However, there are some symptoms that clearly suggest a cause other than growth. Does the child have very severe, long-lasting pain (longer than 15 minutes) in combination with feverWithout a cold, this suggests an infection or other illness rather than the pain of growing. In addition, redness and swelling in the joints speak against growth pain.

What can you do about this pain? You can put a hot water bottle on the affected areas of the child. Targeted too Massages or the administration of a mild pain reliever such as Ibuprofen can help. However, it is advisable to simply discuss the procedure with a doctor. Growing pains are usually quite normal and physiological and do not require any therapy. However, it should always be clarified whether there is something else behind the pain. Other possible causes of pain in the hollow of the knee are joint misalignments on the leg in children, which can be congenital or acquired. The pain can then of course also be localized elsewhere on the leg (e.g. in the ankle), this depends on the misalignment.

Pain in the back of the knee caused by the thigh

The muscles of the thigh are involved in limiting the hollow of the knee (see "Biceps tendon tendinosis"). Therefore, diseases, strains and tears of the thigh muscles, especially the biceps femoris muscle, can cause pain in the hollow of the knee. This pain can radiate into the thigh.

Pain in the back of the knee when stretching

Here, too, the cause lies in the lower attachments of the ischiocural muscles. If this is inflamed, the back of the knee hurts, especially when trying to straighten the knee. In extreme cases, this results in a gait with slightly bent knees.

Knee pain due to tendinitis

Often, knee pain also occurs due to tendinitis in the knee. Tendon inflammation is often caused by overuse or improper stress in the knee joint, which is why athletes are often affected. Symptoms are mainly new pain after movement, redness and knee swelling. If the tendinitis is chronic, the pain can also occur at rest or at night. In order to make the diagnosis, a detailed consultation with a doctor, a physical examination, various exercise tests, and magnetic resonance imaging of the knee joint are necessary. Those affected should take it easy, take anti-inflammatory drugs, and cool the knee. Physiotherapy can also alleviate the symptoms.

Read more on the subject at: Tendinitis in the knee and Tendon inflammation in the hollow of the knee

Appointment with a knee specialist?

I would be happy to advise you!

The knee joint is one of the joints with the greatest stress.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Please note

In no case does the “self” diagnostic agent replace a visit to your trusted doctor! We also make no claim to the completeness of the differential diagnoses presented (alternative causes). We assume no liability for the correctness of the self-diagnosis you have made! We strictly reject any form of self-therapy without consulting your doctor!

Anatomy of the knee joint

Thigh bone (femur)
Medial meniscus
External meniscus
Fibula
Shinbone (tibia)

A - Right knee joint from the front

Inner thigh muscle -
Vastus medialis muscle
Femur -
Femur
Kneecap -
patella
Inner meniscus -
Meniscus medialis
Inner band -
Ligamentum collaterale tibiale
Internal calf muscle
Gastrocnemius muscle,
Caput mediale
Shin -
Tibia
a - Inner ligament injury
(Inner ligament tear)
b - tear of the medial meniscus
c - medial
(internal) knee osteoarthritis

You can find an overview of all Dr-Gumpert images at: medical illustrations

A - Right knee joint from the front

External hamstring muscle -
Vastus lateralis muscle
Femur -
Femur
Kneecap -
patella
Outer meniscus -
Lateral meniscus
Outer band -
Ligamentum collaterale fibulare
Fibula -
Fibula
Shin -
Tibia
External calf muscle
Gastrocnemius muscle,
Caput laterale

a - Ligament injury
(Outer ligament tear)
b - External meniscus tear
c - Lateral
(external) knee arthrosis

You can find an overview of all Dr-Gumpert images at: medical illustrations

To the diagnostic

Using our “self” diagnostic is easy. Follow the respective link offered, where the location and description of the symptoms best match your symptoms. Pay attention to the point of the shoulder joint where the pain is greatest.

Where are your complaints?

Medical terms related to the knee joint

For the exact anatomical assignment, we refer to the Anatomy Lexicon our page.

Here are some key terms related to knee pain:

Head fibulae - fibula head
dorsal- back
Fibula - fibula
Femur - thighs
Femoral condyle - thigh roll
Gon - knee, knee joint,
Hoffa - Fat body of the knee joint
lateral - outside, on the side
Medial collateral ligament - inner band
Ligamentum collaterale laterale - outer band
Ligamentum cruciatum anterius - anterior cruciate ligament
Ligamentum cruciatum posterius - posterior cruciate ligament
medial - Inside
Medial meniscus - medial meniscus
Lateral meniscus - External meniscus
patella - kneecap
Patellar tendon - kneecap tendon
popliteal - concerning the hollow of the knee
Quadriceps tendon - anterior femoral tendon
Tibia - shin
Tibial plateau - articular surface of the tibia
Tibial tuberosity - Elevation of the kneecap tendon attachment to the shin
ventral - front

Pangonarthrosis

Synonyms:
Osteoarthritis of the entire knee joint, Gonarthrosis
Place of greatest pain:
Not clearly assignable. Pain around the entire joint
Pathology / cause:
Cartilage damage caused by wear and tear with inflammation of the mucous membranes and almost even disease involvement of all parts of the knee joint.
Age:
Older age (> 50 years)
Gender:
Women> men
Accident:
No. However, "activation" of an existing, dormant osteoarthritis is possible through a knee injury.
Type of pain:
Stinging, light to dull, drawing. Stiffness of the knee joint. Limited mobility of the knee.
Pain development:
Slowly increasing, sometimes stabbing, sometimes pulling depending on the stage of osteoarthritis.
Pain occurrence:
Morning start-up pain. Increase in pain under exertion (with increasing walking distance).
External aspects:
Swelling, possible overheating. Often bow legs or knock knees. Visible loss of normal knee contour.
Further information:
You can find comprehensive information under our topic: Osteoarthritis of the knee

Rheumatoid arthritis

Synonyms:
Rheumatism, primary rheumatoid arthritis, PCP, RA, rheumatoid arthritis
Place of greatest pain:
Not clearly assignable. Pain around the entire joint.
Pathology / cause:
Rheumatic inflammation of the knee joint mucosa. Usually other joints are also affected.
Age:
middle to old age
Gender:
Women> men
Accident:
No
Type of pain:
piercing, bright, burning
Pain development:
Both acute relapses and chronic pain are possible.
Pain occurrence:
Persistent pain. Exercise pain.
External aspects:
Overheating, swelling. Visible loss of normal knee contour.
Further information:
You can find comprehensive information under our topic: Rheumatoid Arthritis.

Osteochondrosis dissecans

Synonyms:
Bone necrosis, bone death, Ahlbäck's disease, aseptic bone necrosis, joint mouse, dissecat, osteochondritis dissecans, osteonecrosis, OD, dissecting osteochondrosis
Place of greatest pain:
Not clearly assignable. Pain around the entire joint. Partial maximum pain over the inner femoral roll.
Pathology / cause:
Unexplained bone death (aseptic osteonecrosis), predominantly of the inner thigh roll.
Age:
Childhood and adolescence. Preferably towards the end of growing age. Occurrence in adulthood as part of osteoarthritis (Ahlbäck's disease).
Gender:
Boys / Girls 2: 1
Accident:
No
Type of pain:
Uncharacteristic knee pain.
Pain development:
creeping, changeable.
Pain occurrence:
Exercise pain. Blockages after loosening a piece of cartilage / bone.
External aspects:
None, possibly swelling
Further information:
You can find comprehensive information under our topic: Osteochondrosis dissecans.

Irritable knee

Synonyms in the broader sense:
Overuse knee
Place of greatest pain:
Not clearly assignable. Pain around the entire joint.
Pathology / cause:
Inflammatory overload reaction of the synovial membrane.
Age:
Every age. Mostly after unusual sporting activity.
Gender:
no gender preference
Accident:
No
Type of pain:
piercing, bright, burning
Pain development:
Often a few hours or the day after exercise.
Pain occurrence:
Persistent pain. Exercise pain.
External aspects:
Overheating, swelling. Serous (yellowish clear) fluid during knee joint puncture.

Reactive arthritis

Synonyms:
Coxitis fugax (in children)
Place of greatest pain:
Not clearly assignable. Pain around the entire joint.
Pathology / cause:
Inflammatory, immunological reaction of the synovial membrane after a viral infection (e.g. gastrointestinal infection, upper respiratory tract, disease of the lower urinary tract).
Age:
every age
Gender:
no gender preference
Accident:
No
Type of pain:
piercing, bright, burning
Pain development:
Often days after viral infection.
Pain occurrence:
Continuous pain, stress pain
External aspects:
Overheating, swelling

Bacterial infection

Synonyms:
purulent arthritis
Place of greatest pain:
Not clearly assignable. Pain around the entire joint. Partial maximum pain over the inner femoral roll.
Pathology / cause:
Bacterial knee inflammation either through direct introduction of germs or as part of a bacterial infection via the bloodstream. Sources can be chronic sinusitis or chronic root inflammation. Direct spread of germs can result from a puncture of the knee joint.
Age:
Every age. Via the bloodstream (haematogenic especially in young children)
Gender:
no
Accident:
Possibly with opening of the knee joint or after an operation.
Type of pain:
Stinging, bright, burning.
Pain development:
Mostly acute with rapid progress.
Pain occurrence:
Continuous pain, stress pain.
External aspects:
Overheating, swelling, redness. Fever! Putride (purulent, cloudy) liquid in the case of knee joint puncture.

Cruciate ligament injury

Synonyms in the broader sense:
anterior cruciate ligament tear, ACL rupture, cruciate ligament lesion, knee instability, cruciate ligament insufficiency, cruciate ligament rupture, cruciate ligament plastic surgery, anterior cruciate ligament
Place of greatest pain:
Not clearly assignable. Pain around the entire joint.
Pathology / cause:
Rupture of the anterior or posterior cruciate ligament
Age:
Every age. Young, active people. Female soccer players are particularly at risk.
Gender:
No gender preference.
Accident:
Adequate accident, mostly with twisting of the knee joint. Combined injuries with involvement of other structures are possible, especially the meniscus and outer ligament.
Type of pain:
Piercing, bright.
Pain development:
Acute, in connection with the accident.
Pain occurrence:
Exercise pain. Knee instability.
External aspects:
Swelling. Functional restriction of the knee joint. Bloody fluid when the knee is punctured (hemarthrosis).
Further information:
You can find comprehensive information under our topic: Rupture of the anterior cruciate ligament or Rupture of the posterior cruciate ligament

Pain on the inside of the knee

Pain on the Inside of the knee can have different causes, the following are common causes:

Medial meniscus damage: In our knee we have two Menisci, the inner and outer meniscus, which are mainly used to repair bumps in the knee and To dampen shocks. In young people, the menisci are still very large resilient and flexible. Here damage is most likely caused by one acute injury like in sports. In particular, sports like tennis, Soccer or To ski put a lot of strain on the menisci.
With age, the elasticity of the menisci decreases and wear and tear occurs. This can lead to damage to the menisci even with slight overuse or sometimes without any force.

Since the Medial meniscus more firmly in knee is anchored and not as flexible as that External meniscus injuries are more common here. Acute injuries often go with one Joint swelling hand in hand and pain on the inside of the knee, which through Turning and bending movement be reinforced.

In the case of meniscus damage due to wear and tear, the symptoms are not quite as clear, but they can also be found here internal knee painwhich increase steadily under load and over time.

arthrosis on the inside of the knee: Osteoarthritis is one Joint wearwho that age-appropriate measure exceeds. Especially with a misalignment of the legs, the so-called Bow legs it may be due to the excessive unilateral burden osteoarthritis of the knee, which is also noticeable in pain.

Inflammation and tendon damage: Also the inflammation of the naturally occurring in the knee Bursa can cause pain on the inside of the knee, as well as an injury to the tendon of the Semimembranosus musclewhich one Flexor is in the knee joint.

That too wrong footwear and an accompanying one Foot malposition can cause pain on the inside of the knee.

When climbing stairs

Knee pain when climbing stairs is load-dependent pain that can be triggered, among other things, by knee osteoarthritis behind the kneecap. Again, it is age-related wear.

Read more on the topic: Pain behind the kneecap

Overloading the patellar tendon, the so-called patellar tendon, can also cause pain when climbing stairs. Jump athletes are often affected by this type of knee pain, which is why this form is also known as the "jumper knee". With the help of physiotherapy and anti-inflammatory drugs, this irritation of knee pain usually disappears on its own.

You might also be interested in this topic: Cruciate ligament overstretched

Knee pain when jogging

The so-called "Runner's knees“Is probably known to almost every avid jogger. Hardly anyone does not even complain of knee pain in their training life. There are several causes for the pain in the knee when running and often there are very simple things that everyone can influence, such as Wear the right footwear, stretch enough, avoid overloading through too much training or training too quickly.
Often there is also a Imbalance of the muscle groups involved, especially the Thigh musclesthat supports the knee and gives it stability is often neglected by joggers.

Especially with beginners or after long breaks in sports, knee pain occurs more frequently when jogging.

Once the pain is there, the only thing that helps is rest and waiting until the knee has recovered.If the knee still hurts after a few days, you should visit the Orthopedists advisable (see also: Jogging with knee osteoarthritis). On longer medication with Painkillers how Ibuprofen and aspirin should be omitted as this is in the long run severe side effects to the stomach and kidneys. Furthermore, one should make sure that the points mentioned above are applied to the individual training in order to avoid renewed pain.

Pain on the outside of the knee

Pain on the outside of the knee can also result arthrosis (Wear and tear). The cause for this is usually a misalignment, the so-called Knock kneeswhich results in a severe disproportionate load on the outer knee.

Damage or tears to the tendon of the Hamstring biceps can also be noticeable on the outside of the knee. Athletes, especially runners, are mainly affected by exercise-related tendon damage. This typically leads to Tenderness at the attachment point of the tendon, as well as possible swellings in the corresponding area with a thickened tendon of the thigh muscle.

Knee pain - front

If the pain is only felt at the front of the knee, it may be a "Jumper knees“Act. This means the damage to the Kneecap tendon (Patellar tip syndrome). This is a harmless overload of the knee, which with Quiet and possibly physiotherapy completely regressed. In addition, such pain can also be a symptom of wear on the kneecap, a so-called retropatellar arthrosis.
Please also read our article on this Retropatellar arthrosis.

If there is no simple regression, especially with children, the Sinding-Larsen-Johansson disease be considered. This is a painful inflammatory reaction the origin of the patellar tendon, where a piece of bone separates from the kneecap. With the loosened piece of bone, there is a risk that it will die (necrotize). The therapy takes a long time (three -12 months) and consists of Protection, cooling and anti-inflammatory drugs.

Similar to Sinding-Larsen-Johansson disease is that which also occurs in children Osgood-Schlatter disease. Here too there is one painful irritation of the patellar tendon, but at the base of the shin, from which pieces of bone can also detach and die. Treatment is the same as for Sinding-Larsen-Johansson disease. Both have good prognoses under therapy.

Also one Inflammation of the bursa in the knee and shape disorders of the kneecap can cause pain on the outside.

Pain in the back of the knee

Common causes of backbone pain are Injuries to the posterior horn of the meniscus. There can also be a so-called Baker's cystwhich can also cause severe pain.

The Baker cyst is one Cyst in the hollow of the kneewhich emerges from a protuberance of the dorsal joint capsule between Calf muscles Gastrocnemius muscle and semimembranosus muscle.
Most often it arises in connection with damage to the knee joint, such as: a Meniscus damage. Depending on the size of the cyst, the pain can vary, but it can also be with very large cysts Compressions of nerves and vessels come in the hollow of the knee, which leads to numbness and paralysis in the area of the lower legs and feet.

Also Sports injuries and overload can manifest itself in the form of pain in the hollow of the knee. Pain in the hollow of the knee occurs especially when the knee flexor muscles are overused or worn.

Caution Pain in the hollow of the knee can also have a completely different origin than the knee. Leg vein thrombosis also causes pain in the hollow of the knee. However, these require rapid clarification and therapy. That is why it is important to think about the cause of new knee pain, if you have been doing more sport than usual recently, if the symptoms appeared more insidious or suddenly, there may be other risk factors for diseases such as thrombosis (e.g. a long-haul flight , longer immobilization). If you are unsure, a doctor should be consulted as a precaution.

Other causes of knee pain

Causes of knee pain beyond the knee joint:

The pain is usually transmitted and projected onto the knee joint.

They are not intended to be presented in detail. There are almost always additional, distant knee-joint complaints at the point of origin of the pain. Conditions that can cause referred knee pain include:

Hip osteoarthritis (often!)
Pseudoradicular pain syndrome (facet syndrome, SI joint affection, SI joint blockage, degenerative lumbar spine syndrome)
Foot and ankle disorders (foot deformities, running style (jogging), incorrect footwear)