[36M] With chronic right knee pain and instability

Patient Description

A 36-year-old male with a history of professional wrestling presents with chronic sharp pain in the right knee, located above and along the top of the kneecap, persisting for approximately six months. The pain is constant throughout the day and night, exacerbated by standing, transitioning from sitting to standing, and walking for more than 20 minutes. The patient reports instability, locking, and popping sensations when bending and extending the knee, as well as swelling after activity, constant stiffness, and changes in range of motion. Additional symptoms include clicking, catching, and grinding sensations, particularly on the outer side and top of the knee. The patient has a history of self-diagnosed knee injuries but has not sought formal medical evaluation or treatment due to lack of insurance. He has used knee stabilizers in the past but currently does not have one. No redness or warmth around the knee joint has been noted. The patient has not tried any treatments or self-care measures such as rest, ice, or over-the-counter pain relief, aside from self-massage when the pain becomes severe. No medications are currently being taken.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your knee pain:

  • Patellofemoral Pain Syndrome (Runner's Knee): This condition is common in athletes and can cause pain around or behind the kneecap. It often results from overuse, muscle imbalances, or improper alignment. The sharp pain, instability, and popping you describe could be related to this condition.

    • Treatment typically involves physical therapy to strengthen the muscles around the knee, improve flexibility, and correct any alignment issues. Rest, ice, and over-the-counter pain relievers can also help manage symptoms.

  • Meniscus Tear: The meniscus is a piece of cartilage that provides cushioning in your knee joint. Tears can occur due to twisting motions or degeneration over time. Symptoms include pain, swelling, stiffness, and a catching or locking sensation.

    • Treatment may involve rest, physical therapy, and possibly surgery, depending on the severity of the tear.

  • Osteoarthritis: This is a degenerative joint disease that can cause pain, stiffness, and swelling. Given your history of wrestling, it's possible that wear and tear over time has contributed to this condition.

    • Management includes lifestyle modifications, physical therapy, pain relief medications, and in some cases, surgical interventions.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest and Ice: Give your knee a break from activities that worsen the pain. Apply ice packs to reduce swelling and numb the area.

  2. Over-the-Counter Pain Relief: Consider using non-prescription pain relievers like ibuprofen or acetaminophen to help manage pain and inflammation.

  3. Strengthening Exercises: Gentle exercises to strengthen the muscles around your knee can help improve stability and reduce pain. Consider consulting a physical therapist for guidance.

  4. Knee Support: If possible, use a knee brace or stabilizer to provide additional support and reduce strain on your knee.

  5. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share your notes with a healthcare provider when you are able to see one.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe pain that doesn't improve with rest or medication
  • Significant swelling or redness around the knee
  • Inability to bear weight on your leg
  • Fever or signs of infection

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a proper diagnosis and treatment plan.

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1 mo ago

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People Also Ask

What are the common causes of knee pain in athletes like wrestlers?

Common causes of knee pain in athletes, especially those involved in high-impact sports like wrestling, include overuse injuries such as patellofemoral pain syndrome, meniscus tears, ligament injuries, and osteoarthritis due to wear and tear over time.

How can I differentiate between a meniscus tear and patellofemoral pain syndrome?

A meniscus tear often presents with pain, swelling, stiffness, and a catching or locking sensation in the knee. Patellofemoral pain syndrome typically causes pain around or behind the kneecap, instability, and popping sensations. A healthcare professional can provide a definitive diagnosis through physical examination and imaging tests.

What are some effective self-care measures for managing chronic knee pain?

Effective self-care measures for managing chronic knee pain include resting the knee, applying ice to reduce swelling, using over-the-counter pain relievers, performing strengthening exercises for the muscles around the knee, and using a knee brace for support.

When should I seek medical attention for knee pain?

You should seek medical attention for knee pain if you experience severe pain that doesn't improve with rest or medication, significant swelling or redness, inability to bear weight on the leg, or signs of infection such as fever.

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