[41M] Long-term knee pain with complications

Patient Description

A 41-year-old male has been experiencing severe knee pain for about 20 years, characterized by a burning sensation that has recently started to spread down the shin and into the ankle. The pain, which sometimes reaches a severity of 9 or 10 out of 10, is associated with a history of ACL and cartilage damage. The patient notes that walking can sometimes alleviate the pain. Additional symptoms include swelling, a crunching feeling in the knee, and the knee frequently locking up. The knee is described as warm to the touch, and the patient experiences shooting pains from the knee to the ankle, particularly at night. The patient has a medical history of being pre-diabetic and a recovering addict, currently taking Suboxone and etodolac. No known allergies are reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Osteoarthritis: This is a degenerative joint disease that can cause pain, swelling, and a crunching feeling. It's common in people who have had previous injuries to the joint, like an ACL tear. The warmth you're feeling in your knee could be due to inflammation associated with osteoarthritis.

    • Treatment typically involves pain management with over-the-counter or prescription medications, physical therapy, and in some cases, surgery.
  • Post-traumatic arthritis: This is a form of osteoarthritis that develops after an injury, like an ACL tear. It can cause similar symptoms to osteoarthritis.

    • Treatment is similar to that of osteoarthritis.
  • Chronic regional pain syndrome (CRPS): This is a rare condition that can cause severe, burning pain, usually in an arm, leg, hand, or foot. It often develops after an injury. The fact that your pain is spreading could suggest CRPS.

    • Treatment typically involves medications, physical therapy, and psychological therapy.
  • Nerve damage: The burning pain and the fact that it's spreading could suggest some form of nerve damage or neuropathy. This could be due to a variety of causes, including your previous injury, diabetes, or other conditions.

    • Treatment typically involves managing the underlying cause and medications to manage the pain.

What you can do

You should definitely see a doctor about your symptoms. They can provide a formal assessment and order relevant tests if necessary. In the meantime, here are a few things you can do:

  1. Rest your knee as much as possible and avoid activities that make your symptoms worse.
  2. Apply a cold pack to your knee for 15-20 minutes at a time, several times a day, to help reduce inflammation and pain.
  3. Over-the-counter pain relievers, like ibuprofen, can help manage your pain. However, you should check with your doctor before starting any new medications, given your other health conditions and current medications.
  4. Gentle exercises and physical therapy can help strengthen your knee and improve your symptoms. However, you should only start this under the guidance of a healthcare professional.

What you should look out for

Here are a few signs that you should seek medical attention immediately:

  • If your pain becomes severe or unbearable
  • If you notice any significant swelling, redness, or warmth around your knee
  • If you develop a fever or other signs of infection
  • If you notice any changes in your ability to move or use your knee

Remember, I'm an AI and not a doctor. It's important to consult with a healthcare professional for a formal diagnosis and treatment.

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6 mo ago


People Also Ask


What are the common symptoms of osteoarthritis in the knee?

Common symptoms of osteoarthritis in the knee include pain, swelling, stiffness, a crunching sensation during movement, and warmth around the joint due to inflammation.


How can post-traumatic arthritis develop after an ACL injury?

Post-traumatic arthritis can develop after an ACL injury due to the damage and wear on the joint over time. This can lead to symptoms similar to osteoarthritis, such as pain, swelling, and reduced mobility.


What is Chronic Regional Pain Syndrome (CRPS) and how is it treated?

Chronic Regional Pain Syndrome (CRPS) is a condition characterized by severe, persistent pain, often following an injury. It can cause burning pain, swelling, and changes in skin color or temperature. Treatment typically involves medications, physical therapy, and sometimes psychological therapy.


What are the signs of nerve damage in the leg?

Signs of nerve damage in the leg can include burning pain, tingling, numbness, weakness, and pain that spreads or radiates. It may be caused by injury, diabetes, or other conditions affecting the nerves.

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