In fact, the causes of internal knee pain include: knee arthrosis, medial collateral ligament injuries, medial meniscus injuries, rheumatoid arthritis, goose leg bursitis or anserine bursitis, of the mid-patellar fold and bruises to the medial knee.
Brief anatomical recall of the Knee
The knee is the important synovial joint of the human body, located between the femur (superiorly), tibia (inferiorly) and patella (anteriorly).
Its anatomy is quite complex and includes:
- The articular cartilage, which covers the lower surface of the femur, the inner side of the patella and the center of the upper surface of the tibia, protecting all these bones from mutual friction;
- The synovial membrane, which covers the joint from the inside and produces the synovial fluid, a fluid with a lubricating action for all the internal structures of the knee;
- The collateral ligaments, the cruciate ligaments and the patellar tendon, which, all together, guarantee the stability of the joint and the correct alignment between the femur and the tibia;
- The synovial bags, which are small sacs of synovial membrane, filled with a lubricating fluid very similar to synovial fluid;
- The internal meniscus (or medial meniscus) and the external meniscus (or lateral meniscus), which are pads of cartilage with a cushioning and anti-friction function, located on the sides of the upper surface of the tibia.
Inner Knee Pain means Pain in the Medial Portion of the Knee
"Inner knee" is the slang term for the medial portion of the knee.
Hence, internal knee pain is, in specialist language, pain in the medial portion of the knee.
In anatomy, the word "medial" is synonymous with proximity to the sagittal plane, that is the antero-posterior axis that symmetrically separates the human body into two parts, giving rise to a right half and a left half.
Which Medical Figure Treats Internal Knee Pain?
The causes of internal knee pain are a matter for orthopedic doctors, ie doctors specialized in the diagnosis, treatment and prevention of pathologies that can affect the musculoskeletal system.
Who Suffers Most from Inner Knee Pain?
Internal knee pain is a common symptom, which can affect people of all ages and which has a "higher incidence among athletes and generally very active individuals.
, has as its most common causes:
- L "osteoarthritis of the knee;
- Injuries to the medial collateral ligament;
- Injuries to the medial meniscus;
- Rheumatoid arthritis;
- The so-called goose leg bursitis or anserine bursitis;
- The so-called mid-patellar fold syndrome;
- Bruises to the medial knee without damage to the joint components.
Knee osteoarthritis
Knee osteoarthritis is chronic inflammation of the knee, which results from the degeneration of the articular cartilage present on the femur and / or the cartilage of the menisci present on the tibia.
Knee osteoarthritis is, unfortunately, an irreversible and progressive condition; it produces, in fact, injuries to the cartilage of the knee that are impossible to recover and with a tendency to worsen over time.
In the medical field, osteoarthritis of the knee is the condition also known as gonarthrosis or osteoarthritis of the knee.
Did you know that ...
Osteoarthritis is a form of arthritis (inflammation of the joints); to be precise, it is a form of "wear and tear" arthritis of the articular cartilages.
Of the numerous forms of existing arthritis, osteoarthritis is the most common: in the United States alone it affects 27 million people!
Injuries to the medial collateral ligament
The medial collateral ligament, or internal collateral ligament, is the knee ligament located on the internal side of the joint, originating on the so-called medial epicondyle of the femur and ending on the so-called medial condyle of the tibia.
Injuries to the medial collateral ligament consist of strains or, at worst, tears of the connective-fibrous tissue making up the ligament in question.
Usually, strains and tears of the medial collateral ligament are the result of a knee sprain, following a sudden and abrupt trauma (bad fall, abnormal torsion, etc.).
People who play sports in which sudden changes of direction in running and jumps are expected to suffer the most from injuries to the medial collateral ligament (eg: football, rugby or basketball) and the elderly with walking problems.
In medicine, the term "sprain" indicates an injury to the "musculoskeletal system, which is characterized by a" temporary alteration of the internal anatomical relationships of a "joint and the consequent damage, more or less deep, to one or more components articular.
Injuries to the medial meniscus
The medial meniscus, or internal meniscus, is the crescent-shaped (or C) -shaped layer of fibrous cartilage, which takes place on the medial portion of the upper surface of the tibia and serves, mainly, to absorb shocks to the joint. .
Injuries to the medial meniscus consist of injuries, lacerations and splits of the fibrous cartilage making up the internal meniscus.
In most cases, medial meniscus injuries are the result of a knee sprain following an abrupt and sudden traumatic event; more rarely, they result from repeated improper stresses on the joint, which, in the long run, are harmful to the internal meniscus.
Did you know that ...
There are various types of medial meniscus injury; the most common types of medial meniscus lesions include: the radial lesion, the flap lesion, the "bucket handle" lesion, the longitudinal lesion and the degenerative lesion.
Rheumatoid arthritis
Rheumatoid arthritis is a chronic inflammatory disease of the synovial joints, which has as its main target the synovial membrane and which, over time, determines the alteration of the joint capsule, ligaments and articular cartilage.
Rheumatoid arthritis is a medical condition that originates from a malfunction of the immune system, which is the reason for its inclusion in the list of autoimmune diseases.
The exact cause that alters immune system functions and leads to rheumatoid arthritis is uncertain; however, it is a fact that factors such as "belonging to the female sex, over 40 years of age, cigarette smoking and having come into contact with some pathogens such as "herpes virus or the Epstein Barr virus.
Goose leg bursitis
In the medical field, the term "bursitis" indicates the "inflammation of a synovial bursa, ie the" inflammation of one of those synovial membrane sacs containing synovial fluid, which are among the characteristic elements of the synovial joints and which serve to reduce the " friction between ligaments, tendons and articular cartilages.
Goose leg bursitis is inflammation of the synovial bursa of the knee between the medial collateral ligament and the so-called goose leg (or pes anserinus), ie the medial prominence present on the proximal end of the tibia on which the sartorius, gracilis and semitendinosus muscles are inserted.
The following can cause goose leg bursitis:
- Direct trauma to the synovial bag described above, such as to cause the injury;
- Overuse of the knee joint;
- The abnormal friction between the synovial bursa described above and one of the adjacent anatomical structures;
- Poor stretch and poor flexibility of the hamstrings.
In goose leg bursitis, the pain in the internal knee is the result of the compression that the synovial bursa, protagonist of the condition in question, exerts on the adjacent joint structures, following its inflammation and consequent swelling.
Did you know that ...
Risk factors for goose leg bursitis include obesity, knee osteoarthritis and medial meniscus injuries.
Mid-patellar fold syndrome
In medicine, the term "plica" referring to a "synovial joint refers to one of the characteristic folds present on the synovial membrane.
The mid-patellar fold syndrome is irritation, followed by inflammation, of one of the typical folds present on the medial portion of the synovial membrane of the knee.
Generally, the midpatellar fold syndrome is related to overuse of the knee: for example, it can be caused by the continuous repetition of a flexion movement.
Medial knee contusions
Bruises to the knee in the medial area are injuries of the internal portion of the knee that do not compromise the integrity of the joint structures, but which are still responsible for pain.
Typically, the origin of internal knee bruises are involuntary falls or blows that directly affect the internal side of the joint.
Internal knee bruises are a condition of mild clinical significance.
Causes of Inner Knee Pain in Young People
In young people, the most common causes of inner knee pain are slightly different from those reported for adults and the elderly.
Specifically, these causal factors are:
- Patellar subluxation;
- Patellar or patellar tendonitis;
- Tibial apophysitis or Osgood-Schlatter syndrome.
Complications
If the cause is a clinically relevant condition such as knee osteoarthritis or if the treatment of the triggering cause is inappropriate, the pain in the internal knee can take on the characteristics of a chronic condition, which afflicts the patient even during the performance of the most trivial activities. daily (eg: climbing stairs or entering or exiting the car).
When to see a doctor?
Inner knee pain is a symptom that should concern and prompt the affected person to see a doctor when:
- It has been going on for several days;
- Despite the rest and the application of ice, it persists and shows no signs of improving;
- It is the result of a knee sprain;
- It is associated with several other symptoms (e.g. joint stiffness, swelling, reduced joint mobility, etc.).
and anti-inflammatory, which many people underestimate.
As a rule, in the presence of internal knee pain, doctors recommend applying ice 4-5 times a day, for at least 15-20 minutes;
- Taking non-steroidal anti-inflammatory drugs (NSAIDs).
Thanks to their anti-inflammatory power, NSAIDs relieve the painful sensation; - Application, around the knee, of an elastic compression band.
The use of an elastic compression band serves to mitigate any swelling and a possible sense of instability at the knee level; - Elevation of the lower limb.
Keeping the lower limb elevated reduces the blood supply to the knee; less blood flow to a painful knee relieves pain and helps resolve any swelling.
What to do if Conservative Therapy fails?
If your internal knee pain persists despite the above conservative therapy, your doctor will suggest more invasive treatments, mildly or significantly (depending on the circumstance), including:
- Localized injection of corticosteroids.
Corticosteroids are very effective anti-inflammatory drugs; however, due to their possible adverse effects, doctors use them only if strictly necessary; - The use of a knee brace as a support element for the joint;
- Physiotherapy.
Essential for when internal knee pain and associated symptoms are not affected by the benefits of rest, physiotherapy includes strengthening and stretching exercises for all the muscles of the suffering lower limb; in particular, it is worth noting the importance of strengthening the muscles of the lower limb. thigh. - Drainage of excess fluid (therapeutic arthrocentesis).
It consists in introducing a special needle inside the suffering knee (to be precise where it locates the swelling) and aspirating.
Often, upon aspiration, the treating physician accompanies the injection of an anti-inflammatory drug belonging to the category of corticosteroids and / or the injection of a hyaluronic acid. - The surgery.
It is the most invasive solution ever, even if - it is important to point out - today the operating techniques are much less bloody than in the past.
Surgery becomes the only way forward, when not only conservative treatments, but also those just mentioned (corticosteroids, knee braces, etc.) have proved ineffective.
How the Cause of Inner Knee Pain Affects Therapy
In the therapeutic management of inner knee pain, the cause of the pain is important because:
- It affects the duration of conservative therapy.
- It affects the likelihood of success of conservative therapy.
- It is the "element on which the planning of a possible physiotherapy" is based. Physiotherapy exercises vary in relation to the cause of inner knee pain.
- Similarly to the previous case, it is the element on which the planning of a possible surgical intervention is based. For each cause of internal knee pain, there is an ad hoc surgical treatment.
