 | Robert Cusick, M.D. M.D., is a partner in the Kansas Joint & Spine Institute, Chartered with a specialty in reconstructive surgery of the hips and knees, and orthopedic trauma surgery. He received his BS from the University of Illinois, and graduated from the University of Illinois College of Medicine. After a five-year Orthopaedic Residency program at the University of Kansas-Wichita, he spent one year completing a fellowship in Adult Reconstructive Surgery at the Institute for Bone and Joint Surgery in Phoenix, Arizona. Dr. Cusick is on the teaching faculty at the University of Kansas School of Medicine-Wichita, and is an active lecturer in the medical community. The Kansas Joint and Spine Institute can be contacted at (316) 858-1900. |
Health & Medicine
2002-06-01 15:05:00
What if it’s not my knee?
Question: I am having lots of pain on the inside of my knee but I can't remember doing anything to aggravate it. How do I know it's my knee and not my foot or ankle that's causing the problem?
Answer: There are two locations away from the knee that are known to frequently produce pain which may mistakenly seem to be in the knee. The more common of the two is pain radiating from the lower back down the back of the leg and affecting the knee. This pain is usually the result of either arthritis in the lower spine which constricts the space available for the nerves, or from a bulging disc in the lower spine. The best way to differentiate the source of this type of pain is by a careful physical examination. The second place away from the knee where knee pain may arise is in the hip. A branch of one of the primary nerves which travels down the leg is located directly in front of the hip joint. In a situation where a patient may be able to manage some long-standing hip pain due to osteoarthritis, the local inflammation surrounding the hip may affect the nerve which travels to the knee. In this situation, it is very easy for a physician to focus on the knee pain, and ignore the hip X-rays. Again, a very thorough physical examination should help the physician decide on the source of the knee pain. It is fortunately rare for pain from the foot or ankle to be interpreted by a patient as knee pain. Because of the way we bear weight on our legs, pain starting in the ankle or foot will usually be felt in that same location. It should be understood, however, that a deformity of the foot or ankle, such as very flat feet or a poorly healed fracture, can throw off the overall alignment of the lower leg and lead to knee pain over time. Outside of a situation of poor alignment for other reasons, pain felt deep inside the knee with no predisposing injury can be a result of several conditions. Wear and tear can affect the cartilage on the ends of the bones and produce arthritis over time, or can affect the soft cartilage of the knee, the meniscus, and produce degenerative tears over time. One of the four main ligaments of the knee can suffer a tear or sprain, leading to lots of pain, but will usually be associated with an injury. It is important that significant pain inside the knee which is not relieved by rest, ice or anti-inflammatory medication be evaluated by a qualified physician who may prevent you from doing any further damage to your knee.
