Knee pain is one of the most common musculoskeletal complaints affecting people of all ages in Malaysia and around the world. Whether you are a young sportsperson, a working professional, or an elderly person, knee pain can significantly impact your daily activities and quality of life. This article seeks to provide a comprehensive overview of knee pain, discussing its causes, symptoms, diagnosis, preventive measures, and treatment options.

Prevalence of Knee Pain in Malaysia

According to a cross-sectional study published in the Malaysian Orthopaedic Journal, knee osteoarthritis (OA) is particularly prevalent in adults over the age of 55, with up to 30% of this population group reporting symptoms of knee pain. The Ministry of Health Malaysia has also identified knee pain as a significant public health concern, especially in urban areas where physical inactivity and obesity are more common.

Common Causes of Knee Pain

Knee pain can arise from a variety of causes, which may be acute (sudden onset) or chronic (long-standing). Understanding the underlying cause is essential for effective management. The most common causes include:

• Osteoarthritis: This is the most frequent cause of chronic knee pain, especially in people above 50 years of age. Wear and tear of the knee’s cartilage leads to pain, swelling, and stiffness. The prevalence of osteoarthritis is rising due to increasing life expectancy and sedentary lifestyles.
• Injuries: Sports injuries, falls, or accidents can lead to ligament sprains (such as ACL or MCL), meniscus tears, or fractures. These are common among young adults and athletes.
• Rheumatoid Arthritis: An autoimmune condition where the body’s immune system attacks the joint lining, causing inflammation and pain.
• Gout: An increase in uric acid levels in the blood can cause crystal deposits in the knee joint, leading to sudden, severe pain and swelling.
• Bursitis: Inflammation of the small fluid-filled sacs (bursae) that cushion the knee joint.
• Infections: Septic arthritis or tuberculosis of the knee, though less common, can present with severe pain, swelling, and fever.
• Patellofemoral Pain Syndrome: Commonly seen in adolescents and young adults, especially females, often due to overuse, improper footwear, or biomechanical problems.

Other Risk Factors & Causes

Several risk factors can predispose individuals to knee pain:

• Age: Risk increases with age.
• Obesity: Excess body weight puts additional stress on the knees, accelerating cartilage wear. In Malaysia and globally, there has been a rise in obesity rates, particularly in urban areas.
• Occupation: Jobs that involve repetitive knee bending, squatting, or heavy lifting (e.g., agriculture, construction) increase risk.
• Sports Participation: High-impact sports such as badminton, football, or running may increase injury risk if proper techniques and warm-ups are not practised.
• Previous Injuries: Past knee injuries can make the joint more susceptible to future problems.

Symptoms Associated with Knee Pain

Knee pain may be localised or diffuse and can be accompanied by other symptoms, such as:

• Swelling and stiffness
• Redness and warmth to the touch
• Weakness or instability
• Popping or crunching noises
• Inability to fully straighten or bend the knee
• Locking or catching of the knee

The severity and combination of symptoms often provide clues to the underlying cause and guide further evaluation.

Diagnosis of Knee Pain

A thorough evaluation includes a detailed medical history, physical examination, and, if necessary, investigations. Your doctor may ask about the nature of the pain, its onset, activities that worsen or relieve it, and any history of trauma or systemic illness.

Common diagnostic tests include:

• X-rays: Useful for detecting bone fractures or osteoarthritis.
• MRI scans: Provide detailed images of soft tissues like ligaments, tendons, and cartilage.
• Blood tests: To identify infections, gout, or autoimmune conditions.
• Joint aspiration: Removal of fluid from the knee for laboratory analysis, especially if infection or gout is suspected.

Prevention of Knee Pain

While not all causes of knee pain are preventable, several measures can help reduce the risk:

• Maintain a Healthy Weight: Even a small reduction in weight can significantly decrease stress on the knee joints.
• Exercise Regularly: Focus on strengthening the muscles around the knee, especially the quadriceps and hamstrings without causing excessive strain, such as walking, cycling, or swimming.
• Use Proper Footwear: Wear shoes that provide adequate support, especially during sports or long periods of standing.
• Avoid Sudden Increases in Activity: Gradually increase exercise intensity and duration to prevent injuries.
• Practice Safe Techniques: Use proper posture and techniques during sports and occupational activities.
• Warm Up and Cool Down: Always warm up before exercise and cool down afterward.

Treatment Options

Treatment depends on the underlying cause and severity of knee pain. Options range from home-based remedies to medical interventions.

• Home Care: The R.I.C.E. protocol (Rest, Ice, Compression, Elevation) is effective for minor injuries. Over-the-counter pain relievers like paracetamol or ibuprofen may provide relief.
• Physiotherapy: A physiotherapist can design a customised exercise programme to strengthen knee-supporting muscles, improve flexibility, and restore function.
• Medications: Depending on the cause, your doctor may prescribe painkillers, anti-inflammatory drugs, corticosteroids, or disease-modifying agents for conditions like rheumatoid arthritis or gout.
• Injections: Corticosteroid or hyaluronic acid injections may be used to reduce inflammation and provide lubrication in osteoarthritis.
• Surgical Intervention: In severe cases, procedures such as arthroscopy, ligament reconstruction, or total knee replacement may be necessary, especially for advanced osteoarthritis or irreparable injuries.

Conclusion

Knee pain is a multifaceted problem with a wide range of causes, from injuries and arthritis to lifestyle and cultural factors. Early recognition, preventive measures, and appropriate treatment are key to reducing pain and maintaining mobility. If you experience persistent or severe knee pain, consult a healthcare professional for an accurate diagnosis and tailored treatment plan. With timely intervention and proper care, most people can manage knee pain effectively and continue to lead active, fulfilling lives.

Sources:

• https://morthoj.org/
• https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/
• https://www.webmd.com/pain-management/knee-pain/knee-pain-overview