Fact or Fiction? Common Misconceptions About Knee Pain
Knee injuries are among the most common orthopaedic conditions treated today. But because of that, there are also a lot of myths about knee pain, treatments and surgeries. We asked Dr. Lucas Wymore, a sports medicine specialist with expertise in complex knee injuries and arthroscopy, to provide insight on the top patient misconceptions about knee injuries:
Myth: All knee pain is from the knee.
Pain felt in the knee can come from a primary knee source – arthritis, a ligament tear, meniscus injury, and tendonitis are all common causes – but sometimes the pain is referred from other locations. Hip conditions can sometimes present as knee pain. Pinched nerves in the spine can also present as pain around the knee. Only a thorough exam can help identify the source of pain.
Myth: Cortisone injections are bad.
Cortisone is a name for a type of corticosteroid. These are powerful anti-inflammatory medications that can be used to treat a variety of conditions, either with pills by mouth or shots. They can have a great pain-relieving effect on various knee conditions, and depending on the problem, can sometimes cure it with a single shot. Too much cortisone can cause problems, so everyone should be monitored. While cortisone does not cure arthritis, it can be very helpful managing the symptoms.
Myth: Running causes arthritis.
A recent review from the American Journal of Sports Medicine shows that no conclusive evidence exists to associate running with the development of arthritis (Timmins et al AJSM May 2017). While further study could provide more information, at this time, there is no reason to stop running in order to prevent later arthritis. In other studies, runners were shown to have less pain than non-runners, even when both groups had the same amount of arthritis.
Myth: All meniscus tears need surgery.
Meniscus tears are a very common injury, and knee arthroscopy (using a fiberoptic camera and small incisions) have made meniscus surgery a very common outpatient surgery with good results. However, some patients have meniscus tears as well as another source of knee pain. In these cases, the meniscus may not be the reason the knee hurts. A complete evaluation by your orthopedic surgeon can help identify the source of pain, and decide if surgery is the best option.
Myth: Physical Therapy does not help.
Physical therapy (PT) is a modality that is often prescribed by orthopedic surgeons to restore the body back to health. It can make a significant difference in decreasing pain and increasing function. Therapy modalities such as ultrasound and electric stimulation can ease muscle pain, while exercises restore flexibility and muscle balance. After surgeries, physical therapy can play a pivotal role in the recovery process. Numerous researchers have demonstrated that physical therapy is critical following anterior cruciate ligament (ACL) reconstruction, and that patients outcomes correlated directly with their participation in PT.
Myth: I would never want my knee replaced.
When the time is right, a knee replacement can be a life changing operation, decreasing pain and improving function. A number of studies have shown that knee replacements have a great increase in quality-adjusted years of life. Just like any operation, there are risks associated with knee replacement. Complications (such as infection) can have significant consequences, but fortunately, these are relatively uncommon. If knee arthritis is severely limiting your function and quality of life, consultation with a joint replacement surgeon can help determine if a knee replacement is the right option.
Lucas Wymore, M.D., is a sports medicine surgeon practicing at the Southern Maryland Orthopaedic & Sports Medicine care center in Leonardtown and Waldorf, MD. To remain involved in the community, he provides sideline coverage for St. Mary’s Ryken High School and serves as a consultant for St. Mary’s and Charles County High Schools. He previously cared for the San Diego Padres, San Diego Aztecs and the Tar Heel varsity sports teams at the University of North Carolina in Chapel Hill.