Pain in the back of the knee can be attributed to a variety of possible causes. In particular, it is conceivable that the pain is not caused by a local condition, but that another focus of disease is responsible. Anyone complaining of pain in the back of the knee should therefore seek medical advice to clarify the problem.
What is pain in the back of the knee?
Pain in the back of the knee occurs as a mirror image up to the kneecaps. However, it is quite possible that the pain radiates to other areas of the body. Pain in the back of the knee occurs in mirror image up to the kneecaps. However, it is quite conceivable that the pain also radiates to other areas of the body, such as the upper or lower leg. It is also possible that the actual cause lies in the upper or lower leg area and that the pain in the popliteal fossa thus results from the neighboring tissue. In addition, it is very difficult to establish a general definition of pain in the popliteal fossa due to the wide variety of causes. Ultimately, the designation localizes the location of the pain, whereas this does not yet allow the actual cause to be determined. The list of those diseases that cause the pain below the knee is long. It can be exemplarily a meniscus damage, a special kind of thrombosis, a cyst or a strain. These and many other diseases can cause the pain, consequently the complex sensation of the affected person.
Causes
Pain in the back of the knee can have a variety of causes, although two basic patterns can be derived. Young people tend to experience pain in the knees during their sports activity, which to that extent can be inferred from a sports injury. As a rule, the injury is to the capsular or ligamentous apparatus. In contrast, the disease occurs in advanced years mostly due to a wear and tear disease. Often, in older people, it is a cyst formation, usually due to osteoarthritis disease. As a result, patients experience both swelling and a stabbing pain in the affected popliteal fossa. Cysts form in other cases, particularly in the case of meniscus disease or rheumatoid arthritis. Furthermore, a biceps tendon tendinosis can also trigger the pain in the back of the knee. In this case, the local tendons are affected by overload. The overload can occur in both young and elderly people due to lifestyle habits. In this cause, the suffering develops into a pulling pain that is triggered especially by further strain. Lastly, the pain in the back of the knee can be attributed to thrombosis that has formed in the legs or pelvic area. Since the condition can be life-threatening, affected individuals should seek immediate medical attention for pain in the back of the knee.
Diseases with this symptom
- Meniscus injuries
- Baker cyst
- Osteoarthritis
- Cruciate ligament rupture
- Rheumatism
- Meniscus tear
Diagnosis and course
The diagnostic procedure for pain in the back of the knee depends on the underlying condition. As a rule, the doctor will first try to narrow down the cause by asking questions. In this respect, the cause is quickly found if the patient states that he or she has done a lot of sports or spent many hours gardening. In these cases, an overload of the popliteal fossa can be assumed. However, if the symptoms do not subside after a short time, further diagnostic steps should be initiated. Imaging techniques in particular are helpful in localizing the site of origin. Magnetic resonance imaging (MRI) is useful for this purpose, as it not only shows cysts on the image. Rather, it can often also clarify their cause. This is particularly important in order to exclude the possibility of thrombosis in the patient. This is because the Baker cyst deceives with the same symptoms as a thrombosis, which, on the other hand, can be life-threatening. Furthermore, MRI can also be used to visualize damage to muscles and tendons. Since pain in the back of the knee can have a variety of causes, this presents the physician with a great challenge. He must use differential diagnostics and take the anatomy of the knee into account in order to systematically clarify the basic problem.
Complications
Pain in the popliteal fossa can have various causes, these consequently have various complications and consequences. Typically, such pain occurs with a Baker’s cyst. This can grow larger as it progresses and pinch nerves and vessels, limiting movement of the knee joint. It can also cause compartment syndrome to develop. Muscle groups are no longer supplied with sufficient blood and may die as a result. Furthermore, pain in the back of the knee results from underlying rheumatic diseases. In osteoarthritis, progressive wear of the joint cartilage occurs. The joint becomes inflamed and swells severely with pain. As it progresses, the bone can become exposed and the pain worsens. Also, the bone may become debris and cavities called boulder cysts develop. The joint may deform and become immobile without treatment. Similar complications arise in rheumatoid arthritis. This autoimmune disease affects not only the joints, but also the heart and kidneys in particular. Inflammation of these organs is the result, which can end in heart failure (cardiac insufficiency) or kidney failure (renal insufficiency). Thromboses in the leg veins can also cause pain to radiate to the back of the knee. In the worst case, the blood clot can break loose and be carried with the bloodstream. This can lead to a pulmonary embolism with shortness of breath and chest pain or even a stroke.
When should you go to the doctor?
If pain in the back of the knee persists, you should always see a doctor. This advice is especially true if accompanying symptoms are noticed, such as radiating pain, discoloration on the leg, swelling or hyperthermia. The basic rule for a visit to the doctor is pain that lasts for several hours, radiates to other parts of the body, leads to movement restrictions or worsens. Pain in the back of the knee that occurs after prolonged bending, heavy lifting or other exertion may disappear after a few hours. In this case, a visit to the doctor is not necessary. Relief of the back of the knee is usually sufficient. If necessary, the knee should be cooled and rested for a few days. If the affected person has taken a long train or plane trip the day before, a leg vein thrombosis could be present. In this case, a visit to the doctor is indispensable. In younger people, pain in the back of the knee often leads the doctor to conclude that a sports injury such as meniscus damage has occurred. If the affected person notices that the pain tends to occur on the left or right side of the back of the knee, the meniscus may have been damaged. It is most noticeable in the form of pulling or stabbing pain when the knee is rotated. In older people, degeneration-related wear and tear such as Baker’s cyst is probably present. Since it can also be about the symptoms of knee osteoarthritis, the visit to the doctor is advisable in any case.
Treatment and therapy
After the doctor has found the cause of the pain in the back of the knee, the actual therapy procedure begins. In the case of slight overstrain, regular care with special ointments as well as sparing the aching leg is sufficient. To ensure stability, it may also be advisable to bandage the knee. This prevents further stress episodes. If, on the other hand, a cyst has been diagnosed, this can often also be treated by regular application of ointments. In addition, anti-inflammatories are used and in rare cases patients have to receive cortisone injections. In addition, those affected should give their knee sufficient rest, even in the case of a cyst. In severe and acute cases, surgical intervention may be unavoidable. For example, localized cysts are removed. The risk, however, is that cyst-related pain may recur even after surgery. If, on the other hand, affected persons suffer from thrombosis, the clots must be removed as quickly as possible to prevent the disease from growing. First, an attempt is made to dissolve the clot by taking medication. To the extent that this does not bring success, surgical intervention is necessary to remove the clot.
Outlook and prognosis
The further course and complications depend largely on the cause of the pain in the popliteal fossa. If the pain in the back of the knee is caused by a thrombosis, for example, immediate examination and treatment by a doctor is usually necessary.With the help of injections, however, this pain can be limited relatively well. The affected person must relieve the strain on his legs and is therefore restricted in his movement and sporting activities. Short-term treatment with the help of painkillers is possible, but should not be permanent. If the pain in the back of the knee is caused by the so-called Baker’s cyst, it must be treated medically. In most cases, the diagnosis of this pain is relatively feasible by taking X-rays to help. Only in a few cases is surgery necessary to treat the pain in the back of the knee. If the pain is ordinary old-age pain, no special treatment is usually necessary. In case of ordinary overuse of the legs, the pain in the back of the knee disappears after a few days. If there are restrictions in movement, the affected person may have to rely on walking aids.
Prevention
To prevent pain in the back of the knee, especially active people should pay attention to important rest. Especially after sports activity, the leg and consequently the knees should be given time off. Since competitive athletes cannot reconcile such off times with their training goals, they should resort to relief exercises in the meantime. In contrast to these causes, which can cause pain in the back of the knee, especially in young people, there are no ways to reduce age-related signs of wear and tear. Only regular exercise sessions can have a preventive effect, as this strengthens the body’s circulation. However, it must be taken into account that the body is not overloaded.
What you can do yourself
Regardless of whether it is an overexertion of the knee joint, a fluid accumulation (in the case of a so-called Baker’s cyst) or a strain, first of all the leg should be spared. In the case of acute pain – for example after a fall – the PECH rule applies: take a break, cool with ice, apply compression (simple application of pressure with the hand or use of an elastic bandage) and elevate the leg. If the discomfort does not subside after a few days, a doctor should be consulted, because the causes of pain in the back of the knee are varied. If it is apparent that the complaints always occur after sport, a break should be taken at first to relieve the stress on the tendons and muscles. In case of overstrain, heat applications by means of red light or warm compresses have proven to be beneficial. If the back of the knee feels warm and swollen, it is an inflammation. In this case, the affected region should be cooled. For the following days it is recommended to wear a bandage or a sports splint, as it were. To prevent strains and overexertion, sports scientists recommend stretching at the beginning of every sports session. However, the benefits of these exercises are now controversial. In addition to taking classic painkillers, naturopathy also offers supportive preparations: the trace element selenium has been shown to reduce inflammatory processes in the body. Physiotherapy can provide relief from the symptoms and long-lasting relief with the help of massages and manual therapy.