Is this knee pain worth going to a doctor for?
March 19, 2011 8:23 AM   Subscribe

My knee hurts. Is this just a normal aging thing, or should I see a doctor?

I'm female, mid 30s, normal-to-under weight, but out of shape. I don't run, cycle, anything like that. In the last two weeks, one of my knees has been hurting off and on. It's not unbearable to walk, but it's not fun. I have to keep it in the right position when I sit and lay down. It doesn't look bruised or swollen or like the kneecap is out of place.

My pain is connected to going up stairs; at our house we have 3 steps and then a landing, and then to continue up the stairs you turn to the right. There's another landing, and another right. It's at the landings, where I turn, that my knee POPS and the pain starts. It does go away in a few hours. In fact, the last two Saturdays I've spent most of the day walking around in the cold (Solidarity!) and it was bearable (no stairs).

So... does this just happen as you get older? A lot of people complain about aches and pains. Or is this something to get checked out before it gets worse? I have really good insurance, but no paid time off, so I hate the thought of forgoing a couple hours pay to go to the doctor, just to be told "go home and rest it." I don't know what else they could do (I have pain meds already).
posted by desjardins to Health & Fitness (23 answers total) 4 users marked this as a favorite
I hate to be that guy, but the answers to these questions are almost always go thee to the doctor. No one wants to, or should, tell you it's fine when then there's a risk that six months later it falls off while you're playing croquet, or something else like osteoarthritis, or whatever scary thing WebMD says.
posted by oxford blue at 8:30 AM on March 19, 2011

I can not tell you why your knee hurts. I can tell you about old age. I am shortly to be 82 and my knees do not hurt and in an hour I am off to the woods with some friends to walk some 3 miles.
One story had it that knees hurt for those who pounded the roads by running for many years. I ran for over 25 years and there are no ill effects as yet for me.

Get checked by orthopedic doctor.
posted by Postroad at 8:30 AM on March 19, 2011 [14 favorites]

I have sought treatment for knee pain several times in the last 10 years (I'm 45 now). I have never been told simply to rest it. I have been amazed by how, say, a physical therapist or doctor, based on my description of my symptoms (like your very specific popping problem at the landings) has been able to either provide an appropriate brace to wear for awhile, or exercises to strengthen the specific weak spots. I remember coming away from a first PT appointment once thinking, "Wow, she really understands how the knee is put together."

I've also gotten good advice about using pain meds. For instance, I learned that I was undermining myself by taking anti-inflammatories only until the pain went away; more than once my doctor has told me to stay on a course of NSAIDs for a solid two weeks regardless of my comfort level, in order to really get on top of any inflammation.

And, finally, I had a knee surgery about three years ago now that completely relieved some persistent knee pain. The surgeon told me it would eventually come back, because it was arthritis-related, but I've had 2+ years of not having to deal with it at all, which I have very much enjoyed. And this was after thinking, for a long time, that I was just experiencing the inevitable effects of age.

I'm sorry you have to take paid time off to visit the doctor, but in my experience seeking treatment for knee pain has been both educational and effective.
posted by not that girl at 8:32 AM on March 19, 2011 [3 favorites]

Our bodies do get less resilient with time but you are young enough and that sounds like minimal enough exertion that you probably have something that's worth checking out.
posted by mmascolino at 8:36 AM on March 19, 2011

You don't know what else they could do because you're not a doctor, silly. That's why they get paid the big bucks. Even if it is age (and I'm not saying it is, I have no clue), there's still probably something a doctor can do for you. You should go. Don't sign up up for any more pain in life than necessary!
posted by cgg at 8:49 AM on March 19, 2011

Doctor for sure! They can probably refer you to a good physical therapist who can give you a daily routine that will strengthen tiny little muscles you don't even know you have to support the kneecap or something.

I've had bad knees for a long time, and I had exercises to do that yoga has since replaced. My mother lived with knee pain for most of her life until she finally had the knee MRI'd; once they knew what was wrong, they fixed it with outpatient surgery within a month of the scan.

So, go to the doctor—maybe it is just aging and there's nothing they can do to fix it, but you've got nothing to lose but your co-pay knee pain!
posted by kitarra at 8:51 AM on March 19, 2011

I am 40, and just made an appointment with an orthopedic surgeon/sports med dude for very similar reasons. I don't have popping, but my knees have crackled for a decade now when bending and I do have pain on stairs, some days better, some days worse, which I control by being scrupulous about my "stair climbing form". But who wants to always be thinking when going up and down stairs? Because my knees don't pain me to walk I have been able to ignore a lot.

I did my right knee an extra injury shoveling snow this year, and that is what pushed me over the edge to see a doc, but I probably should have gone some time ago. I read not too long ago (forgetting details) that women will frequently present with serious knee problems because they... wait for it...assume that the pain is a normal part of aging and don't seek treatment until things are quite bad.

Between that article making me feel like I was being needlessly stoic, and the fact that my knee issues are starting to interfere with my martial arts training (which is the only form of exercise I have EVER had any interest in doing), it was time for me to see a doc, which I hatehatehate because I hate errands of all kinds, and I have to take a whole half-day off because I take a bus an hour to work and that's just how it works out, but I think it is a good thing and I would recommend you give yourself the gift of a doctor's visit. Because maybe, just maybe, the doc will actually be able to help.

I am moderately hopeful.
posted by acanthous at 8:53 AM on March 19, 2011 [1 favorite]

ah, found the article. It's actually about knee replacement surgery, but my takeaway from it was, maybe if my knees hurt I should see if I can do something about it (which will almost certainly not be replacement knees) rather than letting it impair my quality of life and make me unhappy.

Good luck!
posted by acanthous at 9:01 AM on March 19, 2011

A doctor would likely prescribe a course of NSAIDs and/or physical therapy. The PT was very helpful to me because it helped me to consciously position the knee in the proper position when going up and down stairs.

I have also found, counter-intuitive though it is, that moderate bicycle riding is very helpful. I think it is because the knee is exercised consistently in the same position over time.
posted by yclipse at 9:09 AM on March 19, 2011

It's worth seeing a Dr.

I'm 34, I had similar symptoms which started a few years ago... it turned out to be degenerative knee changes/loss of cartilage/osteoarthritis.

No cure, but there are treatments like Celebrex for the pain/inflammation - and things like hydrotherapy to build up the muscles around the knee joint, to protect the joint.

Also, if it's something really nasty, like rheumatoid arthritis, you want to catch it and treat it as soon as you possibly can, before it gets a chance to do any damage.
posted by Hot buttered sockpuppets at 9:18 AM on March 19, 2011

Response by poster: Okay, okay, I'll go see a doctor. And now for my next AskMe: do I have to tell my husband he was right?
posted by desjardins at 9:18 AM on March 19, 2011

Telling your husband that he was right will make him feel acknowledged, which will be great for your marriage, which will allow you to avoid using your next ask metafilter question about marital problems, which would lead to everyone here telling you to go get couples counseling, which would force you to take even more time off work and lose even more pay.
posted by medusa at 9:25 AM on March 19, 2011 [12 favorites]

it's definately not normal wear. Painful popping is a sign of tendon problems. It may be due to something you're doing all the time that you're not thinking about, but you're still going to need to get it checked out and it will probably take more than just rest to put it right. I'd get to a doctor.
posted by randomkeystrike at 11:20 AM on March 19, 2011

Go straight to a specialists if you can, but if soemone recommends surgery then get a second opinion.

IANAD, but for what it's worth I'll take a stab at an ignorant diagnosis. It sounds like some minor damage and inflamation to a ligament. If it's the torsion movement on the landing then it could be the anterior cruciate ligament. Of course take that with a grain of salt.

You know the old joke about the patient that tells the doctor "when I do this it hurts" and the doctor says "then don't do that", it's true. This may be incredibly tedious but try to avoid the movement that causes the pain. That may mean robotically walking fully to the top of the stairs, then lifting each foot to turn, then continue and repeat.
posted by P.o.B. at 1:05 PM on March 19, 2011

Three days ago I saw my doctor for almost exactly the problem you describe. His advice was exactly the opposite of P.o.B.'s. He mentioned that "go home and rest it" is almost never the right solution to knee problems---knees are "so badly designed" (his words) that they require the support of strong muscles to work properly. Conclusion: Don't listen to anyone here, except the part where they tell you to see your doctor. Then you'll learn what your particular knee needs.
posted by drdanger at 1:25 PM on March 19, 2011

Well just to clarify I did say go to a doctor and to take what I said with a grain of salt.
TBH though I was going to mention you should look forward to some rehab and a future of exercising to stave off anymore injurie, but I tried to keep what I said as general as possible because it could very well be the start of an arthiritic condition.
In any case speaking of anecdotal stories, I've never ever heard of any medical advice that didn't include a period of rest after an injury.
posted by P.o.B. at 1:51 PM on March 19, 2011

And by they way, OP, the opposite of my advice would be to not see a doctor, get surgery, and to do the movements that caused the pain whenever possible. So I'm not sure where my advice is exactly off course for you.
posted by P.o.B. at 1:58 PM on March 19, 2011

I would be concerned if you have been on a high dose of prednisone in the last 6 months. If that is the case, definitely mention it to your doctor.
posted by waitangi at 2:32 PM on March 19, 2011

Sorry, mention it to an orthopedic doctor.
posted by waitangi at 2:32 PM on March 19, 2011

I'm sorry, P.o.B., if I sounded like I was criticizing your advice specifically. OP doesn't report any injury, so we text-based diagnosticians have even less to go on than usual. Please ignore everything I've said except "see a doctor".
posted by drdanger at 3:29 PM on March 19, 2011

Check out the book Pain Free by Peter Egoscue. Got me through mystery foot pain last year. He's got a chapter on knees-- it's an exercise physiology approach. Very smart. Very helpful.
posted by enzymatic at 3:42 PM on March 19, 2011 [1 favorite]

I had a pain like this in my wrist for a few years (annoying but not hugely debilitating; it would flare up in response to me doing something strenuous or weird, so I could always 'explain' it but at the same time, my other wrist never hurt from the same activity, etc.). I *did* go to the doctor, multiple times, to both a gp and two different orthopedic surgeons. And got cortisone shots, which helped, but mostly I was pushed off, due to the reasons in parentheses, and because the orthopedists couldn't figure it out. And then, one day, my wrist swelled up hugely, for no 'reason' (i.e. I hadn't done any activity that would have injured it). I had to go onto prednisone and vicodin for a few weeks to deal with it, until I could get into surgery to have my synovial tissue removed --> it turned out that the cause of my pain all that time and then the ultimate huge swelling was an autoimmune attack on the synovium that was best dealt with by removing the synovium.

The point I am getting to reallly slowly is that even a specialist may not do a satisfactory job with these sorts of vague symptoms, especially when there is sort of a 'reason' like your stairs. As sockpuppets mentions, it is best to catch attacks on the joint early. If your orthopedist doesn't find a cause for your pain, see a rheumatologist too -- a good orthopedist should send you along to one anyway if there is a hint of damage to cartilage, etc., but if you are early in your symptoms, like i was, there may be no sign of autoimmune damage yet. I will never know if I could have avoided surgery (and the weeks of realllly bad wrist pain) by just getting my immune system under better control during the more minor symptoms, because I didn't know that rheumatologists are *also* are a great resource for joint pain...The best time to see one is before joint damage has happened.....
posted by Tandem Affinity at 5:46 PM on March 19, 2011

In my own situation the knee pain and dysfunction was due to a severe vitamin D deficiency. I am now on 4000 IU per day. This of course may not be the "fix" you need but it worked for me.
posted by andreap at 12:47 AM on March 20, 2011

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