Knee pain is a common condition that can have many causes. Knee pain can sometimes occur after an injury or fall. In other cases, sudden knee pain might indicate a more severe problem, such as arthritis. So, what causes sudden knee pain without injury, and how do we determine the cause?
What causes sudden knee pain without injury?
Sudden knee pain without injury can be caused by any one of the following:
Osteoarthritis
This disease process is the most common form of arthritis. Sudden knee pain without trauma can be the first sign of osteoarthritis. We generally consider it a degenerative condition, although recent evidence suggests that inflammation may play a significant role. Additionally, degenerative meniscal tears are often a component of the problems associated with early osteoarthritis.
Causes of osteoarthritis include acute knee injury, inactivity, and lifestyle factors such as diabetes and obesity.
Treatment should improve lifestyle factors, including weight loss, exercise, and diet. Ibuprofen tablets can help in the short term. In more severe cases, hyaluronic acid or platelet-rich plasma (PRP) injections can be beneficial.
Gout
Gout is a type of inflammatory arthritis that usually affects one joint at a time. Although it commonly affects the big joint, it can also affect the knee.
Acute inflammation occurs when high uric acid levels in the body accumulate in a single joint. This process triggers a severe reaction, resulting in pain and swelling. Typically, the knee joint is swollen and red due to inflammation.
Gout is treated with medications such as ibuprofen or colchicine. In some cases, we suggest an ultrasound-guided cortisone injection. Diet and lifestyle factors, such as losing weight, reducing alcohol consumption, and avoiding foods like sardines, anchovies, and mackerel, typically help reduce flare-ups.
Psoriatic arthritis
Psoriatic arthritis is an immune condition that affects the skin and joints, especially the knees. This condition causes swelling, pain, and redness in the knee joint. The skin rash is typically characterised by silvery-grey or red, scaly spots that appear on the front of the knees or the tips of the elbows.
We’re not sure what causes psoriatic arthritis, but both genetic and environmental factors play a role. Not all people with psoriasis will develop psoriatic arthritis.
Treatment consists of anti-inflammatory medications, such as ibuprofen, corticosteroids, and immune-modulating drugs. A cortisone shot may be necessary to help alleviate acute knee joint swelling.
Rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disease in which the immune system attacks the synovial lining of joints. Unlike other forms of inflammatory arthritis, this condition typically affects joints on both sides of the body.
While most cases develop slowly, some can suddenly occur with acute swelling.
Treatment of rheumatoid arthritis starts with ibuprofen tablets. In severe cases, we use steroids or immune drugs.
Runner’s knee
Also known as patellofemoral pain syndrome or chondromalacia patellae, this condition is caused by excessive pressure on the back of the kneecap, resulting in knee pain. Generally, the cause of runner’s knee is related to overuse and biomechanical factors that increase the forces behind the kneecap. These factors include muscle weakness of the thigh and buttock muscles, hamstring tightness, and flat feet.
Runners’ knees can cause sudden knee pain without injury. It often worsens after prolonged periods of sitting, running, climbing stairs, and kneeling. Additionally, knee pain can occur suddenly, especially after a long run.
Treatments consist of regular ice, ibuprofen tablets, and taping. Additionally, physical therapy is crucial for enhancing your knee and pelvic biomechanics, including stretching, strengthening your buttocks, and adjusting your running shoes. Costine injections are rarely used, except in cases where kneecap arthritis is present.
How Do We Diagnose Sudden Knee Pain Without Injury?
Often, we use blood tests to search for acute inflammation. Generally, we start with inflammatory markers such as CRP and ESR. These markers will be elevated in inflammation, but will not tell us the exact type of arthritis. Additionally, not all individuals with active inflammatory arthritis will exhibit elevated inflammatory markers.
Additionally, we perform serologic blood tests to help confirm the diagnosis. Examples include rheumatoid factor, anti-CCP antibodies, and anti-nuclear antibodies (ANA). Uric acid levels are helpful in gout. Genetic testing for HLA-B27 can aid in diagnosing certain types of arthritis.
Sometimes, we take a fluid sample from the knee joint to test for cells and other particles, such as crystals.
Finally, imaging can confirm the diagnosis of osteoarthritis. A plain X-ray or MRI of the knee is helpful in these cases.
Final word about sudden knee pain without injury
Sudden knee pain without an apparent injury requires expert attention to obtain the correct diagnosis. We recommend consulting a sports medicine expert who can confirm a diagnosis and prescribe the appropriate treatment.
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