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Knee pain, sharp twinges behind knee cap, occasional difficulty in straightening the knee. Cause and recommendations?

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Orthopaedic Surgeon
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Hi. I'm a 32-year-old woman. I have been experiencing some knee pain for the past year, particularly in my left knee. I used to do a lot of dancing, but have only danced minimally the past 4 years. I do walk a fair amount, but have high end walking shoes with great arch support.

The knee pain is often generally mildly achy in both knees, but I get some sharp twinges in my left knee behind the knee cap sporadically throughout the day. On rare occasions it is steady enough and painful enough to make walking at a normal pace difficult, and it becomes too painful to fully straighten or bend my knee to its full range of motion. Most often I can carry on my normal activities, but am just aware of some mild pain. It has been several months since I've had an entire pain-free day. It's nothing debilitating, and I honestly am used to it, but I'm concerned about long-term knee problems.

I met with a family friend yesterday who is a physical therapist. He watched me squat on each leg and walk back and forth to see how I was using my legs. He said I do not use my hips much at all; my back remains erect when I stand, sit, and squat, putting all the pressure on my knees. I also reach my legs forward when I'm walking instead of engaging my hips, again putting most of the stress on the knees.

One other thing to add: a year and 3 months ago I had a co-worker who happens to be a nurse practitioner and reiki master give me a massage/reiki treatment. I did not know anything about reiki and did not feel anything as she had her hands down on my knees. When she finished, she asked if I had knee problems, and said there was 'a lot of stuff moving around in there.' I had never experienced any knee pain, but my knees were in a significant amount of pain for the entire week following her treatment. They have not felt normal since that day. I am wary to go back, but also wonder if the 'stuff' that got moved around knocked something out of whack that needs to be fixed. Then again, it may have nothing to do with my knee pain; she may have just sensed a problem there that I was not aware of, that was just starting to give me issues.

Do you have any suggestions or thoughts on what the problem might be? And what would you recommend? My health insurance is extremely limited, making trips to the doctor for testing, scans, etc. next to impossible at the moment.
Posted Fri, 14 Jun 2013 in Arthritis
Answered by Dr. Vaibhav Gandhi 7 hours later

I am Dr. Vaibhav Gandhi, I am Orthopaedic surgeon and knee specialist. I went through the details submitted with diligence. Since you were involved in dance activities, meniscal / ligament injuries are more likely the cause of this pain. The injury or degeneration of meniscus can lead to pain in a particular position.

Without an opportunity to examine the knee, I am unable to comment further. You need to undergo MRI scan of knee to isolate the cause.
Various arthritis leads to pain and stiffness in knee or back. Besides the MRI, you also would need to get a few blood test to rule out arthritis.

These test can be performed under the guidance of a competent knee surgeon/orthopedician.

In the interim you can take pain killers and cartilage protecting medicine from your doctor for pain relief. Physiotherapy such as short wave diathermy and ultrasonic therapy can be helpful. And so will quadriceps exercises. You can learn about these exercise and include pain therapies from a physiotherapist.

Hope this answers your query. Let me know if you need clarifications

Take care

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