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What Causes Severe Pain In The Knee While Walking Or Running?

Posted on Thu, 1 Jun 2017

Question: My father is suffering from severe pain from knee joint upto above foot and the pain becomes severe when walking or running. Is it due to cholesterol tablet which is of 40 mg since i saw there would be severe muscle/joint pains as side effects. What should i do. Should we perform any medical tests to diagnose? If he is sitting or sleeping then there i no pain.What type of shoe should he wear while walking/running? This severe pains started when he started to run in the morning time. Is it anything to worry?

Answered by Dr. Naval Mendiratta (49 minutes later)

Brief Answer:
Knee Pain

Detailed Answer:
Good evening

thank you for writing on health care magic

Well, the sort of pain your father has below knee to foot could be either due to the muscles or to the joints..I would like to ask you a few queries to distinguish between the 2..

1. Does he have difficulty in getting up from chair or squatting position?

2. Does the calf muscle pain on walking???and gets better at rest...??

3. Past history of smoking?

4. Any difficulty in early mornings when he wakes up..

We need to distinguish between the two. It can be either Osteoarthritis due to knees or as you suspected it can be due to cholestrol medicine( It causes more of muscle calf pain)...

DO let me know these queries

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (17 minutes later)

1. Does he have difficulty in getting up from chair or squatting position? --- No

2. Does the calf muscle pain on walking???and gets better at rest...??---- yes but if one leg pain stops,pain starts in other leg and the pain varies from one portion to other. But this comes only when he walks for long distance approx 1.5 kms.

3. Past history of smoking? ---- No

4. Any difficulty in early mornings when he wakes up.. No

Does any medical tests needs to be performed?

Answered by Dr. Naval Mendiratta (10 hours later)

Brief Answer:
Calf pain

Detailed Answer:
Good evening

Well, from your history it does sound like Claudication pain( that is, the blood flow doesnt reach the legs adequately when on prolonged walking...And on stopping it comes back again)...

As from your history, doesnt look like knee pain

1. Firstly reduce the dose of the cholestrol medicine to 10 mg. 40 mg is too high a dose to continue for long

2. If on reducing the dose, it doesnt improve you will need further test:

(i) MRI of the lumbosacral spine: to rule out any canal stenosis

(ii) Doppler( Arterial+ Venous) of the lower limbs to rule out any clotting...

Hope the information was useful

Do let me know for more queries

REgards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (3 days later)

He has a massive heart attck 1 year back hence the doctor has prescribed high dose. Can it be due to any vitamin deficinecy? How can we verify using any simple blood tests

Answered by Dr. Naval Mendiratta (39 minutes later)

Brief Answer:
Cause of calf pain

Detailed Answer:
Good evening

Well, the blood tests may not pick up these kind of pains. Maximum we can get done is CPK, LDH and Aldolase levels. That will just help us in figuring out if the muscles of the calf are getting involved due to the medicine or not, But yes they may not explain this pain( Claudication one)...

For the claudication , we have to run through these other tests to see where exactly is the blood getting obstructed and why he develops pain after walking only...

As for the cholestrol medicine, you can ask your doctor if it can be reduced. Normally after 6-8 months we cut down the dose. moreoever the medicine should not give you any side effects, as walking is very essential for his heart and if he is not able to do so , we need to sort it out...

Hope the information was useful

If you run through these blood tests, let me know with the results

Regard
Dr Naval

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Naval Mendiratta (1 hour later)

Does simple x ray of the leg find out the issue? or directly should we go for mri scan?

Answered by Dr. Naval Mendiratta (17 hours later)

Brief Answer:
Scan recommended

Detailed Answer:
good evening

Well, the x ray doesnt pick up the nerves or vessel problems. It is good for bones only. I would suggest MRI but before that I would suggest a good clinical examination. I can point out the possibilities from history but till we examine him. properly, we won't know where to start theday investigations from

So I have given you the most likely. probability in his case. Discuss it with your family doctor once and so we can plan ahead

do let me know for more queries

Regards
dr naval

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Naval Mendiratta (4 hours later)

Whom should i meet? is it general physician or an orthopedist? Can the pain be due to chicken guniya? He suffered from chicken guniya 4 years back? What all tests to be done to rule out the pain s not due to chicken guniya

Answered by Dr. Naval Mendiratta (43 hours later)

Brief Answer:
Delayed reply

Detailed Answer:
good morning

Sorry for the late reply. Was out of town and just got back

Well consult a physician. An orthopedic won't be able to guide you properly. if there s rheumatologist around you that would be even better.

Nah it doesn't look like chikungunya related pain. He doesn't have much of joint pains which are common after this infection and moreover 4 years is a long time for symptoms to appear back..

Hope the information was helpful

do let me know for more queries

sorry for the delay again

Regards
dr naval

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Above answer was peer-reviewed by : Dr. Remy Koshy