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Knee pain at rest: causes and treatment

by Alivia Nyhan
Published: Last Updated on

Do you have knee pain at rest? You should know that it is common for knee pain to manifest itself right at night because this is the time when the body and all the joints have the most rest and rest, which work hard throughout the day.

It is essential to have a good diagnosis and a pharmacological, medical treatment oriented to the cause to be treated according to the symptoms and the personal needs of the patient.

The knee hurts just at rest can range from osteoarthritis to even gout and, less frequent, such as torsion of the tendons. If you want to know more about this topic, we invite you to continue reading this article by FastlyHealabout knee pain at rest: causes and treatment.

Knee pain at rest from osteoarthritis

Osteoarthritis is considered a matter of common query regarding pain in the knee joint. Also, it represents a common cause of knee pain at rest. It is usual in middle-aged people since it is caused by the degeneration of bone tissue.

It is also known as wear and tear osteoarthritis; it is a progressive but slow disease that worsens over time. It is also credited as the most common degenerative disease of the knee.

The knee has a soft tissue called articular cartilage that allows it to act as a shock absorber and protector of the bones that make up this great joint, enabling it to flex and straighten healthily without any problem. When a person has osteoarthritis, the cushioning and protective cartilage have worn away. This is why osteoarthritis due to wear and tear occurs over time; the cartilage then becomes rough and deteriorates in addition to having worn down.

The characteristic symptoms of this condition revolve around stiffness and throbbing pain, signs that get worse in the morning and after a long time at rest. Other symptoms are:

  • Pain when touching the knee.
  • Loss of flexibility.
  • When rest has given way, there may be a squeaking sensation.

The risk factors for osteoarthritis are

  • Age: logically, the older, the greater the possibility of wear of the articular cartilage.
  • Heredity: there are indications that due to genetics, that is, direct relatives with osteoarthritis, there is a greater risk of presenting it. Likewise, other hereditary diseases condition the appearance of osteoarthritis, such as having bowed legs.
  • Sex: it is related to the increased probability that women have of men suffering from osteoarthritis.
  • Obesity: it is a relevant risk factor for suffering from osteoarthritis due to the additional body weight that the combined carries.
  • Work: Likewise, some work that involves more significant pressure on the joints is a risk factor, such as those that have to stand for a long time.
  • Athletes: Athletes and athletes also have an additional risk of suffering from osteoarthritis due to the excessive use of the joints and, therefore, cartilage.
  • Other underlying diseases: suffering from gout or Lyme disease leads to osteoarthritis.

How to treat knee pain at rest due to osteoarthritis?

Once the diagnosis has been made through medical evaluation in conjunction with some paraclinical such as X-rays and MRI, the doctor raises the following treatment options:

  • Lifestyle: modifying the patient’s lifestyle is essential to minimize the risks of worsening this condition.
  • Do low-impact exercises like swimming, walking, and cycling.
  • Losing weight is reasonable if one of the risk factors asis obesity; this reduces the stress on the knees.
  • You can also indicate exercises to strengthen the leg muscles.

The doctor may indicate if the pain does not subside after lifestyle modification.

  • Nonsteroidal anti-inflammatory drugs or NSAIDs, such as aspirin or ibuprofen, help ease pain and reduce swelling.
  • Acetaminophen: Also useful for mild pain and with fewer side effects than NSAIDs.
  • Steroid injections are powerful as anti-inflammatories; they can only be applied directly to the knee by a healthcare professional.

If the pain worsens and is disabling, the doctor may ultimately suggest surgery:

  • Arthroscopy is a procedure that allows smoothing of the worn cartilage; this will be useful when the osteoarthritis is not advanced.
  • Joint replacement: total or partial where a joint prosthesis replaces the joint.

Knee pain at rest due to osteonecrosis

Osteonecrosis means the death of bone tissue; it is a common disease that manifests with knee pain at rest, especially at night; this pain may radiate or extend the legs.

It is a form of arthritis that is obtained due to the deficit of blood circulation in some specific place of the bone.

Although osteonecrosis or vascular necrosis is a degenerative disease of the human skeleton, whose ideal place of involvement is the head of the femur, its second favorite place is the knee. Currently, two types are described:

  • Spontaneous or primary osteonecrosis.
  • Secondary osteonecrosis.

10% of patients with spontaneous osteonecrosis refer to the existence of a previous traumatic antecedent, as is signed by a review article about spontaneous osteonecrosis of the knee, Barcelona-Spain [1].

It is usually frequent in deaths greater than in men; its cause is not precisely described, but it revolves around some risk factors such as:

  1. Trauma or fracture-like injuries.
  2. Bone dislocations.
  3. Blood vessels are covered by fat.
  4. Anemia drepanocítica.
  5. Use of corticosteroids.
  6. Alcoholism and tobacco.
  7. Patients are suffering from systemic lupus erythematosus.
  8. Kidney transplant patients.

Non-traumatic osteonecrosis is more common in men, is bilateral in more than 60% of cases, and occurs between 30 and 50 years of age, according to the Merck Manual [2].

The usual symptoms of osteonecrosis are:

  • At first, the pain manifests itself during activities, but then in later stages, the pain in the knee can manifest itself even while at rest or resting.
  • Limitation of movement does not usually appear in the early stages of osteonecrosis but when the pain becomes disabling.

It is helpful to recognize the symptoms, a specialized medical evaluation, and even perform an MRI to identify this condition early.

How to treat knee pain at rest due to osteonecrosis?

Once this disease has been identified, treatment is focused on

  • Relieve the pain first, for which NSAIDs or acetaminophen is indicated, and apply local heat; hot showers will also be helpful.
  • Decrease the amount of time you are standing or walking.
  • The use of a cane may be beneficial to relieve weight on the affected knee.
  • Exercises in the water allow for strengthening the surrounding muscles.
  • Arthroscopy, in this case, will not be beneficial since it would not modify the course of this condition.
  • The idea is to prevent the bone from dying, so it may be required to perform a surgery where decompression is achieved to allow blood to flow.

Knee pain at rest from gout

Likewise, gout is another disease that produces knee pain at rest; this is nothing more than an accumulation of uric acid crystals in the knee joint and other body joints, causing intense and intermittent painful inflammation.

It is also considered a type of arthritis; the leading cause is high concentrations of uric acid in the blood. This is medically called hyperuricemia.

The typical characteristic of gout is that the pain appears suddenly at night, that is, precisely during rest, and although initially it usually manifests itself in the hallux toe or big toe, it can also affect other joints such as the ankles and knees.

Uric acid comes from a diet that contains a high amount of purines, an organic compound found in foods such as bluefish (tuna and sardines), shellfish, and animal entrails; to a lesser extent, they are found in meats and legumes.

Likewise, gout is characterized by the fact that the joint becomes red and hot, as well as the limitation of joint movement. Together these symptoms are commonly called a gout attack, which usually occurs at night.

Gout attacks can also include symptoms such as:

  • Temperature greater than 38.5 ° C.
  • Increased heart rate or tachycardia.
  • General discomfort.

There are some risk factors for gout:

  1. Diet rich in seafood, meat, and alcoholic beverages such as beer.
  2. The greater the weight, the greater the production of uric acid and the greater the difficulty for the kidneys to eliminate it.
  3. You are suffering from diabetes mellitus, kidney diseases, metabolic syndrome, uncontrolled high blood pressure conditions the appearance of gout.
  4. Consumption of some medications that, as a side effect, tend to increase uric acid levels. This occurs in the case of aspirin and thiazide diuretics.
  5. In addition, there is a greater chance of suffering from gout if there is a family member who also suffers from it.
  6. Gout tends to be more common in men between 30 and 50.

How to treat knee pain at rest from gout?

Before knowing the ideal treatment to treat gout, it should be taken into account that the doctor is the specialist to diagnose it, and in most cases, it will be necessary:

  • Direct microscopic examination of the synovial fluid of the knee joint.
  • X-ray of the affected joint.
  • Assessment of characteristic symptoms.

On the other hand, the doctor should indicate medications that improve the inflammation and pain of the joint without neglecting rest, immobilization of the affected joint, changes in diet, weight loss, and the application of local ice to improve the described symptoms of the gout attack.

The medical treatment is aimed at:

  1. Relieve the inflammation crisis, especially with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) from the beginning of the gout attack until several days later, as specified by the specialist. Corticosteroids (prednisone) are also helpful in acute gout attacks.
  2. Prevent later attacks of gout: this measure includes losing weight, avoiding alcoholic beverages, stopping the use of drugs that have as a side effect an increase in uric acid in the blood, and following a diet low in purines.
  3. Finally, it is adequate to reduce uric acid levels in the blood (<6 mg/dl) to prevent the crystals of this acid from forming again in the joints; for this, treatment with allopurinol, the drug of choice for gout, since by inhibiting xanthine oxidase, the concentration of uric acid in the blood decreases considerably.

Other medications available to treat gout are:

  • Febuxostat is used when allopurinol is contraindicated.
  • Uricasa is used ultimately due to allergic reactions that can occur after use.
  • Probenecid and sulfinpyrazone are drugs that allow uric acid to be excreted through the urine.

Knee pain at rest: other causes

Finally, there are other reasons why knee pain can occur during rest:

  • Anterior knee pain, also known as patellofemoral pain syndrome, is associated with other injuries due to the overuse of the knee joint. The characteristic of anterior knee pain is that it tends to be acute and can affect both knees simultaneously, making it significantly worse when sitting for a long time. Anterior knee pain is usually treated with analgesics, cold compresses, and rest; physiotherapy may also be indicated depending on other associated injuries.
  • Tendon torsion: the pain in the knee can also be related to the torsion of the ligaments or tendons, although this injury usually occurs during sports practice. The pain can be reflected even while at rest, and inflammation of the knee can also be evidenced. This injury is generally treated surgically after reconstruction of the ligament.
  • Knee bursitis is another cause that usually manifests with knee pain during mobilization and rest. This condition is the inflammation of a sac of fluid content called a bursa, located near the knee joint. Usually, the person suffering from bursitis has restricted mobility due to severe pain. Knee bursitis is generally treated with medications that improve symptoms, such as NSAIDs and corticosteroids; you can even be referred to a physiotherapist if necessary.
  • Lastly, rheumatoid arthritis can also cause knee pain at rest. This chronic disease affects the joints, notably the knees, clinically presenting inflammation, intense pain, limitation of joint mobilization, rarely manifests with fever and general weakness. Generally, pain tends to wake the person during rest.

Regardless of the condition, the best way to determine the reasons for knee pain during rest is after evaluating the traumatologist, which will indicate the necessary tests and indicate the diagnosis and effective treatment.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Knee pain at rest: causes and treatment , we recommend that you enter our Bones, Joints and Muscles category .

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