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Pain Management

Knee/Leg Pain

06/11/2007

Question:

I am having pain behind my left knee. It started a couple of months ago. One day I was fine, and then the next day it was there. I did not do anything that I am aware of to injure it. I cannot bend my knee all the way, I have to pull my leg up to bend it, to tie my shoe, to put on socks etc, but I can cross it over my other leg. It isn't excruciating. It is more a dull ache. It has prevented me from sleeping at times as I cannot get comfortable.

Just yesterday, it entered into my calf, and now my calf feels like it is in a constant charlie horse, or has been overworked, muscle ache. I play a lot of tennis or I used to, and now I can`t push off. It stiffens up when I sit for a while, but then once walking, I can move. Any idea what this might be? Thank you for your help!

Answer:

Sudden onset knee pain without any inciting event is uncommon but may be due to underlying popliteal muscle sprain/strain or bursitis or underlying baker's cyst (a benign collection of joint fluid) which is extending. This would explain your difficulty to flex about the knee and constant dull achy pain which is worsened with prolonged immobilization.

Ultrasound or MRI may give a definitive diagnosis. Conservative treatment includes rest, ice, compression, elevation and NSAID's and Tylenol. You should be evaluated by your physician or a specialist in sports medicine, orthopedics or physical medicine/rehab.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University