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Sports Medicine

Meniscus Tear and Numb Toes

07/22/2011

Question:

My surgeon suspects I have a torn meniscus in my right knee. Please know I am a runner and I am having the same symptoms in both knees x3 weeks. MRI scheduled for next week for right knee, which locks. Recently the bottoms of my toes on my left foot started tingling, and today my right foot toes started tingling. I have significant pain in the backs of my knees, not much in the front/kneecap area. I also have lower back discomfort and tingling in outer hips. When sitting on chair or floor I can fully extend both legs but when standing up my right knee locks and I cannot fully extend the leg. Since I`ve been walking with a limp and shuffling around with my knees constantly bent, I think it might be the cause of my lower back pain. Any ideas? My number one question is: Is it common for the BACKS of the knees to ache when a person has a torn meniscus? Do I have a popliteus injury that`s causing the backs of my knees to ache? Is the knee trouble causing my toes to tingle or is it sciatica from my lower back? Thank you for your time. I look forward to your response.

Answer:

It would be unusual to develop symptoms due to a meniscus tear in both knees at the same time without a history of acute injury to both knees.

A meniscus tear by itself would not cause tingling in the foot, but sometimes a meniscus tear causes enough fluid accumulation within the knee to result in a Baker's cyst, which if large enough can create pressure on the nerve (tibial nerve) in back of the knee. But again, it is very unlikely that the tingling symptoms in both feet are due to the simultaneous development of bilateral Baker's cysts, each large enough to put pressure on the tibial nerve in each leg. 

Pain from nerve irritation in the lower back, and/or pain from lumbar discs or facet joints, can be referred down into the legs -usually the back of the leg(s) rather than the front... therefore, you may or may not have a lower back problem causing pain in the back of your knees. Alternatively, you could have a bilateral knee problem altering your positions and movements, thereby causing you to place abnormal forces on your lower back, resulting in a lower back problem secondary to a primary knee problem.

Since meniscus tears which are symptomatic often involve the posterior/back part of the meniscus, it is not uncommon for meniscal tears to cause pain in the back of the knee.

A popliteus injury is an unusual condition, but when it occurs, is usually in the form of "popliteus tenosynovitis" resulting from overuse - particularly excessive downhill running. Pain from this would be located on the outer/lateral side of the knee rather than the back of the knee.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University