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Offline knight_of_knee

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types of knee pain
« on: January 09, 2005, 08:24:36 AM »
I was wondering if people would be willing to describe the types of knee pain they have.

I've seen several people on the various boards mention feeling bone on bone pain.  How does that feel?

I can't tell if I'm feeling bone on bone pain or cartilage caught between bones pain.  I also have pain inside my knee.  I can't touch or poke where the pain is... its just inside.  

Anyone willing to share their perceptions of pain?

Sid

Offline kythreas1

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Re: types of knee pain
« Reply #1 on: January 09, 2005, 10:02:01 AM »
Sid, I assume I have joint pain from various sites.I am 3/12 post menisectomy(medial) and know of various different pains I have and do feel.
Meniscus pain is located along the joint line if medial then medialy and is marked upon pressing on the region and bending knee.It is a sharp pain that can catch and prevent one from fullfilling the range of movement commenced.It may be associated with clicking in joint or locking of joint. The other pain I feel post op is probably one of a generalised nature I think due to inflammation(synovitis).This pain is dull all over the joint esp in the back a bit like a tooth ache that prevents you from doing or thinking of anything elas.

I hope this adds to your understanding of some types of knee pain.

Philip

Offline Heather M.

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Re: types of knee pain
« Reply #2 on: January 09, 2005, 11:17:24 AM »
I have several different types of pain--bone pain (arthritis or chondromalacia, essentially severe pain from the damaged articular cartilage), soft tissue pain (scar tissue, extremely tight muscles, inflamed tendons/tendinitis), and nerve pain (in my case it is a neuroma on the lateral part of the knee and nerves wrapped in scar tissue), which gives electrical shock, hot, burning, tight, and tingling sensations.

The best description I have for bone pain or the really deep, arthritis type of pain--including a meniscal tear and compressed meniscal cyst in my case--is a badly infected tooth.  The pain is so deep that I can't ignore it, can't focus on anything else, will snap out loud if my dog even jumps on the couch next to me.  With bone-deep pain, you hold still, not moving or doing anything at all, and the pain just washes over you in waves.  There is no specific place to point to that hurts--it's generally a whole area larger than the size of a silver dollar, and often can encompass the entire lower half of my knee joint.    

So I can't rub the bone pain away--this is different for me than soft-tissue type pain, which includes my lateral release site, severe tendinitis, IT band syndrome, and scar tissue in general.  This soft tissue pain can at times be relieved by me massaging the area involved--I can almost always isolate it to an area under 3 inches wide.  So that's one of the ways I differentiate bone pain (no rubbing in the world makes it feel better) from soft tissue pain and nerve pain.  The nerve pain is what I'd describe using every stereotypical adjective--tingling, burning, twitching, icy-hot, and sharp electrical ZAPS.

The worst for me is the deep bone pain, at least when it's really bad.  Unlike the soft tissue and nerve pain, rest and icing and elevating doesn't seem to stop the bone pain.  So I can get it just lying in bed at night--that stinks!  At least with the soft tissue and nerve pain I can head it off by not doing too much or being on my feet for extended periods of time.  I can prevent it for the most part, by avoiding the activities that bring the pain on.  But the bone pain just doesn't seem to respond to rest and rehab.  Once I do something to set it off, it just throbs and throbs--sometimes for days.  And it's my own weather station, because I can use this bone pain to judge upcoming weather events, rain, barometric pressure changes, etc.  The absolute worst is a grey, rainy day where I have to be on my feet and do things like shop for groceries and such.  Or when I simply have to get something done on the computer and spend time in that word processing position.  And once I've set this kind of pain off, when I have to be on my feet the feels like it is getting a huge railroad spike driven in--so I get the feeling of severe impact with each step I take, then the pain radiates out in sharp waves in a circle from the impact site.  That is the worst, without a doubt.

Gee, I think I've spent entirely too much time analyzing my pain.  I guess it's a member of the family now--the annoying, freeloading, passive-aggressive relative that you can't get rid of and who won't leave on his own!  

Cont'd
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Heather M.

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Re: types of knee pain
« Reply #3 on: January 09, 2005, 11:17:41 AM »
(Cont'd)

Anyway, despite my no doubt hypochondriac descriptions of my pain, it truly is an individual thing.  Many people report similar symptoms (like the joint line pain kythreas talked about with meniscal tears), and you can definitely get a doctor's attention when you use these keywords.  But everyone perceives pain differently, and what is agony to one is mere annoyance to another.  Anatomical studies have shown that individuals have a wide variety of physical characteristics in their nerves and the sheaths/tissues that surround them.  The belief is that this accounts for the so-called high and low pain threshold individuals.  I used to think I had a very high pain threshold--when I'm really hurting with serious pain, I don't talk about it or tell anyone, I just shut down.  If I have a nagging, irritating pain like a skinned knee or headache, I may mention it in irritation to my family or friends.  But serious pain is different--I had an inflamed appendix for over 7 days which went on to peritonitis by the time I finally went to the hospital for diagnostic testing and had surgery.  The funny thing?  I didn't even *want* to go to the hospital, but it had become obvious to my co-workers that I was having problems--I couldn't even stand up straight on the day my department finally staged a mutiny and put me (protesting the whole way in my bent over position) in a car with my assistant.  Destination was the ER and after that, surgery.  But I kept insisting that it wasn't that bad, right up until I almost died in the operating room!  

And when I was 17 I was in a serious car accident--fractured sternum, broken collarbone, cardiac contusion, and separated shoulder.  I healed entirely without any narcotic painkillers--I was only given a 'new wonder drug' which was IBUPROFEN in the cardiac intensive care unit and during the 30 days I spent in bed recovering.  My doctors were concerned about addiction in a teenager, so they didn't even give me CODEINE, for crying out loud (don't get me started--my mom almost killed the surgeon).  It took a year before I wasn't in severe bone pain every day--your sternum or breastbone is a very thick chunk of bone, and it takes a long time to heal.  I dealt with it by taking Medipren (the precursor to Advil and OTC ibuprofen) and kept my full schedule at school and with my friends.  I just hurt all the time, and developed a semi-permanent stoop in my posture from trying to take the pressure off my healing sternum.

So I really don't think I'm being immodest when I say I have a high pain threshold.  But this knee thing--going into year four as I type this--has gotten the better of me.  The pain is constant, every day, and getting to be unbearable.  So I guess it's understandable that I would isolate and analyze my different types of pain.

Hope some of this information helps you, but please realize that you will get all different kinds of responses from people, as pain is individual.  It sounds like your pain is really impacting your life--what is the doctor doing to help you?

Heather

PS The torn meniscus/cartilage type of pain I had is just as bad as the bone pain I described--it's indistinguishable, because the meniscus is the pad between two bits of bone that carry your body weight.
« Last Edit: January 09, 2005, 11:18:05 AM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline stgiles16

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Re: types of knee pain
« Reply #4 on: January 09, 2005, 04:33:19 PM »
Heather, you gave a PERFECT  description of bone pain. I have tried to describe it to my husband and OS and it is a very difficult thing to do. It is true that it just crashes over you in waves and freezes you in one spot. At least now I have a better way of describing it. When it hits. I normally will just hold on to something, stand perfectly still with the bad leg held up so no weight on it and breath really deeply LOL.
My bone pain isnt terrible anymore but I do have to aching, swelling, stiff pain almost constantly. My good knee is seriously achy now. I dont know what is wrong with it but the pain is primarily in the back and inside of the knee. I woke up yesterday, looked at my husband and said "it is either raining outside or is going to rain today" Yep, my joints were right again and I didnt even have to leave the bed to know it .

missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline PattiAnn237

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Re: types of knee pain
« Reply #5 on: January 09, 2005, 04:59:38 PM »
I really glad someone posted this because I was just thinking about this the other day.  Heather M (as usual!!!) you are really good at describing this kind of things.  I am trying to learn more about the anatomy of my knee so i too can know where all this pain comes from.

I have a lot of achey pain all up and down the muscles of my leg.  I can stretch it and massage it, and take ibuproffen and it usually only last about an hour.

My worst pain is this sharp horrible pain that I get when i bend my knee, its worse if Im bearing weight, but I get it even if Im not.  It literally feels like someone is sticking peices of broken glass into the back of my kneecap.  The pain it so intense it makes me shake.  the good thing is I can rest and don't  have this pain.

Now the third kind of pain that I have is becoming worse (after reading this i fear it is bone pain)  it a gnawing, aching kind of pain, it makes me very irritable and uncomfortable.  When I have it I feel like I can't sit still, and like I really want to rip out my kneecap and rub underneath it.

Wow thinking about the pain is giving me a headache.

Anyway if anyone can relate or can explain to me any of my pain I would appriciate it!

Take care, ~Patti
25 y/o
Left knee- lateral tilt, lateral tracking, arthritis
LR 8/5/04 (failed)
Diagnostic Scope- 5/2/05 (scar tissue removed)
Holding off on TTT till I can get through school!

ariel

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Re: types of knee pain
« Reply #6 on: January 09, 2005, 06:04:23 PM »
I essentially get two types of pain:

Momentary "sharp pain" when moving towards a squatting down position or sometimes fully straightening my leg etc, etc - (as if something momentarily touches or gets pinched - often tends to cause 4 or 5 days of aching pain afterwards in the back of the knee and calf.

"knawing/aching pain" - typically set off by the slightest of "over-exertion" or sharp pain incidents - tends to last, again, for 4 or 5 days - the aching comes from the back of the knee and spreads down the back of my calf.

Because the sharp pains only come relatively rarely and for a few seconds, it tends to be the "knawing/aching" pains that distress me the most - at it's worst, I tend to have to get up out of the chair every 30 seconds to a minute to try and shake the pain off - then sit down again, but within another 30 seconds/minute or so the aching pain has built up again and I have to get up again to shake the pain off and this goes on from say tea-time (6 o'clock in the evening) until I go to bed (and then it's still aching !!)




« Last Edit: January 09, 2005, 06:24:45 PM by ariel »

Offline sienna

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Re: types of knee pain
« Reply #7 on: January 10, 2005, 02:59:05 AM »
Hmmm, interesting topic.
I had to fill out a sheet filled with pain words that were grouped into about 11 different categories.  It was interesting because often you can't think of the words you need to describe the pain.  I even found some to describe pain I had and didn't even realise.  I put in extra info cos that was what I was told to do and then later in the report they said I was exaggerating my pain.  You could imagine how angry and upset I was over that.  But lets just say I wrote a 4 page letter destroying every argument in her 1 1/2 page report and sent it for her perusal.  Nasty person.

Anyway...

Like Heather said, pain is personal and don't let anyone tell you it's in your head or that you are exaggerating.  How could they possibly know what you are feeling!

I have a few instances where I get pain.  First I have nerve pain due to a major nerve being cut and caught in scar tissue.  It is an achy hot numb feelling that used to prevent me from standing for more than 10 min.  I am on neurontin to control that.  The whole area of my knee is numb yet when you touch it with certain things I get different feelings.  If you touch my scar I get referred sensation in other areas of my knee kind of like pins and needles.  Light touch tends to be very irritating and often makes me jump or react quickly.  When the sun is on it or the weather is hot, it burns and throbs.  Also, when it is really cold, it gets a very specific and sharp cold burn.  I find this much worse than hot burn.
It aches if the weather is changing.  I get sharp pain in the joint if I put my foot down too hard when walking.  I can't twist because it produces a sharp twinge like you are hurting myself even though I am not.  And if I dont' exercise, it feels all junky and swollen on the inside even nothing seems to show on the outside.  
This nerve pain also prevents me from playing anything and running.  I can jog a few paces on tippy toes otherwise I get a sharp pain in the middle of my joint on impact.  I managed to hop about 2 in off the ground the other day!  It has taken me more than a year to get off the ground when hopping.  Man that was a sight to see: an adult trying to jump and not getting off the ground!

I also have grinding under my kneecap and can't sit on the floor and draw my heel up to my butt.  It produces a sharp pain under the knee cap.  The grinding was worse but has settled to a smooth grinding ever since my patella finally popped.  It had wanted to pop for months but never did and used to just hurt.

My original pain was from a meniscus tear, which is all better.  I used to get a sharp pain at the back of my knee when trying to squat or bend my knee past a certain point.  I actually managed to squat, pain free, for the first time in  2 yrs.  Yay for me! ;D

so now I don't know if the trade off was worth it.  A sharp pain upon deep bending, which was easliy avoided OR all the above stuff.
Not that I have a choice now.  sigh.
What I do now is try to ignore it and do what I can.
rk posterior meniscus tear. Successfully repaired 10 Sep,03. Now have nerve damage and cps which goes with it.  I want to slap the person who said 'It just takes time....'

Offline Amanda

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Re: types of knee pain
« Reply #8 on: January 10, 2005, 04:45:38 AM »
Heather and stgiles16
Can you tell me what condition it is that produces the 'bone on bone' pain you describe?  Is it arthritis? It sounds horrible!!
Thanks
R Lateral horizontal cleavage tear and cyst 1997
Partial meniscectomy 18/07/03
Cyst resolved after 3 months
Re-tear 7/8/2004
2nd partial meniscectomy 12/11/04
Hardened meniscus with 40% left

Offline stgiles16

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Re: types of knee pain
« Reply #9 on: January 10, 2005, 05:06:09 AM »
MIne is a defect on the medial femoral chondyle but arthritus can cause this pain too.
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline Heather M.

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Re: types of knee pain
« Reply #10 on: January 10, 2005, 10:49:04 AM »
Mine is also a deep osteo-chondral defect--in my case, it's on the back of the patella.

In other words, arthritis.  It stinks. :P

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Linds

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Re: types of knee pain
« Reply #11 on: January 10, 2005, 01:58:07 PM »
This is an interesting topic, thanks Mr Squid for posting it. ;D I to often wonder about this stuff...many times, after an appointment with someone new...when they ask you on a scale of 1-10 where is your pain? I always find it funny, cause everyone is different, and for you it might be a 4 and for someone else it might be a 10.  Anyway...

My pain, well that is something for me that is always changing..but i'll try for what's going on these days.

I have some soft tissue pain which is achey and I can't pinpoint exactly where it is, just my whole knee hurts.  

I have a couple of other types of pain that I have no idea really what they are.  I have the really sharp pain on the backs of my patellae.  And on the LAteral side of my patellae and femur.  This is really sharp pain sometimes, that stops me dead in my tracks and makes me want to put my legs up and not move them anymore...ever.  I have pain in the joints when the knee is in flexion at all and weight bearing. This is under the kneecaps but not on the lateral side. This is again really Sharp stop you dead in your tracks pain, although, since I get this with all my physio exercise I have tried to work through it... to get some muscle back.  When my knees get really agravated from sitting to long, walking around too much that sort of thing, it is a real burning pain, and no matter what I do I can't get compfortable, I can take drugs, ice, put pillows under my legs, betwenn my legs, wrap my knees, brace my knees and nothing except rest and time will make this pain go away.  I aways say that this pain feels like there is sand in my kneejoints, just from the burning.  Then I have  a new pain...one that is really ticking me off,  I can't even put my legs straight when they hurt now to rid me of pain, because even straight my knees hurt, the lateral pain and the under the kneecap pain.
I also have  a new pain which I have kind of wondered is meniscus related.  Sometimes when I sit down and such I get pretty severe pain at the medial joint line. It's not what I would have thought mensical pain would feel like.  It's very painful but it's not like a clicky thing or anything like that, it just REALLY hurts and nothing but just gently moving the knee is a small range of motion and sitting and waiting will make it go away.
I too have the soft tissue pain, like at the lateral release site and on my left knee at one other portal from the scope.  

So...there is my pain, this is really interesting, I think it will also be interesting just to see how the descriptions vary from person to person.
Hugs
linds
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?