Clinic: One year ago, I fell and broke my arm. While my arm
has healed, my knees also have been bothering me since I fell.
I have arthritis in both knees and a slight tear in the
meniscus on one knee, but both knees are extremely painful
when I walk. Is it possible that arthritis is causing this
much pain, or could there be another reason, perhaps related
to my fall? I am 59.
possible that your knee pain could be traced back to your
fall. You may have injured your knees without realizing it
when you fell, or the trauma of the fall could have caused
your arthritis to flare. Either way, you should make an
appointment to have your condition evaluated. That evaluation
will guide treatment going forward.
Any time you
experience physical trauma, such as a fall, and it results in
a serious injury, such as a broken bone, there’s the
possibility of something called a “distracting injury.”
That means the severity of one injury — in your case, the
broken arm — masks the urgency of other damage that occurred
due to the trauma. So you may have injured your knees when you
fell, but the extent of those injuries didn’t become
apparent until after your arm healed.
in your knees adds complexity to the situation because, in
some cases, an acute injury can trigger mild arthritis to
become more intense. Once that happens, the arthritis pain is
unlikely to return to the level it was before the injury
Based on the
symptoms you describe, the meniscus tear you have in one knee
is not likely to be contributing significantly to your knee
pain. Meniscus tears involve damage to the cartilage that acts
as a cushion between your shinbone and thighbone. These tears
are common with age. About half of people older than 50 have a
meniscus tear. In patients with arthritis in the knee, the
percentage of people who have a tear is even higher. Minor
tears may not cause any symptoms. When they do, they tend to
affect the mechanics of the knee — often causing pain or
symptoms such as locking, catching or buckling of the knee.
the source of your knee pain, see your primary care physician.
X-rays can show the nature of the injury to your knees and
reveal the extent to which your arthritis may be contributing
to the pain.
arthritis is fairly severe, it is likely the main culprit, and
there are various treatment options available. A knee brace
can be used to take pressure off the section of the knee joint
most affected by arthritis and reduce pain. Medications for
pain relief often are useful, too. They may include
nonprescription or prescription nonsteroidal anti-inflammatory
drugs, such as ibuprofen, naproxen sodium, diclofenac sodium
and celecoxib. In some people, acetaminophen may ease
measures aren’t enough, an injection of a corticosteroid
medication into the knee to reduce inflammation or hyaluronic
acid to provide lubrication may offer relief. In about 75
percent of patients, either type of injection may reduce
symptoms, but the amount of time it lasts varies considerably.
Some people only need injections once every two years to keep
symptoms at bay. Others see a return of pain in less than a
month. The response to these injections often dictates the
next steps needed.
are under investigation, too, such as platelet-rich plasma
injections and stem cell treatments. These therapies are
available at some academic medical centers, including Mayo
Clinic, and may be worthwhile to explore when other options
for reducing arthritis knee pain have been unsuccessful.