I have recent knee pain without injury, what should I do?

There are many different causes of knee pain without a recent knee injury, including osteoarthritis, meniscus tears, knee-cap tracking problems and gout. These can be longstanding conditions that do not cause any symptoms, but sometimes pain will start without any apparent cause. Most of the time, these conditions are not emergencies, and you can schedule an appointment to see your primary care or orthopedic health care provider. Reasons to go the emergency department include severe pain not relieved with treatment at home.


Until you reach a doctor, you will want to do the following:

REST AND ELEVATION–This means not putting any weight on the leg until you know what is wrong, or until you start to feel better.  If swelling develops, lie down and keep the leg elevated on some pillows.  When you get up, you may need to use some crutches.  While rest is important, you can and should test the knee and try to increase activity as tolerated within 24 hours.  Prolonged inactivity can put you at risk to develop a blood clot in the veins of the leg.

ICE – Ice is a very effective anti-inflammatory. You can ice your knee for 20 minutes every hour. Prevent ice burns by protecting your skin with a towel between your skin and the ice pack.

ANTI-INFLAMMATORY MEDICATIONS ** DO NOT EVER ATTEMPT TO TAKE ANTI-INFLAMMATORY MEDICATIONS IF YOU HAVE A HISTORY OF ALLERGY TO ANTI-INFLAMMATORY MEDICATIONS OR ASPIRIN. DO NOT TAKE ANTI-INFLAMMATORY MEDICATION IF YOU ARE NOT SURE IF YOU HAVE AN ALLERGY TO THEM. **
Anti-inflammatory medications, also known as NSAIDs, include the over the counter medications ibuprofen (also sold as Motrin or Advil), naproxen (also sold as Aleve), and many different prescription medications. Anti-inflammatory medications are very useful after a recent injury in decreasing pain and inflammation. Tylenol (or acetaminophen) is not an anti-inflammatory; it may also help with pain, but will not help with inflammation.

Studies have shown that all anti-inflammatory medications carry a VERY MINIMALLY increased risk for heart attack in people with heart conditions. If you are concerned about this risk or have a heart condition, you should not take anti-inflammatory medication until speaking to a health care provider.




What will they do for me if I go to an Urgent Care center or an Emergency Room?


If you feel the need to go an Emergency Room after a knee injury, you can expect the following:

X-Ray – You will most likely have an X-ray to determine if you have a fracture. If you do have a fracture, the emergency room physician will determine if you can go home, or if you need to be admitted for the attention of an orthopedic surgeon. X-rays are excellent for diagnosing fractures, and they are also very good at showing osteoarthritis. An X-ray will not reliably show injury to soft tissues, such as ligaments, tendons, muscles and most cartilage injuries. Emergency departments DO NOT routinely order MRI’s for patients. After leaving the emergency department, your primary care doctor or orthopedic doctor will examine you and determine if an MRI is necessary.

Examination – You will be examined by a health care provider. They will determine if there are any urgent conditions that need further testing, treatment or admission to the hospital.

Discharge Home – In most cases, patients are able to return home without being admitted to the hospital. After a knee injury, it is very common for the Emergency Department to send you home with a knee immobilizer – or a brace that prevents you from bending the knee – until you are seen by your primary care doctor or orthopedist. It is very common for emergency room physicians to prescribe pain medication, anti-inflammatory medication, and/or muscle relaxers. Again, emergency departments do not routinely order MRIs.





Do I need a knee brace after a knee injury?

There are certain soft tissue injuries for which you should wear a brace. While most of these injuries are detectable by physical exam, the Emergency Department or Urgent Care center will want you to wear the brace until you are seen by your primary care doctor or orthopedic doctor – your doctor may tell you it is OK to remove the brace given by the emergency department. Remove the brace only at your own risk before you see your health care provider.