Mystery Chronic Knee Discomfort

Bones, joints and muscles
1

Hi guys, this is my first post on here. 24 year old healthy male.
About 3 years ago I had a seemingly non-serious slip in some mud, and fell to the ground on my right inner knee. I bounced back up and was walking fine, never feeling anything was dislocated or unstable. I iced immediately after getting home and was very cautious with the knee in the weeks following the slip. A few weeks after that, a constant, dull sensation started to occur in my outer knee, just above and to the right of my right kneecap. A few months after the injury, I went on a month-long trip to Europe and walked around 20 000 steps every day, but the soreness did not increase or decrease, it would simply sometimes feel more tired than other times at random. A month or two after that, I went to physio for the first time to discover my right leg had much less flexibility when bending. That physiotherapist helped get the flexibility back to normal, but the soreness remained. That sensation has continued to this day, sometimes increasing in sensation, sometimes lessening in sensation. But overall, it is a constant feeling of discomfort and the general feeling of the leg being heavy and tiring quickly.

I have gotten an ultrasound, MRI, X-ray, all of which gave me results saying my knee is in perfect condition. I’ve been to 3 different physiotherapists and consulted with 2 different orthopedic surgeons, and none of them can seem to find the real reason behind this constant dull soreness. The pain does not seem to be related to how much force is applied to it, because I can run on the treadmill of a half an hour and feel fine, but sometimes simply walking for an hour or two will tire it out very quickly. Even when I jump up and down onstage pain is not triggered (though there is some minor swelling afterward). A few weeks ago I got a steroid injection, which slightly reduced the soreness for a while, but I feel the leg going back to its usual state already. Recently, through self-massaging, I realized that when I press certain areas on my inner right knee, specifically where the two large bones connect, a jarring sensation (not pain, but a very sudden, intense sensation) will trigger on the opposite side of my knee, where the bones meet on the outer side.

I am writing to this forum because I simply have no idea what else to try. I have done every quad-strengthening, glute-strengthening exercise etc in the book and nothing seems to change the sensation. If anyone has any suggestions or information at all, I would be very appreciative.

2

First, MRIs of the knee can often be inconclusive or show nothing as long as the bones are structurally sound. Back in my 50’s I had that happen four times…twice each knee. In those days, the ortho surgeon would just scope the knee to take a look. In my cases, he found two meniscus tears and two ripped off femoral condyle cartilages. I recovered from each one in 7-10 days. The problem is that these days docs just don’t “go in and take a look” anymore…at least not here in Texas. It’s an option if you can find a doc to do it. Something is obviously wrong; the question is how to find out what the cause is.

After failed cortisone, comes SynVisc (or similar) injections. These all lubricate the knee and prevent anything from rubbing against something it shouldn’t. You can do some research and ask your doc.

Another thing you can try is COOLIEF. This is a cooled radiofrequency ablation of the nerves where the pain is located. Google their website to find a certified MD or DO near you. It is supposed to work very well on osteoarthritic joints although any arthritis should have been apparent in your imaging. Still, the procedure has been very successful for a lot of people in pain. I just had it done on my hip…takes 6-12 weeks to take full effect.

The best topical relief is Voltaren Gel (RX in the US, generic diclofenac elsewhere…check for interactions). Great anti-inflammatory that you can use a few times a day…best at bedtime. You may also want to look into acupuncture or some Cannot Be Discussed remedies.