Burning pain in knee inflammation
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Burning pain in the knee area is generally not due to arthritis. There are other situations, though where burning pain is noted.
Iliotibial band syndrome (ITBS) is the most common cause of lateral knee pain. It is a common affliction in runners. ITBS is believed to result from recurrent friction of the iliotibial band (ITB) sliding over the lateral femoral condyle.
Low mileage runners usually improve with a regimen of anti-inflammatory medication and stretching. High mileage, competitive runners typically require a more aggressive treatment approach and a strict adherence to rest.
The primary symptom of ITBS is sharp pain or burning on the outside part of the knee. Generally, pain is not felt at the start of the run but symptoms develop after a short period of time into the run. Early on, symptoms subside after completion of the run, but return when the patient starts another run. With progression, pain can develop even with walking, and is particularly noted when ascending or descending stairs.
On examination, there is localized tenderness over the distal ITB where the band moves across the lateral femoral condyle. Crunching, snapping, or edema can occur over the affected area.
Treatment involves rest, physical therapy, and a course of anti-inflammatory medicines. If there is no response then ultrasound-guided injection of platelet-rich plasma (PRP) may be indicated.
Bursae are small sacs of fluid that cushion the outside of the knee joint so that tendons and ligaments glide smoothly around the joint. Bursitis is a condition when the bursae become inflamed. Bursitis can cause warmth, pain, swelling and redness over the affected area. The pain is often described as burning. The most common bursae affected are the prepatellar bursa located in front of the patella and the pes anserine bursa on the inner side of the knee below the joint line. The patient will have pain when they walk or when they negotiate stairs.
Referred pain from the low back or from arthritis affecting the hip occasionally will present with burning pain located in the knee. This occurs because the nerve supply to the knee originates in the spine and crosses the hip joint.
Tendinitis, particularly, tendinitis involving the patellar tendon can cause burning pain. Pain is felt directly over the patellar tendon which connects the patella to the tibia. People who engage in activities involving running, kicking, and jumping get this problem. Treatment includes rest, physical therapy, and anti-inflammatory medicines early on. If the problem persists, then ultrasound-guided needle tenotomy followed by injection of PRP is indicated.
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