What Can Cause Pain In The Patella & How is it Treated?

Pain in the Patella or Patellar Pain is an excruciating pain that a person experiences in the front of the knee around the patella and kneecap.¹ Pain the patella usually occurs in sprinters and runners, but it may also be experienced by people who do not participate in sports, but have a job where they have to stand for prolonged periods of time. The pain in the patella may be so much that the patient may find it difficult to negotiate stairs, perform activities, which require kneeling down on all fours, and thus may impact daily household chores and also their job duties. The major contributing factor for pain in the patella is overuse and putting pressure on the knee due to stringent training for sporting activities like sprinting and running or having a job, which requires prolonged standing thus putting pressure on the knee. Usually, patella pain can be treated conservatively with rest and exercise, but sometimes surgery may also be indicated for treatment of pain in the patella or Patellar Pain.

Some of the causes of pain in the patella or patellar pain are:

Vigorous physical activity like running, sprinting, or standing for long hours puts excess pressure on the kneecap and the surrounding region resulting in pain in the patella.
Using improper techniques while running may also cause Patellar Pain.

Another cause of pain in the patella is patellar malalignment. This is caused when the patella is pushed to one side of the trochlear groove during bending of the knee, thus causing excess pressure in the patella and irritating the soft tissue causing severe pain.

A person suffering from pain in the patella or patellar pain will have difficulty negotiating stairs, will have pain when bending or standing for some time, also have difficulty kneeling down. This pain may aggravate with increased activity and improve with rest and avoiding activities that aggravate the pain. The patient may also experience pain in the patella after sitting for long hours as the knees are bent during sitting. Long airplane rides may also be difficult for the patient. The patient may also hear a popping or clicking sound with walking or climbing stairs.

Physical Examination: To diagnose a cause for pain in the patella or patellar pain, the physician will first conduct a physical examination of the affected region. The physician may ask questions as to when the symptoms started and what factors make the symptoms worse or better. The physician will then palpate the patellar region to look for any signs of tenderness and also to look at the exact location of the pain. The physician may also ask the patient to jump or bend the knees to listen to any popping or clicking sounds. This will also give the physician an idea as to whether the patellar region is generally weak or not. The physician will then check for pain with movement of the knee and the stability of the knee. A cause for the pain in the patella or patellar pain may also be detected by taking radiologic studies in the form of x-rays or CT or MRI scans to look at the internal structures of the knee, especially if a patellar malalignment is suspected to be the cause of pain in the patella.

Conservative Treatment: The aim for the treatment of pain in the patella is to relieve the symptoms of the patient. The treatment modalities usually are conservative which include certain lifestyle changes like avoiding activities, which may aggravate the symptoms. Along with this, the patient will be recommended to use ice packs over the affected region for 15 to 20 minutes two to three times a day. Heat and compression will also be recommended to reduce pain and inflammation in the affected area. The patient will also be prescribed antiinflammatories to control the pain in the patella. The patient may also be recommended a change in the shoe wear which take excess stress off of the lower part of the leg.

The next step in treatment of pain in the patella is induction of exercises for strengthening and range of motion. The patient will be recommended to focus on quad stretching and strengthening as these are the muscles which stabilize the kneecap or the patellar region. Exercises may also be recommended to strengthen the lower back and abdominal muscles. The patient may also be recommended orthotics to be used for stabilization of the foot and ankle and take extra stress off of the lower legs.

Surgical Treatment: This is reserved only for extreme cases and is very rare. When it comes to surgical procedures for treatment of pain in the patella or patellar pain, arthroscopy can be done to look at the structures of the patella and look for any damage to the kneecap. A debridement may be done to remove damaged cartilage from the knee. In case retinaculum tendon becomes tight and pulls the patella out of the trochlear groove then a procedure called as lateral release is done to rectify patellar malalignment and treat pain in the patella or patellar pain.

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Also Read:

• Causes & Symptoms of Patellar Dislocation or Kneecap Dislocation
• Acute Patellar Injury: Causes, Symptoms, Treatment- R.I.C.E, Knee Braces
• Patellar Tendinitis or Jumper’s Knee: Symptoms, Grades, Treatment- Knee Support
• Patellar Tendon Rupture or Patellar Tendon Tear: Causes, Symptoms, Treatment, Prognosis, Recovery
• Exercises for Patellar Tendonitis or Jumper’s Knee
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