Knee Pain When Sitting

[Dr. Sushanta Kumar Ghose]

There are many different causes of knee pain. You can get pain in the knee following an injury or you can get the gradual onset of knee pain with no direct reason behind it. In order to best treat knee pain, you need to know why it is occurring. If you can treat the cause of the knee pain, you can better get a handle on its treatment. Here, knee pain while sitting, which can affect some people, will be discussed in detail.

What Causes Knee Pain When Sitting?
The most common cause of knee pain when you sit is called patellofemoral pain syndrome. This is a common condition, especially among athletes, teens, and those who engage in manual labor. No one knows the exact cause of the problem; however, it may be due to being overweight, using the knees too much, an injury or a malalignment of the knee cap. The pain is worse when sitting because the kneecap is not in proper alignment when the person is sitting down.

Other less common causes of knee pain when sitting include:

ŸOsgood Schlatter’s disease. This hurts in the front of the knee over the tibial tubercle because this is where the inferior patellar ligament inserts. The pain is more common among young males who have undergone a growth spurt. Just touching the tibial tubercle when sitting can result in pain.

ŸOsteoarthritis. There is wear and tear on the joint so that the bones touch one another without cartilage in between. This results in extreme pain in the knee.

ŸKnee bursitis. The fluid filled sac between the tendons, muscles and bones becomes inflamed and can enlarge. Because it is inflamed, there can be redness and tenderness of the area just beneath the patella.

ŸA Baker’s cyst. The pain is from inflammation of the bursa behind the knee and, when you sit, you put extra pressure on the inflamed bursa and it hurts more. The pain is better when standing up because the bursa doesn’t have so much pressure on it. It can be drained if it doesn’t go away on its own.

What Other Symptoms Will Show with Knee Pain When Sitting?

This pain usually comes on gradually although trauma can cause sudden pain. The main symptom is pain in the area of the patella and behind the patella. However, the pain is diffuse and difficult to localize. Pain is usually worse when going up stairs, going down stairs, bicycling, squatting, running, and kneeling or when you sit for a long period of time. The pain usually aches but can be sharp at times. Other symptoms include crepitus about the knee and a sensation of the knee "giving way". When it comes on gradually, you may not feel it when sitting right away but, over time, the knee pain will occur all of the time.

How to Deal With Knee Pain When Sitting
1.  Do Less Stressful Activities
You can manage knee pain while sitting with home remedies. These include stopping the thing that causes the pain to be worse until you feel better. You may need to practice low impact exercises that won't stress the knee joint. Try swimming or bicycling as these put less tension on the knee. Try to lose weight if you are overweight by eating less and by doing the above low impact aerobic activities. Don’t resume regular activities until your knee pain has resolved.

2.  Practice RICE Method
RICE means taking rest to the knee, using ice packs on the knee, compressing the knee with an ACE wrap and keeping the knee elevated. The RICE method should be done by anyone who has an inflamed or sore knee as this reduces inflammation and lessens swelling.

3.  Medications
You can also use nonsteroidal anti-inflammatory medications (NSAIDs), including naproxen sodium (marketed as Aleve and Naprosyn) and ibuprofen (marketed as Motrin and Advil). You can also use aspirin for the pain and inflammation. These medications can decrease inflammation, swelling, and pain in the knee. See your doctor if the knee pain gets worse or doesn't get better with them. Try not to use acetaminophen (Tylenol) as this medication does not fight inflammation and only addresses the pain.

4.  Physical Therapy Exercise
You can try physical therapy for knee pain when sitting, in which exercises will be recommended by a physical therapist. The exercises can improve your strength, range of motion and knee endurance. You should try to strengthen the quadriceps muscles as these help stabilize the kneecap and help the knee straighten. You may also need to take some exercise to strengthen the muscles of the abdomen and low back area.

5.  Orthotics
The doctor may recommend orthotic devices. These are inserted in the shoes so that the foot and ankle are more stable. This relieves the stress in your leg and can be found at a pharmacy or made for you especially.

6.  Arthroscopy
The doctor can look inside the knee with an arthroscope and can scrape off any cartilage that might be loose or friable. This can be done under general anesthesia, so you don’t feel anything while it is being done.

7.  Tibial Tubercle Transfer
The doctor may try to put the kneecap into its proper position by moving the tendon and a part of the tibial tubercle to a different position. This realigns the patella so that you don’t get it rubbing against the bones while walking or sitting.


Author: Sushanta Kumar Ghosh, Physiotherapy Specialist, DIU Medical Center