Conditions

Neck Pain

Neck pain can result from a variety of causes, ranging from overuse injuries and whiplash to diseases such as rheumatoid arthritis and meningitis.

Worn Joints

Just like all the other joints in your body, your neck joints tend to experience wear and tear with age, which can cause osteoarthritis in your neck.

Nerve Compression

A variety of problems in your neck’s vertebrae can reduce the amount of space available for nerves to branch out from the spinal cord. Examples include:

  • Stiffened disks. As you age, the cushioning disks between your vertebrae become dry and stiff, narrowing the spaces in your spinal column where the nerves exit.
  • Herniated disks. This occurs when the inner gel-like material of a disk protrudes through the disk’s tougher outer covering. The protrusion can press on nerves exiting the spinal column, causing arm pain or weakness, or on the spinal cord itself.
  • Bone spurs. Arthritic joints in your neck can develop bony growths that may press on nerves.

Injuries

Rear-end collisions often result in whiplash injuries, which occur when the head is jerked forward and then backward, stretching the soft tissues of the neck beyond their limits. This can also lead to damage of the facet joints which can cause chronic pain associated with headaches, lateral pain into neck shoulder and upper back as well as arm.

Diseases

Neck pain can sometimes be caused by diseases, such as:

  • Rheumatoid arthritis. After the joints in the hands and the feet, the joints in the neck are the next most commonly affected by rheumatoid arthritis.
  • Meningitis. This infectious disease causes the lining of the brain and spinal cord to swell. One of the most common symptoms of meningitis is neck pain and stiffness.
  • Cancer. Rarely, neck pain can be caused by cancerous tumors in the spine. The cancer may have traveled to the spine from other parts of your body.

Tests and Diagnosis

Your doctor often will be able to diagnose the cause of your neck pain and recommend treatment just by asking questions about the type, location and onset of your pain. In some instances, however, imaging tests, nerve tests or lab tests may be warranted.

Imaging Tests

  • X-rays can reveal areas in your neck where your nerves or spinal cord may be pinched by bone spurs or a bulging disk. But many people, especially those over 60, have these findings and don’t experience any neck pain.
  • Computerized tomography (CT). CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of the internal structures of your neck.
  • Magnetic resonance imaging (MRI). MRIs utilize radio waves and a strong magnetic field to create especially detailed images of bones and soft tissues, including the spinal cord and the nerves coming from the spinal cord.

Nerve Tests

If your doctor suspects that your neck pain may be related to a pinched nerve, he or she may suggest electromyography (EMG). This test involves inserting very fine needles through your skin into a muscle to determine whether specific nerves are functioning properly.

Lab Tests

Blood tests. Blood tests can sometimes provide evidence of inflammatory or infectious conditions that may be causing your neck pain.

Nerve Blocks

Nerve block procedures can be performed under live X ray and conscious sedation to not only provide a specific diagnosis but in many cases a long term treatment option or cure for the painful condition. These procedures are considered extremely safe with few reported complications and are almost pain free secondary to the IV sedation.

Headache Pain

Most people have headaches from time to time. But if you have a headache more days than not, you may be experiencing a variety of head pain known as chronic daily headaches.

The incessant nature of chronic daily headaches makes them among the most disabling headaches. Aggressive initial treatment and steady, long-term management may reduce pain and lead to fewer chronic daily headaches.

Tests and Diagnosis

Your doctor will probably do a physical exam to check for signs of illness, infection or neurological problems. If the cause of your headaches remains uncertain, you may need blood or urine tests to identify any underlying medical conditions. Sometimes imaging studies — such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan — are recommended. An electroencephalogram (EEG) can also help diagnose brain tumors, injury or inflammation.

Many headaches can be associated with injuries to the head and neck and can be diagnosed and treated with nerve block procedures some performed under live X ray and conscious sedation that can provide a specific diagnosis and in many cases a long term treatment option or cure for the painful condition.

Shoulder Pain

Shoulder pain includes any pain that arises in or around your shoulder. Shoulder pain may originate in the joint itself, or from any of the many surrounding muscles, ligaments or tendons. Shoulder pain usually worsens with activities or movement of your arm or shoulder.

Certain diseases and conditions affecting structures in your chest or abdomen, such as heart disease or gallbladder disease, also may cause shoulder pain. Shoulder pain that arises from some other structure is called “referred pain.” Referred shoulder pain usually doesn’t worsen when you move your shoulder.

Referred pain to the shoulder can also be caused by neck injuries and can be diagnosed and treated by utilizing shoulder injections and nerve blocks in the neck region that can help determine the source of the pain and provide a long term treatment option.

Causes of shoulder pain may include:

  • Ankylosing spondyliti
  • Avascular necrosis
  • Brachial plexus injury
  • Broken arm
  • Bursitis
  • Cancer
  • Cervical facet syndrome
  • Cervical radiculopathy
  • Dermatomyositis
  • Dislocated shoulder
  • Ectopic pregnancy
  • Frozen shoulder
  • Heart attack
  • Infection
  • Multiple sclerosis
  • Osteoarthritis
  • Pericarditis
  • Pneumothorax
  • Polymyalgia rheumatica
  • Polymyositis
  • Rheumatoid arthritis
  • Rotator cuff injury
  • Separated shoulder
  • Septic arthritis
  • Shingles
  • Spinal cord injury
  • Sprains and strains
  • Tendinitis
  • Tendon rupture
  • Thoracic outlet syndrome
  • Torn cartilage

Arm Pain

Arm pain usually refers to pain originating from somewhere between your shoulder and your wrist. However, arm pain doesn’t have to originate in your arm; spinal problems or injuries can cause pain that you feel in your arm but that actually arises in your neck and upper back. Pain that radiates into your left arm can even be a sign of a heart attack.

Your arms are made up of three major bones and nerves as well as muscles, tendons, ligaments and joints. All are susceptible to damage or injury that can cause arm pain.

Often, arm pain is fairly minor, but some fractures and nerve problems can cause severe pain and may require extensive medical care. Other types of arm pain usually respond well to home treatments.

Most arm pain results from an injury in an accident or fall. Older adults with fragile bones, active children and people who participate in contact or adventure sports are especially vulnerable. Repetitive stress injuries can also cause pain in your upper arms and wrists. So can damage to the brachial plexus — the network of nerves in your neck and shoulder that carry signals between your spinal cord and arms.

Common causes of arm pain include:

  • Brachial plexus injury
  • Broken arm
  • Broken wrist/broken hand
  • Bursitis
  • Cancer (malignancy), primary or metastatic
  • Carpal tunnel syndrome
  • De Quervain’s tenosynovitis
  • Herniated disk
  • Rotator cuff injury
  • Sprains and strains
  • Tendinitis
  • Tennis elbow
  • Thoracic outlet syndrome
  • Ulnar nerve entrapment

Elbow Pain

Your elbow is a complex joint that allows you to perform pushing and pulling movements and to rotate your forearm. Elbow pain can be caused by injury or strain to the bones in your elbow joint, the surrounding muscles or the tendons, which attach the muscles to the bones. Elbow pain may also be due to damage arising from the elbow joint’s network of nerves, blood vessels and ligaments. On occasion, problems in your neck, shoulder and upper arm, or your forearm and wrist can result in elbow pain.

Elbow pain usually isn’t serious, but because you use your elbow in so many ways, elbow pain can definitely affect your life

Most elbow pain results from overuse injuries; many sports, hobbies and jobs require repetitive hand, wrist or arm movements. Elbow pain may occasionally be due to arthritis, but in general, your elbow joint is much less prone to wear-and-tear damage than are many other joints.

Common causes of elbow pain include:

  • Cubital tunnel syndrome, which occurs when the ulnar nerve on the inside of your elbow is irritated or injured
  • Dislocation
  • Elbow fracture
  • Golfer’s elbow
  • Ligament sprains and tears
  • Little league elbow syndrome (pitcher’s elbow) — an injury mainly affecting children and rapidly growing adolescents involved in throwing sports such as baseball
  • Olecranon bursitis — inflammation of a small sac of fluid (olecranon bursa) on the tip of your elbow
  • Osteoarthritis
  • Osteochondritis dissecans
  • Radial tunnel syndrome, which occurs when the radial nerve becomes compressed just beyond your elbow (sometimes called resistant tennis elbow)
  • Sprains and strains
  • Tendinitis
  • Tennis elbow

Wrist Pain

Wrist pain is a common complaint. Many types of wrist pain are caused by sudden injuries that result in sprains or fractures. But wrist pain also can be caused by more long-term problems — such as repetitive stress, arthritis and carpal tunnel syndrome.

Because so many factors can lead to wrist pain, diagnosing the exact cause of long-standing wrist pain sometimes can be difficult. An accurate diagnosis is crucial, however, because proper treatment depends on the cause and severity of your wrist pain.

Wrist pain may vary, depending on what’s causing it. For example, osteoarthritis pain is often described as being similar to a dull toothache, while tendinitis usually causes a sharp, stabbing type of pain. The precise location of your wrist pain also can give clues to what might be causing your symptoms.
When to see a doctor

Not all wrist pain requires medical care. Minor sprains and strains, for instance, usually respond to ice, rest and over-the-counter pain medications. But if pain and swelling last longer than a few days or become worse, see your doctor. Delays in diagnosis and treatment can lead to poor healing, reduced range of motion and long-term disability.

Causes

Your wrist is a complex joint made up of eight small bones arranged in two rows between the bones in your forearm and the bones in your hand. Tough bands of ligament connect your wrist bones to each other and to your forearm bones and hand bones. Tendons attach muscles to bone. Damage to any of the parts of your wrist can cause pain and affect your ability to use your wrist and hand.

Injuries

  • Sudden impacts. Wrist injuries often occur when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures. A scaphoid fracture involves a bone on the thumb side of the wrist. This type of fracture may not show up on X-rays immediately following the injury.
  • Repetitive stress. Any activity that involves repetitive wrist motion — from hitting a tennis ball or bowing a cello to driving cross-country — can inflame the tissues around joints or cause stress fractures, especially when you perform the movement for hours on end without a break. De Quervain’s disease is a repetitive stress injury that causes pain at the base of the thumb.

Arthritis

  • Osteoarthritis. In general, osteoarthritis in the wrist is uncommon, usually occurring only in people who have injured that wrist in the past. Osteoarthritis is caused by wear and tear on the cartilage that cushions the ends of your bones. Pain that occurs at the base of the thumb may be caused by osteoarthritis.
  • Rheumatoid arthritis. A disorder in which the body’s immune system attacks its own tissues, rheumatoid arthritis is common in the wrist. If one wrist is affected, the other one usually is, too.

Other diseases and conditions:

  • Carpal tunnel syndrome. Carpal tunnel syndrome develops when there’s increased pressure on the median nerve as it passes through the carpal tunnel, a passageway in the palm side of your wrist.
  • Ganglion cysts. These soft tissue cysts occur most often on the top of your wrist opposite your palm. Smaller ganglion cysts seem to cause more pain than do larger ones.
  • Kienbock’s disease. This disorder typically affects young adults and involves the progressive collapse of one of the small bones in the wrist. Kienbock’s disease occurs when the blood supply to this bone is compromised.

Tests and Diagnosis

During the physical exam, your doctor may:

  • Check your wrist for points of tenderness and swelling
  • Ask you to move your wrist to see if your range of motion has been decreased
  • Assess your grip strength and forearm strength

In some cases, your doctor may suggest imaging tests, arthroscopy or nerve tests to help pinpoint the cause of your wrist pain.

Imaging Tests

  • X-rays. Using a small amount of radiation, simple X-rays can reveal bone fractures, as well as evidence of osteoarthritis.
  • Computerized tomography (CT) scan. CT scans can provide more-detailed views of the bones in your wrist. A CT scan takes X-rays from several directions and then combines them to make a two-dimensional image.
  • Bone scan. In a bone scan, a small amount of radioactive material is injected into your bloodstream. This makes injured parts of your bones brighter on the resulting scan images.
  • Magnetic resonance imaging (MRI). MRIs use radio waves and a strong magnetic field to produce detailed images of your bones and soft tissues. For a wrist MRI, you may be able to insert your arm into a smaller device rather than have your entire body slide into a full-size MRI machine.

Arthroscopy

If imaging test results are inconclusive, your doctor may perform an arthroscopy, a procedure in which a pencil-sized instrument is inserted into your wrist via a small incision in your skin. The instrument contains a light and a tiny camera. Images are projected onto a television monitor.

Nerve Tests

If your doctor thinks you have carpal tunnel syndrome, he or she might order an electromyogram (EMG). This test measures the tiny electrical discharges produced in your muscles. A needle-thin electrode is inserted into the muscle, and its electrical activity is recorded when the muscle is at rest and when it’s contracted. Nerve conduction tests also are performed as part of an EMG to assess if the electrical impulses are slowed in the region of the carpal tunnel.

Upper and Middle Back Pain

What is upper and middle back pain?

Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your rib cage camera.

Your ribs attach to a long, flat bone in the center of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.

The upper and middle back (called the thoracic spine) has:

  • 12 vertebrae. These bones attach to your rib cage. They make up the longest part of your back.
  • Discs camera that separate each vertebra and absorb shock as you move.
  • Muscles and ligaments that hold the spine together.

Upper and middle back pain is not as common as low back pain or neck pain, because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck. Instead, they work with the ribs to keep the back stable and help protect vital organs, such as the heart and lungs.

What causes upper and middle back pain?

Upper and middle back pain may be caused by:

  • Overuse, muscle strain, or injury to the muscles, ligaments, and discs that support your spine.
  • Poor posture.
  • Pressure on the spinal nerves from certain problems, such as a herniated disc.
  • A fracture of one of the vertebrae.
  • Osteoarthritis caused by the breakdown of cartilage that cushions the small facet joints in the spine.
  • Myofascial pain that affects the connective tissue of a muscle or group of muscles.

In rare cases, pain may be caused by other problems, such as gallbladder disease, cancer, or an infection.

What are the symptoms?

Common symptoms of upper and middle back pain are:

  • A dull, burning, or sharp pain.
  • Muscle tightness or stiffness.

More serious symptoms that need to be treated right away include:

  • Weakness in your arms or legs.
  • Numbness or tingling in your arms, legs, chest, or belly.
  • Loss of bowel or bladder control.

How is upper and middle back pain diagnosed?

Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a physical exam. Your doctor may also order an imaging test, such as an X-ray or an MRI, to find out if something such as a broken bone or a herniated disc is causing your pain.

Low Back Pain

What is low back pain?

Low back pain can happen anywhere below the ribs and above the legs. The lower back camera is the connection between the upper and lower body, and it bears most of the body’s weight. So it’s pretty easy to hurt your back when you lift, reach, or twist. In fact, almost everyone has low back pain at one time or another.

What causes low back pain?

Causes of low back pain include:

  • Overuse, strain, or injury
  • Aging
  • Herniated disc
  • Arthritis
  • Compression fractures
  • Illness
  • A spine problem you were born with

Often doctors don’t really know what causes low back pain. But it is more likely to become long-lasting (chronic) if you are under stress or depressed.

What are the symptoms?

Depending on the cause, low back pain can cause a range of symptoms. The pain may be dull or sharp. It may be in one small area or over a broad area. You may have muscle spasms.

Low back pain can also cause leg symptoms, such as pain, numbness, or tingling, often extending below the knee.

A rare but serious problem called cauda equina syndrome can occur if the nerves at the end of the spinal cord are squeezed. Seek emergency treatment if you have weakness or numbness in both legs or you lose bladder or bowel control.

Most low back pain is short-term (acute) and will go away in a few weeks. It is more likely to become long-lasting (chronic) if you are depressed or under stress.
How is low back pain diagnosed?

The doctor will ask questions about your past health, symptoms, and activities. He or she will also do a physical exam. Your answers and the exam can help the doctor rule out a serious cause for the pain. In most cases, doctors are able to recommend treatment after the first exam.

X-rays, CT scans, and MRIs don’t usually help.

But if you have a back pain problem that has lasted longer than 4 weeks, or if your doctor thinks you may have more than muscle pain, it might be time for one of these tests.
How is it treated?

Most low back pain will improve with basic first aid, which includes resting for a day or two, getting up and active as soon as possible, and taking over-the-counter pain medicine as needed.

Walking is the simplest and maybe the best exercise for the lower back. It gets your blood moving and helps your muscles stay strong.

The most common causes of low back pain are:

  • Injury or overuse of muscles, ligaments, and joints.
  • Pressure on nerve roots in the spinal canal. This can be caused by:
    • A herniated disc, sometimes brought on by repeated vibration or motion (as during sport activity or when using a machine or lifting in the wrong way) or by a sudden heavy strain or increased pressure to the lower back.
    • Osteoarthritis, usually caused by getting older. When osteoarthritis affects the small joints in the spine, it can lead to back pain. Osteoarthritis in other joints, such as the hips, can cause you to limp or to change the way you walk. This can also lead to back pain.
    • Spondylolisthesis, a defect that allows one vertebra to slide over another.
      Spinal stenosis, or narrowing of the spinal canal, which is usually caused by getting older.
    • Fractures of the vertebrae caused by a lot of force, such as from an auto or bicycle accident, a direct blow to the spine, or compressing the spine by falling onto the buttocks or head.
    • Spinal deformities, including curvature problems such as severe scoliosis or kyphosis.
  • Compression fractures. These are more common among post-menopausal women with osteoporosis and in men or women after long-term corticosteroid use. In a person with osteoporosis, even a small amount of force put on the spine, as from a sneeze, may cause a compression fracture.

Less common spinal conditions that can cause low back pain include:

  • Ankylosing spondylitis, which is a form of arthritis that most often affects the spine.
  • Bacterial infection. Bacteria are usually carried to the spine through the bloodstream. You may have back pain from an infection in the bone, in the spinal discs, or in the spinal cord. An infection may enter the spine from:
  • An infection somewhere else in the body.
  • Intravenous (IV) drug use.
  • Surgery or injection treatments.
  • An injury.
  • Spinal tumors, which are growths on the bones and ligaments of the spine, on the spinal cord, or on nerve roots.

Hip Pain

The hip joint is designed to withstand repeated motion and a fair amount of wear and tear. This ball-and-socket joint — the body’s largest — fits together in a way that allows for fluid movement.

Whenever you use the hip (for example, by going for a run), a cushion of cartilage helps prevent friction as the hip bone moves in its socket.

Despite its durability, the hip joint isn’t indestructible. With age and use, the cartilage can wear down or become damaged. Muscles and tendons in the hip can get overused. The hip bone itself can be fractured during a fall or other injury. Any of these conditions can lead to hip pain.

If your hips are sore, here is a rundown of what might be causing your discomfort and how to find hip pain relief.

Causes of Hip Pain

These are some of the conditions that are most likely to cause hip pain:

Sacroiliac Joint Dysfunction

Sacroiliitis (sa-kro-il-ee-EYE-tis) is an inflammation of one or both of your sacroiliac joints, which connect your lower spine and pelvis. Sacroiliitis can cause pain in your buttocks or lower back, and may even extend down one or both legs. The pain associated with sacroiliitis is often aggravated by prolonged sitting, standing or by stair climbing.
Arthritis

Arthritic conditions such as osteoarthritis and rheumatoid arthritis are among the most common causes of hip pain, especially in older adults. Arthritis leads to inflammation of the hip joint and the breakdown of the cartilage that normally cushions your hip bones. The pain gradually gets worse as the arthritis progresses. People with arthritis also feel stiffness and have reduced range of motion in the hip.

Hip Fractures

Fractures of the hip are a particular problem in elderly people. With age, the bones can become weak and brittle. Weakened bones are more likely to fracture during a fall.

Bursitis

Inflammation of the small, fluid-filled sacs (called bursae) that protect muscles and tendons is usually due to repetitive activities that overwork or irritate the hip joint.

Tendinitis

Tendons are the thick bands of tissue that attach bones to muscles. Tendinitis is inflammation or irritation of the tendons. It’s usually caused by repetitive stress from overuse.

Muscle or Tendon Strain

Repeated activities can put strain on the muscles, tendons, and ligaments that support the hips. When these structures become inflamed from overuse, they can cause pain and prevent the hip from functioning normally.

Cancers

Tumors that start in the bone (bone cancer) or that spread to the bone can cause pain in the hips, as well as in other bones of the body.

Avascular necrosis (also called osteonecrosis)

This condition occurs when blood flow to the hip bone is reduced and the bone tissue dies as a result. Although it can affect other bones, avascular necrosis most often occurs in the hip. It can be caused by a hip fracture or dislocation, or from the long-term use of high-dose steroids (such as prednisone), among other causes.

Leg Pain

Leg pain usually refers to pain originating from somewhere between your pelvis and your heels. However, leg pain doesn’t have to originate in your leg; spinal problems or injuries can cause leg pain that is felt in your leg but that actually arises in your lower back.

Leg pain can be constant or intermittent, develop suddenly or gradually, and affect your entire leg or a localized area, such as your shin or your knee. It can also take a number of forms — stabbing, sharp, dull, aching or tingling.

Some leg pain is simply annoying, but more severe leg pain can affect your ability to walk, put weight on your leg or feel stable.

Most leg pain results from wear and tear, overuse, or injuries in joints or bones or in muscles, ligaments, tendons or other soft tissues.

Other conditions can also cause leg pain; blood clots in the veins of your legs (deep vein thrombosis) or varicose veins can cause pain, swelling and even open sores. Narrowed arteries can reduce blood flow to your legs, leading to pain that gets worse with exercise and improves with rest. Infections, too, can cause leg pain.

Some common causes of leg pain include:

  • Achilles tendinitis
  • Achilles tendon rupture
  • ACL injury
  • Baker’s cyst
  • Bone cancer
  • Broken leg
  • Bursitis
  • Chondromalacia patella
  • Chronic exertional compartment syndrome
  • Claudication
  • Deep vein thrombosis (DVT)
  • Fibromyalgia
  • Gout
  • Growth plate fractures
  • Hamstring injury
  • Herniated disk
  • Knee bursitis
  • Legg-Calve-Perthes disease
  • Torn meniscus
  • Muscle cramp
  • Night leg cramps
  • Osgood-Schlatter disease
  • Osteoarthritis
  • Osteomyelitis
  • Patellar tendinitis
  • Peripheral neuropathy
  • Posterior cruciate ligament injury
  • Posterior tibial tendon rupture
  • Pseudogout
  • Rheumatoid arthritis
  • Sciatica
  • Shin splints
  • Sprains and strains
  • Stress fractures
  • Tendinitis
  • Thrombophlebitis
  • Varicose veins

Knee Pain

Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions — including arthritis, gout and infections — also can cause knee pain.

Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. In some cases, however, your knee may require surgical repair.

Causes

Knee pain can be caused by injuries, mechanical problems, types of arthritis and other problems.

Injuries

A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:

  • ACL injury. An ACL injury is the tearing of the anterior cruciate ligament (ACL) — one of four ligaments that connect your shinbone to your thighbone. An ACL injury is particularly common in people who play basketball or go downhill skiing, because it’s linked to sudden changes in direction.
  • Torn meniscus. The meniscus is formed of tough, rubbery cartilage and acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.
  • Knee bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint.
  • Patellar tendinitis. Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous cords that attach muscles to bones. Runners, skiers and cyclists are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

Mechanical Problems

  • Loose body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement — the effect is something like a pencil caught in a door hinge.
  • Knee ‘locking.’ This can occur from a cartilage tear. When a portion of cartilage from the tear flips inside the knee joint, you may not be able to fully straighten your knee.
  • Dislocated kneecap. This occurs when the triangular bone (patella) that covers the front of your knee slips out of place, usually to the outside of your knee. You’ll be able to see the dislocation, and your kneecap is likely to move excessively from side to side.
  • Hip or foot pain. If you have hip or foot pain, you may change the way you walk to spare these painful joints. But this altered gait can interfere with the alignment of your kneecap and place more stress on your knee joint. In some cases, problems in the hip or foot can refer pain to the knee.

Types of Arthritis

  • Osteoarthritis. Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It’s a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
  • Rheumatoid arthritis. The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.
  • Gout. This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
  • Pseudogout. Often mistaken for gout, pseudogout is caused by calcium pyrophosphate crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
  • Septic arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. There’s usually no trauma before the onset of pain. Septic arthritis often occurs with a fever.

Other Problems

  • Iliotibial band syndrome. This occurs when the ligament that extends from the outside of your pelvic bone to the outside of your tibia (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome.
  • Chondromalacia patellae (patellofemoral pain syndrome). This is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It’s common in young adults, especially those who have a slight misalignment of the kneecap; in athletes; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.
  • Osgood-Schlatter disease. This condition affects the softer area of bone near the top of the shinbone, where bone growth occurs. It’s most common in boys who play games or sports that involve running or jumping. The discomfort can last a few months and may continue to recur until the child’s bones stop growing.
  • Osteochondritis dissecans. Caused by reduced blood flow to the end of a bone, osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone. It occurs most often in young men, particularly after an injury to the knee.

Tests and diagnosis

Imaging tests

  • X-ray. Your doctor may first recommend having an X-ray, which can help detect bone fractures and degenerative joint disease.
  • Computerized tomography (CT) scan. CT scanners combine X-rays taken from many different angles, to create cross-sectional images of the inside of your body. CT scans can help diagnose bone problems and detect loose bodies.
  • Ultrasound. This technology uses sound waves to produce real-time images of the structures within and around your knee, and how they are working. Your doctor may want to maneuver your knee into different positions during the ultrasound, to check for specific problems.
  • Magnetic resonance imaging. MRI uses radio waves and a powerful magnet to create 3-D images of the inside of your knee. This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.

Lab Tests

If your doctor suspects an infection, gout or pseudogout, you’re likely to have blood tests and sometimes arthrocentesis, a procedure in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.

Ankle Pain

Your ankle — the joint where your foot and leg meet — is an intricate network of bones, ligaments, tendons and muscles. Strong enough to bear your body weight, your ankle can be prone to injury and pain.

You may feel ankle pain on the inside or outside of your ankle or along the Achilles tendon, which connects the muscles in your lower leg to your heel bone. Because ankle pain can sometimes indicate a serious problem, severe ankle pain should be evaluated by your doctor, especially if it follows an injury. Although mild ankle pain often responds well to home treatments, it can take time to resolve. See your doctor when any ankle pain doesn’t improve within a few weeks.
Causes

Injury to any of the bones, ligaments or tendons in the ankle can cause ankle pain. Most ankle pain, however, is the result of a sprain, which occurs when your ankle rolls over your foot, causing an ankle ligament to stretch or even tear. Though sprains are often sports related, they can occur when you walk on an uneven surface or simply take a misstep.

Common causes of ankle pain include:

  • Achilles tendinitis
  • Achilles tendon rupture
  • Avulsion fracture
  • Broken ankle/broken foot
  • Gout
  • Osteoarthritis
  • Pseudogout
  • Rheumatoid arthritis
  • Septic arthritis
  • Sprained ankle
  • Sprains and strains
  • Stress fractures

Foot Pain

Foot pain can affect any part of your foot, from your toes to your Achilles tendon at the back of your heel. Some foot pain is simply an annoyance. But foot pain can also be more serious, especially if it’s the result of injury or certain chronic conditions. Minor foot pain usually responds well to home treatment. More severe foot pain needs medical attention. If not treated, some types of foot pain can lead to long-term damage or disability.
Causes

Most foot pain is due to poorly fitting shoes, injury or overuse. But structural defects and medical conditions, such as arthritis and diabetes, also can lead to foot problems.

Common causes of foot pain include:

  • Achilles tendinitis
  • Achilles tendon rupture
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  • Bone spurs
  • Broken ankle/broken foot
  • Broken toe
  • Bunions
  • Bursitis
  • Corns and calluses
  • Diabetic neuropathy
  • Flatfeet
  • Gout
  • Hammertoe and mallet toe
  • High heels or poorly fitting shoes
  • Ingrown toenails
  • Metatarsalgia
  • Morton’s neuroma
  • Osteoarthritis
  • Peripheral neuropathy
  • Plantar fasciitis
  • Plantar warts
  • Poor posture or postural defects
  • Posterior tibial tendon rupture
  • Rheumatoid arthritis
  • Stress fractures
  • Tarsal tunnel syndrome