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Sports Medicine

Pain in knees, seems to be nerve sensitive

02/23/2009

Question:

For a few years now I have had pain in my knees on a regular basis. It comes and goes, oft seemingly at random. It started in my left knee and later also spread to my right knee. Doctors have done everything, x-rays, etc., nothing helped. No cause was found. Recently however, I came to realize that the pain is slowly but clearly increased (and sometimes triggered) by rubbing the Quadriceps. Any ideas or suggestions? Could it be that there is something with the nerve?

Answer:

Despite your noticing that rubbing your quadriceps muscles (the front thigh muscles) worsens and sometimes triggers your knee pain, there really is NOT a particular nerve in the front thigh area that could be responsible for your symptoms. More likely, there could be a sensitive area such as a "trigger point" within your quadriceps muscles (particularly the rectus femoris) which could "refer" pain to your knees. If this is the case, this could be the "primary" or direct cause of your knee pain, or alternatively, could be "secondary" to a problem involving the knee (such as patellofemoral pain, which often appears normal on X-rays) and/or elsewhere, such as the foot and/or hip.

Although a physical examination is necessary to confirm this, if you do have "trigger points", these usually arise due to some type of biomechanical imbalance - in muscle length and/or strength - as can be determined, and treated, by a therapist with expertise in manual treatment (physical therapist, athletic trainer, medical restorative massage therapist, etc.).

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University