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Main Line (Austin Area)
Chronic pain

What Does Meniscus Pain Feel Like And How Can You Get Relief?

By Advanced Pain Care

Meniscus pain is typically sharp and stabbing, and can have an audible or palpable popping or clicking, or even a mechanical locking sensation where the knee literally cannot be moved (called “painful mechanical symptoms”).  Meniscus tear pain  can make even the most simple tasks feel unbearable, like rolling over in bed, getting out of a chair or car seat, twisting, or squatting and kneeling or crossing the leg. Anyone can experience pain from a meniscus tear, and unfortunately for us all, meniscus tears become more common as we get older. Thankfully, Advanced Pain Care is well-versed in meniscus tear management.  We can offer patients a variety of options to mitigate symptoms and lead fulfilling pain-free lives!

Identifying Meniscus Pain

The meniscus is one of two  types of cartilage in the knee joint. It  is a C-shaped wedge on each side of the knee joint in between the femur and tibia, which is distinguished from the cartilage on the ends of the bone that covers the joint surface. The meniscus primarily functions to distribute loading stresses on the joint surface. 

When the meniscus wears out or is injured, a tear may result.  One may experience painful mechanical symptoms like those described above, which are activity related.  This is different from arthritis symptoms (when the joint cartilage wears out) that is commonly dull and aching and worse with extended weightbearing, and often worse when not active.  Meniscus pain is localized to the joint line on either side of the knee, whereas arthritis pain is more often felt in the front and back. 

When we see patients for potential meniscus tears at Advanced Pain Care, we ask them to describe the pain to eliminate other possibilities. No two patients are the same, and sometimes they don’t even realize they have a meniscus tear!  In fact, we’ve reviewed studies of volunteers put into MRI scanners who had no clue their meniscus was torn.  This proves that many individuals may have a meniscus tear, but it may not be causing troubling symptoms.  When a meniscus tear does become symptomatic, the symptoms can range from simply nagging to very debilitating. If the tear is extensive, it risks becoming displaced and could lock the joint to the point where a patient cannot move the knee at all.

Can Meniscus Pain be Treated at Home?

There are different levels of treatment available for meniscus pain, and it depends on the severity of the tear and symptoms. If a torn meniscus is present but feels okay most of the time, it’s possible to treat the pain conservatively with a steroid shot in the joint (not as bad as it sounds!)  and activity modification. However, those experiencing more severe meniscus pain, especially painful  mechanical symptoms like giving-way and locking, and can’t walk or turn without substantial discomfort, will likely require more surgical treatment.

When we first examine patients, we’ll confirm if the joint line is tender or if we can feel the mechanical popping and catching in the knee. The next step is to perform an MRI to assess the presence of and severity and configuration of the tear.

The bad news is that substantial meniscus tear pain is likely not going away without surgery.  The meniscus does not have a good blood supply in adults, so once torn, there is little chance of healing.  Thus, although the severity of symptoms may come and go, they never go away, and often get much worse when physically active.  The good news is the surgery to repair the meniscus is a quick and straightforward operation.

First, we’ll go over some steps of how to reduce meniscus pain without surgery:

  1. Limit your activity. This is especially important for young people.  Children and young adults (early 20’s) have a somewhat better chance of being lucky and naturally healing their meniscus because it has a better blood supply.
  2. Avoid impact activities like running and jumping.
  3. Avoid twisting, kneeling, squatting, and sitting with legs crossed.
  4. Elevate and ice your knee to reduce swelling (sometimes present early after tearing).

Treating Meniscus Pain with Surgery

Knee arthroscopy (or a knee “scope”) is used to evaluate the inside of the knee joint and remove or repair the torn meniscus tissue.  The surgeons at Advanced Pain Care make three small incisions around the knee, about large enough to fit a number two pencil through. Using a fiber optic lighted scope with a camera on it, we can use small instruments to evaluate the meniscus tear and decide if we can repair or partially remove the meniscus. Meniscus repair typically involves sewing the meniscus back down to the joint’s lining or attaching it to the tibia bone, commonly using sutures and anchors (that hold the suture to soft tissues or bone). For a patient to do well, they must be young enough, have the right type of tear, and not have limiting medical conditions such as diabetes that would interfere with the healing process.  After a meniscus repair, expect to spend up to  six weeks on crutches in a knee brace. While it’s a lot to ask of a patient, it is a good option for younger adults who want to preserve the integrity of their knees. It’s essentially a knee longevity issue; a stable, functioning repaired meniscus can significantly reduce patients’ chances of developing arthritis later in life.

In the cases where a meniscus is not repairable, a partial meniscectomy is performed.  This is actually the more common scenario.   In this procedure, we remove unstable meniscal flaps and fragments,  and smooth out the remaining and stable meniscal tissue.  A partial meniscectomy only takes about 20 minutes to complete, and patients are then sent home to ice and elevate for two days then return gradually to activities.  A stationary bike is very useful for rehabilitation, and formal physical therapy can be done if the patient wishes.  Most patients are back to full activity within a few weeks to a month or so. 

Who Experiences Meniscus Pain?

While meniscus tears are a common injury for athletes, the general population is susceptible, especially work activities.  Any activity that causes you to forcefully and suddenly twist or rotate your knee can result in a meniscus tear, but so can simple daily activities like lifting a heavy piece of furniture or getting up from a squat.

The meniscus is elastic in adolescence and young adulthood, but it becomes more brittle and susceptible to injury with age. At Advanced Pain Care, we’ve treated patients that have torn their meniscus simply from getting a leg tangled in sheets rolling out of bed in the morning or twisting the knee while walking the dog.  Sometimes it doesn’t  take much to tear a meniscus.  Some patients never know how the meniscus tear happened.  

How Our Multidisciplinary Clinic Best Serves Meniscus Pain Patients

After a meniscus surgery, about half of our patients with underlying asymptomatic arthritis return to their lives without much disruption and without worsened or worsening arthritis pain.  However, the other half of patients who already had asymptomatic arthritis start having new and worsening arthritis symptoms.  The die was cast for those patients the day they tore the meniscus, as it became dysfunctional then; the surgery did not cause the arthritis pain to worsen.  Fortunately, at Advanced Pain Care, we are experts in treating arthritis pain, as well, which may include medications and injections.  Ultimately, when a person with knee arthritis can no longer tolerate the discomfort and physical limitations, we can perform a partial or total knee replacement surgery as the last resort.

Because APC is a multidisciplinary clinic, we are well-positioned to treat multiple complaints besides meniscus tear.   It’s like putting the pieces of a jigsaw puzzle together, and when we’re able to see a clear picture of the patient’s pain, it is convenient and efficient to be able to address all the issues under one roof with our specialist teams.  We pride ourselves on giving patients a clear clinical picture on what’s going on and how to achieve maximum comfort and pain relief, as well as best functional outcomes.