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Nerve Pain in Knee: Causes, Symptoms, and Treatment

By September 9, 2022No Comments

Nerve pain in knee can restrict a person from performing everyday activities. The pain is identified with numbing and tingling sensations in the knees. If left untreated, the knee nerve pain can become a nuisance and life-altering. 

Nerve pain in the knee usually occurs in the lumbar spine, small nerves of the knee, and the pelvis. Many people experience severe knee pain after surgery due to incisions. Others can have nerve pain due to knee arthritis or ligament injuries. 

Initial knee nerve pain treatment includes OTC anti-inflammatory medications, steroid injections, icing, and physical therapy. If the pain persists, your healthcare provider may recommend surgery or an orthobiologic method, such as cell-based therapy or platelet-rich plasma (PRP) therapy.

What is Nerve Pain in Knees?

Nerve pain is a burning, numbing, or tingling sensation in the knees. The knee has the peroneal nerve, which extends from the sciatic nerves. The sciatic nerves run through each leg from the lower back

When you have nerve pain in knee, it can cause multiple symptoms that may affect your entire leg. Some common signs of knee nerve pain include:

  • Tingling that feels like needles 
  • Pain
  • Numbness
  • Burning sensation
  • Difficulty lifting toes
  • Struggles in walking

People with arthritis can experience severe symptoms, such as:

  • Swelling
  • Clicking and grinding sensations
  • Popping sensations
  • Ligament injuries 
  • Meniscus tears

Causes of Knee Nerve Pain

Causes of Knee Nerve Pain

Nerve pain in knee commonly occurs after surgery, particularly knee replacement. In this procedure, your healthcare provider stretches the outside nerves of the affected knee. It could result in weakness in the ankle, also known as “foot drop.” 

Apart from peroneal and sciatic nerves, multiple sensory nerves run through the inside and outside of your knees. These nerves can get irritated because of knee braces, pressure, or incisions during surgery. Bow-legged knees can also stretch these nerves, causing pain.  

Some common causes of knee nerve pain are:

Surgery

Multiple surgeries can affect the nerves in the knees, leading to severe pain or swelling. These could be knee, abdominal, or back surgeries. 

Lumbar Spine

A lumbar spine segment consists of two consecutive vertebrae (L4-L5), an intervertebral disc, two facet joints, and two spinal nerves. The pain originating from the lumbar spine is termed Sciatica Syndrome, which is nerve pain running through the leg. 

Sciatica Syndrome arises from the lumbar degenerative disc disease or herniation. This condition irritates the nerve roots of the lumbar spine, causing pain in the leg. 

The lumbar spinal nerves are numbered from 1 to 5. These nerves provide different sensations (including pain) and information to their designated areas. 

For example, L2 nerve root irritation goes to the inner thigh and groin. L3 provides painful sensations to the anterior thigh, and pain in L4 goes to the medial and front areas of the knee toward the kneecap. 

Patellofemoral Stress Syndrome

Patellofemoral stress syndrome is when the kneecap moves from its usual position toward the lateral side of the leg. It could also happen before surgery, known as a lateral release. In this condition, the kneecap comes under pressure and pain.

The nerves around the kneecap can also pass pain up to the spinal nerve roots, causing severe nerve pain in knee.

Peroneal Nerve Injury

The peroneal nerves behind your knee can become irritated due to increased pressure, surgery, or overdo of any activity. Peroneal nerve injury can cause pain outside your knee that passes down towards the calf, toes, and lateral shin. 

Ligament Injuries

Your knee has multiple ligaments that maintain the joint’s stability, such as ACL, MCL, and PCL. When these ligaments become torn or damaged, the inflammation puts pressure on the knee’s peroneal nerve. As a result, you feel severe nerve pain in knee. 

Braces, Casts, and Compression Stockings

Many things can compress the nerves outside your knee and cause severe pain. Leg braces, casts, and compression stockings can pressurize the peroneal nerve in your knees. 

Treatment for Nerve Pain in Knee 

Treating your knee nerve issue depends on the intensity of the pain. However, several causes of nerve pain can be easily treated through lifestyle changes and orthobiologic methods.

Initial Treatment

The treatment for nerve pain caused due to pinched nerves is focused on relieving the pressure. The initial treatment methods recommended for knee nerve pain include:

    • Steroid Injections. Your doctor may also give you corticosteroid injections to reduce inflammation and knee pain.
    • Icing. You can also apply ice to the inflammation near your knees.
    • Avoid Physically Demanding Activities. Many activities can compress the peroneal nerve in your knee, such as squatting, the frequent crossing of legs, and wearing high-knee boots and compression garments. Avoid doing these activities. 
  • Physical Therapy. Your physical therapist would suggest you straighten your knee, leg, and back to relieve nerve pressure in the knee.
  • Orthopedic Devices. Your doctor may recommend wearing support devices to move smoothly.

Orthobiologic Methods 

If the nerve pain in knee persists, orthobiologic procedures are the best treatments. Cell-based therapy and platelet-rich plasma therapy (PRP) are popular orthobiologic methods that replace your damaged tissues with newer ones. 

  • Cell-based Therapy. After diagnosing your knee condition, your doctor will go for one of the two types of cell-based therapy: Minimally Manipulated Adipose Tissue Transplant (MMAT) and Bone Marrow Concentrate (BMAC). MMAT includes transplanting your inflamed adipose tissues, while BMAC involves replacing the damaged bone marrow cells with healthy ones. 
  • Platelet-rich Plasma (PRP) Therapy. Platelet-Rich Plasma (PRP) therapy stimulates the growth of healthy tissues in your body. A human body needs platelets to produce fibrin, a sticky web promoting tissue development. Platelets also enhance the healing process. 

Cell-based or stem cell therapy is completed within 1.5-2 hours, while PRP therapy takes 45 minutes. After the treatment, your doctor will probably send you home within a few hours. 

What is the Recovery Time for Knee Nerve Pain Treatment? 

The recovery duration for your knee pain may differ depending on the intensity. The healing period of common knee injuries is 4 to 12 weeks. You can shorten your recovery time with prompt treatment and prevention. 

Dr. Matthew HC Otten

Director of Regenerative Orthopedic and Sports Medicine
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan State University Alumni

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