Back Disorders and Knee Pain

Most people assume if they have knee pain it is due to a problem with the knee joint. This is not always the case! While the discomfort can be due to a knee condition, it can also be the result of a disc protrusion or a pinched nerve in your lower back. Working with a physical therapist can help determine if that is the case.

The nerves that transmit the sensation of pain to the legs and feet are located in the lower back region. Occasionally with age or injury, the discs between the vertebrae can bulge out and press on these nerves. When this occurs the nerve becomes irritated and sends out pain signals. The location of the pain depends on which disc is protruded. How bad the pain is depends on how much of the disc is pressing on the nerve.

The nerves that send fibers to the knee are located at the second, third, and fourth lumbar vertebral levels in the lower back area. If something like a disc or arthritic joint is compressing on the nerves at these locations, the pain very may be felt in the knee region. This condition can be diagnosed by your physician with a thorough history and physical exam.

If the nerve that travels to your thigh and knee is irritated or pinched, you may feel a host of symptoms. These may include:

• Pain in the front of your thigh
• Knee pain
• Numbness or tingling in your thigh
• Weakness in your hip or quadriceps muscle.

If you have any of these symptoms, you need to check in with your doctor to see if your pain is truly coming from your spine or your knee. Your hip may also be the culprit here, so a careful examination is necessary to find the true cause of your knee pain.

Treating knee pain due to spinal nerve compression or irritation can be accomplished with surgery, but it is not recommended to even think about surgery until you have exhausted conservative measures. The conservative route is often favored initially. Sometimes, steroid injections may be used to help decrease inflammation around your nerve root, but again, these should not be your initial treatment for your pain.

Physical therapy management of disc herniation or pinched nerve includes back stretching exercises as well as core strengthening activities. A physical therapist trained in the McKenzie Method can quickly assess your condition and use specific movements and exercises to determine if your pain is coming from your spine or your knee. In general, if you do a back exercise and the pain centralizes to your spine, your knee pain is likely coming from your back. Continuing through a progression of exercises to centralize your pain can help you quickly and safely get rid of your knee pain and get back to your normal activity.

If your knee pain is improved by exercises for your spine, your PT can also show you postural correction exercises and strategies to help keep pressure off your nerve to eliminate your knee pain and prevent future problems.

If movements in your spine have no effect on your knee pain, your PT may perform knee special tests to see if your pain is caused by a problem with the knee joint or hip joint.

Pain in your thigh or your knee can certainly be coming from the knee joint proper, but it can also come from a pinched nerve in your back. Visiting your doctor and then working closely with a physical therapist who is a spinal specialist can help you quickly and safely determine the cause of your pain and can help you fully return to your normal active lifestyle.

Edited by Brett Sears, PT on March 13, 2016.