Knees Ache? It Could Be You...

Knees Ache? It Could Be Your Hips' Fault

Main Category: Arthritis News
Article Date: 12 Jun 2007 - 0:00 PDT

Howard shuffles slowly into his physician's office, complaining of persistent pain in his right foot. An examination reveals that his foot is fine, but that he has a pinched nerve in his neck and that's what is making his foot hurt.

Meanwhile, a few blocks down the street, Mary Ann limps into her doctor's examining room, almost in tears over the relentless ache in her left knee. It turns out that both of her knees are in perfect shape. The doctor, however, informs her that the pain in her knee might be a sign of a hip disorder, and subsequent examination confirms this to be the case.

What both patients are experiencing is a phenomenon known as "referred pain," which Daniel Mazanec, M.D., a rheumatologist and director of the Spine Center at Cleveland Clinic, describes simply as "pain in an area of the body that is distant from the source of the pain," according to the Cleveland Clinic's Arthritis Advisor. A classic example of referred pain, he notes, is the distress experienced in the left arm by a person in the midst of a heart attack. And for some people with acute appendicitis, the first warning sign will not be in the abdomen but in the right shoulder.

Referred pain is not to be confused with radiated pain. "If you have a herniated disk," Dr. Mazanec explains, "you'll have pain in your back and you're also likely to have it in your leg, because that's where the nerve that's irritated happens to travel and the pain can be expected to radiate along that pathway. Referred pain, on the other hand, travels along unexpected pathways."...

Arthritic pain
Patients with arthritis can also experience referred pain. "It almost always occurs in the joints," says Dr. Mazanec, "and it is most frequently observed in people with hip osteoarthritis. It's not unusual for patients with this condition to experience pain in the groin. But there may also be discomfort or pain in the front of the thigh that runs all the way down to the knee."

Knee pain that accompanies hip osteoarthritis may intensify over time, Dr. Mazanec explains, and worsening discomfort will result from movement of the hip rather than from overuse of the knee, since the hip-to-knee referral of pain does not go both ways...

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