Pain behind the knees

[Laurel Menlo Park]

I am a healthy, active 54-year old, 5'10" 140 lbs.  I exercise regularly, have a healthy diet, sleep well, and have no history of chronic pain or any other medical conditions.  I own a small ad agency; most of my work is at the desk & computer, but I am up & down the stairs & moving around the office quite a bit.  I awoke 2 days ago with lower back pain, which felt like a pinched nerve.  Aspirin or aleve provided adequate relief & it subsided.

Yesterday, the pain (related I assume?) seemed to move down to behind my knees.  It is not responding to aspirin & became strong enough it woke me out of a sleep.  I have just spent about an hour at 4am on the computer searching for this topic & was led to your website.  None of the matches I found made any sense (lupus, arthritis, RLS, etc) because this came on so suddenly and there is a total lack of other syptoms.  

The pain in dull, throbbing, and is not relieved by changing positions--pretty constant whether I'm lying down in any position or sitting.  It's better standing but I can't sleep or work standing.  There is still some pain in the hips/lower back.  I have had no change in activity, no unusual exercise or movement or change in routine.  

This is so uncharacteristic for me--the pain, the reading about med issues online--I want to see if this is possibly symptomatic of something serious, but mostly what I can do to relieve the pain so I can sleep & work.  Any suggestions?

[wendelyn]

There are a few self-tests that you can do to determine if you have a DVT (Deep Vein Thrombosis).  You need only compare the temperature of your left vs. right leg and the coloration between the two.

I had a DVT a couple of years ago.  I had back pain for about 4 days before my right leg went completely dead.  It wasn't until I consulted a nurse the day my leg completely died, that I noticed that my right leg was purple!  At any rate, I got to stay in the ICU for about 4 days, so it is very very dangerous.

Do you take estrogen, smoke or take anything else that could thicken the blood?  These, along with a birth defect and ephedra, caused my DVT when I was only 22 and now I am never allowed to have any hormones again.

Good luck and I truly hope you do not have a DVT.

[ozark]

if i were you , i'd go to the emergency room to rule out a clot...is your leg bigger on that side than the other?

[Laurel Menlo Park]

Pain has now extended to groin, feels exactly the same in the crease between torso & thigh as it does in the crease behind the knee--as though someone were putting strong pressure across the crease.

[Kevin Pho, MD]

Whenever I hear about pain behind the knees, you want to rule out a blood clot (deep venous thrombosis).  This is unlikely, but certainly possible.  A simple ultrasound would be a reasonable test for this.

Assuming that's negative, then you can look at less serious diseases.  They can include a Baker's cyst (a fluid filled collection behind the knee) as well as various types of muscle strains or nerve impingements.  These can be treated with anti-inflammatories and physical therapy if these causes are suspected.  Further testing can include plain films or an MRI of the back, as well as referrals to an orthopedist or neurologist.

I would discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b