Low Back Knee Pain? One of the more common misdiagnoses we see on a day to day basis is a patient with minimal back pain and knee pain, but whose knee pain is really being caused by a pinched nerve in the back. What? Is it possible that a patient with a pinched nerve in the back doesn’t have much back pain? Isn’t it the knee causing the back to be sore? Sometimes. The nerves in the low back go to the legs, so if I were to reach into your back right now and pinch a nerve, you’d feel it somewhere in your thigh, knee, leg, or foot and likely not much in your low back. Most doctors have been tranined to diagnose picnhed nerves in the back only when there’s numbness or tingling down the leg (sciatica), but to ignore the back when there’s just pain someplace in the leg. As an example, take this patient of Dr. Hanson’s who was seen yesterday. The patient had severe arthritis of both knees and was deemed a candidate for a Regenexx-AD stem cell procedure because of his displaced meniscus tissue from prior meniscus “chop” surgeries. He denied any back issues at the time. He obtained only minimal improvement with the stem cell procedure for the knee arthritis, so Dr. Hanson went digging deeper. Turns out the patient did have some off/on back issues through the years and sure enough, his exam and later his MRI showed that he had an L5-S1 disc bulge pressing on a spinal nerve. Dr. Hanson treated the disc bulge with the Regenexx-PL-Disc procedure and now his knee pain is 60% better as a result of the low back treatment. We see this all the time. As a result, we can’t stress enough that a thorough vetting of your low back is critical if you have hip, knee, ankle, or foot pain. As another example, read this blog post about a rock climber who was told he had severe intractable plantar fascititis but really had a low back problem. Another patient that comes to mind was a late 30’s mother of two who was told she needed a hip replacement because her MRI showed a congenitally short hip socket and mild arthritis, but who really had a disc bulge irritating the S1 nerve. We treated her S1 nerve problem with the Regenexx-PL-Disc procedure and her hip pain went away. You might be saying to yourself about now, “But my doctor said I have ___ arthritis (insert hip, knee, ankle in the blank) so that must be what’s causing my pain!” While your arthritis may need to be treated as well, it may not be the main cause of why you hurt. Recent research showing that some patients still have severe knee pain after a knee replacement only strengthens the argument that we need to be doing more to identify the source of knee pain before major surgery to chop out the joint. To learn more about the science behind these concepts, see our practice’s e-book, Orthopedics 2.0. For a shorter discussion of the science, see this post where recent research connects nerve problems with arthritic pain.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…