Sharp nerve pain in the knee when kneeling can be distressing. This discomfort, which intensifies with pressure, is a common complaint. Understanding its potential causes can help demystify the sensation. This article explores nerve pain and its manifestations in the knee, particularly when kneeling.
Understanding Nerve Pain
Nerve pain, also known as neuropathic pain, arises from damage or dysfunction within the nervous system. Unlike typical pain that signals tissue injury, neuropathic pain results from incorrect signals sent by affected nerves. It often presents with distinct characteristics, differing from the dull ache of muscle strain or the throbbing of joint inflammation.
Individuals describe neuropathic pain in various ways, including burning, tingling, shooting, or electric shock-like sensations. Numbness or a “pins and needles” feeling can also accompany it. Sometimes, even light touch or pressure can trigger intense discomfort, a phenomenon known as allodynia. This type of pain can arise from conditions directly affecting the nerves, such as compression, inflammation, or injury.
Causes of Sharp Nerve Pain in the Knee When Kneeling
Sharp nerve pain in the knee when kneeling often points to specific nerves becoming compressed or irritated by the kneeling position. The unique anatomy of the knee makes certain nerves vulnerable to such pressure.
One common source of pain is the saphenous nerve or its infrapatellar branch, which are purely sensory nerves. The saphenous nerve runs along the inner thigh and knee, providing sensation to the skin in that region. When kneeling, direct pressure or stretching can compress this nerve, especially as it exits the adductor canal or near the inner knee. This compression can lead to sharp, burning, or electric-like pain on the inner side of the knee, often exacerbated by squatting or direct contact.
The infrapatellar branch of the saphenous nerve is particularly susceptible to injury due to its superficial location over the kneecap. Direct trauma, such as kneeling on hard surfaces, or even surgical procedures around the knee, can damage or irritate this branch. When this nerve is affected, pain is typically felt over the front and inner aspect of the knee and can be worsened by knee flexion or sustained pressure from kneeling.
Another nerve that can cause sharp pain with kneeling is the common peroneal nerve, located on the outer side of the knee. This nerve wraps around the fibular head, a bony prominence just below the knee. Prolonged kneeling or squatting can directly compress the common peroneal nerve against this bone, leading to sharp or burning pain along the outer knee and down the leg. Symptoms can also include tingling, numbness, or even weakness in the foot, known as foot drop, if the compression is significant.
Referred pain from the lumbar spine can also manifest as sharp nerve pain in the knee when kneeling. Nerves originating in the lower back, such as the L3 or L4 nerve roots, extend down the leg and can cause pain around the knee if compressed at their spinal origin. Conditions like a herniated disc or spinal stenosis in the lower back can irritate these nerve roots. Kneeling might alter spinal alignment or nerve tension, thereby intensifying the radiating pain felt in the knee.
When to Seek Medical Attention
While occasional knee discomfort might resolve with rest, certain symptoms warrant prompt medical evaluation. If the sharp nerve pain in your knee is sudden and severe, especially after an injury, seek medical attention. Inability to bear weight or significant swelling around the knee are also concerning signs.
Other red flag symptoms include loss of sensation or muscle weakness affecting leg movement, or signs of infection like redness, warmth, or fever. If pain is persistent, worsening, or significantly impacts daily activities, consult a healthcare professional.
Diagnostic Process and Treatment Approaches
Diagnosing the cause of sharp nerve pain in the knee when kneeling typically begins with a thorough patient history and physical examination. The healthcare professional will ask about the pain’s characteristics, its onset, and factors that worsen or alleviate it. During the physical exam, they assess the knee’s range of motion, stability, and conduct a neurological assessment for sensation and muscle strength. Specific tests, such as palpating nerve pathways or assessing for a Tinel’s sign (a tingling sensation when tapping over an irritated nerve), may also be performed.
To further investigate, imaging tests like X-rays or Magnetic Resonance Imaging (MRI) may be ordered to visualize bones, soft tissues, and nerves. In some cases, nerve conduction studies and electromyography (EMG) can help assess nerve function and identify nerve damage or entrapment. These diagnostic tools collectively help pinpoint the specific nerve involved and the nature of its irritation or injury.
Treatment approaches for sharp nerve pain in the knee aim to reduce symptoms and address the underlying cause. Conservative treatments are often the first line of defense. These may include resting the knee, applying ice, and modifying activities to avoid aggravating movements like prolonged kneeling. Physical therapy is frequently recommended to improve muscle strength, enhance flexibility, and promote nerve mobility.
Bracing or taping may also provide support and reduce pressure on affected nerves. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, can help manage discomfort. If conservative measures are insufficient, medical interventions may be considered.
Nerve blocks, involving injections of anesthetic or corticosteroid medications, can provide temporary pain relief and reduce inflammation. For chronic pain, radiofrequency ablation, which uses heat to disrupt pain signals, might be an option. Medications for neuropathic pain, such as gabapentin or pregabalin, may also be prescribed. In rare and severe cases where nerve compression is significant and unresponsive to other treatments, surgical decompression may be necessary.