Diagnosis: Why do I have knee and ankle pain in my same leg?

Knee pain can be difficult to manage, especially if you already suffer from osteoarthritis of the knee or any other type of arthritis. But then, you suddenly started to feel ankle pain, too. You did not expect this type of additional foot pain to appear, but its not getting any better. Is there any relationship with your knee pain? Why do you have ankle pain and knee pain simultaneously, and what can you do about it?

What causes pain in your knee and ankle at the same time?

The cause of pain in your ankle and knee at the same time has many possible explanations, and it all depends on the type of pain you’re feeling. For example, if you’re feeling some numbness in your leg and changes in color in the skin along with the pain symptoms, it is likely caused by a circulatory problem called deep vein thrombosis (blood clots). Luckily, this cause is not the most common because it can be a medical emergency.

Another option is that you have a mechanical problem affecting your leg articulations. This is usually the case in overweight people, who put extra strain on one leg and typically start feeling knee pain, which then migrates to other articulations of the affected leg. But we also need to consider osteoarthritis as one of the most important causes of knee and ankle pain at the same time.

Even if you have osteoarthritis of the knee and no problems in your feet, it is very likely that you will feel pain both in your knee and your ankle. Even asymptomatic cases of osteoarthritis in the knee cause some problems in the feet due to the leg’s biomechanics.

Is my posture contributing to foot pain?

In most cases, foot pain in the same leg as knee pain is caused by a mechanical problem, and a bad posture has a significant role. For example, in osteoarthritis of the knee, different studies show that these patients tend to adopt an aberrant foot posture that affects the biomechanics and load of weight in your entire leg. Pronation of the foot is often a problem, which is also associated with a reduction in mobility on the same side. It not only causes ankle pain on the same side of knee pain but also other musculoskeletal foot conditions.

The leading cause is excessive foot pronation in patients with osteoarthritis of the knee as a compensatory response to knee pain. This pronation shifts the weight and the pressure, forcing the knee joint laterally to try to reduce knee pain, but causing foot disturbances. This misalignment of the articulations also happens in asymptomatic knee osteoarthritis and people without arthritic conditions in the affected leg. Thus, it is crucial to evaluate how the patient walks, especially during the stance phase of walking.

Hip mechanics sometimes play a significant role, too. When you have a previous hip condition, it also affects the loading of your weight to your knee and then your foot. If we add excess body weight due to pregnancy or obesity, the problem becomes worse over time.

What can I do to solve the problem?

If your biomechanics have an alteration, modified footwear is probably your best choice to solve the problem regardless of osteoarthritis. This type of footwear is made to reduce excessive pronation of the feet, especially in the affected leg, and prevent a similar aberrant position in the contralateral leg. It is very important to look for a licensed professional because this type of footwear should be adapted to you, your feet, and the specific angle of inclination that is causing the problem.

In some cases, losing weight also becomes a viable option. Remember that we all have leg differences, sometimes a larger leg or any other mechanic variances that create potential asymmetry in your weight loads. The knee is the first articulation that suffers from this type of problem. But after a while, the foot also becomes painful and worsens when you keep walking.

If you have an underlying knee condition such as osteoarthritis of the knee, it is essential to follow your doctor’s recommendations. Physical therapy is necessary to recover your mobility, and pain medications can help reduce knee problems and go back to your feet’ appropriate position. Keep in mind that knee osteoarthritis progression worsens if you neglect your condition, and foot pain is often reported simultaneously with knee pain, but it sometimes precedes knee pain. The best alternative here is to talk to your doctor to evaluate your biomechanics, knee conditions if you have one, and your options for weight loss if necessary.

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Conclusion

Ankle pain sometimes appears along with knee pain in the same leg, especially in osteoarthritis of the knee, alterations in the biomechanics when you’re walking, or due to excess weight and other mechanic alterations of your leg. Most cases are not an emergency but it is critical to highlight that if you feel this type of leg pain associated with sudden changes of coloration in the skin and a numbing or tingling sensation, it is important to rule out deep vein thrombosis.

In most cases, the problem is solved by following your doctor’s indications in the case of osteoarthritis of the knee, using a type of modified footwear that eliminates the aberrant foot position, or losing weight to reduce the excess loads on your articulations.

References:

Paterson, K. L., Hinman, R. S., Hunter, D. J., Wrigley, T. V., & Bennell, K. L. (2015). Concurrent foot pain is common in people with knee osteoarthritis and impacts health and functional status: data from the Osteoarthritis Initiative. Arthritis care & research67(7), 989.

Vullo, V. J., Richardson, J. K., & Hurvitz, E. A. (1996). Hip, knee, and foot pain during pregnancy and the postpartum period. Journal of family practice43(1), 63-69.

Gross, K. D., Felson, D. T., Niu, J., Hunter, D. J., Guermazi, A., Roemer, F. W., … & Hannan, M. T. (2011). Association of flat feet with knee pain and cartilage damage in older adults. Arthritis care & research63(7), 937-944.

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