Pain on the inside of your knee..It may not be your meniscus.

It’s half term and I hope there are a good few of you hitting the slopes right now. The six nations has also started and its there us a big correlation with increased stress on the inside of the knee. So it’s a busy time of year for me when clients start to present with pain in this area and clients can be concerned that they may have torn there meniscus (cartilage inside the knee) Though this may a diagnosis that I have to either rule in or out, there is another cause of pain in this area that isn’t as well recognised.

Understanding Saphenous Nerve and Its Role in Medial Knee Pain

Ours bodies intricate network of nerves plays a crucial role in sending signals from the periphery to the brain, helping us perceive sensations such as touch, temperature, and pain. One of the nerves involved in sensation in the knee region is the saphenous nerve, a branch of the femoral nerve. While commonly associated with the inner part of the lower leg and knee, the saphenous nerve’s role in medial knee pain is not always fully understood

In this blog, we’ll take a deeper dive into the saphenous nerve, its anatomical path, and how it can contribute to medial knee pain, helping you better understand this often-overlooked cause of discomfort.

What is the Saphenous Nerve?

The saphenous nerve is the largest sensory branch of the femoral nerve, originating from the L3-L4 spinal levels. It provides sensation to the skin on the inner side (medial side) of the lower leg and foot. After branching from the femoral nerve, the saphenous nerve travels down the inner thigh and knee, eventually reaching the medial aspect of the leg, where it innervates the skin.

Saphenous Nerve and the Medial Knee

The medial knee is the area on the inner side of the knee joint, and the saphenous nerve plays a crucial role in supplying sensation to this region. The saphenous nerve passes through the adductor canal (a passage in the thigh) and enters the medial knee area, where it provides sensory information about the skin and soft tissues.

Causes of Medial Knee Pain Related to the Saphenous Nerve

The saphenous nerve is typically involved in medial knee pain when it becomes entrapped, compressed, or irritated. Here are some common causes of saphenous nerve-related knee pain:

1. Saphenous Nerve Neuritis (Saphenous Nerve Irritation)

• What it is: Neuritis refers to inflammation of a nerve. In this case, the saphenous nerve can become irritated or inflamed due to repetitive use, direct trauma, or prolonged pressure.
• Symptoms: People with saphenous nerve neuritis may experience a dull ache or sharp pain on the inner part of the knee, often aggravated by activity or prolonged sitting. The pain can sometimes radiate down the medial aspect of the lower leg.

2. Saphenous Nerve Compression or Entrapment

• What it is: The saphenous nerve can become compressed or trapped within the tissues of the thigh or knee. This compression can occur when the nerve passes through tight spaces, such as the adductor canal, or due to swelling from injury.
• Symptoms: Entrapment can cause pain, numbness, tingling, or a sensation of “pins and needles” in the medial knee or lower leg. The pain is often localized but can extend down to the ankle in more severe cases.

3. Injury or Trauma

• What it is: Direct trauma or injury to the knee, such as during a fall or car accident, can cause swelling or scarring in the area where the saphenous nerve passes, leading to pain or irritation.
• Symptoms: Pain, swelling, and possible tingling along the medial knee and leg. The pain can be sharp or aching and might be aggravated by bending or moving the knee.
• Treatment: Rest, ice, and anti-inflammatory medications are essential for managing pain and swelling. Physical therapy to improve knee function may also be recommended.

Symptoms of Saphenous Nerve-Related Medial Knee Pain

Individuals suffering from saphenous nerve-related medial knee pain may experience:

• Localized pain along the inner aspect of the knee.
• Tingling or numbness that may extend down the inner thigh or lower leg.
• Pain exacerbated by activity, such as walking, climbing stairs, or kneeling.
• A sharp or burning sensation along the medial side of the knee.

Treatment Options for Saphenous Nerve-Related Knee Pain

Treatment will depend on the severity of the condition but generally involves a combination of the following approaches:

1. Conservative Measures
   • Medical acupunctures along the nerve root can help reduce neural sensitivity
   • ART (Active Release Technique can help free off the nerve and a couple of its potential entrapment sites
   • Progressive loaded exercises after manual therapy that help the nervous system learn that is safe to load this area of the body.
   • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation control.
2. Nerve Block or Steroid Injections:
   • If pain persists or is severe, nerve blocks or steroid injections may be used to reduce inflammation and provide temporary relief.
3. Surgical Decompression:
   • If conservative treatments fail, and the nerve is severely compressed or entrapped, surgery may be necessary to relieve pressure on the saphenous nerve.

So if you are currently suffering with medial knee pain that isn’t responding to rest then please get in touch and lets get you moving pain free again and back to the things you love most.

Till next time

Mario