Joint pain in the legs can make walking and standing difficult, often contributing to a change in gait. The pressure of supporting the upper body weight when suffering with a joint disorder can aggravate joint pain and swelling and it is important to seek appropriate treatment or it can hamper daily functioning. The knee and ankle are prone to a number of joint disorders, although diseases affecting the smaller joints of the toes can be equally painful and disturbing.

Osteoarthritis

Osteoarthritis is the most common form of arthritis and occurs due to the wearing down of cartilages in the joints, and occurs more frequently in the elderly. Women are more affected than men. Hereditary factors and a history of joint injury may be among the risk factors for developing osteoarthritis. It is a chronic degenerative disease which can affect any joint but leg pain occurs when it involves the hips, knees, and low back area. There is pain in the joints during and after movement such as walking, stiffness of the joints (especially on getting up in the morning or after a period of inactivity), and restriction of joint mobility. X-ray and magnetic resonance imaging (MRI) help in diagnosis, and blood tests may be useful to rule out other causes of joint pain such as rheumatoid arthritis.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disorder, commonly affecting the small joints of the hands and feet. RA is an autoimmune disease where the lining of the joint is affected, causing painful swelling of the joints. It is a bilateral condition, affecting joints of both sides symmetrically. Small joints, such as those of the ankle and feet, are affected initially but in the later stages the knees and hips can become involved too. Joint pain, swelling and morning stiffness lasting for many hours are common symptoms of rheumatoid arthritis. X-ray and blood tests for rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies may help in diagnosis.

Gout

Gout is a painful condition caused by deposition of uric acid crystals in the joints. The joint at the base of the big toe is most commonly affected, but the ankle and knee joint may be involved too. There is typically a sudden, severe attack of pain, tenderness, swelling, and redness of the big toe, often waking a person up from sleep. Men are more likely to be affected than women, and certain factors such as excessive alcohol intake, diabetes mellitus, hypertension, and a family history of gout may be considered as risk factors for development of this disease.

Pseudogout

Pseudogout is a condition where calcium pyrophosphate crystals are deposited in the joints instead of uric acid crystals, causing joint inflammation and pain. It typically affects the large joints of the arm and legs, with the knee being particularly prone and may last for several days or weeks.

Septic Arthritis

Septic arthritis is an infection in a joint where the infection has spread from some other part of the body. Bacterial infection is most common, normally affecting a single joint, and causing severe pain. The knee joint is usually affected, but the ankle or hip may be involved as well.

Other diseases affecting the joint

Systemic illnesses such as autoimmune diseases like systemic lupus erythematosus (SLE), psoriasis, hepatitis, Lyme disease, and inflammatory bowel disease may cause joint inflammation and pain.

Drugs

Joint pain is among the common drug side effects and many drugs can cause leg joint pain. Some of the drugs may aggravate other joint disorders while others like anticoagulants (example – warfarin) can result in bleeding within the joint along with pain.

Knee pain

Knee pain is a common symptom, that may occur a few times in life without any discernible cause. In the event of pain associated with a swollen knee and difficulty in putting any weight on the joint, it is advisable to consult with a doctor to identify other pathologies that may be contributing to knee joint pain.

Knee Joint Pain
  • Injury to the knee joint is very common and may affect any of the ligaments, tendons, or bursae surrounding the joint. The ligaments, cartilages, bones, and menisci forming the knee joint may also be involved in the injury. Ligament injuries and meniscal tears occur regularly in sports related injuries. Fractures of the bones of the knee joint, including the patella, may occur in motor vehicle accidents and severe falls. These injuries give rise to swelling and pain in the knees even on rest, with the pain increasing on bending the knee(s) or putting weight on the joint when standing or walking.
  • Tendonitis or inflammation of the tendon may occur either in front of the knee (patellar tendonitis) or back of the knee (popliteal tendonitis). Patellar tendonitis, also known as jumper’s knee, since it is often produced by activities such as jumping, causes pain and swelling in front of the knee, just below the patella or knee cap.
  • Osteoarthritis and rheumatoid arthritis are common causes of pain and swelling of the knee joint, along with restricted mobility.
  • Baker’s cyst or popliteal cyst is a localized collection of fluid at the back of the knee, often following arthritis, and is a frequent cause of pain and swelling at the back of the knee.
  • Chondromalacia patellae is the softening of the cartilage under the patella (knee cap) and is a common cause of knee joint stiffness associated with deep knee pain, especially in younger women. It may be aggravated by prolonged sitting or climbing stairs.
  • Bursitis of the knee may occur on the inside of the knee (anserine bursitis) or in front of the patella (pre-patellar bursitis). The latter is also known as “housemaid’s knee” as it occurs most commonly due to kneeling and putting excessive pressure on the knee cap. The knee cap may be painful, often associated with a tender lump, and there may be difficulty in kneeling or bending the knees.
  • Runner’s knee or patellofemoral pain (also referred to as anterior knee pain) is not restricted only to runners and is a common cause of knee pain in young people. There may be diffuse pain behind the patella, aggravated by climbing stairs, running or jumping, or it may even occur after prolonged sitting. Although often used synonymously with chondromalacia, it is not the same, but runner’s knee may lead to chondromalacia patellae.

Ankle Pain

Ankle pain may be accompanied by joint swelling, redness and detectable heat or occur without any other signs and symptoms. Some causes of ankle pain include :

  • Ankle sprain is the most common cause of ankle pain. It occurs due to stretching or tearing of a ligament.
  • Tendonitis of the ankle may occur due to trauma or inflammatory arthritis. Also refer to Achilles Tendon Pain.
  • Fractures and other ankle bone injuries.
  • Arthritis such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.
  • Infection resulting in septic arthritis.
  • Gout or pseudogout.
  • Tarsal tunnel syndrome.

Article reviewed by Dr. Greg. Last updated on December 7, 2009