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08-09-2013 | Paediatrics | Article

Survey finds undertreatment of knee pain in adolescents


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medwireNews: Adolescents with knee pain are less likely to seek medical care if their symptoms develop slowly than if they result from acute trauma, a study by Danish researchers has shown.

The finding is significant because knee pain, whether of insidious or traumatic onset, has an unfavorable prognosis and early treatment offers the best chance of a good outcome.

Michael Rathleff (Aarhus University) and team used an online questionnaire to canvass 2846 schoolchildren aged 15-19 years about their health, physical activities, quality of life, and pain.

A total of 2200 adolescents replied (a response rate of 77%), 670 of whom reported experiencing knee pain at least monthly. Of these, 504 were telephoned by a physiotherapist and asked about their knee pain in more detail.

Writing in BMC Musculoskeletal Disorders, Rathleff and co-authors report that 59% of the people with knee pain had sought medical care and 18% were currently under medical treatment.

These proportions varied according to type of pain onset, such that patients with traumatic onset were more likely than those with insidious onset to have sought medical care (70.3 vs 53.8%) and to be currently under treatment (25.9 vs 13.6%).

Medical therapies for knee pain included exercises, foot or knee orthotics, surgery, non-steroidal anti-inflammatory drugs, and advice from the general practitioner. The most frequent approach was a combination of exercise and orthotics, prescribed for 68% of those under treatment.

In a logistic regression analysis, independent predictors for having sought medical care were the duration and severity of pain and traumatic as opposed to insidious onset; the same factors predicted being under medical treatment, alongside contact with the general practitioner.

Commenting on the findings, Rathleff’s team says that while the majority of adolescents with knee pain seek medical care, just 18% are currently being treated.

They note that “long-term prognosis of knee pain is not favourable and treatment seems to offer greater reductions in pain compared to a ‘wait-and-see’ approach,” and conclude: “General practitioners, adolescents and parents need to be aware that knee pain with insidious onset may be equally serious as knee pain with traumatic onset regarding pain severity, pain duration and reductions in health-related quality of life.”

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Joanna Lyford, Senior medwireNews Reporter

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