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HouseDoc, Attending Physician
Category: Medical
Satisfied Customers: 3262
Experience:  Licensed by the State of New York
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I have a stabbing pain like a lightning bolt in the inside

Customer Question

I have a stabbing pain like a lightning bolt in the inside soft area of my right knee. It is worse at night and keeps me awake. It has been going on for a week today. That morning I was on my knees washing the dog, climbing in the attic to put Christmas stuff away and then went to Curves for a easy workout. Pain started in hip area, went like hot molten lava down the front of my leg to my foot and then settled with this pain in the side of my knee for the last five days. It seems to help a lot to put moist heat on it. I tried cold and Tens stimulator but they didn't help. Only the heat.
there is no swelling or discoloration
Submitted: 7 years ago.
Category: Medical
Expert:  Dr. S RIAZ replied 7 years ago.

Hello Customer,


You must see an orthopedic surgeon. Examination and imaging needs to be done. You may be having sciatica. There could also be other causes like osteoarthritis, bursitis, tendonitis, torn ligament etc. Seeing an orthopedic surgeon will help. To read more about knee pain you can follow this link - I hope, it helps. Thanks.



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Customer: replied 7 years ago.
I did not find this information helpful at all. I do not have any more idea than I did before. Sorry but I do not believe the information was worth a fee. I am sure you are affective most of the time, just not this time. Thanks anyway.
Expert:  Dr. S RIAZ replied 7 years ago.
I am opting out so that other experts can help you. Thanks.
Expert:  HouseDoc replied 7 years ago.

I've read your initial post and from your description your pain is most likely secondary to the increased activity that you've had over the past several weeks. You've been climbing into the attic, washing the dog, exercising...all these activities will lead to increase stress on your hip joint and your lower back. It will also place significant stress on your knees. When you perform such activities you will cause muscle spasm in the area of the buttocks leading to an irritation of a nerve that pass through this region called the sciatic nerve. Furthermore, your symptoms are also suggestive of a radiculopathy. That is to say, a compression of the nerve roots originating from the L3-L4, L4-L5 and L5-S1 spinal is possible. This could be because of degenerative disc disease or a prior low back injury from a fall.


In terms of treatment, since you have already tried Ibuprofen and Tylenol, you may need something stronger such as Aleve. This will help reduce any inflammation at the level of the nerve roots and also at the joint level. In addition to this, you should use a cold pack after any kind of increased activity on your knees. This will help reduce inflammation. You should place a heat pack about 30 minutes before going to bed. Using the heat pack will help reduce muscle spasm. This should be done 15-20 minutes at a time. If the above treatment does not work you may need something stronger such as a Medrol Dose Pack. You are also advised to consider getting a MRI of your Lumbo-sacral spine. This will help determine if you have any degenerative disc disease that is severe enough to cause your symptoms.


Customer: replied 7 years ago.
I thought the sciatic nerve presented pain in the outside of the leg. My pain is in the fleshy part of the inside of my thigh and knee.
Expert:  HouseDoc replied 7 years ago.

The sciatic nerve pain typically starts in the back or the buttocks and shoots down to the foot. It typically gets aggravated by climbing stairs, or exercise. Often when patient have sciatica they will start guarding their leg such that it does not touch the ground too much. This results in more stress on the knee which can start causing irritation of the tendons and ligaments in the knee. Again the best treatment for this is icing the knee after using it for some time to reduce inflammation You should also take an anti-inflammatory medication such as Aleve which will also help reduce inflammation. Finally you should place a heat pack on the knee before going to bed to reduce muscle spasm. The fact that heat is helping your suggests that a portion of your symptoms may be due to muscle spasm. I suggest that you continue to use heat. I also suggest that you get an MRI of your L/S Spine to determine if you have any degenerative disc disease which can also cause symptoms similar to what you are describing.