Red flags & when to go in person for Patellofemoral Pain Syndrome

Audience: adult

Patellofemoral Pain Syndrome (PFPS) is a common cause of knee pain, especially around or behind the kneecap. It often results from overuse, muscle imbalances, or poor knee alignment. Symptoms usually include aching or sharp pain during activities like climbing stairs, squatting, or sitting for long periods. While many cases improve with rest, physical therapy, and simple exercises, some signs require in-person medical evaluation. This guide helps you understand when to seek urgent care and what telemedicine can and cannot address regarding PFPS. Remember, telemedicine provides helpful education and initial advice but is not a substitute for hands-on exams or emergency care. If you experience severe pain, swelling, or inability to move your knee, please see a healthcare provider in person promptly.

Red flags — go in person / ER

• Sudden severe knee pain after a fall or injury — seek emergency care immediately.
• Inability to fully bend or straighten the knee — see a healthcare provider promptly.
• Swelling, redness, warmth, or fever with knee pain — may indicate infection; seek urgent evaluation.

What telemedicine can do

• Providing education about PFPS causes and symptoms.
• Recommending general self-care and exercise strategies.
• Monitoring symptom changes and advising when to seek in-person care.
• Answering questions about pain management and activity modifications.

What telemedicine cannot do

• Performing physical examination or assessing knee stability.
• Ordering or interpreting imaging tests like X-rays or MRIs.
• Diagnosing fractures, ligament tears, infections, or other serious conditions.
• Providing hands-on treatments such as physical therapy or injections.

What is Patellofemoral Pain Syndrome?

Patellofemoral Pain Syndrome (PFPS) causes pain around or behind the kneecap. It often happens due to repeated stress on the knee joint, muscle weakness, or misalignment. This condition is common in active adults and athletes but can affect anyone. The pain may worsen with activities like running, jumping, climbing stairs, or sitting with bent knees for a long time.

Common Symptoms

Symptoms of PFPS typically include:

These symptoms often develop gradually and may improve with rest and gentle exercises.

When to Seek In-Person Care

Some signs mean you should see a healthcare provider in person right away:

If you experience any of these, urgent evaluation is important to rule out serious conditions like fractures, ligament injuries, or infections.

How Telemedicine Can Help

Telemedicine can provide:

However, telemedicine cannot perform physical exams, imaging tests, or procedures needed for diagnosis and treatment of severe or complex knee problems.

Preparing for Your Telemedicine Visit

Before your tele-visit, prepare by:

How to prepare for your tele-visit

• Write down your knee symptoms, including when they began and what makes them better or worse.
• Note any recent injuries or activities that may have triggered the pain.
• Prepare a list of questions or concerns to discuss during your visit.
• Ensure your device is charged and connected to a stable internet connection.
• Find a well-lit area where you can show your knee to the healthcare provider if needed.

After your tele-visit

• Follow the exercise and self-care advice given during the visit.
• Use pain relief methods as recommended, such as ice or over-the-counter medications.
• Monitor your symptoms and note any changes or worsening.
• Schedule an in-person visit if red flag symptoms develop or if pain does not improve.
• Maintain communication with your healthcare provider for follow-up as needed.

FAQs

Can Patellofemoral Pain Syndrome heal on its own?

PFPS often improves with rest, activity modification, and exercises to strengthen the muscles around the knee. However, healing times vary, and persistent symptoms should be evaluated by a healthcare provider.

What exercises help with PFPS?

Exercises that strengthen the quadriceps, hip muscles, and improve knee alignment often help. Examples include straight leg raises, wall sits, and hip abduction exercises. A healthcare provider can guide you on the best exercises for your condition.

When should I stop exercising if I have knee pain?

If you experience sharp or worsening knee pain during or after exercise, it is best to stop and rest. Consult your healthcare provider for advice on modifying your activity safely.

Is surgery ever needed for PFPS?

Surgery is rarely needed for PFPS and is usually considered only if conservative treatments fail and there is an underlying structural problem. Most people improve with non-surgical care.

Sources

1. Patellofemoral Pain Syndrome — MedlinePlus, U.S. National Library of Medicine.
2. Patellofemoral Pain Syndrome: Clinical Review — National Library of Medicine.
3. Patellofemoral Pain Syndrome (Runner's Knee) — Mayo Clinic.
4. Knee Pain Management — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you have severe symptoms or concerns, please seek evaluation by a healthcare professional in person.