New Study: Your Meniscus Tear may be Caused by a Bad Nerve in Your Back

You don’t often hear meniscus tear and bad back nerves in the same sentence.  But we see patients all the time who have low level issues in their low back causing problems in the knee. Most of these patients don’t think they have a back issue because their back doesn’t hurt much. However, a new study just published has linked a little known joint sense (proprioception) with knee meniscus tears. Proprioception means position sense. Small nerves in your knee measure exactly how much your knee is bent and then send signals up to your spinal cord in your low back. The spinal cord or the brain (cerebellum) then figure out how well to adjust various muscles in your leg to support the knee. Bad proprioception can come from a prior ACL knee surgery (the ligament also provides these signals) or a blockage of the signal by an irritated nerve in your back (on which the signal is carried). You probably wouldn’t know you had poor proprioception in your knee. Perhaps you would feel that something “wasn’t right”. This new study looked at 105 patients and measured proprioception by determining the least number of degrees they could perceive that their knee joint had moved. It then used ultra-high definition MRI (3.0 Tesla) and scored their knee meniscus for tears. After adjusting for other variables like excessive weight, the patients with the poorest proprioception had the most meniscus tears. The upshot? Poor nerve perception of where your knee is in space makes for subtly sloppy movement, which chews up the knee just like an unstable joint with a bad ligament. If you’re diagnosed with a meniscus tear, your next job is to determine if you have subtle nerve issues that caused it.

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile