The knee is considered the most worn joint in the human body. According to statistics, one third of patients with musculoskeletal problems complain of pain. This symptom can be a sign of a serious condition, especially if both knees are painful. In order not to waste time and maintain leg mobility, it is important to consult a doctor immediately after the appearance of discomfort.
Where does the pain come from?
The knee is a large mass joint in the leg, the structure of which includes fairly large bones (femur, tibia and patella), a joint cavity lined with hyaline cartilage, as well as several pairs of ligaments (main, upperand subsagittal, internal and external, cruciate) and meniscus.
Pain receptors are not located in all parts, so when you complain of pain in the knee joint, it is most often localized:
- in the synovial membrane;
- ligament;
- periosteum.
Good to know! The components of the knee, including the cartilage, are not innervated so by definition they cannot be damaged. Even if the cause of discomfort is the destruction of the tissues lining the joint, the pain indicates that the periosteum and joint capsule are involved in this process.
Pain can be caused by:
- degenerative-inflammatory process of cartilage lining joints;
- soft tissue, connective, cartilage infections;
- arthritis (bursae, cartilage, tendons);
- injuries to ligaments, menisci, bones;
- circulatory disorders in the knee area.
Each group of pathologies is characterized by specific signs, the identification of which helps to determine the diagnosis and choose the appropriate treatment method.
Degenerative inflammatory disease
Arthritis (gonarthrosis) accounts for up to one-third of all cases of localized pain in one or both knees. This disease affects older people and develops gradually. Mild discomfort after exercise gradually becomes common, and after 2-3 years, walking even a short distance is accompanied by pain in one knee or both legs at the same time.
Good to know! Gonorrhea is not characterized by symptoms that are worse with rest. At night, when sitting and even when standing still for short periods of time, my knees do not bother me.
In addition to the discomfort of arthritis, patients also complain of brittle and deformed joints. Swelling, redness and heat in the leg joints are not typical symptoms of this disease.
Menstrual trauma
Meniscal injuries are characterized by the sudden appearance of the main symptom - acute pain in one leg, less often in both legs. It always appears during active movements: running, jumping, when moving unsuccessfully on skis or skates. This process is accompanied by a clear sound and a feeling of crunch in the knees.
The intensity of the pain is so severe that it is impossible to bend or lift the affected leg. After a quarter of an hour, symptoms gradually subside. Without help, inflammation will develop within 24 hours:
- swelling appears in the injured knee area;
- enhanced pain syndrome;
- limited mobility.
When trying to lean on the leg, a sharp pain appears, as a result of which the limb is bent. If you do not consult a doctor for treatment, all the listed symptoms will gradually decrease and disappear after about a month. However, after a long ride, hypothermia, or exercise, they will return.
Inflammatory and infectious processes
Infectious and non-infectious arthritis, bursitis, and synovitis are often companions to degenerative diseases and injuries. The nature of pain in inflammatory diseases is aching, twisting or flare-up, sometimes like burning.
Good to know! Unlike other causes, knee discomfort with arthritis increases when resting or sleeping and reduces with movement. Symptoms become especially strong after prolonged exertion.
The disease is accompanied by swelling and redness of the joints, and inflammation of the joint capsule may be accompanied by fluid accumulation. The deformity that occurs looks like an elastic lump on the surface of the knee. The skin on it stretches, becomes shiny and turns red.
Joint blood supply disorders
The so-called vascular pain often occurs in adolescence and accompanies a person throughout life. The reason for their appearance may be the uneven development of various tissues of the limbs: the bones "take over" the vessels and muscles, causing muscle tension later.
Salient features of vascular symptoms in the knee:
- Symmetric - discomfort occurs in both limbs;
- Aggravated pain occurs with sharp changes in temperature, weather changes, physical activity;
- quickly weakens after massage.
This type of pain does not require special treatment, except for the use of topical treatments.
Tendonitis
Periarthritis of the trochlea (one of the ligaments in the knee) is a typical disease of older women. This symptom only occurs when carrying heavy objects and going down stairs. When bending or moving on flat surfaces there is no feeling of discomfort or very weakness. There is no significant limitation in mobility of the affected limb. There is no swelling, redness or deformity during periarticular inflammation.
Treatments
Knee treatment should be entrusted to doctors - orthopedists, traumatologists, rheumatologists or surgeons. Specialists from other areas can also participate in therapy: physiotherapists, orthopedists, massage therapists. . . The goal of therapy is not only to eliminate the symptom, but also to restore its function and prevent repeated exacerbations.
Before starting treatment, diagnosis is made:
- radiograph of the joint, which allows you to visualize damage to bones, cartilage and meniscus;
- CT or MRI are methods that can detect abnormalities of blood vessels, soft tissues, bones and cartilage;
- Joint ultrasound, which allows you to detect cartilage damage and determine the volume and density of synovial fluid;
- Arthroscopy - method of visual examination of the joint cavity using optical equipment;
- microscopic analysis of joint fluid to detect infection and inflammation.
Treatment tactics are chosen based on the diagnosis, but the plan is always the same:
- The first phase is symptomatic treatment and pain relief.
- The main stage is eliminating the causes of discomfort.
- The final stage is the restoration of the joints.
To eliminate symptoms, conservative therapy with painkillers and anti-inflammatory drugs is enough. They are prescribed as topical treatments - ointments, gels - and in pill form. Additionally, doctors recommend using distracting and warming substances.
In the early stages, it is important to provide rest for the affected joint. It is necessary to exclude loads:
- long walks;
- lift the weight;
- practice certain sports that require active squatting or jumping.
If a limb is injured, on the advice of the treating physician, you can use a tight immobilization bandage, orthotics or even a cast.
Additional medications may also be prescribed depending on the diagnosis made:
- synthetic enhancers and vitamin-mineral complexes;
- NSAIDs, including in injectable form;
- preparations with chondroitin and glucosamine;
- The agent accelerates the regeneration of damaged tissues.
After objective improvement, a course of general strengthening exercises, physiotherapy, massage and exercise therapy is prescribed to restore joint function, strengthen muscles and tendons. tendon.
If conservative therapy is ineffective, radical methods are used - surgical and minimally invasive intervention. Direct signs for them are:
- severe pain that cannot be overcome by painkillers;
- formation of purulent exudate in the joint cavity or purulent cavity in the soft tissues of the joint;
- partial or complete blockage of the joint;
- Significant deformation of the cartilage that changes or prevents joint function;
- damage to the internal components of the joint - bones, cartilage, menisci, cruciate ligaments.
After surgery, conservative therapy is continued to prevent complications and reduce discomfort. To restore mobility, strengthen and stabilize the joints of the legs, rehabilitation is performed, including physiotherapy, exercise, massage, hydrotherapy, etc. v. See a doctor promptly if you feel uncomfortable.