The knee is considered to be the joint that experiences the most damage in the human body. According to statistics, every third patient with musculoskeletal problems complains of pain. This symptom may be a manifestation of serious pathology, especially if both knees hurt. In order not to waste time and maintain leg mobility, it is important to immediately consult a doctor as soon as discomfort appears.
Where does the pain come from?
The knee is a large block joint in the leg whose structure includes quite large bones (femur, tibia and patella), a joint cavity lined with hyaline cartilage, and several pairs of ligaments (main, upper and lower vertical, internal and external lateral, cruciate) and meniscus.
Pain receptors are not located in all elements, so when you complain of pain in the knee joint, it is most often localized:
- in the synovium;
- ligaments;
- periosteum.
Pleased to hear it! The elements of the knee, which consist of cartilage, have no innervation, so by definition they cannot hurt. Even if the cause of the discomfort is damage to the tissue lining the joint, pain indicates that the periosteum and lining of the joint capsule are involved in the process.
Pain may be caused by:
- degenerative inflammatory processes in the cartilage lining the joints;
- infections of soft tissue, connective, cartilage;
- arthritis (bursa, cartilage, tendons);
- injuries to ligaments, meniscus, bones;
- circulatory disorders in the knee area.
Each group of pathologies is characterized by specific signs, the identification of which helps determine the diagnosis and choose adequate treatment.
Degenerative inflammatory disease
Arthrosis (gonarthrosis) causes one third of all cases of pain localized in one or both knees. This disease attacks elderly people and develops gradually. Mild discomfort after exercise gradually becomes commonplace, and after 2-3 years, walking even short distances is accompanied by pain in one knee or both legs at once.
Pleased to hear it! Gonarthrosis is not characterized by exacerbation of symptoms at rest. At night, when sitting and even when standing quietly for short periods, my knees don't bother me.
In addition to the discomfort caused by arthrosis, patients complain of cracking and deformation of the joints. Swelling, redness and heat in the joints of the feet are not characteristic of this disease.
Meniscus injury
Meniscus injury is 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, during unsuccessful ski or skate maneuvers. The process is accompanied by a crisp sound that is clearly heard and felt 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, the symptoms subsided. If help is not provided, inflammation develops within 24 hours:
- swelling appears in the injured knee area;
- pain syndrome increases;
- limited mobility.
When trying to lean on the leg, a sharp shooting pain occurs, which causes the limb to bend. If you do not consult a doctor for therapy, all the above symptoms gradually subside and disappear after about a month. However, after long walks, hypothermia, or exercise, they return.
Inflammatory and infectious processes
Infectious and non-infectious arthritis, bursitis, synovitis often accompany degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, twisting or bursting, sometimes burning.
Pleased to hear it! In contrast to other causes, discomfort in the knees of arthritis sufferers increases at rest, during sleep, and subsides when moving. The symptoms become very strong after prolonged physical activity.
This disease is accompanied by swelling, redness of the joints, and if the joint capsule is affected, it can be accompanied by fluid accumulation. The deformation that occurs looks like an elastic lump on the surface of the knee. The overlying skin tightens, shines, and turns red.
Disorders of joint blood supply
The so-called vascular pain often occurs in adolescence and accompanies a person throughout his life. The reason for its appearance may be the uneven growth of various tissues of the limb: bones "overtake" blood vessels and muscles, which causes tension in the muscles.
Typical symptoms of veins in the knee:
- symmetry - discomfort occurs in both limbs;
- exacerbation of pain occurs with sharp changes in temperature, weather changes, physical activity;
- weakens quickly after massage.
This type of pain does not require specific treatment, except for the use of local remedies.
Tendon inflammation
Periarthritis of crow's feet (one of the ligaments in the knee) is common in older women. Symptoms only appear when carrying heavy objects and going down stairs. When bending or moving on a flat surface there is no discomfort, or very weak. There are no significant restrictions on the mobility of the affected limb. There is no swelling, redness, or deformation during periarthritis.
Treatment methods
It is advisable to entrust knee care to doctors - orthopedists, traumatologists, rheumatologists or surgeons. Specialists from other fields can also take part in therapy: physiotherapists, chiropractors, massage therapists. The goal of therapy is not only to eliminate symptoms, but also to restore function, and prevent repeated exacerbations.
Before starting therapy, diagnosis is carried out:
- joint radiography, which allows you to visualize damage to bones, cartilage and meniscus;
- CT or MRI is a method that can detect abnormalities in blood vessels, soft tissue, bones and cartilage;
- Ultrasound of joints, which allows you to detect cartilage damage and determine the volume and density of synovial fluid;
- arthroscopy - a method of visual examination of the joint cavity using optical devices;
- microscopic analysis of intra-articular fluid to detect infection and inflammation.
Treatment tactics are selected based on the diagnosis, but the scheme is always the same:
- The initial stage is symptomatic treatment and pain relief.
- The main stage is to eliminate the cause of discomfort.
- The final stage is joint recovery.
To eliminate symptoms, conservative therapy using pain relievers and anti-inflammatory drugs is sufficient. They are prescribed in the form of local drugs - ointments, gels - and tablets for oral administration. Additionally, doctors recommend distractions and warming agents.
In the early stages, it is important to rest the affected joint. It is important to exclude loads:
- long walks;
- lifting weights;
- practicing certain sports that require active squatting or jumping.
If a limb is injured, on the advice of the attending physician, you can use a tight immobilizing bandage, orthosis or even a cast.
Additional medications may also be prescribed depending on the diagnosis made:
- general strengthening agents and vitamin-mineral complexes;
- NSAIDs, including injectable form;
- preparations with chondroitin and glucosamine;
- agents that accelerate the regeneration of damaged tissue.
After objective improvement, a course of general strengthening exercises, physiotherapy, massage and exercise therapy is prescribed to restore joint function, strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. The direct indications are:
- intense pain that cannot be relieved by analgesics;
- the formation of purulent exudate in the joint cavity or purulent cavities in the soft tissues of the joint;
- partial or complete blocking of the joint;
- significant cartilage deformation that alters or hinders joint function;
- damage to the internal elements of the joint - bones, cartilage, meniscus, 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 carried out consisting of physiotherapy, exercise therapy, massage, hydrotherapy, etc. To prevent repeated exacerbations, it is recommended to load the limbs sufficiently, avoid hypothermia, and consult a doctor immediately if discomfort occurs.