The knee is considered to be the most worn joint in the human body. According to statistics, every third patient with musculoskeletal problems complains of pain. This symptom may be a manifestation of a serious pathology, especially if both knees hurt. In order not to waste time and maintain leg mobility, it is important to see a doctor immediately after discomfort appears.
Where does the pain come from?
The knee is a large block joint on the leg, its structure includes relatively large bones (femur, tibia and patella), a joint cavity filled with hyaline cartilage, as well as several pairs of ligaments (main, upper and lower vertical, inner and outer sides, cruciate) andmenisci.
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.
Good to know! The elements of the knee, which consist of cartilage, are deprived of conservation, so by definition they cannot hurt. Although the cause of the discomfort is the destruction of the tissue lining the joint, the pain indicates that the periosteum and the lining of the joint capsule are involved in the process.
Pain may be caused by:
- degenerative process-inflammation of the cartilage lining the joints;
- infections of soft tissue, connective tissue, cartilage;
- joint inflammation (bursa, cartilage, tendon);
- injuries to ligaments, meniscus, bones;
- circulatory disorders in the knee area.
Each group of pathologies is characterized by certain signs, the identification of which helps determine the diagnosis and choose adequate treatment.
Degenerative-inflammatory diseases
Arthrosis (gonarthrosis) accounts for up to a 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 short distances is accompanied by pain in one knee or both legs at once.
In addition to discomfort with arthrosis, patients complain of crunching and joint deformation. Swelling, redness, and heat in the leg joints are not typical for this disease.
Meniscus injury
Meniscal injury is characterized by the sudden appearance of the main symptom - acute pain in one, less often in both legs. It always appears during active movement: running, jumping, during unsuccessful maneuvers on skis or skates. The process is accompanied by a clearly audible sound and felt a creaking 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 subside. If help is not provided, inflammation develops within 24 hours:
- swelling appears in the area of the injured knee;
- increased pain syndrome;
- mobility is limited.
When trying to lean on the leg, a sharp piercing pain occurs, which causes the limb to bend. If you do not consult a doctor for therapy, all the listed 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 are often companions to degenerative diseases and injuries. The nature of pain in inflammatory pathology is aching, twisting or bursting, sometimes burning.
Good to know! Unlike other causes, discomfort in the knee with arthritis increases during rest, during sleep, and decreases during movement. Symptoms become stronger especially after prolonged physical exercise.
The disease is accompanied by swelling, redness of the joints, and when the joint capsule is involved, it may be accompanied by fluid accumulation. The deformation that occurs looks like a rubbery lump on the surface of the knee. The skin over it tightens, becomes shiny, and becomes red.
Disruption of joint blood supply
The so-called vascular disease often occurs in adolescence and accompanies a person throughout his life. The reason for their appearance may be the uneven growth of different tissues in the body: bones "overcome" vessels and muscles, which causes tension in the latter.
Special features of vascular symptoms in the knee:
- symmetrical - discomfort occurs in both limbs;
- aggravation of pain occurs with sudden changes in temperature, weather changes, physical activity;
- quickly weak after massage.
This type of pain does not require special treatment, except for the use of local medicines.
Tendon inflammation
Periarthritis of the crow's feet (one of the ligaments in the knee) is typical for older women. Symptoms occur only when carrying heavy objects and going down stairs. When bending or moving on a flat surface there is no discomfort, or it is very weak. There is no significant limitation in the mobility of the affected limb. There is no swelling, redness, or deformity during periarthritis.
Treatment methods
It is advisable to entrust knee treatment to a doctor - orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other areas can also take part in therapy: physiotherapists, chiropractors, massage therapists. The goal of therapy is not only the elimination of symptoms, but also the restoration of their function, and the prevention of repeated exacerbations.
Before starting therapy, diagnostics are carried out:
- radiography of the joint, which allows you to visualize damage to the bones, cartilage, and meniscus;
- CT or MRI is a method 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 - a method of visual examination of the joint cavity using an optical device;
- microscopic analysis of intra-articular fluid to detect infection and inflammation.
Treatment tactics are chosen 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 painkillers and anti-inflammatory drugs is sufficient. They are prescribed in the form of local medicine - ointment, gel - and in tablets for oral administration. In addition, doctors recommend distraction and warming agents.
In the initial stages, it is important to give rest to the affected joints. It is necessary to exclude the load:
- long walk;
- weight lifting;
- practice certain sports that require active squats or jumps.
If the limb is injured, on the advice of the attending physician, you can use a tight immobilizing bandage, orthosis, or even a plaster cast.
Additional medication may also be prescribed depending on the diagnosis made:
- general strengthening agents and vitamin-mineral complexes;
- NSAIDs, including in injectable form;
- preparations with chondroitin and glucosamine;
- an agent that accelerates 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 interventions and surgery. Direct pointers for them are:
- severe pain that is not corrected by analgesics;
- the formation of purulent exudate in the joint cavity or purulent cavity in the soft tissue of the joint;
- partial or complete blocking of the joint;
- significant deformation of cartilage that changes or restricts joint function;
- damage to the internal elements of the joint - bone, cartilage, menisci, cruciate ligament.
After surgery, conservative therapy is continued to avoid complications and reduce discomfort. To restore mobility, strengthen and stabilize the leg joints, rehabilitation is carried out, which consists of physiotherapy, exercise therapy, massage, hydrotherapy, etc. To avoid repeated exacerbations, it is recommended to load the limb moderately, avoid hypothermia, and consult. doctor immediately if discomfort occurs.