The knee is one of the most used joints in the human body. According to statistics, every third patient with musculoskeletal problems complains of pain. This symptom can be a manifestation of a serious pathology, especially if both knees hurt. In order not to lose time and maintain the mobility of the leg, it is important to consult a doctor immediately after the appearance of discomfort.
Where does the pain come from?
The knee is a large block joint on the legs, the structure of which includes rather large bones (femur, tibia and patella), a joint cavity lined with hyaline cartilage, as well as several pairs of ligaments (main, upper and lower vertical, inner and outer lateral, cruciate) and menisci.
Pain receptors are not found in all elements, so if you complain of knee joint pain, it is most often localized:
- in the synovium;
- ribbons;
- periosteum.
Good to know! The cartilage elements of the knee are deprived of innervation, so by definition they cannot be injured. Even if the cause of the discomfort is the destruction of the tissues lining the joint, the pain indicates that the periosteum and the lining of the joint capsule are involved in the process.
Pain can be caused by:
- degenerative-inflammatory processes of the cartilage lining the joint;
- infections of soft, connective, cartilaginous tissues;
- arthritis (bursa, 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.
Degenerative-inflammatory diseases
Arthrosis (gonarthrosis) accounts for one third of localized pain in one or both knees. This disease affects elderly people and develops gradually. Slight discomfort after training gradually becomes common, and after 2-3 years even walking short distances is accompanied by pain in one knee or in both legs at the same time.
In addition to the discomfort caused by arthrosis, patients complain of cracking and deformation of the joints. Swelling, redness and warming of the joints of the legs are not characteristic of this disease.
Meniscal injuries
Injuries to the meniscus are 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, unsuccessful maneuver on skis or skates. The process is accompanied by an audible and palpable crack in the knee.
The intensity of the pain is so strong that the affected leg cannot be bent or lifted. After a quarter of an hour, the symptom subsides. If no help is provided, inflammation develops within 24 hours:
- swelling appears in the area of the injured knee;
- the pain syndrome increases;
- mobility is limited.
When they try to lean on the leg, a sharp stabbing pain occurs, causing the limb to bend. If you do not consult a doctor for therapy, all the listed symptoms will gradually subside and disappear after about a month. However, they return after a long walk, hypothermia or exercise.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, and arthritis often accompany degenerative diseases and injuries. The nature of pain occurring in inflammatory pathologies is aching, twisting or exploding, sometimes burning.
Good to know! Unlike other causes, knee discomfort associated with arthritis increases during rest and sleep and decreases during movement. The symptom becomes particularly strong after prolonged physical exertion.
The disease is accompanied by swelling and redness of the joints, and if the joint capsule is affected, it can also be accompanied by fluid accumulation. The resulting deformity looks like an elastic lump on the surface of the knee. The skin above it becomes tighter, shiny and reddened.
Articular blood supply disorders
The so-called vascular pain often appears in adolescence and accompanies a person throughout his life. The reason for their appearance may be the uneven growth of various tissues of the limbs: the bones "get ahead" of the blood vessels and muscles, which causes tension in the latter.
Distinctive features of knee vascular symptoms:
- symmetry - discomfort occurs in both limbs;
- the aggravation of the pain is associated with a sharp change in temperature, a change in the weather, physical activity;
- quickly weakens after the massage.
This type of pain does not require special treatment, except for the use of local remedies.
Tendonitis
Periarthritis of the crow's feet (one of the ligaments of the knee) is characteristic of older women. The symptom occurs only when carrying heavy objects and going down stairs. When bending or moving on a smooth 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 deformation during periarthritis.
Treatment methods
It is advisable to entrust the treatment of knees to doctors - orthopedists, traumatologists, rheumatologists or surgeons. Specialists from other fields can also participate in the therapy: physiotherapist, chiropractor, masseur. The aim of the therapy is not only to eliminate the symptom, but also to restore its functionality and prevent repeated exacerbations.
Before starting the therapy, a diagnosis is made:
- x-ray of the joint, which allows to visualize damage to the bones, cartilage and menisci;
- CT or MRI are methods that can detect abnormalities of blood vessels, soft tissues, bones and cartilage;
- Ultrasound of the joints, which allows the detection of cartilage damage and the determination of the volume and density of synovial fluid;
- arthroscopy - a method of visual inspection of the joint cavity with an optical device;
- microscopic analysis of intra-articular fluid to detect infection and inflammation.
The 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 causes of discomfort.
- The last stage is the restoration of the joints.
Conservative therapy with painkillers and anti-inflammatory drugs is sufficient to eliminate the symptoms. They are prescribed in the form of local remedies - ointments, gels - and tablets for oral administration. In addition, doctors recommend distraction and warming agents.
In the initial stage, it is important to rest the affected joint. Loads must be excluded:
- long walk;
- weight-lifting;
- practicing certain sports that require active squatting or jumping.
If a limb is injured, a tight immobilizing bandage, orthosis or even a plaster cast may be used on the advice of the attending physician.
Depending on the diagnosis, additional drugs may be prescribed:
- general tonics and vitamin-mineral complexes;
- NSAIDs, also in the form of injections;
- preparations with chondroitin and glucosamine;
- agents that accelerate the regeneration of damaged tissues.
After the objective improvement, general strengthening exercises, physiotherapy, massage and gymnastics therapy are prescribed to restore the functionality of the joints and strengthen the muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct indications to them are as follows:
- intense pain that is not corrected by painkillers;
- the formation of purulent discharge in the joint cavity or the formation of purulent cavities in the soft tissues of the joints;
- partial or complete blocking of the joint;
- a significant deformation of the cartilage that changes or blocks the function of the joints;
- damage to the internal elements of the joint - bone, cartilage, meniscus, cruciate ligament.
After surgery, conservative therapy continues to prevent complications and relieve discomfort. In order to restore mobility, strengthen and stabilize the joints of the legs, rehabilitation is carried out, which consists of physiotherapy, exercise, massage, hydrotherapy, etc. standsIn order to prevent repeated exacerbations, moderate loading of the limbs, avoidance of hypothermia and consultation are recommended. consult a doctor immediately if discomfort occurs.