The knees are considered the most worn out joint 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 there is pain in both knees. TimeIn order not to waste and maintain the mobility of the legs, it is important to immediately consult a doctor if discomfort appears.
Where does the pain come from?
The knee is a large block joint on the legs, 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, 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 often localized:
- in the synovium;
- ligaments;
- Periosteum.
Good to know! The elements of the knees, consisting of cartilage, are deprived of innervation, so by definition they cannot hurt. Even if the cause of discomfort is the destruction of the tissues lining the joint, pain indicates that the periosteum and the layer of the joint capsule are damaged in this process. Are included.
Pain may be caused by:
- Degenerative-inflammatory processes of the cartilage lining the joint;
- Infection of soft, connective, cartilaginous tissues;
- Inflammation of joints (bursa, cartilage, tendon);
- injuries of ligaments, meniscus, bones;
- Circulatory disorders in the knee area.
Each group of pathologies has specific symptoms, the identification of which helps to determine the diagnosis and select adequate treatment.
degenerative-inflammatory diseases
One third of all cases of localized pain in one or both knees are caused by arthrosis (gonarthrosis). This disease affects older people and develops slowly. Mild discomfort after exercise gradually becomes common. And after 2-3 years, pain starts in one knee or both the legs together even while walking a short distance.
In addition to discomfort from arthrosis, patients complain of cramps and deformities in the joints. Swelling, redness and warmth in the joints of the legs are not typical for this disease.
fiscal blows
Meniscal injuries are characterized by the sudden appearance of the main symptom - intense pain in one, less often in both legs. It always appears during active movement: running, jumping, during unsuccessful maneuvers on skis or skates. With this process the kneeThere are clearly audible and felt spasms.
The intensity of the pain is so severe that it is impossible to bend or lift the affected leg. The symptom subsides after a quarter of an hour. If assistance is not provided, swelling develops within 24 hours:
- Swelling appears in the area of the injured knee;
- The pain syndrome intensifies;
- Mobility is limited.
When trying to lean on the leg, there is a sharp stinging pain, which causes the limb to bend. If you do not consult a doctor for treatment, all the listed symptoms gradually subside and after about a monthDisappear. However, after a long walk, hypothermia or training, they return.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, synovitis are frequent companions of degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, twisting or tearing, sometimes burning.
Good to know! Unlike other causes, discomfort in the knees with arthritis increases at rest, during sleep and decreases during movement. The symptom becomes especially strong after prolonged physical exertion.
This disease is accompanied by swelling, redness of the joints, and when the joint capsule is involved, it may be accompanied by the accumulation of fluid. The deformity that occurs looks like an elastic lump on the surface of the knee. The overlying skin hardens, becomes shiny and turns red.
joint blood supply disorder
The so-called vascular pain often occurs in adolescence and accompanies the person throughout his life. The reason for their appearance may be the uneven growth of various tissues of the limbs: the bones "outgrow" the vessels and muscles, which subsequently cause tension. Are made.
Distinctive features of vascular symptoms in the knees:
- Symmetry – discomfort occurs in both limbs;
- Exacerbation of pain occurs with a sharp change in temperature, change in weather, physical activity;
- Becomes weak quickly after massage.
This type of pain does not require special treatment, except for the use of local remedies.
inflammation of tendon
Periarthritis of crow's feet (one of the ligaments in the knees) is typical for older women. This symptom occurs only when carrying heavy objects and going down stairs. There is no discomfort when bending or walking on a flat surface, or itVery 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 the treatment of knees to doctors - an orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other fields can also take part in the therapy: physiotherapists, chiropractors, massage therapists. The goals of therapy are not only the elimination of the symptom, but also the restoration of its functionality and prevention of repeated exacerbations.
Before starting therapy, diagnosis is made:
- Radiography of the joint, which allows you 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 you to detect cartilage damage and determine the amount and density of synovial fluid;
- Arthroscopy – a method of visual examination of the joint cavity using an optical instrument;
- Microscopic analysis of intra-articular fluid to detect infection and inflammation.
Treatment tactics are selected depending 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 final stage is restoration of the joints.
To eliminate the symptoms, conservative therapy using pain relievers and anti-inflammatory drugs is sufficient. They are prescribed for local treatment - ointments, gels - and in the form of tablets for oral administration. Additionally, the doctor pays attentionRecommend distractions and warming agents.
At the initial stage, it is important to provide rest to the affected joint. It is necessary to exclude loads:
- hiking;
- lifting weights;
- Practicing certain sports that require active squats or jumps.
If a limb is injured, on the advice of the attending physician, you can use a tight immobilizing bandage, an orthosis, or even a plaster cast.
Depending on what diagnosis additional medications may also be prescribed:
- General strengthening agents and vitamin-mineral complexes;
- NSAIDs, including in injectable form;
- Preparations with chondroitin and glucosamine;
- Agents that accelerate the regeneration of damaged tissues.
After objective improvement, a course of general strengthening exercises, physiotherapy, massage and exercise therapy is prescribed to restore the functionality of the joints, strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct indications for them are:
- Severe pain that is not relieved by analgesics;
- The formation of purulent exudate in the joint cavity or the formation of purulent cavities in the soft tissues of the joints;
- Partial or complete blockage of the joint;
- significant degeneration of the cartilage that alters or blocks joint function;
- Damage to the internal elements of the joint – bone, 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 carried out, which includes physiotherapy, exercise therapy, massage. , hydrotherapy etc. To prevent recurring pain, it is recommended to exert moderate load on the limbs, avoid hypothermia, and seek consultation. In case of discomfort, consult a doctor immediately.