Knees are considered the most tired 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 are injured. In order not to waste time and maintain the mobility of the legs, it is important to immediately consult a doctor after the discomfort appears.
Where does the pain come from?
The knee is a large block joint on the leg, 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 vertical, upper and lower, internal and external lateral, crossed) and menisci.
Pain receptors are not located in all elements, so when you complain of pain in the knee joints, it is most 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 harm. Even if the cause of the discomfort is the destruction of the tissues lining the joint, the pain indicates that the periosteum and 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, cartilage tissues;
- inflammation of joints (bursa, cartilage, tendons);
- injuries of ligaments, meniscus, bones;
- blood circulation 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 up to a third of all cases of localized pain in one or both knees. This disease affects the elderly 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 in both legs at once.
In addition to suffering from arthrosis, patients complain of cracking and deformity of the joints. Swelling, redness and heat in the joints of the legs are not typical for this disease.
Meniscus injuries
Meniscus injuries 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, during an unsuccessful maneuver on skis or skates. The process is accompanied by a clearly audible and felt crack in the knee.
The intensity of the pain is so strong that it is impossible to bend or lift the affected leg. After a quarter of an hour the symptom subsides. If help is not provided, inflammation develops within 24 hours:
- swelling appears in the area of the injured knee;
- the pain syndrome intensifies;
- mobility is limited.
When you try to lean on your leg, a sharp piercing pain appears, due to which the limb bends. If you do not consult a doctor for therapy, all the listed symptoms gradually disappear and disappear after about a month. However, after a long walk, hypothermia or exercise, they return.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, synovitis are often associated with degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, twisting or bursting, sometimes burning.
Good to know! Unlike other causes, discomfort in arthritic knees increases at rest, during sleep, and decreases during movement. The symptom becomes especially strong after a prolonged physical strain.
The disease is accompanied by swelling, redness of the joints, and when the joint capsule is involved, it can be accompanied by fluid accumulation. The deformity that occurs looks like an elastic lump on the surface of the knee. The skin over it tightens, becomes shiny and turns red.
Common blood supply disorders
The so-called vascular pain often occurs 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 "skip" the vessels and muscles, which causes tension in the latter.
Distinctive features of vascular symptoms in the knees:
- symmetry - discomfort appears in both limbs;
- worsening of pain occurs with a sharp change in temperature, change in weather, physical activity;
- weakens quickly after the massage.
This type of pain does not require special treatment, except for the use of local remedies.
Inflammation of the tendon
Periarthritis of the crow's feet (one of the ligaments in the knees) is typical for older women. The symptom appears 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 are no significant limitations in the mobility of the affected limbs. 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 participate in the therapy: physiotherapists, chiropractors, massage therapists. The goals of therapy are not only the elimination of symptoms, but also the restoration of its functionality and the prevention of repeated irritations.
Before starting therapy, diagnosis is made:
- x-ray of the joint, which allows you to visualize damage to the bones, cartilage and meniscus;
- 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 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 infections and inflammations.
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 causes of concern.
- The last stage is the restoration of the joints.
To eliminate the symptoms, conservative therapy using pain relievers and anti-inflammatory drugs is sufficient. They are prescribed in the form of local remedies - ointments, gels - and in tablets for oral administration. In addition, doctors recommend distracting and warming agents.
In the initial stage, it is important to provide rest for the affected joint. It is necessary to exclude loads:
- long walk;
- lifting weights;
- practicing some 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, an orthosis or even a cast.
Additional medications may also be prescribed depending on the established diagnosis:
- general strengthening agents and vitamin-mineral complexes;
- NSAIDs, including in the form of injections;
- 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 joint function, 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 corrected by analgesics;
- the formation of purulent exudate in the joint cavity or purulent cavities in the soft tissues of the joints;
- partial or complete locking of the joint;
- significant cartilage deformation that changes or blocks joint functionality;
- damage to the internal elements of the joint - bones, cartilage, meniscus, cruciate ligaments.
After surgery, conservative therapy continues to prevent complications and relieve discomfort. To restore mobility, to strengthen and stabilize the joints of the legs, rehabilitation is carried out, which consists of physiotherapy, exercise therapy, massage, hydrotherapy, etc. To prevent repeated irritations, moderate loading of the limbs, avoidance of hypothermia and consultation are recommended. a doctor immediately if discomfort occurs.