The knees are considered the most worn 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 waste time and maintain the mobility of your legs, it is important to consult a doctor immediately after the onset of discomfort.
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, inner and outer 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 knee, which consist of cartilage, are devoid of innervation, so by definition they cannot injure. Even if 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 can be caused by:
- degenerative-inflammatory processes of the cartilage lining the joint;
- infections of soft, connective, cartilaginous tissue;
- joint inflammation (bursa, cartilage, tendons);
- injuries to ligaments, meniscus, bones;
- circulation disorders in the knee area.
Each group of pathologies is characterized by specific signs, the identification of which helps in determining the diagnosis and choosing the appropriate treatment.
Degenerative-inflammatory diseases
Arthrosis (gonarthrosis) accounts for up to a third of all cases of pain localized 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 the discomfort of arthrosis, patients complain of creaking and deformation 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 crunch 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 symptoms subside. 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 trying to lean on the leg, a sharp piercing pain occurs, causing the limb to bend. If you do not consult a doctor for therapy, all of the above symptoms gradually recede and disappear after about a month. However, after a long walk, hypothermia or training, they return.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, synovitis are often accompanying degenerative diseases and injuries. The nature of pain in inflammatory pathologies is pain, twisting or shooting, sometimes burning.
Good to know! Unlike other causes, arthritis knee discomfort increases at rest, during sleep, and eases during movement. The symptom becomes particularly strong after prolonged physical exertion.
The disease is accompanied by swelling and redness of the joints, and when the joint capsule is affected, 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.
Disorders of blood supply to the joints
The so-called vascular pain often occurs in adolescence and follows a person throughout life. The reason for their appearance may be the uneven growth of various tissues of the limbs: the bones "overtake" the vessels and muscles, which causes tension in the latter.
Recognizable characteristics of vascular symptoms in the knees:
- symmetry - discomfort occurs in both limbs;
- worsening of pain occurs with a sharp change in temperature, change in weather, physical activity;
- quickly weaken after the massage.
This type of pain does not require special treatment, apart from the application of local drugs.
Inflammation of the tendon
Periarthritis of the crow's feet (one of the ligaments of the knee) is typical for older women. The symptom occurs 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 limb. There is no swelling, redness or deformation during periarthritis.
Treatment methods
It is recommended to entrust knee treatment to doctors - orthopedists, traumatologists, rheumatologists or surgeons. Specialists from other fields can also participate in the therapy: physiotherapists, chiropractors, massage therapists. The goals of the therapy are not only the elimination of symptoms, but also the restoration of its functionality, and the prevention of repeated exacerbations.
Before starting the therapy, diagnostics are carried out:
- 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 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 remove the cause of the discomfort.
- The final stage is the restoration of the joints.
To eliminate symptoms, conservative therapy with painkillers and anti-inflammatory drugs is sufficient. They are prescribed in the form of local medicines - ointments, gels - and in tablets for oral administration. In addition, doctors recommend distraction and warming agents.
In the initial phase, it is important to provide rest to the affected joint. It is necessary to disconnect the loads:
- long walking;
- weight lifting;
- playing certain sports that require active squatting or jumping.
If the limb is injured, on the advice of the doctor, you can use a solid immobilizing bandage, an orthosis or even a cast.
Depending on the diagnosis, additional drugs may be prescribed:
- means for general strengthening and vitamin-mineral complexes;
- NSAIDs, including in the form of injections;
- preparations with chondroitin and glucosamine;
- means 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 functionality, strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct indications for them are:
- intense pain that is not corrected by analgesics;
- formation of purulent exudate in the joint cavity or purulent cavities in the soft tissues of the joints;
- partial or complete blocking of the joint;
- significant cartilage deformation that changes or blocks joint functionality;
- damage to the internal elements of the joint - bones, cartilages, menisci, cruciate ligaments.
After the operation, conservative therapy is continued to prevent complications and relieve discomfort. Rehabilitation consisting of physiotherapy, exercise therapy, massage, hydrotherapy, etc. is carried out to restore mobility, strengthen and stabilize the leg joints. To prevent repeated exacerbations, it is recommended to moderate the load on the limbs, avoid hypothermia and consult a doctor immediately if discomfort occurs.