The knees are considered the most worn joints in the human body. According to statistics, one in three patients 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 leg mobility, it is important to consult a doctor immediately after discomfort appears.
Where does the pain come from?
The knee is a large block joint of 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 lateral and external, crossed) and menisci.
Pain receptors are not found in all elements, so when complaining of pain in the knee joints, it is most often localized:
- in the synovial membrane;
- ligaments;
- periosteum.
Good to know! The elements of the knees, made up of cartilage, are deprived of innervation, so by definition they cannot hurt. 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 that covers the joint;
- infections of soft, connective and cartilaginous tissues;
- inflammation of the joints (bags, 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 select appropriate treatment.
Inflammatory degenerative diseases.
Osteoarthritis (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.
Good to know! Gonarthrosis is not characterized by an exacerbation of symptoms at rest. At night, when I'm sitting and even when I'm standing quietly for a short time, my knees don't bother me.
In addition to the discomfort of osteoarthritis, patients complain of creaking and deformities of the joints. Swelling, redness, and warmth in the leg joints are not typical for this disease.
Meniscal injuries
Meniscus injuries are characterized by the sudden appearance of the main symptom: sharp pain in one leg, 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 intense that it is impossible to bend or lift the affected leg. After a quarter of an hour the symptom disappears. If no help is provided, inflammation develops within 24 hours:
- swelling appears in the injured knee area;
- pain syndrome intensifies;
- mobility is limited.
When trying to lean on the leg, a sharp stabbing pain occurs, as a result of which the limb bends. If you do not see a doctor for treatment, all of the listed symptoms gradually disappear and disappear after about a month. However, after a long walk, hypothermia, or training, they return.
Inflammatory processes and infections.
Infectious and noninfectious arthritis, bursitis, and synovitis often accompany degenerative diseases and injuries. The nature of pain in inflammatory pathologies is painful, twisting or explosive, sometimes burning.
Good to know! Unlike other causes, knee discomfort with arthritis increases at rest, during sleep, and decreases during movement. The symptom becomes especially intense after prolonged physical exertion.
The disease is accompanied by swelling, redness of the joints, and when the joint capsule is affected, it may be accompanied by fluid accumulation. The deformation that occurs looks like an elastic bulge on the surface of the knee. The skin that covers it becomes tight, becomes shiny and red.
Disorders of blood supply to the joints.
The so-called vascular pain often occurs in adolescence and accompanies a person throughout his life. The reason for its appearance may be the uneven growth of different tissues of the extremities: the bones "overtake" the vessels and muscles, which causes tension in the latter.
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;
- weaken quickly after massage.
This type of pain does not require special treatment, except for the use of local remedies.
tendon inflammation
Periarthritis of the crow's foot (one of the ligaments of the knees) is typical of older women. The symptom occurs only when carrying heavy objects and descending stairs. When bending over 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 deformation during periarthritis.
Treatment methods
It is advisable to entrust the treatment of knees to doctors: orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other areas can also participate in therapy: physiotherapists, chiropractors, masseuses. . . The goals of therapy are not only the elimination of the symptom, but also the restoration of its functionality and the prevention of repeated exacerbations.
Before starting therapy, diagnostics are carried out:
- x-ray of the joint, which allows you to visualize damage to 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 makes it possible to detect damage to the cartilage 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 scenario is to eliminate the causes of discomfort.
- The final stage is the restoration of the joints.
To eliminate symptoms, conservative therapy with analgesics and anti-inflammatories is sufficient. They are prescribed in the form of local remedies (ointments, gels) and in tablets for oral administration. Additionally, doctors recommend distractions and warming agents.
At the initial stage, it is important to provide rest to the affected joint. It is necessary to exclude loads:
- long walk;
- lifting weights;
- playing certain sports that require active squats or jumping.
If you injure a limb, following your doctor's advice, you can use a tight immobilizing bandage, a brace, or even a cast.
Additional medications may also be prescribed depending on the diagnosis made:
- general strengthening agents and vitamin and 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 physiotherapy is prescribed to restore joint functionality and strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used: surgical and minimally invasive interventions. The direct indications for them are:
- severe pain that is not corrected with pain relievers;
- formation of purulent exudate in the joint cavity or purulent cavities in the soft tissues of the joints;
- partial or complete blockage of the joint;
- significant cartilage deformation that changes or blocks joint functionality;
- damage to the internal elements of the joint: bone, cartilage, menisci, cruciate ligaments.
After surgery, conservative therapy is continued to prevent complications and relieve discomfort. To regain mobility, strengthen and stabilize the joints of the legs, rehabilitation is carried out, which consists of physiotherapy, physiotherapy, massage, hydrotherapy, etc. To prevent repeated exacerbations, it is recommended to moderately load the extremities, avoid hypothermia, and consult. Consult your doctor immediately if you feel any discomfort.