The knees are considered the most worn joints in the human body. According to statistics, one in three patients suffering from 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 the appearance of discomfort.
Where does the pain come from?
The knee is a large joint block of the legs whose structure includes fairly 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, lateralinternal and external, crossed) and menisci.
Pain receptors are not located in all elements, so when you complain of pain in the knee joints, they are most often located:
- in the synovium;
- ligaments;
- periosteum.
Good to know! The elements of the knees, made up of cartilage, are deprived of innervation, so they cannot, by definition, hurt. Even if the cause of the discomfort is 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 in the cartilage lining the joint;
- soft tissue, connective, and cartilage infections;
- inflammation of the joints (bursa, cartilage, tendons);
- injuries to ligaments, menisci, bones;
- circulatory disorders in the knee.
Each group of pathologies is characterized by specific signs, the identification of which makes it possible to determine the diagnosis and choose the appropriate treatment.
Degenerative-inflammatory 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. Slight discomfort after exercise gradually becomes commonplace and after 2-3 years, walking even short distances is accompanied by pain in one knee or in both legs at once.
Good to know! Gonarthrosis is not characterized by an exacerbation of symptoms at rest. At night, while sitting and even standing quietly for a short time, the knees don't bother me.
In addition to the discomfort associated with osteoarthritis, patients complain of cracking and joint deformities. Swelling, redness and warmth of the leg joints are not typical for this disease.
Meniscal injuries
Meniscal injuries are characterized by the sudden onset 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 area.
The intensity of the pain is so severe 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 area of the injured knee;
- the pain syndrome intensifies;
- mobility is limited.
When you try to lean on the leg, a sharp, piercing pain occurs, due to which the limb bends. If you do not consult a doctor for treatment, all of the listed symptoms gradually subside and disappear after about a month. However, after a long walk, hypothermia or training, they come back.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis and synovitis often accompany degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, twisting or bursting, sometimes burning.
Good to know! Unlike other causes, knee discomfort associated with arthritis increases at rest, during sleep and decreases during movement. The symptom becomes particularly strong 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 accumulation of fluid. The deformation that occurs looks like an elastic bump on the surface of the knee. The skin covering it firms up, becomes shiny and turns red.
Joint blood supply disorders
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 different tissues of the limbs: the bones "overtake" the vessels and muscles, which causes tension in the latter.
Distinctive features of vascular symptoms of the knees:
- symmetry - discomfort occurs in both limbs;
- exacerbation of pain occurs with a sharp change in temperature, change in weather, physical activity;
- weakens quickly after massage.
This type of pain does not require any special treatment, apart from the use of local remedies.
Inflammation of the tendons
Periarthritis of the crow's feet (one of the ligaments of the knees) is typical for older women. The symptom only occurs when carrying heavy objects and going down stairs. When bending or moving on a flat surface, there is no or very little discomfort. There is no significant limitation of mobility of the affected limb. There is no swelling, redness, or deformity in periarthritis.
Treatment methods
It is advisable to entrust the treatment of knees to doctors - orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other fields can also participate in 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 the prevention of repeated exacerbations.
Before starting treatment, 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 of detecting abnormalities in blood vessels, soft tissues, bones, and cartilage;
- Ultrasound of joints, which can 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 analyzes of intra-articular fluid to detect infections and inflammations.
Treatment tactics are selected depending on the diagnosis, but the scheme is always the same:
- The first step is symptomatic treatment and pain relief.
- The main step is to eliminate the causes of discomfort.
- The final stage is the restoration of the joints.
To eliminate the symptoms, conservative treatment using painkillers and anti-inflammatories is enough. They are prescribed in the form of local remedies - ointments, gels - and in the form of tablets for oral administration. Additionally, doctors recommend distractions and warming agents.
At the initial stage, it is important to give rest to the affected joint. Charges must be excluded:
- long walk;
- lifting weights;
- practicing certain sports that require active squats or jumping.
If a limb is injured, on the advice of the attending physician, you can use a tight immobilization bandage, an orthosis, or even a cast.
Additional medications may also be prescribed depending on the diagnosis made:
- general fortifying agents and vitamin-mineral complexes;
- NSAIDs, including in the form of injections;
- chondroitin and glucosamine preparations;
- 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 the muscles and ligaments.
If conservative treatment is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct indications for them are:
- severe pain that is not corrected by painkillers;
- 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 deformation of the cartilage which modifies or blocks the functionality of the joints;
- damage to the internal elements of the joint - bones, cartilage, menisci, cruciate ligaments.
After surgery, conservative treatment is continued to prevent complications and alleviate discomfort. To restore mobility, strengthen and stabilize the joints of the legs, rehabilitation is carried out, consisting of physiotherapy, exercise therapy, massage, hydrotherapy, etc. To avoid repeated exacerbations, it is recommended to exert moderate strain on the limbs, avoid hypothermia and consult a doctor quickly in case of discomfort.