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 may be a manifestation of a serious pathology, especially if both knees hurt. In order not to waste time and maintain the mobility of the 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 of the legs, 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, upper and lower vertical, inner and outer lateral, cruciate) and meniscus.
Pain receptors are not found in all elements, so when you complain of pain in the knee joints, it is most often localized:
- in the synovium;
- connections;
- periosteum.
Good to know! The elements of the knees, consisting of cartilage, are devoid of innervation, so by definition they cannot injure. Even if the cause of the discomfort is the destruction of the tissues covering the joint, the pain indicates that the periosteum and the mucous membrane of the joint capsule are involved in the process.
Pain can be caused by:
- degenerative-inflammatory processes of the cartilage tissue of the joint;
- infections of soft, connective, cartilaginous tissues;
- inflammation of the joints (bursa, 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 choose adequate treatment.
Degenerative-inflammatory diseases
Arthritis (gonarthrosis) accounts for up to a third of all cases of pain localized to one or both knees. This disease affects the elderly 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 the same time.
In addition to the discomfort of arthrosis, patients complain of crunching and deformation of the joints. Swelling, redness and heat in the joints of the legs are not typical of this disease.
Meniscus injuries
Meniscus injuries are characterized by a sudden appearance of the main symptom - sharp 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 symptom subsides. If no help is provided, inflammation develops within 24 hours:
- swelling appears in the area of the damaged 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 the listed symptoms gradually subside 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 often accompany degenerative diseases and injuries. The nature of pain in inflammatory pathologies is pain, twisting or bursting, 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 strong after prolonged physical exertion.
The disease is accompanied by swelling, redness of the joints, and if the joint capsule is affected, it may also be accompanied by fluid accumulation. The resulting deformity looks like an elastic lump on the surface of the knee. The skin over it tightens, becomes shiny and reddened.
Disorders of joint blood supply
The so-called vascular pain often appears in adolescence and accompanies a person throughout his life. The reason for their appearance may be the uneven growth of the various tissues of the limbs: the bones "outpace" 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 sudden change in temperature, change of weather, physical activity;
- lose weight quickly after a massage.
This type of pain does not require special treatment, except for the use of local remedies.
Inflammation of the tendons
Periarthritis of the ankle (one of the ligaments of the knees) is typical of older women. The symptom occurs only when carrying heavy objects and going down 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 mobility of the affected limb. During periarthritis, there is no swelling, redness, or deformity.
Methods of treatment
It is recommended to entrust the treatment of knees to doctors - orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other fields can also participate in the therapy: physiotherapists, manual therapists, massage therapists. The goals of therapy are not only to eliminate the symptom, but also to restore its functionality and prevent repeated exacerbations.
Before starting the therapy, a diagnosis is made:
- radiography of the joint, which allows you to visualize damage to the bones, cartilages 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 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 inflammation.
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 the elimination of the causes of discomfort.
- The last stage is the restoration of the joints.
To eliminate the symptoms, conservative therapy with pain-relieving and anti-inflammatory drugs is sufficient. They are prescribed in the form of local drugs - ointments, gels - and in tablets for oral administration. In addition, doctors recommend distracting and warming agents.
In the initial stage, it is important to rest the affected joint. It is necessary to exclude loads:
- long walk;
- weight lifting;
- practicing certain sports that require active squatting or jumping.
If a limb is injured, on the recommendation of the attending physician, you can use a tight immobilizing bandage, an orthosis or even a plaster cast.
Additional medications may also be prescribed depending on the diagnosis:
- general strengthening agents 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 gymnastics, 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 with 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 - bone, cartilage, meniscus, cruciate ligaments.
After surgery, conservative therapy is continued to prevent complications and relieve discomfort. To restore mobility, strengthen and stabilize the joints of the legs, rehabilitation is carried out, consisting of physiotherapy, therapeutic gymnastics, massage, hydrotherapy, etc. In order to prevent repeated exacerbations, it is recommended to exercise moderately on the limbs, avoid hypothermia and consult a doctor immediately if discomfort occurs.