The knees are considered the most stressed joints in the human body. According to statistics, every third patient with musculoskeletal problems complains of pain. This symptom can be an expression of a serious pathology, especially if both knees hurt. In order not to waste time and maintain mobility of the legs, it is important to consult a doctor immediately after symptoms appear.
Where does the pain come from?
The knee is a large block joint on the legs, the structure of which consists of fairly large bones (femur, tibia and patella), an articular cavity lined with hyaline cartilage, as well as several pairs of ligaments (main, upper and lower vertical, internal and external lateral, cruciate) and menisci.
Pain receptors are not found in all elements. So if you complain of pain in the knee joints, it is usually localized:
- in the synovium;
- ribbons;
- periosteum.
Good to know! The cartilage elements of the knee are not innervated and therefore, by definition, cannot hurt. Even if the cause of the discomfort lies in the destruction of the tissue lining the joint, pain suggests 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 articular cartilage;
- Infections of soft, connective and cartilage tissue;
- Inflammation of the joints (bursa, cartilage, tendons);
- Injuries to ligaments, menisci, bones;
- Circulatory problems in the knee area.
Each group of pathologies is characterized by specific signs, the identification of which helps to make a diagnosis and select appropriate treatment.
Degenerative-inflammatory diseases
Osteoarthritis (gonarthrosis) is responsible for up to a third of all pain localized in one or both knees. This disease affects older people and develops gradually. Mild discomfort after physical exertion gradually becomes commonplace, and after 2-3 years, even short distances are accompanied by pain in one knee or both legs at the same time.
Good to know! Gonarthrosis is not characterized by worsening of resting symptoms. My knees don't bother me at night, when I'm sitting or even when I'm standing quietly for a short time.
In addition to the symptoms of osteoarthritis, patients complain of grinding and deformation of the joints. Swelling, redness and feelings of heat in the leg joints are not typical for this disease.
Meniscus injuries
Meniscus injuries are characterized by the sudden onset of the main symptom - acute pain in one, less often in both legs. It always occurs during active movement: running, jumping, during an unsuccessful maneuver on skis or skates. The process is accompanied by a clearly audible and noticeable crunch in the knee.
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 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 restricted.
When trying to lean on the leg, a sharp pain occurs, causing the limb to bend. If you do not consult a doctor for therapy, all of the listed symptoms gradually subside 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 and synovitis are common accompaniments of degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, twisting or bursting, sometimes burning.
Good to know! In contrast to other causes, knee pain from arthritis increases at rest and during sleep and decreases with exercise. The symptom becomes particularly severe after prolonged physical exertion.
The disease is accompanied by swelling and redness of the joints; if the joint capsule is involved, fluid accumulation can also occur. The deformation that occurs looks like an elastic knot on the surface of the knee. The skin above becomes tightened, shiny and red.
Disturbances of joint circulation
So-called vascular pain often occurs in adolescence and accompanies a person throughout their life. The reason for their occurrence may be the uneven growth of various tissues of the limbs: the bones "overtake" the vessels and muscles, which leads to tension in the latter.
Special features of the vascular symptoms in the knee:
- Symmetry – discomfort occurs in both limbs;
- an exacerbation of pain occurs with a sharp change in temperature, a change in weather and physical activity;
- weakens quickly after the massage.
This type of pain does not require any special treatment other than the use of local remedies.
Tendonitis
Periarthritis of the crow's foot (one of the ligaments in the knee) is typical of older women. The symptom only occurs when carrying heavy objects and climbing stairs. There is little or no discomfort when bending over or moving on a flat surface. There is no significant restriction in the mobility of the affected extremity. There is no swelling, redness, or deformation in periarthritis.
Treatment methods
It is advisable to entrust the treatment of knees to a doctor - an orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other areas can also take part in the therapy: physiotherapists, chiropractors, masseurs. The goals of therapy are not only to eliminate the symptom, but also to restore its functionality and prevent 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 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 selected based on the diagnosis, but the scheme is always the same:
- The first stage is symptomatic treatment and pain relief.
- The main step is to eliminate the causes of the discomfort.
- The final step is joint restoration.
Conservative therapy with painkillers and anti-inflammatory medications is sufficient to eliminate the symptoms. They are prescribed in the form of local remedies - ointments, gels - and in tablet form for oral administration. In addition, doctors recommend distractions and warming agents.
In the early stages, it is important to give the affected joint rest. Loads must be excluded:
- long walking;
- Lift weights;
- Practicing certain sports that require active squats or jumps.
If a limb is injured, you can use a rigid immobilization bandage, orthosis or even a plaster cast on the advice of the attending physician.
Depending on the diagnosis, other medications may also be prescribed:
- general tonics and vitamin-mineral complexes;
- NSAIDs, including in the form of injections;
- preparations with chondroitin and glucosamine;
- Active ingredients that accelerate the regeneration of damaged tissue.
After objective improvement, a course of general strengthening exercises, physiotherapy, massage and exercise therapy is prescribed to restore the functionality of the joints and strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct indications for this are:
- severe pain that is not relieved by analgesics;
- 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, altering or blocking the functionality of the joints;
- Damage to the internal elements of the joint – bones, cartilage, menisci, cruciate ligaments.
After the operation, conservative therapy is continued to prevent complications and relieve symptoms. To restore mobility, strengthen and stabilize the joints of the legs, rehabilitation is carried out, which consists of physiotherapy, exercise therapy, massage, hydrotherapy, etc. To prevent repeated exacerbations, it is recommended to moderately load the limbs, avoid hypothermia and seek advice. If you experience any symptoms, seek medical attention immediately.