The knees are considered the most worn-out 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 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 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, internal and external lateral, cruciate) andmenisci.
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 knees, consisting of cartilage, are deprived of innervation, so by definition they cannot hurt. Even if the cause of discomfort is the destruction of the tissues lining the joint, pain indicates that the periosteum and the lining of the joint capsule are involved in the process.
Pain may be caused by:
- degenerative-inflammatory processes of the cartilage lining 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 select adequate 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 commonplace, 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 exacerbation of symptoms at rest. At night, when sitting and even when standing quietly for a short time, the knees do not bother me.
In addition to discomfort with arthrosis, patients complain of crunching and deformation of the joints. Swelling, redness, and heat in the joints of the legs are not typical for this disease.
Meniscal injuries
Meniscal 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 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;
- pain syndrome intensifies;
- mobility is limited.
When trying to lean on the leg, a sharp piercing pain occurs, due to which the limb bends. 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, synovitis are often a companion to degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, twisting or bursting, sometimes burning.
Good to know! Unlike other causes, discomfort in the knees with arthritis increases at rest, during sleep, and subsides during movement. The symptom becomes especially strong after prolonged physical exertion.
The disease is accompanied by swelling, redness of the joints, and when the joint capsule is involved, it may be accompanied by the accumulation of fluid. The deformation that occurs looks like an elastic lump on the surface of the knee. The skin over it tightens, becomes glossy, 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 in the knees:
- symmetry - discomfort occurs in both limbs;
- exacerbation of pain occurs with a sharp change in temperature, change of weather, physical activity;
- quickly weaken 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 in the knees) 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 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 - an orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other areas can also take part 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 therapy, diagnostics are carried out:
- radiography 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 inflammations.
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 eliminating the causes of discomfort.
- The final stage is the restoration of the joints.
To eliminate symptoms, conservative therapy using painkillers and anti-inflammatory drugs 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 walking;
- lifting weights;
- practicing certain sports that require active squats or jumps.
If a limb is injured, on the advice 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 what diagnosis was made:
- general strengthening agents and vitamin-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 exercise therapy is prescribed to restore the functionality of joints, 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 deformation of cartilage that changes or blocks the functionality of the joints;
- damage to the internal elements of the joint - bone, cartilage, menisci, cruciate ligaments.
After surgery, conservative therapy 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 prevent repeated exacerbations, it is recommended to moderately load the limbs, avoid hypothermia, and consult a doctor promptly if discomfort occurs.