Knees are considered the most worn-out joints in the human body. According to statistics, one in three patients 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 in the legs, the structure of which includes rather large bones (femur, tibia and patella), a articular cavity lined with hyaline cartilage, as well as several pairs of ligaments (main, upper and lower vertical, inner lateral and external, crossed) and menisci.
Pain receptors are not located in all elements, therefore, when you complain of pain in the knee joints, most often they are located:
- in the synovium;
- ligaments;
- periosteum.
Good to know! The elements of the knees, made up of cartilage, are deprived of innervation, therefore, by definition, they cannot hurt. Even if the cause of the discomfort is the destruction of the tissues covering 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 of the cartilage that covers the joint;
- infections of soft, connective and cartilaginous tissues;
- joint inflammation (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 appropriate treatment.
Degenerative inflammatory diseases
Osteoarthritis (gonarthrosis) is responsible for up to a third of all cases of localized pain in one or both knees. This disease affects elderly people and develops gradually. Slight 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 the same time.
Good to know! Gonarthrosis is not characterized by exacerbation of symptoms at rest. At night, when I'm sitting and even when I'm quiet for a short period of time, my knees don't bother me.
In addition to the discomfort of osteoarthritis, patients complain of clicking and deformations in the joints. Swelling, redness and heat in the leg joints are not typical for this disease.
Meniscal injuries
Meniscal injuries are characterized by the 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 crack 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 help is not provided, inflammation develops within 24 hours:
- swelling appears in the area of the injured knee;
- the pain syndrome intensifies;
- mobility is limited.
When trying to lean on the leg, a sharp, stabbing 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 and synovitis often accompany degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, tortuous or explosive, sometimes burning.
Good to know! Unlike other causes, discomfort in arthritic knees 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 in the joints and, when the joint capsule is involved, may be accompanied by fluid accumulation. The deformation that occurs feels like an elastic lump on the surface of the knee. The skin over it tightens, becomes shiny and turns red.
Joint blood supply disorders
So-called vascular pain often occurs in adolescence and accompanies the person throughout their life. The reason for its appearance may be the uneven growth of the 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 climate, physical activity;
- weaken quickly after massage.
This type of pain does not require special treatment, except the use of local remedies.
Tendon inflammation
Periarthritis of the crow's foot (one of the ligaments in the knees) is typical in 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 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 fields can also participate in the 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:
- X-ray of the joint, which allows you to visualize damage to bones, cartilage and menisci;
- Computed tomography or magnetic resonance imaging are methods that can detect abnormalities in blood vessels, soft tissues, bones and cartilage;
- Ultrasound of the joints, which allows you 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 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 initial phase is symptomatic treatment and pain relief.
- The main step is to eliminate the causes of discomfort.
- The final stage is joint restoration.
To eliminate symptoms, conservative therapy with analgesics and anti-inflammatories is enough. They are prescribed in the form of local remedies - ointments, gels - and in tablets for oral administration. Additionally, doctors recommend distractions and warming agents.
In the initial phase, 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 a limb is injured, on the advice of the attending physician, a tight immobilizing bandage, an orthosis or even a cast can be used.
Additional medications may also be prescribed depending on the diagnosis made:
- general fortifying 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 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. The 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 total blockage of the joint;
- significant deformation of the cartilage that alters or blocks the functionality of the joints;
- damage to the internal elements of the joint - bones, cartilage, menisci, cruciate ligaments.
After surgery, conservative therapy is continued to prevent complications and alleviate discomfort. To restore mobility, strengthen and stabilize the leg joints, 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 consult a doctor immediately if discomfort occurs.