Knee pain: causes and treatment

Severe knee pain means there is a problem with the joint. The peculiarity of the knee joint is that it takes the main load during movement and physical exertion, so it is often injured. The affected knee is difficult to repair, so it is very important to take measures to eliminate the cause of the pain in a timely manner.

Main reason

Causes of knee pain can be:

1. Injuries (acute injuries).They are the most common cause. They occur after a strong blow, excessive bending of the joint and a sharp fall on it. With a mechanical injury, there is severe pain, swelling, there may be a tingling sensation, numbness, the color of the skin in the joint area changes.
2. Arthrosis (gonarthrosis)is the destruction of the tissues of the joint. Gonarthrosis is primary and secondary. Primary disease affects the elderly, while secondary disease causes the consequences of injury or is a complication of other diseases (for example, rheumatoid arthritis). Symptoms: joint pain and stiffness. With a long course of gonarthrosis, joint movements can become impossible.
3. Arthritis (gonarthritis)- inflammatory disease. Hallmarks: pain that increases with movement, joint size increase, fever in the affected knee, redness sometimes.
4. Meniscopathy- damage to the meniscus, which is manifested by acute pain. In the absence of adequate treatment, a transition to a chronic form is possible, as a result of which osteoarthritis develops.
5. Vascular diseases. Thrombosis or embolism (blockage) of the arteries supplying the knee joint leads to osteonecrosis of the articular cartilage, making walking impossible. There are no effective treatments for osteonecrosis. Arthroplasty of the affected joint is performed.
6. periarthritis- this is inflammation of the joint bag and surrounding tissues. With periarthritis, there are pains in the knee joint area without a clear localization. Periarthritis is most often a post-traumatic complication.
7. Bursitisis an inflammation of the synovial sac (bursa). Bursitis can be caused by overuse of the joint, infection, or injury. With this disease, constant severe pain is noted, but freedom of movement is preserved.
8. TendinitisIt is an inflammation of the ligaments and tendons. Symptoms are swelling and pain in the affected area. They increase with the flexion-extension of the knees. Prolonged symptoms of tendonitis are indicative of tendinosis.
9. Baker's cyst- this is a complication after trauma, gonarthrosis or hemarthrosis. A Baker's cyst is a collection of joint fluid in the popliteal sac. The pathology is characterized by pain when bending the knee and a feeling of discomfort when moving. To avoid complications, it is strongly advised not to squat.
10. Osteomyelitis of the leg bonesis a purulent disease associated with an infection, which is a consequence of hematogenous osteomyelitis, an open fracture or a postoperative complication. The most common infectious agent are staphylococci.

Variety of pain

There are these types of knee pain:

1. When squatting. It is usually caused by joint diseases, viral infections, lack of physical activity, poor diet. seen in athletes. If your knees hurt when you squat, then the exercises should be stopped. For prolonged and frequent pain, you should consult a doctor.
2. When bending the legs. This is one of the most common joint problems. It is observed with Osgood-Schlatter disease, damage to the ligaments and meniscus, Baker's cyst, infectious lesions, etc. When pain occurs, it is necessary to limit the load on the leg, refuse to play sports and wear comfortable orthopedic shoes.
3. After running. Associated with diseases such as osteoarthritis, bursitis, synovitis, etc. In this case, the normal operation of the joint stops and, under heavy loads, it begins to collapse. It is necessary to carry out timely treatment of these diseases, otherwise a complete loss of motor functions is possible.
4. Crisp. If there is no swelling, pain and stiffness in the movements, there is nothing to fear. However, this symptom can be caused by a dangerous disease - osteoarthritis, in which the joint cartilage is damaged and severe pain appears. It is very important to start timely treatment of this disease.

Diagnostics

The cause of the pain can be diagnosed in the following ways:

1. General blood test. It allows to detect anemia, leukocytosis, etc.
2. Blood chemistry. Detect an increase in uric acid in gout.
3. X-ray study. This method allows you to detect the pathology of bone tissue. With the help of it, fractures, osteomyelitis and osteoarthritis are diagnosed. X-ray studies are complemented by computed tomography (CT). Menisci, ligaments, bursae, and other soft tissues are not visible on X-rays and CT scans.
4. MRI (magnetic resonance), NMRI (nuclear magnetic resonance). This is modern research. With its help, the pathology of the soft tissues of the joint (menisci, ligaments, etc. ) is diagnosed.
5. Puncture biopsy of the bone. It is carried out in the presence of suspected osteomyelitis or bone tuberculosis.
6. Arthroscopy. It is performed both for diagnosis and for treatment, for example, of a meniscus tear.
7. Ultrasound (ultrasound examination). This is a screening study conducted in cases of suspected traumatic injuries, osteoarthritis, diseases of the meniscus, etc. Ultrasound results should be verified by radiography (CT) and / or magnetic resonance imaging.

Treatment

Treatment should be comprehensive and include both conservative methods and surgical intervention. Let's consider them in more detail:

conservative methods

During an exacerbation, treatment should relieve pain and swelling and then restore normal joint mobility. In the first time after an injury, it is not recommended to move without assistance.

The basis of treatment is anti-inflammatory therapy. It involves the use of the following agents: non-steroidal anti-inflammatory drugs, pyrazolone derivatives, indolacetic acid derivatives, oxicam, glucocorticoids.

In order to strengthen the immune system, the following procedures are prescribed: cryapheresis, plasmapheresis, hemosorption, plasma filtration, immunostimulants.

The specific drug and method of treatment are chosen by the attending physician.

In addition, conservative treatment involves ice packs on the damaged area to relieve pain or hot packs to improve blood microcirculation.

With hemarthrosis, the joint is punctured and the blood accumulated as a result of the trauma is removed.

In addition, conservative treatment includes physiotherapeutic methods: massage, therapeutic exercises and spa rehabilitation. If necessary, the doctor prescribes a special diet that provides for a limited calorie content.

Chondroprotectors are used to nourish the cartilage and reduce destructive processes.

The most common physiotherapy methods are magnetotherapy, laser therapy, cryotherapy, acupuncture.

With gonarthrosis, special shoes and knee pads - orthoses are used. These shoes contribute to the normalization of gait, and knee pads repair the diseased joint.

Surgical intervention

If, after undergoing conservative treatment, the necessary stability of the joint cannot be achieved, surgery is indicated.

The most common surgical techniques are arthroscopy and arthroplasty.

Arthroscopy is a technique that can relieve pain in a joint and increase its mobility. This method of treatment not only eliminates the underlying disease, but also allows you to insert drugs that reduce inflammation into the joint cavity.

Doctor's advice

A pronounced therapeutic effect in osteoarthritis of the 2nd and even the 3rd stage is given by the preparations of hyaluronic acid, which are administered intraarticularly. The introduction of hyaluronic acid is considered an alternative to arthroplasty when it is not possible due to therapeutic contraindications. This is medical manipulation, it has contraindications.

The technique is carried out with such problems:

• damage to the meniscus and cartilage;
• ligament rupture;
• the presence of foreign bodies in the joint;
• rheumatoid arthritis;
• intraarticular fractures.

During the postoperative rehabilitation period, it is recommended to strictly follow medical recommendations when performing therapeutic exercises, avoiding unreasonably early load on the limb.

Endoprosthesis (arthroplasty) is an operation in which the damaged parts of the knee joint are replaced with an artificial implant (endoprosthesis).

Over 95% of endoprostheses that are subject to the mandatory medical insurance function for 10-15 years, and then need to be replaced. Today, far from all regions, the replacement of an endoprosthesis, in contrast to the primary operation, can be issued under mandatory medical insurance. Not all patients after 10-15 years are able to undergo a second surgery due to cardiovascular and other somatic risks. Therefore, it is not worth running with the endoprosthesis. I recommend only resorting to this operation when all other treatment options are exhausted.

Endoprosthesis is performed when restoration of the painless function of the knee joint is not possible with conservative methods and with the help of arthroscopy. After arthroplasty, purulent complications are possible. Antibiotics are prescribed for their prevention. After the endoprosthesis, long-term rehabilitation of the patient is required (up to 6 months).

Folk remedies

Folk remedies can be useful in relieving pain, but they should be carried out in parallel with conventional treatments.

When using folk remedies, be sure to consult a doctor.

Let's take a look at some popular methods:

1. Ointment. For knee pain, prepare 1 tbsp. L. hypericum and 2 tbsp. L. yarrow, crushing them. In a water bath, dissolve 1 tbsp. L. Vaseline. The herb is poured into hot petroleum jelly and rubbed until a homogeneous mass is obtained. This ointment should be rubbed on sore knees at night.
2. Mixture based on rye seeds. You should take 250 g of rye seeds, pour them with 2 liters of water and boil. After the mixture has cooled, it is filtered and 500 g of vodka, 1 kg of honey, 3 tsp are added. barberry root. The mixture is thoroughly mixed and left for 21 days in a dark place. It is recommended to use a mixture of 3 tablespoons. L. before eating. It is necessary to drink 9 liters of the mixture during the treatment period.

If you have knee pain, don't panic. However, if the pain persists for a long time, you should definitely see a doctor. This will avoid many problems.