Knee pain is one of the most common symptoms for which patients turn to orthopedists and other specialists. Many people completely ignore the appearance of unpleasant sensations, considering them age-related and almost natural. But there are many prerequisites for pain in the knee joint, as it has a complex structure, influenced by a number of external and internal damaging factors. Some diseases are serious and require urgent treatment.
Who is more likely to have a knee injury?
The knees are formed by several bones connected by muscles, ligaments, tendons. There are also 5 synovial sacs - cavities surrounded by membranes designed to protect the joint. Between the joints of the bones are the inter-articular cartilage - the menisci, which help the knee to move freely. Disruption of even one part of the knee joint leads to the appearance of unpleasant symptoms.
Knee pain is especially common in people with flat feet. This is a pathology of the foot that impairs the ability of the limbs to absorb shocks. With age, the increased loads on the joints cause their destruction and the development of inflammation - a pain syndrome appears. Different types of deformity of the foot, lower leg have similar consequences.
There are a number of factors that cause knee pain to occur more often:
- Overweight;
- Passive lifestyle;
- High sports loads;
- Diabetes;
- Vascular diseases;
- Adult age;
- Knee surgeries and injuries;
- Work with increased load on the legs.
The causes and treatment of knee pain vary greatly, as does the severity of the sensations. If the knee hurts a lot, the cause may be an injury or an advanced stage of osteoarthritis, a severe inflammatory process. Sometimes the symptom becomes permanent, even at rest, accompanied by swelling, redness of the skin and crunch. All these signs should alert a person and force him to visit a doctor.
Pain due to bruises in the knee
Among the traumatic causes of joint dysfunction, the most common are bruises. Why does the knee hurt if the symptoms are preceded only by a slight bruise? Even a minor injury is accompanied by hemorrhage in the soft periarticular tissues, their swelling. As a result, the nerve roots suffer, soreness occurs.
In more serious cases, the pain in the knee increases with bending and lengthening of the leg, the person stops moving due to sharp sensations in the joint. On palpation, swelling of the legs may be noted, hot to the touch. How to treat such an injury? You should contact a traumatologist, take an X-ray, follow all the recommendations and ensure rest of the feet.
Often traumatic hemarthrosis causes pain in the knee joint after a banal bruise. This is an outflow of blood into the joint cavity, which causes swelling, swelling of the synovial membranes. As a result, the joint fills with blood, inflammation begins in it. Without proper treatment, the injury can lead to the development of chronic osteoarthritis, even at a young age.
Other types of knee injuries
If the leg in the knee hurts and the trauma has contributed to these sensations, the reasons may lie in various damage to the components of the joint. Here are the main ones:
- Meniscopathy. This is a flattening or tearing of the meniscus. Injuries are especially common in professional athletes, people involved in extreme sports, and domestic injuries. One feels that the knee is acutely ill, the nature of the sensations is piercing, dagger, the joint loses mobility for some time.
- Ligament damage. Tearing (stretching) of the ligaments occurs when twisting the leg, after a jump the limb is stretched in an unnatural position. Acute pain occurs, the leg swells, the position of the joint changes, it becomes loose.
- Rupture of the cruciate ligament. Because these ligaments are located inside the joint, the injury often results in bleeding into the knee cavity. Only a puncture will help pump blood and make an accurate diagnosis.
Painful pain in the knee joint sometimes accompanies chronic sprains of the patella. Without treatment of acute trauma in many patients, the sprain becomes chronic and gives regular relapses. In children, this pathology causes an X-shaped curvature of the leg and leads to a serious violation of its function. Sometimes the pathology affects the knees on two legs.
Inflammatory diseases of the knees
Often, standard treatment for knee pain is ineffective. In this case, it is not the joint itself that may be affected, but the surrounding soft tissues. So, tendinitis or tendonitis can be caused by increased stress on the limb, leg injuries in the past, allergies, drug reactions, etc. The knee joint hurts with such a disease, usually during the day or evening, at nightthe pain subsides. In the acute stage, the mobility of the joint is severely limited, the syndrome is permanent, not subject to therapy with ointments, creams. Acute sensations are also observed on palpation of the lateral part of the knee.
If the knees hurt regularly, the symptom worsens after hypothermia, the cause may be synovitis - inflammation of the synovial membranes. Inflammatory exudate appears inside the joint, causing cracking and pain. The causes of the pathology are different:
- autoimmune diseases;
- Metabolic diseases;
- Injuries in the past;
- Osteoarthritis.
Another "popular" disease in which the knees hurt is bursitis. This happens when the bursa (joint bag) becomes inflamed. In addition to the pain syndrome there is redness, swelling, increased sensitivity of the patella. If you do not clarify in time howbursitis is treated, it almost always becomes chronic.
Neoplasms in the area of the knee joint
Malignant tumors with this localization are rare, the pain syndrome is characteristic of them only at a very late stage. More often the pain in the knee joint is inherent in benign formations:
- Baker's cyst. This tumor appears below the knee, on its posterior surface. In appearance, the skin above the cyst is normal, not inflamed, in the curved form the swelling may not be at all. In an upright position at the site of the cyst appears a pronounced, soft, elastic formation. It occurs after a unilateral knee injury that has damaged cartilage. Very often the cyst is accompanied by chronic synovitis, osteoarthritis, rheumatoid arthritis. Large cysts cause not only knee pain, but also severe limitation of limb mobility. Due to compression of blood vessels and nerves, other symptoms are cold skin, paleness, tingling and numbness.
- Meniscus cyst. It occurs in the outer or inner meniscus when a cavity with fluid is located in the cartilage. The knees in this case hurt after heavy loads or at the end of the day. Large cysts can be seen on the side of the joint, while smaller ones can only be seen on ultrasound or X-rays.
A rare pathology is Hoff's disease - the transformation of adipose tissue of the joint, which becomes fibrous and causes joint dysfunction. Against the background of this pathology often develops osteoarthritis, which provokes pain in the knee joint. Causes - hormonal disorders, menopause in women.
Infectious pathologies of the joints
Against the background of infection, the knee joint hurts sharply, sharply, providing rest does not cause relief. Even urogenital and intestinal infections can lead to musculoskeletal complications, leading to reactive arthritis. Bacteria (salmonella, chlamydia, gonococci, etc. ) penetrate the bloodstream into the cavity of the bone joint, settle on the tissues and cause inflammation. The tendons are usually also inflamed, so the knee is swollen and hot to the touch.
Tuberculosis is a serious disease. Mycobacterium tuberculosis multiplies in bone tissue, causing bone melting, necrosis of cartilage and soft tissue. Without emergency treatment, the knee joints ache and collapse, and the process covers more and more areas. As a result, fistulas appear - cavities with pus that can spill out and cause damage to the whole body.
Acute, urgent disease is osteomyelitis of the bone. What to do if your knees hurt and the process is accompanied by weakness, muscle aches, fever up to 40 degrees? If the pain in the knee is dull, popping, and the tissues themselves are swollen, red, with blue, you need to urgently call an ambulance and go to emergency surgery. Otherwise you may lose a leg or die.
Knee pain - causes of degenerative nature
After the age of 50, a huge number of people have knee pain. The prerequisites are the aging of the body, wear and tear of the joint apparatus and the development of the most common pathology - osteoarthritis (gonarthrosis). Leads to thinning, destruction of cartilage with a change in the shape of bone heads. Most often in the early stages of the pathology the knee hurts on one side, after a few years the lesion becomes bilateral. In the morning, the stiffness of the legs worries, but passes quickly. Enhancement of sensations is possible after physical work, intense sports, long walks.
At an advanced stage, the joint tissues collapse, osteophytes grow on the side of the joint space. These are spikes of bone tissue, which in severe cases break off and cause unbearable pain. There are a number of degenerative pathologies whose symptoms will be similar to gonarthrosis:
- Osteochondropathy. Affects the articular surface of the bone, is associated with trauma, sports. Adolescents can develop for no apparent reason.
- Arthritis. Rheumatoid, psoriatic, gouty, provokes chronic inflammation and destruction of the joint.
- Chondromatosis. The etiology is unclear. The disease causes nodules on the synovial membranes that restrict the movement of the knee and cause pain.
Menopausal women often have knee pain due to osteoporosis - thinning of the bones, increasing their fragility. The disease is accompanied by leg cramps, back pain, periodic fractures.
Other prerequisites for knee pain
When the knees hurt, the etiology of the sensations may lie in the defeat of the peripheral nervous system. So sciatic nerve neuropathy against the background of lumbar spine damage leads to a number of symptoms. A person's knees break, the thigh area hurts, the joints of the limb weaken, the sensitivity of the skin is impaired. The reflexes of the legs also change.
Sometimes the whole knee joint hurts due to vascular disorders. Only in adolescence you do not have to worry much - due to the rapid growth of the body, the vessels do not have time to supply the bones with blood. With age, the condition of the joint normalizes - usually by the age of 18-20, the pain stops completely.
In old age, in the presence of atherosclerosis, the knees also often hurt, what to do in this case? Without normalizing fat metabolism, plaque will continue to accumulate inside the arteries. The vessels become clogged, they stop feeding the joint completely. Osteoarthritis develops, the pain becomes chronic. Unpleasant sensations in the knee area can also be caused by varicose veins, thrombophlebitis and vascular thrombosis.
How is the diagnosis made?
People's knees hurt quite often - how to treat the condition can be determined only after the examination. Both acute and pulling knee pain are characteristic of many pathologies, some of which are very dangerous. For diagnosis you should contact a surgeon, orthopedist, neurologist, rheumatologist, traumatologist. He will conduct a study, understand the exact symptoms of the disease, will determine the accompanying signs. Also, the doctor will conduct a series of tests and physical examinations at the initial appointment to clarify the nature of the problem.
What to do when your knees hurt, what instrumental methods will help you identify the causes? Usually attributed to:
- ultrasound;
- NMR;
- CT;
- Radiography.
The choice of the exact technique should be left to the doctor. So the ultrasound reflects well the changes in the legs with osteoarthritis, damage to the meniscus. Radiography perfectly shows bone deformities, the presence of osteophytes. MRI and CT give complete information, they are indispensable in complex diseases. In addition, the doctor will prescribe blood tests to rule out inflammation and rheumatism, if necessary, a biopsy of the joint will be performed. Osteoporosis requires densitometry - it will show the density of bone tissue in a patient.
Treatment of knee pain
If the pathology is traumatic, traumatologists are involved in the treatment, sometimes in a hospital. Mild bruises go away on their own within a few days, for fast resorption of the hematoma it is recommended to apply absorbent ointments on the knee. In case of pain it is necessary to rub ointments with non-steroidal anti-inflammatory components.
How to treat when the knee hurts with its inflammatory lesion? In the acute stage of bursitis, synovitis, arthritis, the affected leg needs rest, during the first 3 days ice compresses can be applied for 15 minutes. Severe pain is relieved by injections of non-steroidal anti-inflammatory drugs, injections of anesthetics directly into the joint. Physiotherapy and exercise are prescribed to prevent chronic inflammation in the joint after the pain subsides.
When a person has knee pain due to gonarthrosis, what to do in this case? The main drugs for treatment are chondroprotectors and injections of hyaluronic acid. These drugs are designed to restore the nutrition of articular cartilage, as a result of which it stops breaking down. Also for knee rehabilitation should be appointed:
- vascular drugs;
- Physiotherapy;
- Gymnastics;
- Massage;
- Vitamin complexes.
Infectious diseases of the joints are an indication for the introduction of antibiotics into the joint cavities or oral administration of drugs. In some cases, it is necessary to perform surgery by removing the tissues affected by pus. Surgical intervention is also used to treat advanced forms of osteoarthritis with an increase in osteophytes. Sometimes just replacing a joint with a prosthesis allows a person to maintain their ability to walk normally.