Knees are considered the most worn joints in the human body. According to statistics, every third patient with problems of the musculoskeletal system complains of pain. This symptom can 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 as soon as discomfort appears.
Where does the pain come from?
The knee on the legs is a large blocking joint, the structure of which includes rather large bones (femur, tibia and patella), the joint cavity is lined with hyaline cartilage, as well as several pairs of ligaments (main, upper and lower vertical, inner and outer lateral, cruciate) and menisci.
Pain receptors are not located in all elements, therefore, 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, which consist of cartilage, are devoid of innervation, so by definition they cannot be harmed. Even if the cause of the discomfort is the destruction of the lining tissues of the joint, the pain indicates that the periosteum and the membrane of the joint capsule are involved in the process.
Pain can be caused by:
- degenerative-inflammatory processes of the lining of the joint cartilage;
- Infections of soft, connective, cartilaginous tissues;
- inflammation of joints (bursa, cartilage, tendons);
- injuries of ligaments, meniscus, bones;
- Blood circulation disorder in the knee area.
Each group of pathologies is characterized by specific signs, the identification of which helps to establish a diagnosis and select an adequate treatment.
Degenerative-inflammatory diseases
Arthrosis (gonarthrosis) accounts for a third of cases of localized pain in one or both knees. This disease affects the elderly and develops gradually. After training, mild discomfort gradually becomes a common occurrence, and after 2-3 years, walking even a short distance is accompanied by one knee or both legs at the same time.
In addition to the discomfort caused by arthrosis, patients complain of cramping and deformation of the joints. Swelling, redness and heat in the joints of the legs are not characteristic of this disease.
Meniscus injuries
Meniscus injuries are characterized by a 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 heard and felt cramp in the knee.
The intensity of the pain is so strong that it is impossible to bend or lift the affected leg. After a quarter of an hour, the symptom disappears. If there is no help, inflammation develops within 24 hours:
- Swelling appears in the area of the injured knee;
- pain syndrome intensifies;
- Mobility is limited.
When trying to stand on the leg, there is a sharp piercing pain, due to which the limb bends. If you do not consult a doctor for therapy, all the listed symptoms gradually disappear and disappear after about a month. However, after a long walk, hypothermia or exercise, they return.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, synovitis are often companions of degenerative diseases and injuries. In inflammatory pathologies, the nature of pain is painful, twisting or exploding, sometimes burning.
Good to know! Unlike other causes, discomfort in the knees during arthritis increases during rest and sleep and decreases during movement. The symptom is especially aggravated after prolonged physical exertion.
The disease is accompanied by swelling, redness of the joints, and fluid accumulation when the joint capsule is involved. The resulting deformity looks like an elastic lump on the surface of the knee. The skin on it stretches, becomes shiny and reddened.
Violation of blood supply to the joints
The so-called vascular pain often appears in adolescence and accompanies a person throughout his life. The reason for their appearance may be the uneven growth of various tissues of the limbs: the bones "overtake" the vessels and muscles, which causes tension in the latter.
Distinctive signs of vascular symptoms in the knees:
- Symmetry - discomfort appears in both limbs;
- The pain is aggravated by a sudden change in temperature, change in weather, physical exertion;
- Fades quickly after massage.
This type of pain does not require special treatment, except for the use of local remedies.
Inflammation of tendons
Periarthritis of the laryngeal leg (one of the ligaments of the knees) is characteristic of older women. The symptom appears only when carrying heavy objects and going down stairs. There is no discomfort when bending or moving on a flat surface, or it is very weak. There is no significant limitation in the mobility of the affected limb. There is no swelling, redness or deformity in periarthritis.
Treatment methods
It is advisable to entrust knee treatment to doctors - orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other fields can also participate in the therapy: physiotherapists, chiropractors, massage therapists. The goal of therapy is not only to eliminate the symptom, but also to restore its functionality and prevent repeated exacerbations.
Before starting therapy, diagnosis is 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 the 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 to eliminate the causes of discomfort.
- The last stage is the recovery of funds.
To eliminate the 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. In addition, doctors recommend distraction and warming agents.
At the initial stage, it is important to rest the affected joint. It is necessary to exclude loads:
- long walk
- weight lifting;
- Practicing certain sports that require active squatting or jumping.
If the limb is damaged, on the advice of the attending physician, you can use a tight immobilization bandage, an orthosis or even a plaster cast.
Additional medications may also be prescribed depending on the diagnosis:
- general strengthening agents and vitamin-mineral complexes;
- Non-steroidal anti-inflammatory drugs, 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 function, strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct instructions for them are:
- severe 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 blockage of the joint;
- significant cartilage deformation that changes or blocks joint function;
- Damage to the internal elements of the joint - bone, cartilage, menisci, cruciate ligaments.
After surgery, conservative therapy is continued to prevent complications and relieve discomfort. In order to restore mobility, strengthen and stabilize leg joints, rehabilitation is carried out, which consists of physiotherapy, exercise therapy, massage, hydrotherapy, etc. Sh. To prevent repeated exacerbations, it is recommended to exercise the limbs moderately, avoid hypothermia and consult. In case of discomfort, consult a doctor immediately.