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 on the main load during movement and physical exertion, which is why 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 reasons

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 a sharp pain, swelling, there may be a tingling sensation, numbness, the color of the skin in the joint area changes.
2. Osteoarthritis (gonarthrosis)is the destruction of the tissues of the joint. Gonarthrosis is primary and secondary. The primary disease affects the elderly, while the secondary causes the consequences of injuries or is a complication of other diseases (for example, rheumatoid arthritis). Symptoms: pain and stiffness in the joint. With a prolonged course of gonarthrosis, movements in the joint may become impossible.
3. Arthritis (gonarthritis)- inflammatory disease. Distinctive signs: pain that increases with movement, increase in the size of the joint, fever in the affected knee, redness sometimes.
4. meniscopathy- damage to the meniscus, which is manifested by sharp 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 an inflammation of the articular bag and the tissues that surround it. With periarthritis, there are pains in the area of the knee joint without a clear localization. Periarthritis is usually a post-traumatic complication.
7. BursitisIt is an inflammation of the synovial sac (bursa). Bursitis can be caused by overuse of the joint, infection, or injury. With this disease, severe and constant pain is observed, but freedom of movement is preserved.
8. tendinitisIt is the inflammation of the ligaments and tendons. The symptoms are swelling and pain in the affected area. They increase with the flexion-extension of the knees. Prolonged symptoms of tendinitis 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 during movement. To avoid complications, it is highly recommended not to squat.
10. Osteomyelitis of the leg bonesIt is a purulent disease associated with infection, which is a consequence of hematogenous osteomyelitis, an open fracture or a postoperative complication. The most common infectious agent is staphylococcus.

varieties of pain

There are such types of knee pain:

1. when squatting. It is usually caused by joint diseases, viral infection, lack of physical activity, poor diet. seen in athletes. If your knees hurt when squatting, then the exercises should be stopped. For prolonged and frequent pain, you should consult a doctor.
2. by bending the legs. This is one of the most common joint problems. It is observed with Osgood-Schlatter disease, damage to the ligaments and menisci, 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 functioning of the joint stops, and under heavy loads it begins to collapse. It is required to carry out timely treatment of these diseases, otherwise a complete loss of motor functions is possible.
4. Crunch. If there is no swelling, pain, or stiffness on movement, then there is nothing to fear. However, this symptom can be caused by a dangerous disease - osteoarthritis, in which the articular cartilage is damaged and severe pain appears. It is very important to start timely treatment of this disease.

Diagnosis

You can diagnose the cause of the pain in the following ways:

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

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 help.

The basis of treatment is anti-inflammatory therapy. It involves the use of the following agents: nonsteroidal anti-inflammatory drugs, pyrazolone derivatives, indoleacetic acid derivatives, oxicams, glucocorticoids.

To strengthen the immune system, the following procedures are prescribed: cryoapheresis, plasmapheresis, hemosorption, plasma filtration, immunostimulants.

The treating physician chooses the specific drug and method of treatment.

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

With hemarthrosis, the joint is perforated and the blood accumulated due to trauma is removed.

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

Chondroprotectors are used to nourish 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 walking, and knee pads repair the diseased joint.

Surgical intervention

If after undergoing conservative treatment it is not possible to achieve the required stability of the joint, surgical intervention 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 enter drugs into the joint cavity that reduce inflammation.

doctor's advice

Hyaluronic acid preparations, which are administered intra-articularly, give a pronounced therapeutic effect in osteoarthritis of the second and even the third stage. The introduction of hyaluronic acid is proposed as an alternative to arthroplasty when the latter is not possible due to therapeutic contraindications. This is a medical manipulation, it has contraindications.

The technique is carried out with such problems:

• damage to the meniscus and cartilage;
• torn ligament;
• the presence of foreign bodies in the joint;
• Rheumatoid arthritis;
• intra-articular fractures.

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

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

More than 95% of endoprostheses that are placed under compulsory health insurance work for 10-15 years and then need to be replaced. Today, far from all regions, the replacement of an endoprosthesis, unlike the primary operation, can be issued under compulsory health insurance. Not all patients after 10-15 years can undergo a second operation due to cardiovascular and somatic risks. Therefore, it is not worth rushing into stents. I recommend resorting to this operation only when all other treatment options have been exhausted.

Endoprosthesis is performed when the painless restoration of the 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 its prevention. After endoprosthesis, long-term rehabilitation of the patient (up to 6 months) is required.

Home remedies

Home remedies can be helpful in relieving pain, but should be done in parallel with conventional treatments.

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

Let's look at some popular methods:

1. Ointment. For knee pain, prepare 1 tbsp. yohyperic and 2 tbsp. ymilenrama, crushing them. In a water bath, melt 1 tbsp. yovaselineThe grass is poured into hot petroleum jelly and rubbed into a homogeneous mass. This ointment should be rubbed on sore knees at night.
2. Mix based on rye seeds. You need to take 250 g of rye seeds, pour them with 2 liters of water and bring to a boil. After the mixture has cooled, it is filtered and 500 g of vodka, 1 kg of honey, 3 tsp. barberry root. The mixture is well shaken and left for 21 days in a dark place. It is recommended to use a mixture of 3 tablespoons. me before eatingIt is required 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 prevent many problems.