Knee joint pain - causes, effective treatment, diagnosis

Every person from time to time feels pain in the knee joint. This may be the result of sudden movement or a symptom of progressive pathology. The knee joint is the largest and anatomically complex element of the musculoskeletal system. It accounts for up to 80% of body weight, leading to increased physical activity and risk of injury. The large number of capillaries, nerve fibers and muscle tissue makes any injury, even a minor one, extremely painful. Damaged nerves cause an infectious-inflammatory process that is accompanied by swelling, discoloration of the skin and elevated local temperature.

As the disease progresses, the joint itself, intra-articular fluid and connective tissues become involved in a pathological condition, which can have serious consequences - the development of arthritis. A general understanding of the anatomical structure of the knee joint will help you understand which element can cause pain and what measures need to be taken to eliminate the pain.

Anatomical structure

The anterior zone of the joint is formed by the patella, in simpler language - the patella. It is connected with the quadriceps (fascicular) thigh muscle, which continues into the patellar ligament and in general combination forms the ligament apparatus consisting of the following types of fascia:

• Tibial lateral branches (small and large);
• posterior supporting nodes - sickle, dorsal, middle and lateral;
• articular transverse and cruciate ligaments of the knee.

Crossed ligaments are most susceptible to injuries - sharp movement, high degree of rotation, fall with subluxation lead to rupture of interminimal joints.

Ligaments are divided into two types:

1. Front - have the function of stabilizing the ankle, especially preventing excessive forward movement. They originate from the back of the large femur, intersect with the posterior ligaments in the knee cavity, and attach to the notch between the anterior protrusions of the tibia.
2. Rear - prevent the lower leg from moving backwards. They start from the anterior upper part of the femur, cross the joint cavity and end between the dorsal protrusions of the tibia.

There is cartilage on the surface of the joint bones. At the junction of the tibia and femur are the menisci - a type of joint lining that has the role of cushioning and stabilization.

There are several synovial sacs (three to five) in the knee joint that provide natural lubrication:

• above the upper leg;
• popliteally deep;
• between tendons in long thigh muscle;
• hypodermic patella;
• in the recess below the knee joint.

Thanks to the knee, a person can perform a step, flexion, extension within the limits indicated by the ligaments.

Causes of pain

Inflammation can develop in the following structures:

• cartilage;
• articulated sheath;
• synovial fluid;
• tibial bones;
• muscles and tendons surrounding the joint;
• ligament apparatus;
• blood vessels, veins, arteries;
• subcutaneous fat;
• epidermis.

The most common causes of knee pain are:

1. Osteoarthritis is the cause of more than 50% of cases of knee pain. It is characterized by slow, gradual destruction of hyaline cartilage. It can be asymptomatic for a long time and get worse in the second phase. Knee joint pain is caused by growing osteophytes that affect nerve endings;
2. Arthritis is an inflammatory pathology that occurs in an acute form. It can be either an independent disease - spondylitis, or a complication of other joint pathologies - arthrosis, rheumatism, etc. Arthritis is characterized by intense pain, accompanied by swelling and redness;
3. Osteochondritis - articular cartilage is inflamed over time by degenerative arthrosis, mechanical injuries;
4. Periarthritis is a disease that occurs in the background of obesity (more common in women). The pathology affects the tendons, muscles and then spreads to the shell of the knee joint. The pain is moderate, receding (as with sprains).
5. Chondromatosis is the formation of nodules on the hyaline cartilage tissue, which eventually spread throughout the capsule of the knee joint. In this case, the soft tissues with a large number of nerve cells are pinched. As a result, the knee hurts constantly, even at rest.
6. Bursitis - the synovial capsule of the knee joint rarely inflames itself, only as a result of injuries or complications of collateral diseases of the joints, and hence the pain.
7. Cellulite - subcutaneous adipose tissue can cause pain only in the case of closely spaced foci of comorbidities. Purulent arthritis, soft tissue abscess can cause inflammatory and painful processes in the protective layer.
8. Dermatitis - the epidermis is affected in the case of infectious pathologies (eczema, erysipelas, psoriasis) or allergic reactions to external stimuli.
9. Osteomyelitis - The bone marrow becomes inflamed due to bacteria that have entered the gelatinous body along with lymph flow. It can also be the result of open injuries or complications of surgery.
10. Synovitis - the capsule of the knee joint is most commonly affected in the elderly over the age of 55, as a result of rheumatism or other chronic pathologies. You can get sick at a young age due to a serious injury.

Types of pain depending on the location

Diseases that cause the development of negative processes also constitute a type of pain:

• Intense, unbearable pain - reactive arthritis, torn menisci and tendons, bursitis in the acute phase;
• Tolerable, but constant pain - synovitis, bursitis in the initial degree;
• Pinching pain - gonarthrosis, arthrosis;
• Vibrating - degenerative arthrosis, in the phase of joint deformation;
• Acute, burning pain - sciatic nerve compression, bone tuberculosis;
• Tingling - osteoporosis, progression of inflammation of the synovial sac, exacerbation of chronic meniscus injury;
• Cramps - inflammation in the soft tissues of the knee joint, muscles and tendons;
• Shooting pain - damage to nerve roots.

Diagnostic measures

If you experience intense pain in the knee joints, you should not delay a visit to the doctor, hoping that "everything will pass". Early diagnosis ensures successful treatment and prevents the development of more serious processes that can cause irreparable damage to health and quality of life. contact a therapist After a standard examination, it is decided to prescribe treatment (which occurs in 70% of cases of complaints of knee pain) or prescribe a comprehensive laboratory and hardware examination, with the involvement of highly specialized specialists.

Running, suspicious pains are studied in different directions:

• Traumatology: If you suspect arthrosis, congenital or acquired dysplasia, joint fracture, dislocation, displacement, radiography, magnetic resonance imaging, ultrasound, a biopsy of fluid in the synovial sac is prescribed to determine where the pain in the knee joint comes from.
• Operations: cyst under the patella, thrombosis, arthritis with purulent formations, ruptures of tendons, meniscus, ligaments, stones inside the joint, hemarthrosis, abscesses diagnosed by ultrasound, fluoroscopy, CT or MR, blood tests, general and rheumatoid factor, hyaline punctureknees, etc.
• Rheumatology: exclusion of systemic diseases (lupus erythematosus, rheumatoid arthritis, gout) is performed with the help of laboratory tests. Complete blood count, hematology, rheumatoid protein, DNA test, uric acid level.
• Neurology and psychiatry: A pinched sciatic nerve does not require a long diagnosis. Muscle tone and sites of inflammation will already be visible on the ultrasound. In the case of mental disorders, when the pain in the knee joint is not confirmed by any fact, but the patient still experiences pain (so-called somatic pain), specific studies for mental abnormalities are prescribed.

Basic diagnostic methods

The most popular ways to quickly and accurately diagnose knee pain are:

• X-ray - allows you to see the knee joint in several projections and determine the location of the lesion. The images show lesions already in the early stages, especially changes in the bone, synovial sac or the appearance of osteophytes.
• Ultrasound examination - modern, high-precision examination determines the thickness of the joint shell, the condition of the ligament structure, the presence of inflammation of any kind and general changes in the knee.
• Doppler - Examination of veins and arteries for aneurysms, plaques and blockages. Quickly and efficiently determines the possible risks and the condition of the inner walls of blood vessels in percent.
• MRI is currently the most accurate way to diagnose. It allows you to see a clear, three-dimensional picture of the knee joint, pathological changes in the synovial fluid, even a slight deformation of the bone tissue, etc. It is rarely prescribed, due to high, for many, prices and contraindications. Examination of patients with implants, metal prostheses and heavier than 150 kg is prohibited.
• CT - the principle of operation is based on X-rays, only in a more modern way. The images are taken in a circular projection, which allows you to get a more accurate image of the knee joint and thus determine the nature and extent of the lesion.
• Angiography is a method of examining the patency of blood vessels by injecting contrast fluid. It determines the functionality of metabolic processes and enables the diagnosis of articular insufficiency in the early stages.
• Complete blood count - prescribed to identify inflammation and pain. The totality of indicators can even lead to the trace of certain diseases and determine joint pathologies only at the very beginning of progression.
• Blood for rheumatoid antibodies - also indicates the presence of inflammation, but specific, systemic or hereditary in nature. For example, this diagnosis is used as a basis for diagnosing rheumatoid arthritis.
• Uric acid is an important test to determine the cause of pain and the stage of exacerbation of gout or infectious arthritis. Elevated levels indicate the accumulation of salt deposits in the joints.
• Wasserman's reaction - is prescribed when sexual infections, syphilis, gonorrhea, chlamydia, etc. are suspected. It is very common to develop joint diseases in the background of certain diseases or as their complications. Therefore, a positive test will allow prescribing the correct treatment, taking into account the type of infection.
• Tumor markers - help identify special substances in the blood that secrete a cancerous neoplasm or its metastases. Thus, synovial sac sarcoma is characterized by the presence of markers of vimentin, cellular external antigen and pancytokeratin.

Treatment of pain in the knee joints

Knee pain can be divided into those that require emergency medical care. And those who have been previously diagnosed. Emergencies include all injuries, fractures, dislocations, abscesses, purulent inflammation, hemarthrosis (bleeding in the joint). The symptoms are identical in all cases - unbearable pain, swelling, redness, inability to move, fever in the knee joint and fever.

Treatment is limited to providing primary care until the ambulance arrives:

• the leg should be raised - put a rolled roller or a hard pillow;
• put an ice pack on your knee and change it every 5-10 minutes;
• take an available pain medication.

In all other cases, treatment is carried out after conducting comprehensive studies and determining the cause. According to the anamnesis, drug therapy, physiotherapy, exercise, massage, homeopathic treatment, local applications, spa rest and, in extreme cases, surgery are prescribed.

Conservative therapy

Traditional drug pain treatment includes the following groups of drugs:

1. Anesthetics. To alleviate the initial symptoms and alleviate the painful condition, you can take simple over-the-counter pain medications. Severe cases associated with loss of mobility and unbearable pain require more serious prescription and over-the-counter medications.
2. NSAIL. Helps to quickly relieve inflammation and swelling.
3. Chondroprotectors. Modern drugs, despite the long course of application, ensure the regeneration of cartilage tissue. The effect is cumulative and long-lasting (up to 10 years, joint pain may not bother after a six-month course, amenable to treatment in the early stages).
4. Glucocorticosteroids. Indicated for patients with autoimmune pathologies to reduce cortisol hormone production and stop disease progression. Doses and regimen are prescribed by a doctor on a strictly individual basis.
5. Immunosuppressants. They suppress the abnormal functioning of the defense system, thus stabilizing the progression of dangerous diseases such as rheumatoid arthritis, lupus erythematosus and vasculitis. They are rarely prescribed, only in the case of an accurate diagnosis and the impossibility of eliminating knee pain in other ways.
6. Hyaluronic acid injections. They are injected directly into the cavity of the knee joint and eliminate pain and lack of synovial fluid. They also contribute to the restoration of hyaline cartilage, thus restoring knee mobility.

Folk recipes

Most people who start to have pain in the knee joint try to eliminate the discomfort with folk methods. You can make lotions, compresses and night applications based on homemade ointments or tinctures. Decoction of herbs, alcoholic tinctures for topical use will help prevent the period of deterioration and alleviate obsessive pain.

The following plants and substances have anti-inflammatory effects:

• Coltsfoot;
• St. John's wort;
• oak bark;
• burdock root;
• Laurel leaf;
• Chamomile flowers;
• Calendula;
• White and black kaolin clay;
• Salt and soda solution;
• Honey products.

For example, mix 10 aspirin tablets, previously crushed, and a glass of liquid honey. Apply a thick layer to the knee in the area of pain localization. Cover with cling film and wrap with woolen material (scarf), best left overnight. The pain is eliminated after the first application.

In the same way, you can apply a clay application where pain occurs. A little olive oil is added to the clay and water mixture to prevent the skin from hardening and tightening.

An effective recipe, which includes honey, salt and soda. Mix 1 teaspoon of salt and soda with honey, in an amount sufficient to cover the knee joint. This method performs three actions at once - removes excess fluid, relieves inflammation and pain, enriches with nutrients.

Oak bark in the form of decoction or alcoholic tincture strengthens blood vessels well, stimulates normal blood circulation. For the decoction, pour 1 tablespoon of dried bark with 1 cup of boiled water, cook in a water bath for 20 minutes. Soak gauze in the decoction and place on the knee in a warm (not hot) form for 30-50 minutes to remove the pain in the knee joint. For alcoholic tincture, use the same proportions, just replace the water with vodka. Insist in a dark cool place for 10-14 days. Apply the same way.

By exchanging various means and methods, you can save the disease for a long time, forget about pain and swelling. The effectiveness of alternative medicine has not been proven, despite the elimination of the primary symptoms - knee pain.

Massage and therapeutic exercises for pain in the knee joints

Comprehensive traditional treatment necessarily includes exercise therapy and massage. Exercises are recommended for all persons who have had or have knee injuries, diagnosed with arthritis, osteoarthritis and other joint diseases, lead an inactive lifestyle (sedentary static work, disability 1-2 groups, housewives, etc. ).

Gymnastics can be performed independently, at a slow pace and in a feasible manner. Gradually increase the number of exercises or, conversely, decrease, depending on how you feel.

1. From a lying position or sitting on a chair, slowly bend and stretch your legs, doing until a state of mild fatigue appears.
2. Bending the leg at the knee, perform rotational movements in a small amplitude, repeat the same on the other leg.
3. Lying on your back, gently pull your legs bent at the knees to your stomach.
4. Put a pillow on a chair and sit so that your legs "hang", perform circular movements in a clockwise direction and vice versa.
5. Sitting on a chair, slowly stretch your leg and stay in that position for 2-5 seconds, also slowly lower it, repeat on the other leg.
6. Stand up straight, straighten your back, slowly bend your leg at the knee and hold in the "heron" position for a few seconds. If possible, increase the delay time every 2 days.
7. If there are no contraindications and health allows, you can complicate the complex. Set the gymnastic stick to the maximum level, which can be reached with a bent leg at the knee. Cross your leg over the "barrier" 10-15 times, then change position.
8. The small complex for stretching the lower leg also contributes to the quick recovery of the knee joint. Lean your palms against the wall, bend your right leg at the knee, put your left leg back. The feet rest completely on the floor. Hold the pose for 30 seconds. Change legs.

Regular performance of simple gymnastics, available to every person, will give visible results in a month - the pain in the knee joint will stop bothering, the mobility of the joint will improve, the swelling will disappear.

The effectiveness of gymnastics will increase significantly if you combine it with a massage course. It can also be a traditional method of exposure and manual therapy for pain. It should only be borne in mind that only experienced professionals with good recommendations should be trusted to perform such procedures. Otherwise, manual manipulations, in the best case, will not have the slightest effect, in the worst case, they will cause a displacement of the joint and worsen the pathological condition. The massage should be performed periodically, no more than 10 sessions, 25-30 minutes a month. Daily procedures are strictly contraindicated. There should be no knee pain during the session. If discomfort is felt, the procedure should be discontinued.

Treatment at home

Treatment of knee pain at home is a prerequisite for outpatient therapy. The patient should help himself with all permitted methods to alleviate the pain and recover as soon as possible.

Therefore, for these purposes it is necessary to adhere to some rules for the treatment of all types of pain:

• Follow all the doctor's recommendations - do not miss taking the prescribed medication, do feasible gymnastics, arrive on time for physiotherapy.
• Examine your diet. Add lots of fresh vegetables, herbs and fruits to your diet. Exclude fatty meats, fried foods and semi-finished products.
• If necessary, use aids to relieve the knee joint - a cane, crutch and other special devices.
• Do not use, without prior consultation with a doctor, prescriptions of traditional medicine, even time-tested and neighborly. What helps one person may be categorically contraindicated for another.
• During the treatment period, if possible, avoid physical activity and ensure rest in bed so that the pain does not return (therapeutic exercises are an exception).
• Provide a comfortable place to sleep and rest - orthopedic mattresses, comfortable chairs and armchairs, preferably with small pedestals so you can comfortably lift sore feet.
• Light self-massage is allowed. Stroking, rubbing improves blood circulation, which enriches the tissues with oxygen. This eliminates muscle cramps and the pain becomes less intense.

Preventive measures

It is almost impossible to fully insure against injuries, sprains or dislocations of the most stressed joint in the body. Everyday life obliges you to do housework, go to work, etc. During normal activities, it is quite possible to get an unexpected injury. But to reduce the risk of developing joint disease is quite possible for every person. Leading rheumatologists have developed a number of recommendations that will help you protect yourself from dangerous pathologies:

• Establish and strictly adhere to a rational regime - work-rest. This is especially true for people whose activities are associated with increased physical activity (athletes, builders, salespeople, metallurgists, miners, etc. ).
• Treat in a timely manner and go through rehabilitation after any infectious diseases. This rule applies even to those "harmless" such as acute respiratory infections or seasonal SARS.
• Avoid exposure to low temperatures, drafts. Train for the weather to prevent hypothermia.
• At the age of 35, it is advisable to undergo a course of treatment with chondroprotectors.
• Monitor your weight carefully. Increasing body weight will inevitably increase the load on the knees, it is worth remembering when you eat another bun.
• To maintain a normal weight, follow the principles of a healthy diet. More vegetables and dairy products - less sweet, spicy, salty, fatty and starchy foods.
• Rethink your lifestyle - quitting smoking, alcohol and other toxic addictions will have a positive impact not only on your knee joints, but on life in general. To overcome addictions, you can turn to your relatives for help - the difficult phase will pass much faster and easier.

Pain in the knee joints is experienced by every person, regardless of age, gender or social status. From the first steps, the joint is subjected to various tests - falls, bruises, injuries, sports, hypothermia. Despite this, many people manage to maintain the mobility, health and functionality of the main compound until old age.