Knee pain (knee joint)

severe knee pain

The knees are more prone to injuries and various diseases than other joints. A significant proportion of patients with an orthopedic traumatologist and rheumatologist complain of severe knee pain. This article tells you what to do if you suddenly experience severe pain. She is being treated, the most important thing is to seek medical attention in time for her problems.

What completely hurts the knee

The knee joint is the most difficult joint as it carries the main load. Structure: three bones (femur, tibia and patella form a single blocked joint consisting of two interconnected joints: femoral-tibial (tibiofemoral) and femoral-patellar (patellofemoral).

The patella is a flat sesamoid (further in the joint) bone that attaches to the head of the femur, slides in its concave groove and acts as a block. Structural features: the anterior surface of the patella is covered with periosteum, the posterior surface connected to the femur is covered with hyaline cartilage. The patella is reinforced with ligaments: head and lateral - vertical (upper and lower) and horizontal (lateral - internal and external).

O transfers the strength of the quadriceps femoris muscle to the musculoskeletal formations of the lower leg, giving elongation of the lower leg at the knee joint. The surface of the articular bones is covered with cartilage that acts as a shock absorber. Additional shock absorbers that protect the joint from damage are two seal-shaped cartilage menisci located between the femur and the tibia. In the correct position, the joint is held by ligaments, tendons and the capsule that surrounds it.

knee joint structure

In case of injuries and diseases, various tissues in the joint are affected. Not everyone can get sick. So cartilage tissue does not have nerve endings and can therefore be destroyed imperceptibly and painlessly. However, the ligaments and the synovial membrane have many nerve endings, and in case of damage, inflammatory processes, they begin to respond immediately, which manifests itself in the form of a pronounced pain syndrome. With significant destruction of articular cartilage, pain may be associated with involvement of the periosteum, the outer layer of the bone, which has good innervation, in the process.

What to do in case of severe knee pain

Intense knee pain may come on suddenly or develop gradually. In any case, it often becomes unbearable. If a severe pain syndrome occurs, calm down and seek medical attention immediately. All this is treated, specialists will be able to help even with an advanced disease. If you cannot see a doctor at the moment, you can temporarily relieve the pain yourself.

But it must be remembered that in case of pain in the knee joint, this is a temporary measure, you still need to seek medical attention, you can not do without it. And it's better not to delay.

How to treat knee and leg pain at home

To relieve your condition with severe pain in the knee joint, you can take the following emergency measures:

  • Perform anesthesia with pills.
  • Use external painkillers (ointments, gels).
  • Injections. In the absence of effect of tablets and external agents, the drug is administered as an intramuscular or subcutaneous injection.

Many medicines are available over the counter without a prescription.

With chronic pain in the knee joint when there is no pronounced inflammation, physical exercises can be performed to strengthen the muscular ligament, improve blood circulation and metabolism. Systematic training leads to a gradual decrease in soreness, despite the fact that the legs are quite brittle.

An approximate set of exercises for knee pain:

  1. Fixed knee. Lie on your back, bend one leg at the knee, lift it and hold it in that position for one minute; the other leg is immobile at this point; quite slowly out and lower the leg, rest for 10 seconds and repeat the exercise with the other leg; repeat 10 times;
  2. Double bending of the legs with fixation of the knees near the face. Lie on your back, bend your legs at hips and knees, attach the latter to your face and hold it for a minute. Then slowly straighten out and lower your legs, rest for 10 seconds and repeat everything; do 5 - 6 approaches, gradually increasing the load.
exercises for knee pain

Acute knee pain requires a state of rest, all physical activity and exercise is contraindicated with it.

In case of acute pain in the knee joint accompanied by swelling and redness of the skin, violation of the general condition, fever, you can not move the leg, it must be kept still. And only after the inflammation begins to subside, you can first go to passive (performed by an assistant) and then to active exercises (performed by the patient himself).

What not to do with pain syndrome

With chronic pain, the following should not be allowed:

  • knee injury - you can avoid this by arranging your life in such a way that the risk of injury is minimized;
  • Excessive body weight is an additional strain on the knees, especially in the elderly;
  • heavy physical exertion, jumping, strength sports; you must not run either;
  • any poisoning so you have to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and focus on infection;
  • wearing uncomfortable tight shoes, shoes with high heels;
  • stress, lack of sleep
  • sedentary lifestyle - you need to force yourself to move at regular intervals.

It is also impossible to make heating pads without a doctor's prescription: with purulent and hemorrhagic (with intra-articular bleeding) processes, they can cause irreparable damage.

When you need to see a doctor as soon as possible

If the knee is sore, emergency medical attention is required if the following symptoms occur:

  • swelling, redness and soreness in the knee combined with fever and general malaise
  • severe pain in the knee immediately after the injury or for some time after that
  • a gradual increase in the intensity of the pain syndrome;
  • intermittent soreness after physical exertion, prolonged standing, sharp straightening of the leg;
  • night pain and related insomnia;
  • if the pain in the knee is very strong, constant, a feeling that the inside of the patella is hurting.

In any case, pain in the knee should be a reason to see a doctor. There is no point in treating on your own: it can temporarily reduce or even eliminate the pain syndrome, but not stop the course of the disease and the destruction of the joint. The treatment should be left to a specialist.

What to do with severe knee pain of a different kind

Soreness in the knee in humans can vary in character and duration. They can be constantly sore or only develop under certain loads, at night, etc. For example, some pathological processes are characterized by pain in the knee when bending, for others - pain in the knee when walking, etc. To understand what exactly and whyit hurts how only a specialist can help a patient.

Knee pain with coronavirus and other viral diseases

Viral infections can cause arthritis. As a rule, these diseases develop on the basis of an existing infection and pass without consequences after its termination. So with the flu and other acute respiratory infections with acute fever, both short-term joint and muscle pain and acute arthritis with inflammation and swelling of the knee joints can occur. Their course is favorable.

Coronavirus infection has its own characteristics: it proceeds differently for each patient. Why this happens is unknown. During the disease, sometimes painful joint pain, swelling and redness occur - a sign of acute arthritis, but then they disappear.

More dangerous is arthritis, which begins about a month after infection with coronavirus. The fact is that it has a significant effect on immunity. Faults in the immune system lead to the development of autoimmune processes. This is especially dangerous for people with close relatives who suffer from chronic arthritis. Experts note a high risk of developing rheumatoid arthritis (RA) in such patients. The first sign of RA is stiffness in movements in the morning (the knee is difficult to bend).

If arthritis occurs after recovery from a viral infection, contact a rheumatologist immediately.

Severe pain below the knee

This may be a sign of a baker's cyst, a dilated bursa filled with fluid in the popliteal area. The cyst and associated pain below the knee appear due to the fact that it is connected to the knee joint and is filled with synovial fluid. In this case, the reverse flow of the liquid is difficult for various reasons. Most often, the cyst develops on the background of bruising, osteoarthritis and arthritis of the knee.

A small cyst can go unnoticed for years. But with its significant size, the surrounding tissues begin to squeeze, the pain below the knee pulls, which intensifies with physical exertion, including walking and running. Women are sick more often. Sometimes the cyst disappears alone, but often it progresses, increasing in volume, which can lead to rupture or suppuration.

If there is pain below the knee, it is better to see a doctor as soon as possible. Conservative (removal of fluid from the cyst, injection of glucocorticoids into it) and surgical (removal of the cyst) are performed.

Severe pain in left or right knee

Severe pain syndrome in combination with edema and redness of the skin above the right or left knee usually indicates the development of an acute inflammatory process. It can be acute nonspecific arthritis (the process can turn into purulent), reactive arthritis, which begins a few days after the delayed urogenital or intestinal infection. Both diseases continue with similar symptoms, the correct diagnosis can only be established after a complete examination.

The right or left knee may suffer from microtraumas, for example in athletes or workers in certain occupations who use more of a (more often right) knee.

It is important at an early stage not to use folk remedies, but to perform the correct treatment, this will allow you to completely recover and forget about pain forever. But even with advanced diseases, a specialist will always be able to help and eliminate pain.

Pain in knees and legs

Depending on the cause of the disease, its course and the presence of complications, severe knee pain can cause:

  • in the lower leg below the kneeare rare, this may indicate compression of the inflamed swollen periarticular tissues in the knee area of the nerve branches innervating the muscles of the lower leg; pain below the knee in the back indicates compression of the branches of the sciatic nerve and pain below the knee in front - that the nerves innervating the anterior surface of the lower leg are interested; a rheumatologist treats such diseases, but consultation of a neurologist is required;
  • above the knee, in the thigh-is often a sign of post-traumatic inflammatory process in the femoral-patellar joint; at the same time, patellofemoral pain develops syndrome; severe pain, pain, sometimes twitching, aggravated by walking; an orthopedic traumatologist and a rheumatologist will help manage pain;
  • from the side, from withinsoreness can develop with trauma and damage to the inner lateral ligament; side pain is strong, twitching, with hemarthrosis (intra-articular bleeding) - ruptures, accompanied by an imbalance in the joint, the whole leg crunches with movement; the same pain occurs when the outer lateral ligament is stretched; help will be provided by an orthopedic traumatologist.

To eliminate the pain syndrome, you need to accurately determine the cause and it is impossible to do alone. Need medical attention.

Pain in the patella in the back, front and side

Patellar pain is almost always the result of acute or chronic injuries:

  • back pain- the causes are associated with the defeat of the femoral-patellar joint with the development of patellofemoral pain syndrome; sore pain, constant, aggravated by walking;
  • in front ofsuch painful sensations give superficial bruising of the knee or frequent prolonged knee with microtrauma of the patella; tenderness is significant as the periosteum, rich in nerve endings, is damaged;
  • knee pain on the side -in case of fracture or damage to the horizontal inner or outer ligaments of the patella; trauma can develop with frequent long-term microtraumas in the ligaments, for example during jumping; accompanied by bleeding in the joint cavity (hemarthrosis); pain syndrome is strong, constant, accompanied by edema; movements in the leg are disturbed.

To prevent the development of persistent joint dysfunction at the scene of an injury, seek the help of an orthopedic traumatologist immediately.

Knee pain radiates to the leg, heel, groin

acute knee pain

The causes of radiating acute pain in the knee must be understood. The reason may be:

  • capture of the femoral nerve; pains are acute, penetrating, beginning suddenly in the groin area, spreading along the anterior-inner surface of the thigh and knee, along the nerve branches they may reach the inner edge of the foot and heel; sometimes the patient has the impression that the knee hurts, but it is not;
  • arthritis (gonarthritis) of various origins: joint swelling leads to squeezing of the nerves and the spread of sharp pains in the knees up to the groin and down to the heel; at the same time, in the knee, there is chiefly pain in pain, with sudden movements becoming an acute with irradiation above and below the knee;
  • bruising, accompanied by hemarthrosis, ligament rupture, sharp swelling and compression of nerves;
  • contusion with fracture or dislocation of the patella and joint imbalance; acute pain in the knee along the thigh radiates to the groin, along the inner surface of the lower leg - below, to the heel.

Severe knee pain of this nature requires immediate medical attention. No folk medicine helps, you have to call an ambulance.

Knee pain during extension and flexion

Most often, knee pain during flexion and extension as well as squatting, a sign of tendonitis, an inflammatory process in the knee joint tendon-ligamentous apparatus. It develops mainly in young men who play sports and is a consequence of frequent repeated microtraumas associated with jumping and constant shaking of the limbs. The first sign is the inability to painlessly straighten the knee.

The cause of painful bending and elongation of the knee can also be osteoarthritis - degenerative -dystrophic changes in the joint with an increase in connective and bone tissue that interferes with movement.

Only treatment of tendonitis or osteoarthritis helps relieve the patient of severe knee pain during flexion extension.

Severe knee pain at night

Night pains are characteristic of inflammatory processes. It can be latent rheumatoid arthritis, periodically inflamed knee joint with osteoarthritis (osteoarthritis). During sleep, joints and periarticular tissues heat up, blood vessels dilate, contributing to increased edema.

Periarticular tissues swell, pinch nerve endings, pain syndrome develops. If at the same time there is pain below the knee behind, this may be a sign of Baker cyst. How to get rid of swelling and night pain? Treating the underlying disease helps.

Knee pain when walking

Pain during movement, jogging, pulling pain below the knee is characteristic of degenerative -dystrophic processes in the knee - osteoarthritis, as joint surfaces during movement are damaged, completely or partially devoid of shock-absorbing cartilage. The periosteum, which has good innervation, suffers. Pain in the knee when walking downstairs is also very common. After exertion, patients notice that the pain in the knee hurts for some time. Tenderness appears at the end of the foot.

Long-term rehabilitation treatment using chondroprotectors - medication that restores cartilage tissue will help. With complete destruction of the joint, arthroplasty.

Pain after exercise - squats, running, lifting weights

This indicates a prolonged microtrauma of the knee joint and the gradual formation of degenerative-dystrophic processes in them. Sometimes pain appears in a right or left knee. The joints are brittle.

If severe knee pain occurs after training, the athlete needs rehabilitation treatment. Otherwise, there will be a gradual decrease in joint function accompanied by first periodic and then constant pain.

Knee pain and crunch

A sharp sudden pain in the knee and a crunch (crackle) indicate a fracture of the meniscus - cartilage-absorbing pads in the knee joint. This may be a result of trauma or age-related wear and tear on cartilage structures.

Severe joint pain may go away, but pain in the knee will remain when you squat, then dysfunction of the limb will gradually increase, accompanied first by pain during exertion and then by constant pain syndrome, which intensifies as the stairs fall down. Over time, the entire limb suffers and crunches, including the foot. Long-term rehabilitation treatment under the supervision of an orthopedic traumatologist helps.

Knee pain and swelling

Pain accompanied by edema always indicates the presence of an inflammatory process. It can be aseptic (without infection, usually after trauma), infectious, infectious-allergic and autoimmune (with allergy to own tissue).

To get rid of such pains, identify their cause and perform the treatment prescribed by a specialist.

Injuries and diseases that cause knee pain

The most common pathologies accompanied by knee pain are:

  1. Closed and open knee injuries with intra-articular fractures, dislocations, meniscus fractures. All lead to the development of inflammatory processes (arthritis), which then turn into degenerative-dystrophic (osteoarthritis) with the formation of permanent pain syndrome and dysfunction of the knee. This is the most common cause of knee pain. Athletes are at risk. Even a minor injury to the knee can cause destruction of the cells in the joint tissue, leading to the development of an inflammatory process. With significant damage, all of these processes are pronounced and accompanied by prolonged pain. The instability of the knee, which develops when the ligament apparatus is damaged, is of great importance. Over time, the instability increases, nearby tissues get damaged, leading to increased pain in the knee joint, especially when walking down stairs. In the absence of proper treatment, the process can be complicated by infection, become purulent, life-threatening for the patient, or become chronic with gradual progression and destruction of the joint, accompanied by severe pain.
  2. Arthritis of the knee joint is an inflammatory process of various origins, accompanied by an increase in body temperature and a violation of the patient's general condition. Patients complain that the pain in the knee constantly hurts. The disease can be contagious, infectious-allergic, autoimmune, metabolic. The inflammatory process also proceeds in different ways depending on the cause that caused it (purulent, rheumatoid, psoriasis, arthritis and other arthritis). Sometimes arthritis can be complicated by a Baker cyst in the popliteal area. Then there is pain below the knee behind. Only appropriate treatment prescribed by a traumatologist or rheumatologist will save from joint destruction and disability.
  3. Knee joint osteoarthritis-degenerative-dystrophic processes in the joint that develop after trauma, acute and chronic inflammatory processes and on the basis of age-related metabolic disorders in the elderly. There is a destruction or thinning of the cartilage cushion tissue (menisci and the cartilage layer that covers the surfaces of the bones). Joint destruction is progressing slowly but steadily. Worried about soreness and crunch when moving. In old age, it is the main cause of knee pain. Bones rub against each other, their structure is destroyed, the joint is deformed, all this is accompanied by severe pain.
  4. Cysts and tumors.

How to treat severe knee pain

Injuries and diseases of the knee often lead to the development of patellofemoral pain syndrome (PFPS) - pain in the anterior part of the knee joint. Changes in the joint gradually destroy the patellar cartilage, contributing to the development of joint instability and constant severe pain in the knees. Only a course of rehabilitation treatment prescribed by a qualified specialist can help.

Diagnostics

knee joint diagnostics

Knee pain has different causes and requires an individualized approach to treatment. First of all, it is necessary to make the correct diagnosis and this will require an examination at the clinic. And only after that is treatment prescribed for knee pain.

Some diseases can not be completely cured, but the doctor will be able to remove the pain and stop the destruction of the joint.

To determine the causes of pain and the diagnosis of the disease, the following examination is performed:

  • Lab testsclinical, biochemical, immunological blood test, if necessary - sampling and examination of intra-articular fluid (microscopy, culture on nutrient media to determine the susceptibility of the detected infection to antibiotics).
  • Instrumental research:Ultrasound- reveals pathology of soft tissue and the amount of intra-articular fluidradiographychanges in the bone tissue of the knee;CT and MRI- a more detailed examination of the pathology of soft and hard tissues;diagnostic arthroscopyappearance and changes in the synovial membrane of the knee.

Treatments for severe knee pain

Therapeutic measures are assigned individually. Pain associated with a knee injury is treated by an orthopedic traumatologist; when the disease develops into a chronic course, a rheumatologist consultation is necessary. If a purulent inflammatory process is suspected, the surgeon will better manage the disease. All chronic inflammatory processes in the joints are treated by a rheumatologist, but specific infectious ones, such as knee tuberculosis, are treated by a phthisiatrician or another close specialist in close contact with a rheumatologist.

First of all, they try to eliminate the pain as much as possible using poppy medicine therapy (modern medicine for knee pain, including ointments) and non-drugs for knee pain (manual therapy, massage, therapeutic exercises, reflexology courses, etc. other traditional methods, folk medicine). To reduce the load on the joint and create rest, various methods of immobilization (rails, rails) and tapping - fastening of the joint with special adhesive tape are used.

In all acute joint pain, an acute examination of the patient is performed with simultaneous anesthesia. All modern and traditional methods of pain treatment are used in the treatment. Thereafter, according to the patient's testimony, they are either admitted to the hospital or prescribed an outpatient procedure followed by rehabilitation. Not a single patient with pain is left without the attention of specialists.