Pain in the knee

pain in the knee joint

The knee joint is one of the largest and most complex joints in the human body. It accounts for about 80% of body weight, and during movements (walking, running, jumping) this number increases many times.

The complex structure and high load make the knees vulnerable to various injuries and the development of pathological processes.

Since there are many nerve endings and blood vessels in the area around the knee joints, any injury or inflammation causes pain and a variety of other unpleasant symptoms.

The inflammatory reaction, in turn, leads to soft tissue edema and increased intra-articular pressure.

The reasons

Pain in the knee joint can have another origin: rheumatic, allergic, traumatic, infectious, oncological and metabolic. In some cases, it occurs for no reason and is caused by severe stress and mental overload. If your knees hurt after 50 years, the most likely cause is deforming osteoarthritis.

Pathological disorders and changes can affect articular surfaces of bones, cartilage, synovial capsule, veins and arteries, nerves, lymph nodes, ligaments, muscles. Depending on the structure affected, the nature and intensity of the pain are different. Based on the combination of characteristic features, some cause can be assumed.

Deformative osteoarthritis

This progressive degenerative disease begins with the destruction of cartilage and gradually spreads to the entire musculoskeletal system. Its symptoms are not only pain in the joint but also a steady decrease in functionality as well as severe deformities.

Pathology is often found in postmenopausal women and after removal of the ovaries. The most common causes of osteoarthritis are trauma, congenital hip dysplasia and inflammation. The inflammatory process may be the result of rheumatic or infectious arthritis, chronic hemarthrosis.

A typical symptom of deforming osteoarthritis is sore pain in the knee on the left or right leg, which worsens after exercise. After a while, the pain disappears and subsides at rest. Over time, their duration increases as the leg bends, a crack is heard, mobility is limited.

If a piece of cartilage enters the joint cavity - the joint mouse - the knee is wedged. After the mouse enters the lumen of the synovial capsule, movement is restored. In the absence of treatment, the joint is completely destroyed and articular surfaces of the articulating bones fuse together - ankylosis, immobility occurs.

Arthritis

In arthritis, the joints of the knee become inflamed and characteristic symptoms occur:

  • pain of varying intensity;
  • stiffness and stiffness;
  • swelling, enlargement of the joint in size;
  • redness and increased local temperature;
  • a symptom of alignment of the patella (with a large accumulation of intra-articular fluid).

Prolonged arthritis can lead to bone deformities, flexion contracture, muscle weakness, ankylosing and loss of limb function.

Arthritis can be primary or secondary. The primary lesion develops as a result of injuries with damage to the meniscus, synovial capsule, and open wounds. Infection of the joint cavity is possible after a puncture or operation. The primary form of the pathology is rheumatoid arthritis, the hallmark of which is a symmetrical joint lesion.

Runner's knee

This syndrome mainly occurs in athletes who run and regularly increases the load on the lower extremities. In medical practice, "running knee" is called chondromalacia patella. As a result of a constant load, the cartilage tissue gradually loses its elasticity and becomes loose, leading to a decrease in the depreciation function of the joint.

knee pads for knee pain

Many athletes use knee pads to prevent dislocations, sprains and inflammation in the joint.

In runners, the patellas tendon pulls inward and the hip rotates outward. The patella shifts relative to the condyles and begins to rub against them. In this case, the cartilage tissue lining the inner surface of the cup is subject to severe wear.

Typical signs of chondromalacia are:

  • sharp pains at the top of the knee that occur during movement and increase as one ascends stairs;
  • stiffness and stiffness of the joint;
  • knee pain at rest, with pressure, the pain intensifies.

Pain in chondromalacia is caused by inflammation of the soft tissues. With a rupture of the intra-articular ligaments, the development of hemarthrosis is possible - bleeding into the articular cavity.

periarthritis

The development of degenerative processes affects not only the articular elements, but also the surrounding ligaments - periarticular tissues. The body's response to such changes is the inflammatory process. The most vulnerable sites for attachment of ligaments, tendons and synovial sacs.

There are acute and chronic forms of periarthritis of the knee. It can also be primary and secondary, developing on the background of another pathology. With periarthritis, the knee hurts and its inner side swells. The pain is tender in nature and increases during walking.

A typical manifestation is a decrease in edema in the horizontal position of the leg. Often, periarthritis is accompanied by general symptoms - an increase in body temperature up to 37, 5 ° C and weakness.

Bursitis

Bursitis is an inflammation of the synovial sac of the joint - the bursa. The inflammatory process can develop as a result of injury or high physical exertion. Under the influence of traumatic factors, the synovial membrane produces an excess volume of fluid.

Risk factors include impaired immunity, long-term treatment with hormonal drugs, alcoholism and kidney pathology. Often, bursitis occurs on the background of scleroderma, diabetes, rheumatoid and rheumatoid arthritis.

The patella is most often affected, popliteal bursitis and Baker's cyst is somewhat rarer - inflammation of the bursa on the inside of the knee. The disease can be serous and purulent when bacteria (most often staphylococci) enter the joint cavity through small wounds and wounds on the skin.

Inflammation of the bursa in acute bursitis occurs suddenly and often passes quickly. Chronic bursitis occurs over a long period of time and is characterized by mild symptoms. Its manifestations are:

  • knees hurt, especially when you press it;
  • range of motion is markedly reduced;
  • the skin over the joint becomes hot;
  • body temperature rises (with an infectious lesion).

Chondromatosis

Articular chondromatosis is a dysplastic process in which chondromic (cartilage) bodies form in the synovial membrane. The cause of congenital chondromatosis has not been determined, the acquired disease develops under the influence of external factors - injuries, high physical exertion and infections.

The leading clinical symptoms of chondromatosis are pain and swelling, which are particularly pronounced when a cartilage fragment (joint mouse) is squeezed between the bones. In addition, "solid" chondromic body causes blockage of the joint.

Important: prolonged course of chondromatosis may lead to the development of osteoarthritis.

Goffs disease (lipoarthritis)

Hoff's disease is an inflammation of the adipose tissue in the joint located in the pterygoid fold. Goff's body is the accumulation of subcutaneous fat between the patellar ligament and the synovium of the knee. This formation contains nerves, blood and lymph vessels. Its purpose is damping and load distribution during movements.

In case of a simultaneous or permanent mechanical impact on Goff's body, the fat lobules are damaged, leading to bleeding and swelling. With the progression of the disease, the adipose tissue is gradually replaced by connective tissue, thereby impairing the function of the knee joint.

At the beginning of the pathology, patients complain of severe pain in the knee, which due to swelling increases in size and does not bend completely. Then there are other symptoms:

  • knee pain at night;
  • on both sides of the knee joint, crepitant formations are felt, causing crackling by pressure;
  • it becomes more and more difficult to lean on the leg;
  • thigh muscle atrophy;
  • instability appears in the joint;
  • my knees constantly hurt, especially in the lower part and on the side.

Common diseases

Knees can not only hurt when the joint itself or the tissues around it are damaged. Often, the answer to the question of why pain occurs is systemic disorders. These include:

  • osteoporosis;
  • bone tuberculosis;
  • osteomyelitis;
  • Reiter's syndrome;
  • Lyme disease (tick-borne Lyme disease);
  • neuropathy of the sciatic nerve in pathologies of the spine;
  • fibromyalgia (chronic pain syndrome in muscles and bones).

Pain classification

The nature and intensity of pain can vary considerably depending on the cause that caused them. So with arthritis, the pain is tender and undulating. Compression of the sciatic nerve and tuberculosis of the bones accompanied by burning pain. In the advanced stages of deforming osteoarthritis and with damage to the menisci, a pulsating pain syndrome occurs.

Pain during walking manifests all types of bursitis, arthritis, periarthritis. Shooting pain is observed in acute bursitis, exacerbation of meniscopathy and severe injuries - fractures, torn ligaments and bruises.

Treatment

After establishing the diagnosis and determining the cause of the knee pain, therapeutic treatment or surgery is prescribed. It should be noted that in some cases, emergency medical attention is required. This applies to any injuries - fractures, dislocations and sprains of the periarticular ligaments as well as purulent inflammation in arthritis. Jamming of the joint in one position due to squeezing of the joint mouse is also an indication for acute treatment.

Prior to the doctor's visit, a number of measures must be taken: firstly, to exclude any movement of the limb. Second, give the leg a raised position. For severe pain, you can take a painkiller or anti-inflammatory. For the first hours after the injury, it is recommended to apply cold compresses, but not more than 10-15 minutes. After this time, take a break and then apply cold on the leg again.

Important: it is forbidden to massage the knee and fix it with an elastic bandage until the diagnosis is established.

Medicine

In the absence of indications for surgery, they begin with the elimination of pain. For this, painkillers and anti-inflammatory non-steroidal drugs (NSAIDs) are used in the form of tablets, injections, ointments and compresses as well as therapeutic blockades.

Pain of autoimmune origin (for example with rheumatoid arthritis) is relieved by hormonal drugs that are injected directly into the joint cavity or taken orally. The most effective is Prednisolone.

If the pain is neurogenic in nature, anticonvulsant drugs are prescribed. When squeezing the tibial or sciatic nerve, B vitamins are required.

In case of diagnosis of allergic arthritis, the doctor prescribes antihistamines, mast cell (mast cell) membrane stabilizers, adsorbents (activated charcoal) and laxatives.

Infectious pathologies are treated with antibiotics, the choice of remedy depends on the type of pathogen.

How to treat deforming osteoarthritis depends on the stage. In the early stages, chondroprotectors are effective, which help restore cartilage tissue and prevent its further destruction. They can be used for intra-articular injections, but are most often given as long-term tablets.

Chondroprotectors are used for arthritis, periarthritis, traumatic injuries, in the recovery period after joint surgery. These drugs have almost no contraindications and are well tolerated.

The course of therapeutic treatment with chondroprotectors is at least four months, and the effect lasts up to six months.

Replacements for intra-articular fluid

The synovial fluid found inside the joint acts as a lubricant and natural shock absorber. These qualities are provided to her by hyaluronic acid, which is able to change the composition of the fluid under the influence of the load. Medicines based on this acid compensate for the lack of natural lubricant and improve its properties.

The knee joint contains about 4 ml of fluid to maintain shock absorption and nourishment to the cartilage. Since cartilage does not have its own blood supply, all the substances it needs dissolve in the synovial fluid.

Due to the constant movement and mixing of the fluid, nutrition enters the cartilage in the required amount. In case of a decrease in the molecular weight and the concentration of hyaluronic acid, the slippage in the joint worsens and the cartilage tissue begins to degrade. So it happens with osteoarthritis, osteoarthritis and some other diseases.

Degenerative and inflammatory processes lead to a narrowing of the joint space and the formation of compensatory bone growth - osteophytes. As the movement in the joint worsens further, the synovial fluid stagnates and loses its properties. There is a need to break the pathological chain.

What to do? The answer is obvious - to inject hyaluronic acid into the joint. Modern medicines are made from natural raw materials or using biotechnology. The natural raw material is a chicken comb or vitreous in the eyes of cattle (cattle). The introduction of the drug can be limited to one injection per year or performed in the course of 3-5 injections per month.

The most effective drugs with high molecular weight. To achieve an anti-inflammatory and lasting analgesic effect, only one injection per year is enough.

Orthopedic devices

To relieve the knee joint and normalize its work, the doctor may recommend wearing a knee brace. This device is used by athletes to prevent injuries and in the complex therapy of various pathologies. Indications for use are arthritis, osteoarthritis, dislocations and subluxations, sprains and instability of the joint.

Important: you can not wear a knee brace for a maximum of three hours a day.

The use of knee pads helps:

  • acceleration of recovery;
  • prevention of damage to the menisci;
  • maintenance of motor ability;
  • reduction of pain and swelling;
  • improve blood circulation and lymph flow.

Knee pain can thus be a symptom of many diseases. Only a doctor can determine the cause after an examination. Before visiting the clinic, it is recommended to reduce the strain on the legs, prevent hypothermia and not self-medicate. Be healthy!