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, therefore it is often injured. The affected knee is difficult to fix, so it is very important to take measures to eliminate the cause of pain in a timely manner.

Main reasons

Causes of pain in the knee 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 feeling of tingling, numbness, the color of the skin in the joint area changes.
2. Arthrosis (gonarthrosis)is the destruction of the tissues of the joint. Gonarthrosis is primary and secondary. The primary disease affects the elderly, while the secondary cause the consequences of injuries or it is a complication of other diseases (for example, rheumatoid arthritis). Symptoms: pain and stiffness in the joint. With a long course of gonarthrosis, movements in the joint may become impossible.
3. Arthritis (gonarthritis)- inflammatory disease. Distinctive signs: pain that increases with movement, an increase in the size of the joint, fever in the affected knee, redness at times.
4. Meniscopathy- damage to the meniscus, which is manifested by sharp pain. In the absence of proper 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 most often a post-traumatic complication.
7. Bursitisis an inflammation of the synovial sac (bursa). Bursitis can be caused by overuse of the joint, infection, or injury. With this disease, severe constant pain is noted, but freedom of movement is preserved.
8. TendinitisIt is inflammation of the ligaments and tendons. Symptoms are swelling and pain in the affected area. They increase with 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 bones of the legis 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 staphylococci.

Varieties of pain

There are such types of pain in the knee:

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. When bending the legs. This is one of the most common joint problems. It is observed with Osgood-Schlatter disease, damage to the ligaments and meniscus, 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 arthrosis, 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 and stiffness in movement, then there is nothing to fear. However, this symptom can be caused by a dangerous disease - osteoarthritis, in which articular cartilage is damaged and severe pain appears. It is very important to start timely treatment of this disease.

Diagnostics

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

1. General blood analysis. Allows you 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 the help of it, 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 and 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. Puncture biopsy of the bone. It is carried out in the presence of suspicions of osteomyelitis or bone tuberculosis.
6. Arthroscopy. It is carried out both for diagnosis and for treatment, for example, with a meniscal injury.
7. Ultrasound (ultrasound examination). This is a screening study conducted in cases of suspected traumatic injuries, osteoarthritis, meniscus disease, etc. Ultrasound results need to 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 assistance.

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

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

The specific drug and method of treatment is chosen by the attending physician.

Also, conservative treatment involves ice compresses on the damaged area to relieve pain or hot compresses to improve blood microcirculation.

With hemarthrosis, the joint is punctured 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 for a limited calorie 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 gait, and knee pads fix 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

A pronounced therapeutic effect in osteoarthritis of the 2nd and even 3rd stage is given by hyaluronic acid preparations, which are administered intraarticularly. The introduction of hyaluronic acid is considered as an alternative to arthroplasty when it 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;
• ligament rupture;
• the presence of foreign bodies in the joint;
• rheumatoid arthritis;
• intraarticular fractures.

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

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

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

Endoprosthetics is performed when the restoration of painless 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 their prevention. After endoprosthetics, a long-term rehabilitation of the patient (up to 6 months) is required.

Folk remedies

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

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

Let's look at a few popular methods:

1. Ointment. For knee pain, prepare 1 tbsp. l. hypericum and 2 tbsp. l. yarrow, crushing them. In a water bath, melt 1 tbsp. l. vaseline. The grass is poured into hot Vaseline and rubbed to a homogeneous mass. This ointment should be rubbed on sore knees at night.
2. Mixture based on rye seeds. You should take 250 g of rye seeds, pour them with 2 liters of water and boil. After the mixture has cooled, it is filtered, and 500 g of vodka, 1 kg of honey, 3 tsp are added to it. barberry root. The mixture is thoroughly stirred and left for 21 days in a dark place. It is recommended to use a mixture of 3 tbsp. l. before eating. It 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 consult a doctor. This will avoid many troubles.