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 bears the main load during movement and physical exertion, therefore 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

The 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 sudden fall. 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 long course of gonarthrosis, joint movements may become impossible.
3. Arthritis (gonarthrosis)- inflammatory disease. Distinctive signs: pain that increases with movement, increase in the size of the joint, fever in the affected knee, sometimes redness.
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 arthrosis 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 is no effective treatment for osteonecrosis. Arthroplasty of the affected joint is performed.
6. periarthritis- it is an inflammation of the joint bag and the tissues surrounding it. With periarthritis, there are pains in the area of the knee joint without 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, constant severe pain is noted, but freedom of movement is preserved.
8. TendonitisIt is an 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 tendonitis are indicative of tendinosis.
9. Baker's cyst- it is a complication after trauma, knee osteoarthritis 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 when moving. To avoid complications, squatting is strongly discouraged.
10. Osteomyelitis of the leg bonesis a purulent disease associated with an infection, 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. In a squatting position. It is usually caused by joint diseases, viral infection, lack of physical activity, poor diet. seen in athletes. If your knees hurt when squatting, the exercises should be stopped. For prolonged and frequent pain, you should consult a doctor.
2. By bending the legs. It is one of the most common joint problems. It is observed with Osgood-Schlatter disease, lesions of ligaments and meniscus, Baker's cyst, infectious lesions, etc. In case of pain, it is necessary to limit the load on the leg, to refuse to play sports and to 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 necessary to carry out timely treatment of these diseases, otherwise a complete loss of motor functions is possible.
4. Bite. If there is no swelling, pain and stiffness in movement, there is nothing to worry about. However, this symptom can be caused by a dangerous disease - arthrosis, in which the articular cartilage is damaged and severe pain appears. It is very important to start timely treatment of this disease.

Diagnostic

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

1. General blood test. Helps detect anemia, leukocytosis, etc.
2. blood chemistry. Detects increased 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 arthrosis 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. Biopsy by puncture of the bone. It is performed when there are suspicions of osteomyelitis or bone tuberculosis.
6. Arthroscopy. It is carried out both for diagnosis and for treatment, for example, with a meniscus injury.
7. Ultrasound (ultrasound examination). This is a screening study conducted in case of suspected traumatic injuries, osteoarthritis, meniscus disease, etc. Ultrasound findings should be verified by radiography (CT) and/or MRI.

Processing

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. Initially after an injury, it is not recommended to move around without help.

The basis of treatment is anti-inflammatory therapy. It involves the use of the following agents: nonsteroidal anti-inflammatories, 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 are selected by the attending physician.

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

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

In addition, conservative treatment includes physiotherapeutic methods: massage, therapeutic exercises and spa rehabilitation. If necessary, the doctor prescribes a special diet with a limited calorie content.

Chondroprotectors are used to nourish cartilage and reduce destructive processes.

The most common methods of physiotherapy are magnetic therapy, laser therapy, cryotherapy, acupuncture.

With gonarthrosis, special shoes and knee pads - braces are used. These shoes contribute to the normalization of the gait, and the 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 relieves pain in a joint and increases its mobility. This method of treatment not only eliminates the underlying disease, but also allows you to introduce drugs into the joint cavity that reduce inflammation.

Doctor's advice

A pronounced therapeutic effect in arthrosis of the 2nd and even the 3rd stage is given by hyaluronic acid preparations, which are administered intra-articularly. The introduction of hyaluronic acid is considered an alternative to arthroplasty when it is not possible due to therapeutic contraindications. This is a medical manipulation, it has contraindications.

The technique is performed with such problems:

• damage to the meniscus and cartilage;
• ligament rupture;
• 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 excessively early load on the limb.

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

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

Endoprosthesis 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 the endoprosthesis, a long-term rehabilitation of the patient (up to 6 months) is necessary.

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 some popular methods:

1. Ointment. For knee pain, prepare 1 tbsp. I. St. John's wort and 2 tbsp. I. yarrow, crushing them. In a bain-marie, melt 1 tbsp. I. petroleum jelly. The grass is poured into hot petroleum jelly and rubbed into a homogeneous mass. This ointment should be rubbed into sore knees at night.
2. Mixture based on rye seeds. You need to 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 teaspoons 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. I. before eating. It is necessary 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 inconveniences.