Knees are considered the most worn joints in the human body. According to statistics, every third patient with musculoskeletal system problems complains of pain. This symptom can be a manifestation of a serious pathology, especially if both knees hurt. It is important to consult a doctor immediately after discomfort appears in order not to waste time and maintain the mobility of the legs.
Where does the pain come from?
The knee is a large block joint in the legs, its structure consists of fairly large bones (femur, tibia and patella), a joint cavity covered with hyaline cartilage, as well as several pairs of ligaments (main, upper and lower vertical, inner and outer lateral, transverse) and menisci.
Pain receptors are not located in all elements, therefore, when complaining of pain in the knee joints, they are most localized:
- in the synovium;
- gardens;
- periosteum.
Good to know! The elements of the knees, which consist of cartilage, lack innervation, so by definition they cannot hurt. Even if the cause of the discomfort is the destruction of the tissues surrounding the joint, the pain indicates that the periosteum and the lining of the joint capsule are involved in the process.
Pain can be caused by:
- degenerative-inflammatory processes of joint lining cartilage;
- infections of soft, connective, cartilaginous tissues;
- inflammation of joints (bursa, cartilage, tendons);
- damage to ligaments, menisci, bones;
- blood circulation disorders in the knee area.
Each group of pathologies is characterized by certain symptoms, the identification of which helps to determine the diagnosis and choose the appropriate treatment.
Degenerative-inflammatory diseases
Arthrosis (gonarthrosis) is up to a third of all cases of localized pain in one or both knees. This disease affects older people and develops gradually. Mild discomfort after exercise gradually becomes common, and after 2-3 years, walking even short distances is accompanied by pain in one knee or both legs at once.
In addition to discomfort with arthrosis, patients complain of creasing and deformation of the joints. Swelling, redness and heat in the joints of the legs are not characteristic of this disease.
Meniscus injuries
Meniscus injuries are characterized by the sudden appearance of the main symptom - sharp pain in one, less often in both legs. It always appears during active movement: running, jumping, during an unsuccessful maneuver on skis or skates. The process is accompanied by a clearly heard and felt crunch in the knee.
The intensity of the pain is so strong that it is impossible to bend or lift the affected leg. After a quarter of an hour, the symptom disappears. If help is not provided, inflammation develops within 24 hours:
- swelling appears in the injured knee area;
- pain syndrome intensifies;
- mobility is limited.
When trying to lean on the leg, there is a sharp piercing pain that causes the limb to bend. If you do not consult a doctor for therapy, all the listed symptoms gradually decrease and disappear after about a month. But they return after a long walk, hypothermia or exercise.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, synovitis are often companions of degenerative diseases and injuries. In inflammatory pathologies, the nature of pain is pain, twisting or bursting, sometimes burning.
Good to know! Unlike other causes, pain in the knees with arthritis increases during rest and sleep and decreases during movement. The symptom is especially strong after prolonged physical exertion.
The disease is accompanied by swelling, redness of the joints and may be accompanied by fluid accumulation when the joint capsule is involved. The resulting deformation appears as an elastic band on the surface of the knee. The skin on it tightens, becomes shiny and red.
Joint blood supply disorders
The so-called vascular pain often occurs in adolescence and accompanies a person throughout his life. The reason for their appearance may be the uneven growth of various tissues of the extremities: the bones "pass" the vessels and muscles, which causes tension in the latter.
Distinctive features of vascular symptoms in the knees:
- symmetry - discomfort occurs in both limbs;
- aggravation of pain occurs with a sharp change in temperature, change of weather, physical activity;
- quickly weakens after massage.
This type of pain does not require special treatment, except for the use of local remedies.
Tendonitis
Periarthritis of the crow's feet (one of the ligaments in the knees) is characteristic of older women. The symptom occurs only when carrying heavy objects and going down stairs. There is no or very little discomfort when bending or moving on a flat surface. There is no significant limitation in the mobility of the affected limb. There is no swelling, redness or deformity during periarthritis.
Treatment methods
It is advisable to entrust the treatment of knees to doctors - orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other fields can also participate in the therapy: physiotherapists, chiropractors, massage therapists. The goals of the therapy are not only to eliminate the symptom, but also to restore its functionality and prevent recurrence.
Before starting therapy, diagnostics are carried out:
- x-ray of the joint, which allows you to visualize damage to bones, cartilage and menisci;
- CT or MRI are techniques that can detect abnormalities of blood vessels, soft tissues, bones, and cartilage;
- Ultrasound of the joints, which allows detecting cartilage damage and determining the volume and density of synovial fluid;
- arthroscopy - a method of visual examination of the joint cavity using an optical device;
- microscopic analyzes of intra-articular fluid to detect infections and inflammations.
Treatment tactics are selected based on the diagnosis, but the scheme is always the same:
- The initial stage is symptomatic treatment and pain relief.
- The main stage is to eliminate the causes of anxiety.
- The last stage is the restoration of the joints.
Conservative therapy using pain relievers and anti-inflammatory drugs is sufficient to relieve symptoms. They are prescribed in the form of local means - ointments, gels - and tablets for oral administration. In addition, doctors recommend distraction and warming agents.
In the initial stage, it is important to rest the affected joint. Loads should be excluded:
- long walk;
- lifting weights;
- engaging in certain sports that require active squatting or jumping.
If a limb is injured, you can use a tight immobilizing bandage, orthosis, or even a plaster cast on the recommendation of the attending physician.
Depending on the diagnosis, additional drugs may be prescribed:
- general strengthening substances and vitamin-mineral complexes;
- NSAIDs, including in the form of injections;
- preparations with chondroitin and glucosamine;
- agents that accelerate the regeneration of damaged tissues.
After the objective has improved, a course of general strengthening exercises, physiotherapy, massage and exercise therapy is prescribed to restore the functionality of the joints, strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct instructions for them:
- severe pain that is not corrected by analgesics;
- the formation of purulent exudate in the joint cavity or purulent cavities in the soft tissues of the joints;
- partial or complete blockage of the joint;
- significant deformation of the cartilage that changes or blocks the functionality of the joints;
- damage to the internal elements of the joint - bone, cartilage, meniscus, cruciate ligaments.
After surgery, conservative therapy is continued to prevent complications and relieve discomfort. Physiotherapy, exercise therapy, massage, hydrotherapy, etc. to restore mobility, strengthen and stabilize the joints of the legs. rehabilitation is being carried out. Moderate loading of the extremities, avoidance of hypothermia, and counseling are recommended to prevent recurrences. If you are concerned, consult your doctor immediately.