Knee joint pain - causes, effective treatment, diagnosis

Everyone feels pain in the knee joint from time to time. This may be the result of a sudden action or a symptom of a progressive pathology. The knee joint is the largest and anatomically complex element of the musculoskeletal system. Up to 80% of body weight, which leads to increased physical activity and the risk of injury. Numerous capillaries, nerve fibers, and muscle tissue make each injury, even a small one, extremely painful. Damaged nerves cause an infectious-inflammatory process, accompanied by swelling, discoloration of the skin and an increase in local temperature.

As progress progresses, the joint itself, intraarticular fluid, and connective tissue become pathological, which can lead to serious consequences - the development of arthritis. A general understanding of the anatomical structure of the knee joint will help you understand which element can cause pain and what measures can be taken to relieve the pain.

Anatomical structure

The anterior zone of the joint is formed by the patella, in simpler language - the patella. It is connected to the quadriceps (fascicular) thigh muscle, which runs in the patellar ligament and generally joins together to form a ligamentous apparatus consisting of the following types of fascia:

• Tibiadan side branches (small and large);
• posterior supporting nodes - sickle, dorsal, median and lateral;
• knee joint transverse and transverse ligaments.

Diagonal ligaments are the most susceptible to injuries - sharp movements, a large degree of rotation, and a fall with subluxation cause fractures of the interminimal joints.

Ligaments are divided into two types:

1. Anterior - they have the function of stabilizing the ankle joint, in particular, preventing excessive forward displacement. They originate from the back of the greater femur, intersect with the posterior ligaments in the knee cavity, and attach to the notch between the anterior protrusions of the tibia.
2. Back - Restrict the lower leg to the back. They begin in the anterior upper part of the femur, pass through the joint cavity, and end between the dorsal protrusions of the calf.

There is cartilage on the surface of the articular bones. There are menisci at the junction of the tibia and femur - a kind of joint lining that acts as a shock absorber and stabilizer.

There are several synovial sacs (three to five) that provide natural lubrication to the knee joint:

• above the knee cap;
• popliteal deep;
• between the tendons in the long thigh muscle;
• hypodermic patella;
• in the indentation below the knee joint.

Thanks to the knee, a person can take a step, bend, stretch within the limits indicated by the ligaments.

Causes of pain

Inflammation can develop in the following structures:

• cartilage;
• joint shell;
• synovial fluid;
• tibia bones;
• muscles and tendons surrounding the joint;
• garden apparatus;
• blood vessels, veins, arteries;
• subcutaneous fat;
• epidermis.

The most common causes of knee pain are:

1. Osteoarthritis is the cause of more than 50% of knee pain. Hyaline is characterized by slow, gradual destruction of cartilage. It can be asymptomatic for a long time and can become severe in the second stage. Pain in the knee joint occurs due to increased osteophytes affecting the nerve endings;
2. Arthritis is an acute inflammatory pathology. It can be either an independent disease - spondylitis, or a complication of other articular pathologies - osteoarthritis, rheumatism, etc. Arthritis is characterized by severe pain, accompanied by swelling and redness;
3. Osteochondritis - degenerative osteoarthritis, inflammation of the articular cartilage over time with mechanical injuries;
4. Periarthritis is a disease that occurs against the background of obesity (mostly in women). It affects the pathological tendons and muscles and then penetrates the cortex of the knee joint. The pain is moderate, tense (as in a sprain).
5. Chondromatosis is the formation of nodules in the hyaline cartilage tissue and eventually spreads to the capsule of the knee joint. In this case, pinching of the soft tissues with a large number of nerve cells occurs. Therefore, the knee is constantly in pain, even at rest.
6. Bursitis - the synovial capsule of the knee joint rarely inflames itself, only as a result of injuries or aggravation of collateral joint disease, and therefore pain.
7. Cellulite - subcutaneous adipose tissue can cause pain only in the case of close foci of concomitant diseases. Purulent arthritis, soft tissue abscess can cause inflammatory and painful processes in the protective layer.
8. Dermatitis - affects the epidermis during infectious pathologies (eczema, erysipelas, psoriasis) or allergic reactions to external stimuli.
9. Osteomyelitis - inflammation of the bone marrow due to bacteria entering the body as a jelly, along with lymph flow. It can also be the result of open injuries or complications from surgery.
10. Synovitis - the capsule of the knee joint is most often affected by rheumatism or other chronic pathologies in people over 55 years of age. At a young age, you can get sick due to a serious injury.

Types of pain depending on the location

Diseases that cause the development of negative processes also constitute the type of pain:

• Severe, unbearable pain - reactive arthritis, torn meniscus and tendons, acute bursitis;
• Tolerable, but constant pain - initially synovitis, bursitis;
• Pinch pain - gonarthrosis, osteoarthritis;
• Vibration - degenerative osteoarthritis, in the stage of joint deformity;
• Acute, burning pain - sciatic nerve compression, bone tuberculosis;
• Singing - osteoporosis, progression of inflammation of the synovial sac, exacerbation of chronic meniscus damage;
• Cramps - inflammation of the soft tissues of the knee joint, muscles and tendons;
• Shooting pain - damage to nerve roots.

Diagnostic measures

If you feel severe pain in the knee joints, you should not delay a visit to the doctor in the hope that "everything will pass. "Early diagnosis ensures successful treatment and prevents the development of more serious processes that can cause irreparable damage to health and quality of life. You should contact a therapist for an initial consultation. After a standard examination, he decides to prescribe treatment (which occurs in 70% of knee pain complaints) or to arrange a comprehensive laboratory and hardware examination with the involvement of highly qualified specialists.

Running, suspicious pains are studied in different directions:

• Traumatology: arthrosis, congenital or acquired dysplasia, joint fracture, displacement, displacement, radiography, MRI, ultrasound, fluid biopsy in the synovial sac to determine where the pain in the knee joint is coming from.
• Surgery: cysts under the patella, thrombosis, arthritis with purulent formations, tendons, menisci, ligaments, stones inside the joint, hemarthrosis, abscess ultrasound, fluoroscopy, CT or MRI, blood tests, general and rheumatoid factor diagnosis, hyaline puncture in the knee joint and hyaline punctures.
• Rheumatology: exclusion of systemic diseases (lupus erythematosus, rheumatoid arthritis, gout) is carried out with the help of laboratory tests. Complete blood count, hematology, rheumatoid protein, DNA test, uric acid level.
• Neurology and psychiatry: Compressed sciatic nerve does not require a long diagnosis. Ultrasound will now show muscle tone and areas of inflammation. In the case of mental disorders, when pain in the knee joint is not confirmed by a single fact, but the patient continues to suffer (so-called somatic pain), special studies are prescribed for mental disorders.

Basic diagnostic methods

The most popular ways to quickly and accurately diagnose knee pain are:

• X-ray - allows you to see the knee joint in several projections and determine the location of the lesion. Images show lesions that are already in the early stages, especially changes in the appearance of bone, synovial sac, or osteophytes.
• Ultrasound examination - a modern, high-precision examination determines the thickness of the joint shell, the condition of the joint structure, the presence of any kind of inflammation and general changes in the knee.
• Dopplerography - examination of blood vessels and arteries for aneurysms, plaques and blockages. Quickly and effectively determines the possible risks and the percentage of the condition of the inner walls of blood vessels.
• MRI is currently the most accurate method of diagnosis. Clear, three-dimensional shape of the knee joint, pathological changes in the synovial fluid, even a slight deformation of bone tissue, etc. For many, it is rarely prescribed due to its high price and contraindications. It is forbidden to examine patients with implants, metal prostheses and weighing more than 150 kg.
• CT - the principle of operation is based on X-rays, only in a more modern way. Images are taken in a circular projection, which allows you to get a more accurate picture of the knee joint, and thus determine the nature and extent of the lesion.
• Angiography is a method of checking the openness of blood vessels by injecting contrast fluid. Determines the functionality of metabolic processes and allows the diagnosis of articular defects in the early stages.
• Complete blood count - is determined to determine inflammation and pain. The sum of the indicators can even lead to the traces of specific diseases, and articular pathologies can be identified only at the very beginning of progress.
• Blood for rheumatoid antibodies - also indicates the presence of inflammation, but it is specific, systemic or hereditary. For example, this test is used to diagnose rheumatoid arthritis.
• Uric acid is an important test to determine the causes of pain and the stage of exacerbation of gout or infectious arthritis. A high level indicates the accumulation of salt deposits in the joints.
• Wasserman's reaction - suspected sexually transmitted infections, syphilis, gonorrhea, chlamydia, etc. The development of joint diseases, such as specific diseases or their complications, is very common. Therefore, a positive test will allow you to determine the correct treatment, taking into account the type of infection.
• Tumor markers - help to identify specific substances secreted in the blood by cancerous neoplasms or their metastases. Thus, synovial sac sarcoma is characterized by the presence of markers of viment, extracellular antigen, and pancytokeratin.

Treatment of pain in the knee joints

Knee pain can be divided into those who require emergency medical care. And pre-diagnosed. Emergency conditions include all injuries, fractures, dislocations, abscesses, purulent inflammation, hemarthrosis (bleeding in the joint). In all cases, the symptoms are the same - unbearable pain, swelling, redness, inability to move, fever in the knee joint and fever.

Treatment is limited to providing first aid until the ambulance arrives:

• feet should be raised - put a rolling pin or a stiff pillow;
• Put a bandage with ice on the knee and change it every 5-10 minutes;
• Take an existing painkiller.

In all other cases, treatment is carried out after a thorough examination and identification of the causes. Based on the anamnesis, drug treatment, physiotherapy, exercise therapy, massage, homeopathic treatment, local applications, spa vacations and, in extreme cases, surgery are prescribed.

Conservative therapy

Traditional drug treatment of pain includes the following groups of drugs:

1. Anesthetics. You can take simple over-the-counter painkillers to relieve the initial symptoms and alleviate the painful condition. In severe cases associated with loss of mobility and excruciating pain, more serious medications that can only be prescribed by a doctor and obtained by prescription are required.
2. NSAIDs. Helps quickly eliminate inflammation & swelling
3. Chondroprotectors. Modern medicine, even if it lasts a long time, provides the restoration of cartilage tissue. The effect is cumulative and long-lasting (up to 10 years, with early treatment, joint pain may not be a concern after a six-month course).
4. Glucocorticosteroids. It is indicated for patients with autoimmune pathologies to reduce the production of the hormone cortisol and stop the progression of the disease. Doses and regimens are strictly determined by the doctor individually.
5. Immunosuppressants. They suppress the abnormal functioning of the immune system, thereby stabilizing the course of dangerous diseases such as rheumatoid arthritis, lupus erythematosus and vasculitis. They are rarely prescribed, only if an accurate diagnosis and knee pain can not be eliminated by other means.
6. Hyaluronic acid injections. They are injected directly into the cavity of the knee joint and relieve pain and deficiency of synovial fluid. They also help restore hyaline cartilage, thereby restoring knee mobility.

Folk recipes

Most people who start to feel pain in the knee joint try to relieve the discomfort with folk remedies. You can make lotions, compresses and night applications based on homemade ointments or tinctures. A decoction of herbs for topical use, alcohol tinctures will help prevent the period of exacerbation and relieve obsessive pains.

The following herbs and substances have anti-inflammatory effects:

• Coltsfoot;
• St. John's wort;
• oak bark;
• burdock root;
• Bay leaf;
• Chamomile flowers;
• calendula;
• White and black kaolin clay;
• salt and soda solution;
• Honey products.

For example, mix 10 previously crushed aspirin and a glass of liquid honey. Apply a thick layer to the knee at the site of pain localization. Cover with cling film and wrap in woolen material (scarf), preferably overnight. The pain disappears after the first application.

In the same way, you can apply a clay application where pain is visible. A little olive oil is added to the clay and water mixture to prevent the skin from hardening and shrinking.

An effective recipe that contains honey, salt and soda. Mix honey with 1 teaspoon of salt and soda until it covers the knee joint. This method performs three actions at once - removes excess fluid, eliminates inflammation and pain, enriches it with nutrients.

Oak bark in the form of a decoction or alcohol tincture strengthens blood vessels well, promotes normal blood circulation. For one decoction, pour 1 tablespoon dried bark with 1 cup of boiled water, cook in a water bath for 20 minutes. Soak the dose in the decoction and apply to the knee in a warm (not hot) form for 30-50 minutes to relieve pain in the knee joint. Use the same proportion for alcohol tincture, just replace the juice with vodka. Insist 10-14 days in a cool dark place. Apply in the same way.

By changing the various tools and methods, you can protect the disease for a long time, forget about pain and swelling. The effectiveness of alternative medicine has not been proven, despite the elimination of the initial symptoms - pain in the knees.

Massage and therapeutic exercises for pain in the knee joints

The complex traditional treatment includes mandatory exercise therapy and massage. Exercise is recommended for all people with or without knee injuries, diagnosed with arthritis, osteoarthritis and other joint diseases, leading a sedentary lifestyle (sedentary static work, 1-2 groups of disabilities, housewives, etc. ).

Gymnastics can be performed independently, at a slow pace and in a possible mode. Gradually increase the number of exercises, depending on how you feel, or vice versa.

1. From a lying position or sitting in a chair, slowly bend and open your legs, doing so until a slight state of fatigue appears.
2. Bend the leg at the knee, perform small amplitude rotational movements, repeat the same thing on the second leg.
3. Lying on your back, gently pull your legs bent at the knees to your stomach.
4. Put a pillow on the chair and sit down to "swing" your legs, make circular movements in a clockwise and counterclockwise direction.
5. Sitting in a chair, slowly stretch your legs and hold this position for 2-5 seconds, slowly lower, repeat on the second leg.
6. Stand up straight, straighten your back, slowly bend your legs at the knees and lie down in a "heron" position for a few seconds. If possible, increase the delay every 2 days.
7. If there are no contraindications and health allows, you can complicate the complex. Place the gymnastic bar at the maximum level that can be achieved with one foot bent at the knee. Throw your foot on the "barrier" 10-15 times, then change position.
8. A small complex for the extension of the lower leg also helps in the rapid recovery of the knee joint. Lean your palms against the wall, bend your right leg at the knee, put your left foot back. The feet stand fully on the ground. Hold the pose for 30 seconds. Change legs.

Regular performance of simple gymnastics, accessible to any person, will give visible results within a month - pain in the knee joint will stop worrying, joint mobility will improve, swelling will disappear.

If you combine it with a massage course, the effectiveness of gymnastics will increase significantly. It can be both a traditional method of exposure and hand therapy for pain. Just keep in mind that such procedures should be performed only by experienced professionals with good recommendations. Otherwise, hand manipulations, at best, will not have the slightest effect, at worst, will provoke joint displacement and aggravate the pathological condition. Massage should be performed periodically, no more than 10 sessions, 25-30 minutes a month. Daily procedures are strictly contraindicated. There should be no pain in the knee during the session. If discomfort is felt, the procedure should be stopped.

Home treatment

Treatment of knee pain at home is a prerequisite for outpatient therapy. The patient should be helped to relieve pain and recover as quickly as possible.

Therefore, for these purposes, it is necessary to follow some rules for the treatment of all types of pain:

• Follow all the recommendations of the treating doctor - do not miss the prescribed medication, do possible gymnastics, come on time for physiotherapy.
• Review your diet. Add lots of fresh vegetables, greens and fruits to your diet. Exclude fatty meats, fried foods and semi-finished products.
• If necessary, use aids to relieve the load on the knee joint - cane, armpit and other special devices.
• Do not use traditional medicine prescriptions, even time-tested and neighbors, without first consulting a doctor. What works for one person may not work for another.
• During treatment, avoid physical activity if possible and provide bed rest to prevent recurrence of pain (except for therapeutic exercises).
• Provide a comfortable place to sleep and relax - orthopedic mattresses, comfortable chairs and armchairs, preferably with small stands, you can easily lift your aching feet.
• Light self-massage is allowed. Squeezing and rubbing stimulates blood circulation, thereby enriching the tissues with oxygen. Thus, muscle spasm is eliminated and the pain is less intense.

Preventive measures

It is almost impossible to completely insure against damage, twisting or dislocation of the most loaded joint in the body. Everyday life allows you to do housework, go to work, and so on. It is quite possible to get an unexpected injury during normal activities. However, it is everyone's responsibility to reduce the risk of developing joint diseases. Leading rheumatologists have developed a number of recommendations to help protect yourself from dangerous pathologies:

• Establish a rational regime and follow it strictly - work-rest. This is especially true for people whose activities are associated with increased physical activity (athletes, builders, salespeople, metallurgists, miners, etc. ).
• Get timely treatment and rehabilitation after any infectious disease. This rule applies even to those who are "harmless" such as acute respiratory infections or seasonal SARS.
• Avoid exposure to low temperatures and drafts. Dress appropriately for the weather to prevent hypothermia.
• It is recommended to undergo a course of treatment with chondroprotectors after the age of 35.
• Watch your weight carefully. Weight gain will inevitably increase the load on your knees, which is worth remembering when eating another bread.
• Follow healthy eating principles to keep your weight normal. More vegetables and dairy products - less sweet, spicy, salty, fatty and starchy foods.
• Reconsider your lifestyle - quitting smoking, alcohol and other toxic addictions will have a positive effect not only on the knee joints, but also on life in general. You can turn to your relatives for help in overcoming addictions - the difficult stage will pass faster and easier.

Everyone, regardless of age, gender or social status, felt pain in the knee joints. From the first steps, it undergoes all kinds of tests together - falls, bruises, injuries, sports, hypothermia. However, many people are able to maintain the mobility, health and functionality of the main joint until old age.