Pain in the knee joint - causes, effective treatment, diagnosis

Every person experiences pain in the knee joint from time to time. This may be the result of a sudden movement or a symptom of a progressive pathology. The knee joint is the largest and anatomically complex element of the musculoskeletal system. It accounts for up to 80% of physical weight, which leads to increased physical activity and the risk of injury. A large number of capillaries, nerve fibers and muscle tissues make every injury, even minor, extremely painful. Injured nerves cause an infectious-inflammatory process, which is accompanied by swelling, discoloration of the skin and increased local temperature.

As progress progresses, the joint itself, intra-articular fluid and connective tissues are drawn into the pathological state, which can have serious consequences - the development of arthritic diseases. A general understanding of the anatomical structure of the knee joint will help you understand which element can cause pain, and what measures should be taken to eliminate pain.

Anatomical structure

The anterior zone of the joint is formed by the patella, in a simpler language - the patella. It is connected with the quadriceps (fascicular) thigh muscle, which continues in the patellar ligament and, in general combination, forms a ligamentous apparatus, which consists of the following types of fascia:

• Lateral branches from the tibia (small and large);
• rear supporting nodes - sickle-shaped, dorsal, median and lateral;
• articular transverse and cruciate ligaments of the knee.

The cruciate ligaments are most susceptible to injury - a sharp movement, a large degree of rotation, a fall with subluxation lead to ruptures 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 large femur, intersect with the posterior ligaments in the cavity of the knee and attach to the notch between the anterior protrusions of the tibia.
2. Rear - restrain the lower leg from shifting back. They start from the anterior upper part of the femur, cross the joint cavity and end between the dorsal protrusions of the tibia.

On the surface of the articular bones is cartilage. At the junction of the tibia and femur, there are menisci - a kind of joint lining that performs a shock-absorbing and stabilizing role.

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

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

Thanks to the knee, a person can perform a step, flexion, extension within the limits indicated by the ligaments.

Causes of pain

Inflammation can develop in the following structures:

• cartilage;
• joint sheath;
• synovial fluid;
• tibia bones;
• muscles and tendons surrounding the joint;
• ligament 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 cases. It is characterized by slow, gradual destruction of hyaline cartilage. For a long time, it can be asymptomatic and sharply aggravate in the second stage. Pain in the knee joint occurs due to growing osteophytes that affect the nerve endings;
2. Arthritis is an inflammatory pathology that occurs in an acute form. It can be either an independent disease - spondylitis, or a complication of other articular pathologies - arthrosis, rheumatism, etc. Arthritis is characterized by intense pain, accompanied by swelling and redness;
3. Osteochondritis - articular cartilage becomes inflamed over time with degenerative arthrosis, mechanical injuries;
4. Periarthritis is a disease that occurs against the background of obesity (more often in women). Pathology affects the tendons, muscles and subsequently passes to the shell of the knee joint. The pain is moderate, pulling (as in a sprain).
5. Chondromatosis is the formation of nodes on the tissue of hyaline cartilage, which eventually spread throughout the capsule of the knee joint. In this case, pinching of soft tissues with a large number of nerve cells occurs. Because of this, the knee hurts constantly, even during the rest period.
6. Bursitis - the synovial capsule of the knee joint rarely inflames itself, only as a result of injuries or complications of collateral joint diseases, hence the pain.
7. Cellulite - subcutaneous fatty tissue can cause pain only in the case of closely spaced foci of concomitant diseases. Purulent arthritis, soft tissue abscess can cause inflammatory and painful processes in the protective layer.
8. Dermatitis - the epidermis is affected in case of infectious pathologies (eczema, erysipelas, psoriasis) or allergic reactions to external stimuli.
9. Osteomyelitis - the bone marrow becomes inflamed due to bacteria that have entered the jelly-like body along with the lymph flow. It can also be the result of open injuries or a complication of surgical operations.
10. Synovitis - the capsule of the knee joint is most often affected in older people over the age of 55, as a result of rheumatism or other chronic pathologies. At a young age, you can get sick due to a severe injury.

Types of pain depending on location

Diseases that provoke the development of negative processes also form the type of pain:

• Intense, excruciating pain - reactive arthritis, torn menisci and tendons, bursitis in the acute stage;
• Tolerable, but constant pain - synovitis, bursitis in the initial degree;
• Pinching pain - gonarthrosis, arthrosis;
• Vibrating - degenerative arthrosis, in the stage of joint deformation;
• Acute, burning pain - compression of the sciatic nerve, bone tuberculosis;
• Stinging - osteoporosis, progression of inflammation of the synovial bag, exacerbation of chronic meniscus injury;
• Cramping - inflammation in the soft tissues of the knee joint, muscles and tendons;
• Shooting pain - damage to the nerve roots.

Diagnostic measures

If you experience intense pain in the knee joints, you should not postpone a visit to the doctor, hoping that "everything will pass. "Diagnosis at an early stage ensures successful treatment and prevents the development of more serious processes that can cause irreparable damage to health and quality of life. For an initial consultation, you should contact a therapist. After a standard examination, he decides to prescribe treatment (which happens in 70% of cases of complaints of knee pain) or prescribes a comprehensive laboratory and hardware examination, with the involvement of highly specialized specialists.

Running, suspicious pains are studied in different directions:

• Traumatology: if you suspect arthrosis, congenital or acquired dysplasia, articular fracture, dislocation, displacement, radiography, MRI, ultrasound, fluid biopsy in the synovial sac is prescribed to find out where the pain in the knee joint comes from.
• Surgery: cyst under the patella, thrombosis, arthritis with purulent formations, ruptures in the tendons, menisci, ligaments, stones inside the joint, hemarthrosis, abscesses are diagnosed by ultrasound, fluoroscopy, CT or MRI, blood tests, general and rheumatoid factor, hyaline puncturecartilage in the knee joint, etc.
• 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: pinched sciatic nerve does not require a long diagnosis. Already on ultrasound, muscle tone and inflammation sites will be visible. In the case of mental disorders, when the pain in the knee joint is not confirmed by a single fact, but the patient continues to experience torment (the so-called somatic pain), specific studies are prescribed for mental abnormalities.

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. The pictures show lesions already in the early stages, in particular changes in the bone, synovial bag or the appearance of osteophytes.
• Ultrasound examination - a modern, high-precision examination determines the thickness of the joint shell, the state of the ligamentous structure, the presence of inflammation of any type and general changes in the knee.
• Dopplerography - Examination of veins and arteries for aneurysms, plaques, and blockages. Quickly and effectively determines the possible risks and the condition of the internal walls of blood vessels in percentage terms.
• MRI is currently the most accurate way of diagnosing. Allows you to see a clear, three-dimensional picture of the knee joint, pathological changes in the synovial fluid, even a slight deformation of the bone tissue, etc. It is rarely prescribed, due to the high, for many, cost and contraindications. It is forbidden to undergo examination for 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. The images are taken in a circular projection, which allows you to get a more accurate picture of the knee joint and thereby determine the nature and extent of the lesion.
• Angiography is a method of examining blood vessels for patency by injecting a contrast fluid. Determines the functionality of metabolic processes and allows diagnosing articular insufficiency in the early stages.
• Complete blood count - is prescribed to identify inflammation and pain. The totality of indicators can even lead to the trail of specific diseases and determine articular pathologies only at the very beginning of progression.
• Blood for rheumatoid antibodies - also indicates the presence of inflammation, but of a specific, systemic or hereditary nature. For example, to establish a diagnosis of rheumatoid arthritis, this analysis is taken as a basis.
• Uric acid is an important test for determining the causes of pain and the stage of exacerbation of gout or infectious arthritis. An elevated level indicates the accumulation of salt deposits in the joints.
• Wasserman's reaction - is prescribed for suspected sexual infections, syphilis, gonorrhea, chlamydia, etc. The development of joint diseases against the background of specific diseases or as their complications are very common. Therefore, a positive test will make it possible to prescribe the correct treatment, taking into account the type of infection.
• Tumor markers - help to identify special substances in the blood that secrete a cancerous neoplasm or its metastases. So, for the sarcoma of the synovial bag, the presence of markers of vimentin, cellular external antigen and pancytokeratin is characteristic.

Treatment of pain in the knee joints

Pain in the knees can be divided into those that require emergency medical attention. And those that are pre-diagnosed. Urgent conditions include all injuries, fractures, dislocations, abscesses, purulent inflammation, hemarthrosis (bleeding into the joint). Symptoms in all cases are identical - unbearable pain, swelling, redness, inability to move, fever in the knee joint and a feverish state.

Treatment is limited to providing primary care until the ambulance arrives:

• the leg should be raised - put a rolled roller or a hard pillow;
• put a bandage with ice on the knee and change it every 5-10 minutes;
• take an available pain reliever.

In all other cases, treatment is carried out after conducting comprehensive studies and establishing the causes. According to the anamnesis, drug therapy, physiotherapy, exercise therapy, massage, homeopathic treatment, local applications, spa holidays and, in extreme cases, surgery are prescribed.

Conservative therapy

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

1. Anesthetics. To relieve the initial symptoms and alleviate the painful condition, you can take simple over-the-counter pain relievers. Severe cases associated with loss of mobility and unbearable pain require more serious drugs that are prescribed only by a doctor and are dispensed by prescription.
2. NSAIDs. Helps quickly relieve inflammation and swelling.
3. Chondroprotectors. Modern drugs, despite the long course of administration, provide regeneration of cartilage tissue. The effect is cumulative and long-lasting (up to 10 years, joint pain may not bother after a six-month course, subject to treatment in the early stages).
4. Glucocorticosteroids. Indicated for patients with autoimmune pathologies to reduce the production of the hormone cortisol and stop the progress of the disease. Doses and regimen are prescribed by the doctor on a strictly individual basis.
5. Immunosuppressants. They suppress the abnormal action of the defense system, thereby stabilizing the progress of such dangerous diseases as rheumatoid arthritis, lupus erythematosus, and vasculitis. They are rarely prescribed, only in the case of an accurate diagnosis and the inability to eliminate knee pain in other ways.
6. Hyaluronic acid injections. They are injected directly into the cavity of the knee joint and eliminate pain and deficiency of synovial fluid. They also contribute to the restoration of hyaline cartilage, thereby restoring knee mobility.

Folk recipes

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

The following plants and substances have anti-inflammatory effects:

• Mother and stepmother;
• St. John's wort;
• oak bark;
• Burdock root;
• Bay leaf;
• Chamomile flowers;
• Calendula;
• White and black kaolin clay;
• A solution of salt and soda;
• Honey products.

For example, mix 10 aspirin tablets, previously crushed, and a glass of liquid honey. Apply a thick layer on the knee in the area of pain localization. Cover with cling film and wrap with woolen material (scarf), preferably left overnight. The pain is eliminated after the first application.

In the same way, you can apply a clay application where pain appears. A little olive oil is added to the mixture of clay and water to prevent hardening and severe tightening of the skin.

An effective recipe, which includes honey, salt and soda. Mix 1 teaspoon of salt and soda with honey, in an amount sufficient to cover the knee joint abundantly. This method performs three actions at once - removes excess fluid, relieves inflammation and pain, enriches with nutrients.

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

By alternating various means and methods, you can preserve 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 primary symptoms - pain in the knees.

Massage and therapeutic exercises for pain in the knee joints

Comprehensive traditional treatment necessarily includes exercise therapy and massage. Exercises are recommended for all people who have had, or have, knee injuries, diagnosed with arthritis, arthrosis and other joint diseases, leading an inactive lifestyle (sedentary static work, disability of 1-2 groups, housewives, etc. ).

Gymnastics can be performed independently, at a slow pace and feasible mode. Gradually increase the number of exercises or, conversely, reduce, depending on how you feel.

1. From a lying position or sitting on a chair, slowly bend and unbend your legs, do until a state of slight fatigue appears.
2. Bending the leg at the knee, perform rotational movements in a small amplitude, repeat the same on the second leg.
3. Lying on your back, gently pull the legs bent at the knees to the stomach.
4. Put a pillow on the chair and sit down so that the legs "dangle", perform circular movements clockwise and vice versa.
5. Sitting on a chair, slowly stretch your leg and hold in this position for 2-5 seconds, just as slowly lower it, repeat on the second leg.
6. Stand up straight, straighten your back, slowly bend your leg at the knee and linger in the "heron" position for several seconds. If possible, every 2 days, increase the delay time.
7. If there are no contraindications and health allows, you can complicate the complex. Put the gymnastic stick at the maximum level, which can be reached with a leg bent at the knee. Throw the leg over the "barrier" 10-15 times, then change position.
8. A small complex for stretching the lower leg also contributes to the rapid recovery of the knee joint. Lean your palms on the wall, bend your right leg at the knee, put your left leg back. Feet fully rest on the floor. Hold the pose for 30 seconds. Change legs.

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

The effectiveness of gymnastics will increase significantly if you combine it with a massage course. It can be both a traditional method of exposure, and manual therapy for pain. It should only be remembered that only experienced professionals with good recommendations should be trusted to carry out such procedures. Otherwise, manual manipulations, at best, will not have the slightest effect, at worst, they will provoke joint displacement and aggravate the pathological condition. Massage should be carried out periodically, no more than 10 sessions, 25-30 minutes per month. Daily procedures are strictly contraindicated. During the session, there should be no pain in the knee. If discomfort is felt, the procedure should be stopped.

Treatment at home

Treatment of knee pain at home is a prerequisite for outpatient therapy. The patient by all permitted methods should help himself to relieve pain and recover as quickly as possible.

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

• Follow all the recommendations of the attending physician - do not miss taking prescribed medications, do feasible gymnastics, come on time for physiotherapy.
• Review your diet. Add plenty of fresh vegetables, herbs and fruits to your diet. Exclude fatty meat, fried foods and semi-finished products.
• If necessary, use auxiliary means to relieve the load from the knee joint - a cane, crutch and other special devices.
• Do not use, without prior consultation with a doctor, traditional medicine recipes, even time-tested and neighbors. What helps one person may be categorically contraindicated for another.
• During the treatment period, if possible, avoid physical activity and ensure bed rest so that the pain does not return (therapeutic exercises are an exception).
• Provide a comfortable place to sleep and rest - orthopedic mattresses, comfortable chairs and armchairs, preferably with small stands so that you can comfortably raise your sore legs.
• Light self-massage is allowed. Stroking, rubbing promote blood circulation, thereby enriching the tissues with oxygen. Thus, muscle spasm is removed and pain becomes less intense.

Preventive measures

It is almost impossible to completely insure against injury, sprains or dislocations of the most loaded joint in the body. Everyday life obliges you to do your household chores, go to work, etc. In the course of normal activities, it is quite possible to receive an unexpected injury. But to reduce the risk of developing joint diseases is quite within the power of every person. Leading rheumatologists have developed a number of recommendations that will help protect yourself from dangerous pathologies:

• Establish and strictly adhere to a rational regime - work-rest. This is especially true for people whose activities are associated with increased physical activity (athletes, builders, sellers, metallurgists, miners, etc. ).
• Timely treat and undergo rehabilitation after any infectious diseases. This rule applies even to such "harmless" ones as acute respiratory infections or seasonal SARS.
• Avoid exposure to low temperatures, drafts. Dress for the weather to prevent hypothermia.
• Upon reaching the age of 35, it is desirable to undergo treatment with chondroprotectors.
• Carefully monitor your weight. Increasing body weight will inevitably increase the load on the knees, this is worth remembering when eating another bun.
• In order to keep the weight normal, adhere to the principles of a healthy diet. More vegetables and dairy products - less sweet, spicy, salty, fatty and starchy foods.
• Reconsider your lifestyle - giving up smoking, alcoholic beverages and other toxic addictions will have a positive impact not only on the knee joints, but also on life in general. To overcome addictions, you can turn to your relatives for help - the difficult stage will pass much faster and easier.

Every person experienced pain in the knee joints, regardless of age, gender or social status. From the first steps, the joint is subjected to all sorts of tests - falls, bruises, injuries, sports, hypothermia. Despite this, many people manage to maintain the mobility, health and functionality of the main compound until old age.