The knees are considered the most worn joints in the human body. According to statistics, every third patient with musculoskeletal problems complains of pain. This symptom can be a manifestation of a serious pathology, especially if both knees hurt. In order not to waste time and maintain leg mobility, it is important to consult a doctor immediately after discomfort occurs.
Where does the pain come from?
The knee is a large block joint of the legs, the structure of which includes rather large bones (femur, tibia and patella), a joint cavity lined with hyaline cartilage and several pairs of ligaments (main, upper and lower vertical, internal and external lateral, sacrum) and menisci.
Pain receptors are not located in all elements, so when you complain of pain in the knee joints, it is most often localized:
- in the synovium;
- ligaments;
- periosteum.
Good to know! The elements of the knees, which consist of cartilage, are deprived of innervation, so by definition they cannot hurt. Although the cause of discomfort is the destruction of the tissue lining the joint, pain indicates that the peritoneum and joint capsule lining are involved in the process.
Pain can be caused by:
- degenerative-inflammatory processes in the cartilage lining the joint;
- infections in soft connective tissue, cartilage tissue;
- inflammation of the joints (bursa, cartilage, tendons);
- injuries to ligaments, menisci, bones;
- circulatory disorders in the knee area.
Each group of pathologies is characterized by specific signs, the identification of which helps to determine the diagnosis and choose the appropriate treatment.
Degenerative-inflammatory diseases
Arthritis (gonarthrosis) accounts for up to a third of all cases of pain localized 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 osteoarthritis, patients complain of creasing and deformation of the joints. Swelling, redness and heat in the joints of the legs are not typical of this disease.
Meniscus injuries
Meniscus injuries are characterized by the sudden appearance of the main symptom - acute 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 audible and felt crunch in the knee.
The intensity of the pain is so severe that it is impossible to bend or lift the affected leg. After fifteen minutes the symptom subsides. If no help is given, inflammation develops within 24 hours:
- swelling appears in the area of the injured knee;
- pain syndrome intensifies;
- mobility is limited.
When trying to lean on the leg, a sharp piercing pain occurs, due to which the limb bends. If you do not consult a doctor for therapy, all the listed symptoms gradually subside and disappear after about a month. But after a long walk, hypothermia or exercise, they return.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, synovitis are often a companion to degenerative diseases and injuries. The nature of pain in inflammatory pathologies is aching, twisting or bursting, sometimes burning.
Good to know! Unlike other causes, discomfort in the knees with arthritis increases at rest, during sleep, and decreases during movement. The symptom becomes particularly strong after prolonged physical exertion.
The disease is accompanied by swelling, redness of the joints, and when the joint capsule is involved, it may be accompanied by fluid retention. The deformation that occurs looks like an elastic lump on the surface of the knee. The skin over it tightens, becomes shiny and turns red.
Common blood supply disorders
So-called vascular pain often occurs in adolescence and follows a person throughout life. The reason for their appearance may be the uneven growth of various tissues in the limbs: the bones "overtake" the vessels and muscles, causing tension in the latter.
Characteristic features of vascular symptoms in the knees:
- symmetry - discomfort occurs in both limbs;
- worsening of pain occurs with a sharp change in temperature, change in weather, physical activity;
- quickly weakens after massage.
This type of pain does not require special treatment, apart from the use of local remedies.
Tendonitis
Periarthritis of the crow's feet (one of the ligaments in the knees) is typical for older women. The symptom only occurs when carrying heavy objects and going down stairs. When you bend or move on a flat surface, there is no discomfort or it is very weak. There is no significant limitation in the mobility of the affected limb. There is no swelling, redness or deformation during periarthritis.
Treatment methods
It is advisable to leave the treatment of knees to doctors - an 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 the elimination of the symptom, but also the restoration of its functionality and the prevention of repeated exacerbations.
Before starting treatment, diagnostics are carried out:
- radiography of the joint, which allows you to visualize damage to bones, cartilage and menisci;
- CT or MRI are methods that can detect abnormalities in blood vessels, soft tissue, bones and cartilage;
- Ultrasound of joints, which allows you to detect cartilage damage and determine 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 chosen based on the diagnosis, but the schedule is always the same:
- The initial phase is symptomatic treatment and pain relief.
- The main stage is to eliminate the causes of discomfort.
- The final stage is the restoration of the joints.
To eliminate symptoms, conservative therapy using painkillers and anti-inflammatory drugs is sufficient. They are prescribed in the form of local agents - ointments, gels - and in tablets for oral administration. In addition, doctors recommend distractions and warming agents.
In the initial phase, it is important to give rest to the affected joint. It is necessary to exclude loads:
- long walk;
- lifts weights;
- play certain sports that require active squats or jumps.
If a limb is injured, on the advice of the attending physician, you can use a tight immobilizing bandage, an orthosis or even a cast.
Additional medication may also be prescribed depending on which diagnosis was made:
- general tonics and vitamin-mineral complexes;
- NSAIDs, including in the form of injections;
- preparations with chondroitin and glucosamine;
- agents that accelerate the regeneration of damaged tissue.
After objective improvement, a course of general strengthening exercises, physiotherapy, massage and exercise therapy is prescribed to restore the functionality of joints, strengthen muscles and ligaments.
If conservative therapy is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct indications for them are:
- intense pain that is not corrected by analgesics;
- 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 cartilage that changes or blocks the functionality of the joints;
- damage to the internal elements of the joint - bone, cartilage, menisci, cruciate ligament.
After surgery, conservative therapy is continued to prevent complications and relieve discomfort. To restore mobility, strengthen and stabilize the joints of the legs, rehabilitation is carried out, consisting of physiotherapy, exercise therapy, massage, hydrotherapy, etc. To prevent repeated exacerbations, it is recommended to moderately load the limbs, avoid hypothermia and consult a doctor immediately if discomfort occurs.