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 the mobility of the legs, it is important to consult a doctor immediately after the appearance of discomfort.
Where does the pain come from?
The knee is a large block joint in the legs, the structure of which includes several large bones (femur, tibia and patella), a joint cavity lined with hyaline cartilage, as well as several pairs of ligaments (main, upper and lower vertical, internal and externallateral, cruciate) and menisci.
Pain receptors are not located in all elements, so when you complain of pain in the knee joints, it is most often located:
- in the synovial membrane;
- links;
- periosteum.
Good to know! The elements of the knees, which are made up of cartilage, lack innervation, so by definition they cannot hurt. Even if the cause of the discomfort is the destruction of the tissues covering the joint, the pain indicates that the periosteum and the lining of the synovial capsule are involved in the process.
Pain can be caused by:
- degenerative-inflammatory processes of the cartilage covering the joint.
- infections of soft, connective, cartilaginous tissues.
- 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 points, the recognition of which helps to determine the diagnosis and choose the appropriate treatment.
Degenerative-inflammatory diseases
Arthritis (knee joint) accounts for up to a third of all cases of pain located in one or both knees. This disease affects older people and develops gradually. Mild discomfort after exercise gradually becomes commonplace, and after 2-3 years, walking even short distances is accompanied by pain in one knee or both legs at the same time.
In addition to discomfort with arthropathy, patients complain of cracking and deformity of the joints. Swelling, redness and heat in the joints of the feet are not typical for 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 occurs during active movement: running, jumping, during an unsuccessful maneuver on skis or skates. The process is accompanied by a clearly audible and felt tingling in the knee.
The intensity of the pain is so intense that it is impossible to bend or lift the affected leg. After a quarter of an hour the symptom subsides. If no help is provided, inflammation develops within 24 hours:
- swelling occurs in the area of the injured knee.
- the pain syndrome intensifies.
- mobility is limited.
When you try to lean on the leg, a sharp piercing pain occurs, due to which the limb bends. If you do not consult a doctor for treatment, all the symptoms listed gradually subside and disappear after about a month. However, after a long walk, hypothermia or training, they return.
Inflammatory processes and infections
Infectious and non-infectious arthritis, bursitis, arthritis is often a companion of degenerative diseases and injuries. The nature of pain in inflammatory pathologies is pain, twisting or bursting, sometimes burning.
Good to know! Unlike other causes, knee discomfort with arthritis increases at rest, during sleep, and decreases during movement. The symptom becomes particularly intense after prolonged physical exertion.
The disease is accompanied by swelling, redness of the joints and when the joint capsule is involved it can be accompanied by fluid accumulation. The deformity that appears looks like an elastic bump on the surface of the knee. The skin on it tightens, becomes shiny and reddened.
Disorders of blood supply to the joints
The so-called vascular pain often appears in adolescence and accompanies a person throughout his life. The reason for their appearance may be the uneven development of different tissues of the limbs: the bones "bypass" the vessels and muscles, which causes tension in the latter.
Distinctive features of vascular symptoms in the knees:
- symmetry - discomfort occurs on both extremities.
- exacerbation of pain occurs with a sharp change in temperature, change in weather, physical activity.
- fade quickly after massage.
This type of pain does not require special treatment, except for the use of local remedies.
Tendon inflammation
Peonitis (one of the joints in the knees) is characteristic of older women. The symptom occurs only 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 deformity during periarthritis.
Treatment methods
It is recommended to entrust the treatment of the knees to doctors - orthopedist, traumatologist, rheumatologist or surgeon. Specialists from other fields can also participate in the treatment: physiotherapists, chiropractors, massage therapists. The goals of treatment 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:
- X-ray of the joint, which allows you to visualize the damage to the bones, cartilage and menisci.
- CT or MRI are methods that can detect abnormalities of the blood vessels, soft tissues, bones and cartilage.
- Ultrasound of the 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 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 the elimination of the causes of discomfort.
- The final stage is the restoration of the joints.
To eliminate the symptoms, conservative treatment with painkillers and anti-inflammatory drugs is sufficient. They are prescribed in the form of topical drugs - ointments, gels - and in tablets for oral administration. In addition, doctors recommend distracting and warming agents.
In the initial stage, it is important to provide rest to the affected joint. It is necessary to exclude loads:
- long walk;
- I am lifting weights;
- practicing 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 immobilization bandage, an orthosis or even a cast.
Additional medications may also be prescribed depending on the diagnosis made:
- general strengthening agents and vitamin-mineral complexes.
- NSAIDs, including injectable form.
- Preparations with chondroitin and glucosamine.
- factors that accelerate the regeneration of damaged tissues.
After objective improvement, a course of general strengthening exercises, physiotherapy, massage and exercise therapy is prescribed to restore joint functionality, strengthen muscles and ligaments.
If conservative treatment is ineffective, radical methods are used - minimally invasive and surgical interventions. Direct indications of these are:
- severe pain that is not corrected with pain relievers.
- formation of purulent exudate in the joint cavity or purulent cavity in the soft tissues of the joints.
- partial or complete occlusion of the joint.
- significant deformation of the cartilage that changes or prevents the functionality of the joints.
- damage to the internal elements of the joint - bone, cartilage, menisci, cruciate ligaments;
After surgery, conservative treatment 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, massage, hydrotherapy, etc. To avoid repeated exacerbations, moderate loading of the extremities, avoidance of hypothermia and consulting a doctor immediately if discomfort occurs are recommended.