Knee pain (knee joint)

Knees are more susceptible to various injuries and diseases than other joints.A significant part of orthopedist-traumatologist and rheumatologist patients complain of severe knee pain.From this article you will learn what to do if you suddenly experience severe pain.She is being treated, the main thing is to seek medical help for her problems in time. 

What exactly hurts the knee?

The knee joint is the most complex joint, as it carries the main load.Structure: three bones (femur, tibia and patella form a single trochlear joint, consisting of two interconnected joints: femorotibial (tibiofemoral) and femoral-patellofemoral (patellofemoral).

The patella is a flat sesamoid bone (joint appendage) that is attached to the head of the femur, sliding in its concave groove and acting as a block.Structural features: the front surface of the patella is covered with periosteum, the back surface, connected to the femur, is covered with hyaline cartilage.The patella is strengthened by ligaments: main and lateral - vertical (upper and lower) and horizontal (lateral - inner and outer).

O transmits the force of the quadriceps femoris muscle to the musculoskeletal formations of the lower leg, ensuring the extension of the lower leg at the knee joint.The surface of the bones that form joints is covered with cartilage, which acts as a shock absorber.Additional shock absorbers that protect the joint from injury are two crescent-shaped cartilaginous menisci located between the femur and tibia.The joint is held in position by surrounding ligaments, tendons, and capsules.

Injuries and diseases affect different joint tissues.Not everyone can get sick.Thus, cartilage tissue does not have nerve endings and therefore can be destroyed invisibly and painlessly.But the ligaments and synovial membrane have many nerve endings and in case of injury or inflammatory processes they start to react immediately, which appears in the form of severe pain.With significant destruction of articular cartilage, pain may be associated with involvement of the periosteum, the outer layer of bone that has good innervation, in the process.

What to do if you have severe knee pain

Severe knee pain can appear suddenly or develop gradually.In any case, it often becomes unbearable.If severe pain occurs, you should calm down and immediately seek medical help.All this can be treated, specialists will be able to help even with advanced disease.If you can't go to the doctor right now, you can temporarily relieve the pain yourself.

But you must remember that if you have pain in the knee joint, this is a temporary measure;you still need to seek medical help;you can not do without it.And it is better not to be late.

How to treat knee and leg pain at home

To alleviate your condition with severe pain in the knee joint, you can take the following emergency measures:

• Treat the pain with tablets.
• Use external painkillers (ointment, gel).
• Injections.If tablets and external agents have no effect, the drug is administered as an intramuscular or subcutaneous injection.

Many medicines can be bought at a pharmacy without a prescription.

For chronic pain in the knee joints, when there is no significant inflammation, you can perform physical exercises that strengthen the muscular-ligamentous system, improve blood circulation and metabolism.Systematic training leads to a gradual decrease in pain, despite the fact that the legs are quite crunchy.

A rough set of exercises for knee pain:

1. Fixed knee.Lie on your back, bend one leg at the knee, lift it and keep it in this position for one minute;the second leg is stationary at this time;straighten and lower the leg very slowly, rest for 10 seconds and repeat the exercise with the other leg;repeat 10 times;
2. Double leg bend with knees near the face.Lie on your back, bend your legs at the hips and knees, fix the latter near your face and hold it like that for a minute.Then slowly straighten and lower your legs, rest for 10 seconds and repeat;do 5-6 approaches, gradually increasing the load.

Acute knee pain requires a state of rest;all physical activity and training are contraindicated.

In case of acute pain in the knee joint, accompanied by swelling and reddening of the skin, violation of the general condition, temperature, you cannot move the leg, you must keep calm.And only after the inflammation begins to decrease, you can first switch to passive exercises (performed by an assistant) and then to active exercises (performed by the patient himself).

What not to do if you are in pain

For chronic pain, the following should not be allowed:

• bruised knee - you can avoid this by arranging your life in such a way as to reduce the risk of injury to a minimum;
• excess body weight is an additional load on the knees, especially in the elderly;
• heavy physical activity, dancing, strength sports;You also don't have to run;
• any intoxication, so you need to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and foci of infection;
• wearing uncomfortable tight shoes, high-heeled shoes;
• stress, lack of sleep;
• sedentary lifestyle - you need to force yourself to move at certain intervals.

It is also impossible to apply warm compresses without a doctor's prescription: in case of purulent and hemorrhagic processes (with intra-articular bleeding), they can cause irreparable harm.

When you should go to the doctor urgently

If your knee hurts, urgent medical attention is required if the following symptoms appear:

• swelling, redness and tenderness in the knee combined with fever and general malaise;
• severe pain in the knee immediately after the injury or some time after it;
• gradual increase in pain intensity;
• pains that appear periodically after physical exercises, prolonged standing, sharp pointing of the foot;
• pain at night and associated insomnia;
• if the pain in the knee is very strong, constant, the feeling that the inside of the patella hurts.

In any case, knee pain should be a reason to consult a doctor.It makes no sense to treat yourself: it may temporarily reduce or eliminate the pain, but it will not stop the progression of the disease and the destruction of the joint.Treatment should be entrusted to a specialist.

What to do for severe knee pain of different types

Painful sensations in the knee can vary in nature and duration among people.They can be constantly painful or develop only under certain loads, at night, etc. For example, some pathological processes are characterized by pain in the knee when bending, others - pain in the knee when walking, etc.Only a specialist can understand what exactly hurts and why, and how to help the patient.

Knee pain due to coronavirus and other viral diseases

Viral infections can cause joint inflammation.As a rule, these diseases develop against the background of an existing infection and pass without any consequences after its termination.Thus, with influenza and other acute viral respiratory infections with acute fever, short-term joint and muscle pain and acute arthritis with inflammation and swelling of the knee joints may occur.Their course is favorable.

The infection with coronavirus has its own characteristics: it happens differently in each patient.Why this happens is not known.During the disease, painful joint pain, swelling and redness sometimes appear - a sign of acute arthritis, but then they go away.

Arthritis, which begins approximately one month after infection with the coronavirus, is more dangerous.The fact is that it has a significant effect on the immune system.Dysfunctions of the immune system lead to the development of autoimmune processes.This is especially dangerous for people who have close relatives suffering from chronic arthritis.Experts note a high risk of developing rheumatoid arthritis (RA) in such patients.The first sign of RA is stiffness in the morning (difficulty bending the knee).

If arthritis appears after recovery from a viral infection, you should immediately contact a rheumatologist.

Severe pain under the knee

This may be a sign of the development of a Baker's cyst - a distended synovial bursa with fluid located in the popliteal area.The cyst and the accompanying pain under the knee appear due to the fact that it is connected to the cavity of the knee joint and is filled with synovial fluid.In this case, reverse fluid flow is difficult for various reasons.Most often, the cyst develops against the background of bruises, arthrosis and arthritis of the knee.

A small cyst can go unnoticed for years.But with its considerable size, the surrounding tissues begin to compress, causing pain under the knee, which intensifies with physical activity, including walking and running.Women get sick more often.Sometimes the cyst disappears on its own, but often it progresses and increases in volume, which can lead to rupture or suffocation.

If you have pain under the knee, it is better to consult a doctor as soon as possible.Conservative treatment (removal of fluid from the cyst, injection of glucocorticoids) and surgical treatment (removal of the cyst) is performed.

Severe pain in the left or right knee

Severe pain in combination with swelling and redness of the skin over the right or left knee usually indicates the development of an acute inflammatory process.This can be nonspecific acute arthritis (the process can turn purulent), reactive arthritis, which begins a few days after a urogenital or intestinal infection.Both diseases present with similar symptoms;The correct diagnosis can be made only after a complete examination.

The right or left knee can suffer from microtrauma, for example, in athletes or workers in certain occupations that use more of one knee (usually the right).

It is important not to use folk remedies at an early stage, but to carry out the appropriate treatment, this will allow you to fully recover and forget the pain forever.But even with advanced diseases, a specialist will always be able to offer help and relieve pain.

Knee and leg pain

Depending on the cause of the disease, its course and the presence of complications, severe knee pain may include:

• in the shin below the knee– are rare, this may indicate compression of the nerve branches that innervate the muscles of the lower part of the leg by inflamed and swollen periarticular tissues in the knee area;pain under the knee in the back indicates compression of the branches of the sciatic nerve, and pain under the knee in the front indicates that the nerves innervating the front surface of the leg are affected;Such diseases are treated by a rheumatologist, but consultation with a neurologist is required;
• on the knee, on the thigh- it is often a sign of the post-traumatic inflammatory process in the femoral-patellar joint;in this case, patellofemoral pain syndrome develops;the pain is strong, aches, sometimes creaking, aggravated by walking;an orthopedic traumatologist and a rheumatologist will help you cope with pain;
• from the side, from the inside– pain can develop with injury and damage to the internal lateral articular ligament;the pain in the side is strong, throbbing, with hemarthrosis (intra-articular hemorrhage) - explosive, accompanied by joint imbalance, the whole leg creaking when moving;the same pain occurs when the external collateral ligament is compressed;help will be provided by an orthopedic traumatologist.

To eliminate the pain, you need to accurately determine its cause, and this is impossible to do on your own.A doctor's help is needed.

Patella pain in back, front and side

Pain in the patella is almost always the result of acute or chronic injuries:

• back knee pain- the causes are related to the damage of the femoral-patellar joint with the development of the patellofemoral pain syndrome;the pain is painful, constant, aggravated by walking;
• ahead– such painful sensations are caused by superficial bruises of the knee or frequent prolonged standing on the knees with microtraumas on the knee cap;pain is important, since the periosteum, rich in nerve endings, is injured;
• pain in the side of the kneein case of rupture or damage of internal or external horizontal patellar ligaments;the injury can develop with frequent long-term microtraumas of the ligaments, for example, during dancing;accompanied by bleeding in the joint cavity (hemarthrosis);the pain is strong, continuous, accompanied by swelling;walking movements are impaired.

To prevent the development of permanent joint dysfunction at the site of injury, you should immediately seek help from an orthopedic traumatologist.

Knee pain radiating to leg, heel, groin

The causes of acute pain radiating to the knee must be understood.The reason may be:

• femoral nerve block;the pain is acute, piercing in nature, starts sharply in the groin area, spreads along the front-inner surface of the thigh and knee, along the nerve branches it can reach the inner edge of the leg and heel;sometimes the patient has the impression that the knee hurts, but it is not so;
• arthritis (gonarthritis) of various origins: swelling of the joint leads to compression of the nerves and the spread of sharp pain in the knees to the groin and to the heel;in this case, a mainly aching pain is felt in the knee, which with sudden movements turns into acute pain with radiation above and below the knee;
• bruising accompanied by hemarthrosis, rupture of ligaments, severe swelling and compression of nerves;
• bruising with a fracture or displacement of the patella and joint imbalance;Acute pain in the knee extends down the thigh to the groin, along the inner surface of the leg - below, to the heel.

Severe knee pain of this nature requires immediate medical attention.No folk medicine will help, you need to call an ambulance.

Knee pain when stretching and bending

Most often, pain in the knee during bending and stretching, as well as during squatting, is a sign of tendonitis - an inflammatory process in the area of the tendon-ligament apparatus of the knee joint.It develops mainly in young people involved in sports and is a consequence of frequent repeated microtraumas associated with constant jumping and swinging of the limbs.The first sign is the inability to straighten the knee without pain.

The cause of painful bending and stretching of the knee can also be arthrosis - degenerative-dystrophic changes in the joint with the growth of connective and bone tissue that hinders movement.

Only the treatment of tendinitis or arthrosis helps to relieve the patient from severe pain in the knee when bending and stretching.

Severe knee pain at night

Night pain is characteristic of inflammatory processes.This may be latent arthritis, periodic inflamed knee joint due to arthrosis (arthrosis-arthritis).During sleep, joint and periarticular tissues warm up, blood vessels expand, which increases swelling.

The periarticular tissues swell, press the nerve endings and pain develops.If at the same time there is pain behind the knee, then this may be a sign of a Baker's cyst.How to get rid of swelling and pain at night?Treating the underlying disease helps.

Knee pain while walking

Pain during movement, running, annoying pain under the knee are characteristic of degenerative-dystrophic processes in the knee - arthrosis, since during movement the articular surfaces are damaged, completely or partially without cushioning cartilage.The periosteum, which has good innervation, suffers.Knee pain when going down stairs is also very common.After exercise, patients notice that the pain in the knee continues to hurt for some time.Over time, pain appears in the leg.

Long-term rehabilitation treatment with the use of chondroprotectors - drugs that restore cartilage tissue - will help.In case of complete destruction of the joint - endoprosthetics.

Pain after exercise - squatting, running, lifting weights

This indicates the long-term microtrauma of the knee joints and the gradual formation of degenerative-dystrophic processes in them.Sometimes the pain appears in one right or left knee.Crackling joints.

If after training there is severe pain in the knee, then the athlete needs rehabilitation treatment.Otherwise, there will be a gradual decline in joint function, accompanied at first by periodic and then constant pain.

Knee pain and stiffness

Sharp, sudden pain in the knee and popping (snapping) indicate a tear of the meniscus - the shock-absorbing cartilage pads in the knee joint.This may be the result of age-related damage or wear of cartilage structures.

Severe joint pain may go away, but knee pain will remain when sitting, then limb dysfunction will gradually increase, accompanied first by pain during exercise and then by constant pain, which intensifies when going down stairs.Over time, the entire limb aches and cracks, including the leg.Long-term rehabilitation treatment under the supervision of an orthopedic-traumatologist helps.

Pain and swelling in the knee

Pain accompanied by swelling always indicates the presence of an inflammatory process.It can be aseptic (without the presence of infection, usually after injury), infectious, infectious-allergic and autoimmune (with an allergy in its own tissues).

To get rid of such pains, you need to identify their cause and carry out the treatment prescribed by a specialist.

Injuries and diseases that cause knee pain

The most common pathologies associated with knee pain are:

1. Closed and open injuries of the knee with intra-articular fractures, dislocations, tears of the meniscus.All of them lead to the development of inflammatory processes (arthritis), which then turn into degenerative-dystrophic processes (arthrosis) with the formation of constant pain and knee dysfunction.This is the most common cause of knee pain.Athletes are at risk.Even a small injury to the knee can cause the destruction of joint tissue cells, which leads to the development of an inflammatory process.With significant injuries, all these processes are pronounced and accompanied by prolonged pain.The instability of the knee, which develops when the ligamentous apparatus is damaged, is of great importance.Over time, instability increases, nearby tissues are damaged, which leads to increased pain in the knee joint, especially when going down stairs.In the absence of proper treatment, the process can be complicated by infection, become purulent, threatening the patient's life, or become chronic with gradual progression and destruction of the joint, accompanied by severe pain.
2. Arthritis of the knee joint is an inflammatory process of various origins, accompanied by an increase in body temperature and a disturbance of the patient's general condition.Patients complain that the pain in the knee hurts constantly.The disease can be infectious, infectious-allergic, autoimmune, metabolic in nature.The inflammatory process also occurs differently, depending on the cause that caused it (purulent arthritis, rheumatoid, psoriatic, gout and others).Sometimes arthritis can be complicated by a Baker cyst located in the popliteal region.Then there is pain behind the knee.Only adequate treatment prescribed by a traumatologist or rheumatologist will save you from joint destruction and disability.
3. Knee arthrosis is a degenerative-dystrophic process in the joint that develops after injuries, acute and chronic inflammatory processes and against the background of age-related metabolic disorders in elderly people.There is destruction or thinning of the absorbing tissue of the cartilage (the meniscus and the layer of cartilage that covers the articular surfaces of the bones).The destruction of the joint progresses slowly but steadily.I am concerned about pain and cramping when I move.In old age, this is the main cause of knee pain.The bones rub against each other, their structure is destroyed, the joint is deformed, all this is accompanied by severe pain.
4. Cysts and tumors.

How to treat severe knee pain

Knee injuries and diseases often lead to the development of patellofemoral pain syndrome (PFPS), pain in the front of the knee joint.Changes in the joint gradually destroy the patellar cartilage, contributing to the development of joint instability and constant severe pain in the knees.Only a course of rehabilitation treatment prescribed by a qualified specialist can help.

Diagnosing

Knee pain has various causes and requires an individual approach to treatment.First of all, it is necessary to make an accurate diagnosis, and this will require examination in a clinic.And only after that the treatment for knee pain is prescribed.

Some diseases cannot be completely cured, but the doctor can eliminate the pain and stop the destruction of the joint.

To determine the causes of pain and to diagnose the disease, the following examination is performed:

• Laboratory tests– clinical, biochemical, immunological blood test, if necessary – sampling and examination of intra-articular fluid (microscopy, culture in nutrient media to determine the sensitivity of the identified infection to antibiotics).
• Instrumental studies: ULTRASOUND– reveals soft tissue pathology and intra-articular fluid volume radiography– changes in the bone tissue of the knee; CT and MRI– a more detailed study of soft and hard tissue pathology; diagnostic arthroscopy- appearance and changes in the synovial membrane of the knee.

Methods for treating severe knee pain

Treatment measures are prescribed individually.Pain associated with a knee injury is treated by an orthopedic traumatologist;if the disease becomes chronic, consultation with a rheumatologist is necessary.If there is a suspicion of a purulent inflammatory process, then a surgeon will be better able to deal with the disease.All chronic inflammatory processes in the joints are treated by a rheumatologist, but special infectious processes, for example, tuberculosis of the knee, are treated by a podiatrist or other specialist in close contact with a rheumatologist.

First of all, they try to eliminate the pain as much as possible, using for this purpose drug therapy (modern drugs for knee pain, including ointments), and non-drug drugs for knee pain (manual therapy, massage, therapeutic exercises, reflexology courses and other traditional methods, folk remedies).To reduce the load on the joint and create rest, various methods of immobilization (splints, splints) are used, as well as gluing - fixing the joint using special adhesive tapes.

For all acute joint pains, an urgent examination of the patient is performed with simultaneous anesthesia.All modern and traditional methods of pain therapy are used in the treatment.After that, according to the indications, the patient is either hospitalized or prescribed a course of outpatient treatment followed by rehabilitation.No patient with pain remains without the attention of specialists.