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

Everyone experiences pain in the knee joint from time to time. This may be due to sudden movements or symptoms of progressive pathology. The knee joint is the largest and most complex anatomical element of the musculoskeletal system. It accounts for up to 80% of physical weight, which leads to increased physical activity and risk of injury. A large number of capillaries, nerve fibers and muscle tissue make every injury, even a small one, extremely painful. Injured nerves cause an infectious inflammatory process, which is accompanied by swelling, discoloration of the skin and an increase in local temperature.

As progress progresses, the joint itself, intra -articular fluid and connective tissue are pulled into a pathological state, 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 elements can cause pain, and what steps need to be taken to eliminate 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 persists in the patellar ligament and, in general, forms the ligament apparatus, which consists of the following types of fascia:

• Lateral branches from tibia (small and large);
• posterior support nodes - crescent -shaped, dorsal, median and lateral;
• transverse ligament and cruciate articular knee.

The cruciate ligament is most susceptible to injury - sharp movements, a large degree of rotation, a fall with subluxation leads to rupture of the interminimal joint.

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 ligament in the knee cavity and attach to the notch between the anterior protrusions of the tibia.
2. Back - keep the lower leg from moving backwards. They start from the top of the anterior femur, cross the joint cavity and end between the dorsal protrusions of the tibia.

On the surface of the articular bone is cartilage. At the junction of the tibia and femur, there is a menisci - a type of joint layer that performs the role of shock absorber and stabilization.

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

• above the kneecap;
• in the popliteal;
• between tendons in long thigh muscles;
• hypodermic patella;
• in a niche below the knee joint.

Thanks to the knee, a person can perform steps, flexions, extensions within the limits indicated by the ligaments.

The cause of the pain

Inflammation can develop in the following structures:

• prone;
• joint gloves;
• synovial fluid;
• tibial bone;
• muscles and tendons that surround joints;
• 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 the slow and gradual destruction of hyaline cartilage. For a long time, it can be asymptomatic and worsen dramatically in the second stage. Pain in the knee joint occurs due to a growing osteophyte that affects the nerve endings;
2. Arthritis is an inflammatory pathology that occurs in an acute form. It can be either an independent disease - spondylitis, or other pathological complications of articular - arthrosis, rheumatism, etc. Arthritis is characterized by severe pain, accompanied by swelling and redness;
3. Osteochondritis - articular cartilage becomes inflamed over time with degenerative arthrosis, mechanical injury;
4. Periarthritis is a disease that occurs against the background of obesity (more often in women). The pathology affects the tendons, muscles and subsequently beyond the shell of the knee joint. The pain is mild, exciting (as in a sprain).
5. Chondromatosis is the formation of nodes in the hyaline cartilage tissue, which eventually spreads throughout the capsule of the knee joint. In this case, pinching of soft tissue with a large number of nerve cells occurs. Because of this, the knee is always sore, even during periods of rest.
6. Bursitis - the synovial capsule of the knee joint is rarely inflamed on its own, only as a result of injury or complications of collateral joint disease, hence the pain.
7. Cellulite - subcutaneous fatty tissue can cause pain only in the case of a close focal length of the corresponding disease. Purulent arthritis, soft tissue abscesses can cause inflammatory and painful processes in the protective layer.
8. Dermatitis - the epidermis is affected in the event of infectious pathology (eczema, erysipelas, psoriasis) or allergic reactions to external stimuli.
9. Osteomyelitis - the bone marrow becomes inflamed due to bacteria that have entered the body like jelly along with the lymph flow. It can also be caused by an open injury or a complication of a surgical operation.
10. Synovitis - the capsule of the knee joint is most often affected in the elderly over the age of 55, as a result of rheumatism or other chronic pathology. At a young age, you can get sick from a serious injury.

The type of pain depends on the location

Diseases that trigger the development of negative processes also form types of pain:

• Severe and excruciating pain - reactive arthritis, torn meniscus and tendons, bursitis in the acute stage;
• Acceptable, but persistent pain - synovitis, bursitis in the early stages;
• Pinching pain - gonarthrosis, arthrosis;
• Vibrating - degenerative arthrosis, in the stage of joint deformation;
• Acute pain, burning - compression of the sciatic nerve, bone tuberculosis;
• Stinging - osteoporosis, the development of inflammation of the synovial bags, exacerbation of chronic meniscus injuries;
• Cramps - inflammation of the soft tissues of the knee joints, muscles and tendons;
• Shooting pain - damage to nerve roots.

Diagnostic measures

If you experience severe pain in the knee joint, you should not delay a visit to the doctor, hoping 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. For an initial consultation, you should contact a therapist. After a standard examination, he decided to prescribe treatment (which occurs in 70% of cases of knee pain complaints) or set up a comprehensive laboratory and hardware examination, with the involvement of a highly specialized specialist.

Running, suspicious pain is studied in different directions:

• Traumatology: if you suspect arthrosis, congenital or acquired dysplasia, articular fracture, dislocation, displacement, radiography, MRI, ultrasound, biopsy of fluid in the synovial sac is prescribed to find out where the pain in the knee joint is coming from.
• Surgery: cysts below the patella, thrombosis, arthritis with purulent formation, rupture of tendons, meniscus, ligaments, stones in the joints, hemarthrosis, abscesses diagnosed with ultrasound, fluoroscopy, CT or MRI, blood tests, general and rheumatoid factors, cartilagehyaline puncture 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 proteins, DNA testing, uric acid levels.
• Neurology and psychiatry: a pinched sciatic nerve does not require a lengthy diagnosis. Already using ultrasound, muscle tone and sites of inflammation will be visible. In the case of mental disorders, when pain in the knee joint is not confirmed by a single fact, but the patient continues to experience torture (so -called somatic pain), special studies are prescribed for mental abnormalities.

Basic diagnostic methods

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

• X -ray - allows you to see the knee joint in several projections and determine the location of the lesion. The images show the lesion is already at an early stage, specifically changes in bone, synovial bags, or the appearance of osteophytes.
• Ultrasound examination - a modern high -precision examination determines the thickness of the joint shell, the state of the ligament structure, the presence of inflammation of any kind and general changes in the knee.
• Dopplerography - Examination of veins and arteries for aneurysms, plaques, and blockages. Quickly and effectively determine the possible risks and conditions of the inner walls of blood vessels in terms of percentage.
• MRI is currently the most accurate way to diagnose. Allows you to see a clear picture, three -dimensionality of the knee joint, pathological changes in synovial fluid, even slight deformation of bone tissue, etc. It is rarely prescribed, because of the high, for many, costs 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 thus determine the nature and extent of the lesion.
• Angiography is a method of examining blood vessels for patency by injecting contrast fluid. Determines the functionality of metabolic processes and allows to diagnose articular insufficiency at an early stage.
• Complete blood count - set to identify inflammation and pain. The whole indicator can even lead to traces of certain diseases and determine the pathology of the articular only at the beginning of development.
• Blood for rheumatoid antibodies - also indicates the presence of inflammation, but is specific, systemic or hereditary. For example, to establish a diagnosis of rheumatoid arthritis, this analysis is taken as a basis.
• Uric acid is an important test to determine the cause of pain and the degree of exacerbation of gout or infectious arthritis. High levels indicate accumulation of salt deposits in the joints.
• Wasserman's reaction - prescribed for suspected sexually transmitted infections, syphilis, gonorrhea, chlamydia, etc. The development of joint disease against the background of certain diseases or because of its complications is 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 identify special substances in the blood that are secreted by cancerous neoplasms or their metastases. So, for synovial bag sarcoma, the presence of vimentin markers, cellular external antigens and pancytokeratin is characteristic.

Treatment of pain in the knee joint

Pain in the knee can be divided into those that require emergency medical treatment. And they are pre-diagnosed. Urgent conditions include all injuries, fractures, dislocations, abscesses, purulent inflammation, hemarthrosis (bleeding into the joints). The symptoms in all cases are the same - unbearable pain, swelling, redness, inability to move, fever in the knee joint and a febrile state.

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

• legs should be raised - put a rolling roller or hard pillow;
• place a bandage with ice on the knee and change every 5-10 minutes;
• take available painkillers.

In all other cases, treatment is carried out after conducting a comprehensive study and determining the cause. According to the anamnesis, drug therapy, physiotherapy, exercise therapy, massage, homeopathic treatments, local applications, spa vacations and, in severe cases, surgery are prescribed.

Conservative therapy

Traditional medicine treatments for pain include the following groups of drugs:

1. Anesthetic. To relieve the initial symptoms and reduce the painful condition, you can take a simple painkiller over the counter. Severe cases associated with loss of mobility and unbearable pain require more serious medications that are only prescribed by a doctor and are available by prescription.
2. NSAIDs. Helps to quickly relieve inflammation and swelling.
3. Chondroprotectors. Modern medicines, despite the long period of administration, provide regeneration of cartilage tissue. The effects are cumulative and long -lasting (up to 10 years, joint pain may not bother after a course of six months, subject to treatment at an early stage).
4. Glucocorticosteroids. Indicated for patients with autoimmune pathology to reduce the production of the hormone cortisol and stop the progression of the disease. Doses and regimens are prescribed by the doctor individually.
5. Immunosuppressants. They block the abnormal action of the immune system, thereby stabilizing the development of dangerous diseases such as rheumatoid arthritis, lupus erythematosus, and vasculitis. They are rarely prescribed, only in cases of accurate diagnosis and inability to eliminate knee pain by other means.
6. Hyaluronic acid injections. They are injected directly into the cavity of the knee joint and relieve pain and lack of synovial fluid. They also contribute to the restoration of hyaline cartilage, thereby restoring knee mobility.

Folk recipes

Most people who start experiencing pain in the knee joint try to get rid of the discomfort with folk methods. You can make lotions, compresses and nightly applications based on homemade ointments or tinctures. Decoction of herbs, alcohol tincture for topical use will help prevent periods of deterioration and relieve obsessive pain.

The following plants and substances have anti-inflammatory effects:

• Coltsfoot;
• St. WortJohn;
• oak bark;
• Burdock root;
• bay leaf;
• Chamomile flowers;
• Calendula;
• White and black kaolin clay;
• Salt and soda solutions;
• Honey products.

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

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

Effective recipes, including honey, salt and soda. Mix 1 teaspoon of salt and soda with honey, in a sufficient amount to cover the knee joint profusely. This method performs three actions at once - removes excess fluid, relieves 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. To decoction, pour 1 tablespoon of dry skin 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 relieve pain in the knee joint. For alcohol tincture, use the same proportions, just replace the water with vodka. Insist in a dark cool place for 10-14 days. Apply in the same way.

By alternating various means and methods, you can sustain the disease for a long time, forgetting about pain and swelling. The effectiveness of alternative medicine has not been proven, despite the removal of the main symptom - pain in the knee.

Massage and therapeutic exercises for pain in the knee joint

Comprehensive traditional treatments necessarily include exercise therapy and massage. Exercise is recommended for everyone who has ever, or suffered from, a knee injury, is diagnosed with arthritis, arthrosis and other joint diseases, leads an inactive lifestyle (inactive static work, 1-2 group disabilities, housewives, etc. ).

Gymnastics can be done independently, at a slow pace and in a workable mode. Increase the number of exercises gradually or, conversely, decrease, depending on how you feel.

1. From a lying or sitting position on a chair, slowly bend and open your legs, doing so until a slight state of fatigue appears.
2. Bend the leg at the knee, do a rotational movement in small amplitude, repeat the same thing on the second leg.
3. Lying on your back, slowly pull the bent leg at the knee to the abdomen.
4. Place a pillow on the chair and sit so that the legs are "dangling", doing circular movements clockwise and vice versa.
5. Sit on a chair, slowly stretch your legs and hold in this position for 2-5 seconds, just as you slowly lower them, repeat on the second leg.
6. Stand up straight, straighten your back, slowly bend your legs at the knees and linger in the "heron" position for a few seconds. If possible, every 2 days, increase the delay time.
7. If there are no contraindications and health allows, you can complicate the complex. Place the gymnastic stick at maximum level, which can be achieved with the legs bent at the knees. Throw the foot over the "barrier" 10-15 times, then change position.
8. The small complex for stretching the lower leg also contributes to the rapid recovery of the knee joint. Lean your palms against the wall, bend your right foot at the knee, place your left foot backwards. Feet rest completely on the floor. Hold the pose for 30 seconds. Change legs.

The usual performance of simple gymnastics, accessible to any person, will give visible results in a month - pain in the knee joint will stop bothering, 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 a traditional method of exposure, and manual therapy for pain. Keep in mind that only experienced professionals with good recommendations should be trusted to perform such procedures. Otherwise, manual manipulations, at best, will have little effect, at worst, they will trigger joint displacement and exacerbate the pathological condition. Massage should be done regularly, no more than 10 sessions, 25-30 minutes a month. Daily procedures are strongly contraindicated. During the session, there should be no pain in the knee. 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 with all permitted methods should help himself to relieve pain and recover as quickly as possible.

Therefore, for this purpose, 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 workable gymnastics, come on time for physiotherapy.
• Review your diet. Add lots of fresh vegetables, herbs and fruits to your diet. Exclude fatty meats, fried foods and semi -finished products.
• If necessary, use aids to relieve the load from the knee joint - crutches, crutches and other special tools.
• Do not use, without prior consultation with a doctor, recipes of traditional medicine, even time -tested and neighbors. What helps one may be absolutely contraindicated for another.
• During the treatment period, if possible, avoid physical activity and make sure to rest in bed so that the pain does not return (therapeutic exercise is an exception).
• Provide a comfortable bed and rest - orthopedic mattresses, comfortable chairs and armchairs, preferably with a small seat so you can lift a sore leg comfortably.
• Mild self -massage is allowed. Rubbing, rubbing promotes blood circulation, thus enriching the tissues with oxygen. As a result, muscle spasms are removed and the pain becomes less intense.

Preventive measures

It is almost impossible to fully insure against injury, sprain or dislocation of the joints that are most heavily loaded in the body. Everyday life requires you to do homework, go to work, etc. While performing normal activities, it is quite possible to receive unexpected injuries. But to reduce the risk of joint disease is in everyone's power. Leading rheumatologists have developed several recommendations that will help protect yourself from dangerous pathologies:

• Establish and strictly adhere to a rational regime - work breaks. This is especially true for people whose activities are associated with increased physical activity (athletes, builders, sellers, metallurgists, miners, etc. ).
• Treat and undergo timely recovery after any infectious disease. This rule applies even to "harmless" ones such as acute respiratory infections or seasonal SARS.
• Avoid exposure to low temperatures, drafts. Dress according to the weather to avoid hypothermia.
• Upon reaching the age of 35, it is desirable to undergo a course of treatment with chondroprotectors.
• Monitor your weight carefully. Gaining weight will definitely increase the load on the knees, this is worth keeping in mind when eating other breads.
• To maintain a normal weight, follow the principles of a healthy diet. 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 impact not only on the knee joint, but also on life in general. To overcome the addiction, you can enlist the help of your relatives - the difficult stages will pass faster and easier.

Everyone experiences pain in the knee joint, regardless of age, gender or social status. From the first step, the joints are subjected to all kinds of tests - falls, bruises, injuries, sports, hypothermia. Even so, many people manage to maintain the mobility, health and function of key compounds until old age.