Knee joint pain - 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 risk of injury. A large number of capillaries, nerve fibers and muscle tissue make any injury, even minor, extremely painful. Damaged nerves cause an infectious-inflammatory process, which is accompanied by swelling, skin discoloration and increase in local temperature.

As progress progresses, the joint itself, intra-articular fluid, and connective tissue retract into the pathological condition, which can have serious consequences - the development of arthritic disease. 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 the pain.

Anatomical structure

The anterior area of the wrist is formed by the patella, in a simpler language - the patella. It connects to the quadriceps (fascicular) muscle of the thigh, which extends into the patellar ligament and, in general combination, forms a ligament apparatus, which consists of the following types of fascia:

• Lateral branches from tibia (small and large);
• Posterior supporting joints - sickle-shaped, dorsal, middle and lateral;
• transverse and crossed articular ligaments of the knee.

Crossed ligaments are more susceptible to injury - a sharp movement, a large degree of rotation, a drop with subluxation leads to rupture of the interminal joints.

Ligaments are divided into two types:

1. Anterior - they have the function of stabilizing the ankle, in particular, preventing excessive forward displacement. They originate from the back of the large femur, intersect with the posterior ligaments in the knee cavity, and attach to the point between the anterior tibial extensions.
2. Rear - brake the lower leg so that it does not move backwards. They start at the front of the upper femur, cross the ankle cavity, and end between the dorsal extensions of the tibia.

On the surface of the articular bone is cartilage. At the junction of the tibia and femur, there are menisci - a type of joint lining that performs a suction and stabilizing role.

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

• over the knee cap;
• deep popliteal;
• between the tendons in the long thigh muscle;
• hypodermic patella;
• in the cut below the knee joint.

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

Causes of pain

Inflammation can develop in the following structures:

• cartilage;
• joint wrapper;
• synovial fluid;
• tibia bones;
• the muscles and tendons surrounding the wrist;
• 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 cases of knee pain. It is characterized by the slow and gradual destruction of the hyaline cartilage. For a long time, it can be asymptomatic and worsen significantly in the second stage. Pain in the knee joint occurs due to the growth of osteophytes affecting the nerve endings;
2. Arthritis is an inflammatory pathology that appears in acute form. It can be either an independent disease - spondylitis, or a complication of other joint pathologies - osteoarthritis, rheumatism, etc. Arthritis is characterized by severe pain, accompanied by swelling and redness;
3. Osteochondritis - articular cartilage inflamed over time with degenerative osteoarthritis, mechanical injuries;
4. Periarthritis is a disease that occurs against the background of obesity (most often in women). The pathology affects the tendons, muscles and then passes into the shell of the knee joint. The pain is moderate, attractive (as in compression).
5. Chondromatosis is the formation of nodules in the hyaline cartilage tissue, which eventually spreads throughout the knee joint capsule. In this case, soft tissue constriction occurs with a large number of nerve cells. Because of this, the knee aches constantly, even during the rest period.
6. Bursitis - the synovial capsule of the knee joint is rarely inflamed, only as a result of injuries or complications of joint collateral diseases, ie pain.
7. Cellulite - subcutaneous adipose tissue can cause pain only in the case of narrow 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 - bone marrow becomes inflamed due to bacteria that have entered the jelly-like body along with the lymphatic flow. It can also be the result of open injuries or a complication of surgical operations.
10. Synovitis - The knee joint capsule is most often affected in the elderly over 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 the location

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

• Intense, excruciating pain - reactive arthritis, rupture of meniscus and tendons, bursitis in the acute phase;
• Tolerable but persistent pain - synovitis, bursitis in the initial degree;
• Clamping pain - gonarthrosis, osteoarthritis;
• Vibrating - degenerative arthrosis, in the stage of joint deformation;
• Acute, burning pain - compression of the sciatic nerve, bone tuberculosis;
• Bite - osteoporosis, progression of inflammation of the synovial sac, exacerbation of chronic meniscus damage;
• Cramps - inflammation in the soft tissues of the knee joint, muscles and tendons;
• Shooting pain - damage to nerve roots.

Diagnostic measures

If you have severe 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 (occurring in 70% of cases of knee pain complaints) or prescribe a thorough laboratory and hardware examination, with the involvement of highly specialized specialists.

Running, suspicious pains are studied in different directions:

• Traumatology: if you suspect osteoarthritis, congenital or acquired dysplasia, joint fracture, dislocation, dislocation, radiography, MRI, ultrasound, synovial fluid biopsy is prescribed to find out where the knee joint pain comes from.
• Surgery: cyst under the patella, thrombosis, arthritis with purulent formations, rupture of tendons, menisci, ligaments, stones within the joint, hemarthrosis, abscesses diagnosed by ultrasound, fluoroscopy, CT or MRI, blood tests, general and rheumatoid factor, cartilagehyaline at the knee joint etc.
• Rheumatology: the 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 analysis, uric acid level.
• Neurology and psychiatry: The suppressed sciatic nerve does not require a lengthy diagnosis. Already on 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 distress (so-called somatic pain), specific studies on mental abnormalities are prescribed.

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 images show lesions already in the early stages, in particular changes in the bone, synovial sac or the appearance of osteophytes.
• Ultrasound examination - a modern high-precision examination determines the thickness of the ankle shell, the condition 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 determines the potential hazards and condition of the inner walls of blood vessels in percentage.
• MRI is currently the most accurate way of diagnosis. Allows you to see a clear, three-dimensional view of the knee joint, pathological changes in the synovial fluid, even a slight deformation of bone tissue, etc. It is rarely prescribed, due to its high cost, for many, and contraindications. Examination is prohibited 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 view of the knee joint and thus determine the nature and extent of the lesion.
• Angiography is a method of examining blood vessels for permeability by injecting a contrast fluid. Determines the functionality of metabolic processes and allows the diagnosis of joint insufficiency in the early stages.
• Complete blood count - is prescribed to identify inflammation and pain. The set of indicators can even lead to traces of specific diseases and determine articular pathologies only at the 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 reaction - is prescribed for suspected sexually transmitted infections, syphilis, gonorrhea, chlamydia, etc. The development of joint diseases in the background of specific diseases or as their complications are very common. Therefore, a positive test will make it possible to determine the appropriate treatment, taking into account the type of infection.
• Tumor markers - help identify specific substances in the blood that are secreted by a cancerous neoplasm or its metastases. Thus, for the synovial sac sarcoma is characteristic the presence of markers of vimentina, external cellular antigen and pancitokeratin.

Treatment of pain in the knee joints

Knee pain can be divided into those that require urgent medical attention. And those that are pre-diagnosed. Urgent conditions include all injuries, fractures, dislocations, abscesses, purulent inflammation, hemarthrosis (bleeding in the joints). The symptoms in all cases are identical - unbearable pain, swelling, redness, inability to move, fever in the knee joint and feverish condition.

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

• the foot should be raised - place a roller or a firm cushion;
• put an ice pack on the knee and change every 5-10 minutes;
• get an available pain reliever.

In all other cases, treatment is performed after conducting comprehensive studies and determining the causes. According to the anamnesis, drug therapy, physiotherapy, exercise therapy, massage, homeopathic treatment, local applications, bath breaks and in extreme cases surgery are prescribed.

Conservative therapy

Traditional pain treatment with medication includes the following groups of medications:

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 excruciating pain require more serious medication that is only prescribed by a doctor and offered by prescription.
2. NSAIDs. Helps relieve inflammation and swelling quickly.
3. Chondroprotectors. Modern medicines, despite the long course of administration, ensure the regeneration of cartilage tissue. The effect is cumulative and long-term (up to 10 years, joint pain may not bother after a six-month course, undergoing treatment in the early stages).
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 regimen are prescribed by the doctor on a strictly individual basis.
5. Immunosuppressants. They suppress the abnormal action of the immune system, thus stabilizing the progression of such dangerous diseases as rheumatoid arthritis, lupus erythematosus, and vasculitis. They are rarely prescribed, only in the case of an accurate diagnosis and inability to eliminate knee pain in other ways.
6. Hyaluronic acid injections. They are injected directly into the knee joint cavity and eliminate pain and lack of synovial fluid. They also contribute to the restoration of hyaline cartilage, thus restoring knee mobility.

Popular recipes

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

The following plants and substances have anti-inflammatory effects:

• Coltsfoot;
• St. John's wort;
• oak bark;
• Burdock root;
• Daphnia Leaf;
• Chamomile flowers;
• Calendula;
• white and black kaolin clay;
• A solution of salt and soda;
• Honey products.

For example, mix 10 pre-crushed aspirin tablets 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 (handkerchief), preferably left overnight. The pain is eliminated after the first application.

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

An effective recipe, which includes honey, salt and soda. Mix 1 teaspoon of salt and baking soda with honey, in an amount sufficient to cover the knee joint profusely. 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 solution 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. Coat the 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, replace water only with vodka. Insist in a cool dark place for 10-14 days. Apply in the same way.

By alternating different tools and methods, you can save 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 - knee pain.

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, osteoarthritis 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 workable way. Gradually increase the number of exercises or, conversely, decrease, depending on how you feel.

1. From a supine position or sitting in a chair, slowly bend and undress your legs, do until a slight fatigue state appears.
2. Bending the leg at the knee, perform rotational movements at a small amplitude, repeat the same on the second leg.
3. Lying on your back, gently pull your legs bent at the knees toward your stomach.
4. Put a pillow on the chair and sit so that the legs "hang", make circular movements in a clockwise direction and vice versa.
5. Sitting in a chair, slowly extend the leg and hold in this position for 2-5 seconds, just as slowly sit down, repeat on the second leg.
6. Stand up straight, straighten your back, slowly bend your leg at the knee and stay in the "hero" position for a few seconds. If possible, every 2 days, increase the delay time.
7. If there are no contraindications and health allows you, you can complicate the complex. Set the exercise bar to the maximum level, which can be achieved with one leg bent at the knee. Jump the leg over the "barrier" 10-15 times, then change position.
8. A small complexion for lower leg extension also contributes to the rapid recovery of the knee joint. Rest your palms on the wall, bend your right leg at the knee, turn your left leg back. The legs rest completely on the floor. Hold the pose for 30 seconds. Change legs.

Regular performance of simple gymnastics, accessible to any person, will give visible results within a month - the pain in the knee joint will cease to bother, the mobility of the joints will improve, the 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. It should only be remembered that only experienced professionals with good recommendations should be trusted to perform such procedures. Otherwise, manual manipulations, at best, will not have the slightest effect, at worst, they will provoke dislocation of the joints and worsen the pathological condition. The massage should be performed periodically, no more than 10 sessions, 25-30 minutes per month. Daily procedures are strictly contraindicated. During the session, there should be no knee pain. If discomfort is felt, the procedure should be discontinued.

Home treatment

Treating knee pain at home is a prerequisite for outpatient therapy. The patient with all permitted methods should help himself to relieve the pain and heal as soon 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 forget to take prescribed medication, do possible gymnastics, come in 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 assistive devices to ease the load from the knee joint - cane, crutches and other special equipment.
• Do not use, without first consulting your doctor, prescriptions of traditional medicine, 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 provide bed rest so that the pain does not return (with the exception of therapeutic exercises).
• Provide a comfortable place to sleep and rest - orthopedic mattresses, comfortable chairs and armchairs, preferably with small backrests so you can comfortably lift your sore feet.
• Light self-massage is allowed. Stroke, friction stimulate blood circulation, thus enriching the tissues with oxygen. Thus, the muscle spasm is removed and the pain becomes less intense.

Preventive measures

It is almost impossible to fully insure against injuries, sprains or dislocations of the busiest load on the body. Everyday life forces you to do housework, go to work, etc. During normal activities, it is quite possible to get a sudden injury. But to reduce the risk of developing joint disease is completely in the power of each person. Leading rheumatologists have developed a set of recommendations that will help protect against dangerous pathologies:

• Strictly adhere to a rational work-rest regime. This is especially true for people whose activities are associated with increased physical activity (athletes, builders, salesmen, metallurgists, miners, etc. ).
• Treat in time and undergo rehabilitation after any infectious disease. This rule also applies to "harmless" ones like acute respiratory infections or seasonal SARS.
• Avoid exposure to low temperatures, currents. Wear for the weather to prevent hypothermia.
• Upon reaching the age of 35, it is desirable to undergo a course of 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.
• 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 - giving up smoking, alcohol 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 phase will pass much faster and easier.

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