Why do your knees hurt: the reasons for what to do

Knee pain is a widespread symptom, signaling distress in the body - the occurrence of joint disease or simply increased leg load.

It is difficult to find a person who has never experienced pain in the knees in a certain period of life.Discomfort, clicks or pains of different intensities in the knee joints occur in both adults and children due to many reasons.The older a person becomes, the higher the likelihood of various diseases, the first sign of which is the pain in the knees.This is due to the age characteristics of the body: slowing off metabolic processes, wear of the cartilage tissue of the joints, joining other problems with the musculoskeletal system, blood vessels, nerves.

Due to the complex anatomical structure, many structures and significant loads experienced, and often overloads, knee joints are very vulnerable.Damage to any element of the structure, for example, a synovial bag, leads to a violation of the motor function of the knee and, accordingly, pain syndrome.Ligaments and menisci are considered the most vulnerable, they are injured in 80–85% of cases.

The anatomical structure of the knee

The knee consists of a knee joint, a distal end of the femur with two tumors and jackets, a tibia tubular bone, muscles, nerves, vessels, ligaments, a patella (knee cup), articular bags and meniscus.

The knee joint is one of the large joints of the body.The femoral bone approaches him from above.The articular surfaces of its lateral (external) and medial (internal) condyles are articulated with the patella and the tibia.Meniski, which are connective tissue cartilage, serve as shock absorbers of the joint.Thanks to them, a rational distribution of human weight on a tiger plateau occurs and the stability of the joint increases.Subtle, double-headed, half-back and other muscles synchronize capsule-ligamentous structures, ensuring the motor activity of the knee joint.

The elements of the knee are interconnected by many ligaments.Inside the joint there are two cross -shaped ligaments - the rear and front.The hobby bones are connected to the fiber and tibia bones with collateral ligaments.The slanting of the popliteal ligament is located in the back of the bursa of the knee joint.The main - synovial capsule, not communicating with the joint, is distinguished from a number of articular cavities.The blood supply to the elements of the knee is carried out by a noble network of blood vessels, and innervation is carried out by nerve fibers.

Causes of knee pain

There are many causes of soreness of the joints of the knees, which can be conditionally divided into several groups.

Traumatic lesions of the elements of the knee:

1. Bitter of the knee.As a result of the gap of blood vessels, local hemorrhage occurs in the soft tissue of the joint.Redness, swelling, damage to the nerve endings leads to pain, difficulty in movement.
2. Full or partial ligament rupture.More often, a partial violation of the integrity of the internal side ligament, which arises from excessive twisting of the lower leg, is diagnosed.

The outer ligament breaks less often than the internal.This is due to a strong deviation of the lower leg inward, when turning the leg for example.The rupture of the cross -shaped ligaments is inevitably accompanied by hemarthrosis.

A complete rupture of both ligaments is often combined with damage to the joint bag, tearing the inner meniscus.Such an injury leads to excess mobility of the knee joint, accompanied by severe pain, the intensity of which depends on the degree of gap.

1. Hemarthrosis of the knee joint - Pouring blood into the joint cavity.There is a traumatic and non -human nature.Traumatic hemarthrosis is observed with ruptures of meniscus, full or incomplete ruptures of ligaments, intraarticular fractures, bruises of the knee area.The non -human option is one of the symptoms of diseases characterized by increased briefness of the walls of blood vessels or a violation of the blood coagulation system.These include hemophilia, scurvy, severe forms of hemorrhagic diathesis.The blood that has accumulated in the joint cavity compresses the tissue, disrupting the blood circulation in them.A special pigment - hemosiderin - negatively affects the ligaments, hyaline cartilage, a synovial bag, leading to the loss of their elasticity.The result of the lesion of the joint Bource is the swelling of her villi and the increased production of joint fluid.The result of repeated hemorrhages is dystrophy and destruction of the joint.
2. Knee meniscopathy - Violation of the integrity of meniscus of the knee joint.In the lateral form, the external meniscus is damaged, with the medial - internal.This is one of the most common, but difficult to diagnose damage to the knee joint.At the risk zone of the disease are not only athletes involved in intensive training, but also ordinary people.The rupture of the meniscus can come from a sharp unusual movement when turning the body, turning the leg, a strong blow to the knee.
3. Dislocation of the knee cup - pathological displacement of the patella.Trauma is diagnosed in no more than 0.7% of cases of the total number of dislocations.More often there is external dislocation, less often - internal, very rarely - vertical or torsion.With an incomplete dislocation, the knee cup is determined over the lateral (external) condyle, with full - from the outside from the lateral condyle.
4. Closed or open fractures of the knee joint, the upper section of the bones of the lower leg or the lower spine. Such injuries are often combined with damage to the soft tissues of the knee, causing massive hemorrhages, excessive mobility in the knee area, its deformation.

Inflammatory and degenerative-dystrophic diseases of the articular elements of the knee:

1. Arthritis - Inflammatory damage to the joint of the knee.A similar mechanism for the development of pathology is observed with osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, gout (with the deposition of urates into the joints).
2. Osteoarthrosis (gonarthrosis) With the defeat of the knee joint of non -inflammatory nature, affecting all its structures and leading to serious degenerative changes.
3. Bursitis With the inflammation of synovial, Bursa leads to pain during bending and extending movements in the knee.
4. Periarthritis tendons of the knee joint - inflammation of the capsule of the goose of the paw, knee tendons, as well as muscles and ligaments surrounding the joint.In this case, the pain occurs mainly during the descent on the stairs, especially with a heavy load, and focuses on the inner surface of the knee.
5. Chondropathy of the patella -Degenerative-non-chic changes in the cartilage of the articular (rear) surface of the patella.The degree of destruction can be different: from areas of light softening to cracks and complete abrasion.

6. Chondromatosis - a serious chronic disease due to the dysplastic process with the islet degeneration of the sections of the articular membrane in the cartilage - chondrom.The ossification of individual cartilaginous bodies is not excluded.
7. Baker's cyst - the formation of a dense elastic round tumor formation in a popliteal fossa located on the opposite side of the patella.The cyst is clearly visible in the exposed state of the knee.Causes discomfort, pain in the popliteal region.With significant sizes, it squeezes blood vessels and nerves, leading to impaired innervation and blood circulation.
8. Goff disease - a disease, accompanied by damage and further degeneration of adipose tissue located around the knee joint.Pinches, edema and other damage to fat cells - adipocytes - end with their replacement with dense fibrous tissue.As a result, the buffer function of the “fat pillow” is disrupted, the adipose tissue itself becomes not capable of playing the role of the shock absorber.
9. Osgud -Swerter disease - a pathology characterized by murders of the bugrous part of the tibia.Diagnostic in adolescents from 10 to 18 years old playing sports.A painful bump appears below the patella, in the absence of treatment, leading to restriction of the leg or complete immobilization, as well as muscle hypotrophy.

Diseases in which irradiation of pain in the knee is possible:

1. Cokesartrosis of the hip joint - chronic damage to the hip joint, accompanied by progressive degeneration and dystrophic changes in it.Often the pain spreads down the outer surface of the thigh to the knee or below.
2. Sedular nerve neuropathy - non -inflammatory damage to the nerve as a result of compression squeezing or spasming of blood vessels.This nerve reaches the feet, starting in the lower back and passing through the tailbone and pelvis.The blockade at any one point for its length leads to impaired sensitivity or pulsating pain.
3. Fibromyalgia - Extracenting defeat of soft tissues of non -inflammatory nature with a combination of symptoms in the form of arthralgia, muscle weakness, depression, etc.

Some systemic diseases leading to knee pain:

1. Osteoporosis - the disease of the bone system of a chronically progressive course, changing the mineral composition and bone density.“Leaching” of calcium from bones leads to their fragility.The process is accompanied by a smoke or aching pain in the limbs.
2. Bones tuberculosis.The tuberculous lesion of the bone site leads to constant severe pain.
3. Osteomyelitis -A disease of an infectious and inflammatory nature, affecting all structural elements of bones.The result of both specific, for example, tuberculosis, and non -specific, more often coccal, osteomyelitis is hyperemia of the skin, edema, local acute pain in bones and muscles, febrile temperature.
4. Some infectious diseases.With Reiter syndrome, in addition to involving the urogenital tract and eye mucosa, joints are affected.One of the manifestations of Lyme's disease is arthralgia.

Types of knee pain

Depending on the etiology, the nature and intensity of pain can be different.

• Aching.With arthritis, osteoarthrosis.
• Acute, strong.With fractures of the elements of the knee, rupture of the ligaments, acute buckthrough, the bruise of the knee, exacerbation of meniscopathy, deforming osteoarthrosis.
• Pulsating.With a launched deforming arthrosis, meniscus injury.
• Drilling.With osteomyelitis.
• Dumb.With Burit, chronic osteochondritis.
• Burning.With compression of the sciatic nerve, tuberculosis process in the bone.
• Firing. When pinching the nerve trunk.
• Pain when walking.With a baker's cyst, buckthrough, arthritis, gonarthrosis, periarthride.
• The pain alone. With gout, arthritis.

Diagnosis of pathologies that cause knee pain

Physical examination:

• collecting anamnesis and complaints;
• Visual inspection with palpation of the knee.

Laboratory research:

• Biochemical and clinical blood tests;
• serological blood test;
• Immunological blood test;
• rheumatological tests;
• Bacteriological analysis of synovial fluid.

Invasive instrumental methods:

• arthroscopy;
• puncture of the joint bag;
• puncture bone biopsy.

Non -invasive instrumental diagnosis:

• radiography of the knee joint;
• densitometry;
• Ultrasound joint study;
• MRI or CT.

Treatment of knee pain

If the pain in one or both knees of the non -human nature of the occurrence, then you should first turn to the therapist, who, based on the patient's complaints and the results of an objective examination, will direct to a narrow specialist - an orthopedist, a rheumatologist, a phlebologist or a neurologist.In case of any injury, you need to contact a surgeon or an orthopedic trauma.

Treatment in each case is different, depends on the cause of the pain, that is, on the type of injury or disease.Each disease has its own treatment regimen.But first, the patient must observe several general rules:

• significantly reduce the duration of hiking and staying on the legs during the day;
• Athletes temporarily (before recovery) abandon training, and ordinary people from running or jumping;
• When increasing the pain, completely abandon movements, apply a fixing bandage from an elastic bandage to the knee;
• wear a bandage or a bandage for the immobilization of the knee joint;
• With a bruise, cold in the place of traumatic effects.

Rheumatoid, psoriatic arthritis, systemic autoimmune diseases need serious integrated treatment, carried out for many months.The basic therapy consists of immunosuppressors, non -steroidal anti -inflammatory and hormonal drugs, gold preparations, etc.

In the treatment of bursitis, painkillers and anti -inflammatory drugs are used.If an infection is detected, then a course of antibiotics.The therapeutic puncture of the bag is carried out to remove excess fluid from the synovial cavity and/or the introduction of one of their corticosteroids.The operation helps to get rid of the chronic inflammation of the brush - the surgical excision of the synovial bag.

With deforming osteoarthrosis, intra -articular injections of glucocorticosteroids, prolonged intake of NSAIDs and chondroprotectors are effective.To relieve pain syndrome, compresses with dimexide or bischofit, ointments and gels with anti -inflammatory effects are locally prescribed.Massage, physiotherapy, therapeutic gymnastics helps.Severe lesions of the knee joint require surgical intervention - joint endoprosthetics.

Treatment of osteoporosis consists in the course of taking bisphosphonates, calcitonins, calcium preparations, vitamin D, etc.

The treatment of meniscus rupture can be conservative or surgical.Conservative therapy consists of analgesics, NSAIDs, hyaluronic acid, chondroprotectors.But first, the joint reposition is performed.

Types of surgical intervention:

• Meniscectomy;
• partial (incomplete) meniscectomy;
• meniscus transplantation;
• arthroscopy;
• Arthroscopic stitching of the rupture of the meniscus.

With any injury to the knee, after treatment, the rehabilitation period, which should take place under the control of a rehabilitologist or orthopedist, is very important.The doctor will compile an optimal joint recovery program.The main methods of postoperative rehabilitation are massage and therapeutic gymnastics.Classes on special simulators are also effective, gradually developing a knee joint.