Why your knees hurt: the reasons for what to do

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

It is difficult to find a person who has never suffered knee pain in a certain period of life.Discomfort, clicks or pain of different knee joint intensities occur in adults and children due to many reasons.The older a person becomes, the more likely to various diseases, whose first sign is knee pain.This is due to the characteristics of the body age: slowing metabolic processes, the wear of joint cartilage tissue, gathering other problems with the musculoskeletal system, blood vessels, nerves.

Due to the complex anatomical structure, many experienced structures and loads experienced and often overload, knee joints are very vulnerable.Damage to any element of the structure, for example, a synovial bag, lead to a violation of knee motor function and therefore pain syndrome.Ligaments and menisci are considered the most vulnerable, they are injured in 80 to 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 tibular tubular bone, muscles, nerves, vessels, ligaments, a patella (knee cup), joint bags and meniscus.

The knee articulation is one of the large joints of the body.The femoral bone approaches him from above.The joint surfaces of their side (external) and medial (internal) conndilies are articulated with patella and tibia.Meniski, which is the cartilage of connective tissue, serves as articulation shock absorbers.Thanks to them, there is a rational distribution of human weight in a tiger plateau and joint stability increases.The subtle, double -headed muscles, half and other muscles synchronize linked capsule structures, ensuring the motor activity of the knee joint.

Knee elements are interconnected by many ligaments.Within the joint, there are two cross -shaped ligaments - the rear and front.Hobby bones are connected to fiber and tibia bones with collateral ligaments.The slope of the popliteal ligament is located on the back of the knee joint.The main - synovial capsule, not communicating with the articulation, is distinguished from various joint cavities.The blood supply for knee elements is performed by a noble blood vessel network and innervation is performed by nerve fibers.

Causes of knee pain

There are many causes of knee joint pain, which can be conditionally divided into various groups.

Traumatic lesions of knee elements:

1. Knee bitter.As a result of blood vessel gap, local hemorrhage occurs in the soft tissue of the joint.The redness, swelling, damage to nerve endings leads to pain, difficulty in motion.
2. Total or partial ligament rupture.More often, a partial violation of the integrity of the internal lateral ligament, which arises from excessive twisting of the leg, is diagnosed.

The outer ligament breaks less frequently than the internal.This is due to a strong diversion of the leg inward, when turning the leg, for example.The rupture of 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 internal meniscus.This injury leads to excess mobility of the knee joint, accompanied by intense pain, whose intensity depends on the degree of gap.

1. Knee joint hemarthrosis - spilling blood in the joint cavity.There is a traumatic and not human nature.Traumatic hemarthrosis is observed with meniscus ruptures, complete or incomplete ligament ruptures, intra -articular fractures, knee area bruises.The non -human option is one of the symptoms of diseases characterized by an increased reduction in blood vessel walls or a violation of the blood clotting system.These include hemophilia, legged and severe forms of hemorrhagic diathesis.The blood that accumulated in the joint cavity compresses the tissue, interrupting the blood circulation in them.A special pigment - hemosiderin - negatively affects ligaments, hyaline cartilage, a synovial bag, leading to the loss of its elasticity.The result of the joint bource injury is the swelling of its villi and the increase in joint fluid production.The result of repeated bleeding is dystrophy and destruction of the joint.
2. Knee Meniscopathy - Violation of the integrity of the knee joint meniscus.In the side form, the external meniscus is damaged, with the medial - internal.This is one of the most common, but difficult to diagnose knee articulation damage.In the risk zone of the disease, there are not only athletes involved in intensive training, but also ordinary people.The rupture of the meniscus can come from a clear movement by turning the body, turning the leg, a strong blow to the knee.
3. Knee cup dislocation - 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 with less frequency - inner, very rarely - vertical or torsion.With an incomplete dislocation, the knee glass is determined on the lateral (external) condyle, with full - from the outside of the lateral condyle.
4. Closed or open fractures of the knee joint, the upper section of leg or lower column bones. Such lesions are often combined with damage to soft knee tissues, causing massive bleeding, excessive knee mobility, its deformation.

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

1. Arthritis - Inflammatory damage to knee joint.A similar mechanism for the development of pathology is observed with osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, gout (with the deposition of urats in the joints).
2. Osteoarthritis (gonarthrosis) With the defeat of the non -inflammatory knee articulation, affecting all its structures and leading to serious degenerative changes.
3. Bursitis With the inflammation of the synovial, Bursa leads to pain during flexion and extending the knee movements.
4. Knee joint periartitrite tendons - Inflammation of the paw goose capsule, knee tendons, as well as muscles and ligaments around 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. Patella -Generative-no-chic in the articular surface cartilage (rear) of the patella.The degree of destruction may be different: from light softening areas to cracks and complete abrasion.

6. Chondomatosis - A severe chronic disease due to the dysplastic process with the degeneration of the articular membrane sections in the cartilage - Chandrom.The ossification of individual cartilaginous bodies is not excluded.
7. Baker 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, he squeezes the blood vessels and nerves, leading to impaired innervation and blood circulation.
8. GOFF disease - A disease, accompanied by damage and additional degeneration of adipose tissue located around the knee joint.Pinks, edema and other adipocyte cell damage - end with dense fibrous tissue replacement.As a result, the buffer function of the "fat pillow" is interrupted, adipose tissue itself becomes unable to play the role of the shock absorber.
9. OSGUD DISEASE - A pathology characterized by murders from the bugous of the tibia.Diagnosis in adolescents aged 10 to 18 years playing sports.A painful collision appears below the patella, in the absence of treatment, leading to leg restriction or complete immobilization as well as muscle hypotrophy.

Diseases in which the irradiation of knee pain is possible:

1. Hip joint cokearthrosis - Chronic damage to the hip joint, accompanied by progressive degeneration and dystrophic changes in it.Often the pain spreads through the outer surface of the thigh to the knee or below.
2. Seduce nerve neuropathy - Non -inflammatory damage to the nerve as a result of compression tightening or spasms of blood vessels.This nerve reaches the feet, starting on the lower back and passing through the scenery and the pelvis.The lock at any point by its length leads to impaired sensitivity or pulsating pain.
3. Fibromyalgia - Extracting the defeat of non -inflammatory soft tissues with a combination of symptoms in the form of arthralgia, muscle weakness, depression, etc.

Some systemic diseases that lead to knee pain:

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

Knee pain types

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

• Sore.With arthritis, osteoarthritis.
• Acute, strong.With fractures of knee elements, ligament rupture, acute bush, knee bruises, exacerbation of meniscopathy, deforming osteoarthritis.
• Pulsating.With a deforming arthrosis launched, meniscus injury.
• Drilling.With osteomyelitis.
• Dumb.With chronic burit osteochondritis.
• Burning.With the sciatic nerve compression, the tuberculosis process in the bone.
• Shooting. By squeezing the nervous trunk.
• Walking pain.With baker cyst, bushing, arthritis, gonartrosis, periority.
• The pain alone. With gout, arthritis.

Diagnosis of pathologies that cause knee pain

Physical examination:

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

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 scholarship;
• bone biopsy of puncture.

Non -invasive instrumental diagnosis:

• knee joint radiography;
• densitometry;
• Ultrasound joint joint study;
• Magnetic resonance imaging or CT.

Knee pain treatment

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

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

• significantly reduce the length of walks and remain in the legs during the day;
• Temporarily (before recovery) athletes abandon training and ordinary people of running or jumping;
• By increasing pain, completely abandon the movements, apply a dressing of a knee elastic bandage;
• Use a bandage or a bandage for knee joint immobilization;
• With a bruise, cold instead of traumatic effects.

Rheumatoid, psoriatic arthritis, systemic autoimmune diseases need severe integrated treatment, performed for many months.Basic therapy consists of immunosuppressants, anti -inflammatory and hormonal non -esteroids, gold preparations, etc.

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

With deformed osteoarthritis, intra -articular injections of glucocorticosteroids, prolonged Ice of NSAIDs and chondroprotectors are effective.To relieve pain syndrome, compress with painxide or bischofit, ointments and gels with anti -inflammatory effects are prescribed locally.Massage, physiotherapy, therapeutic gymnastics help.Severe knee joint injuries require surgical intervention - joint endoprostrate.

The treatment of osteoporosis consists of taking bisphosphonates, calcitonin, calcium preparations, vitamin D, etc.

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

Types of surgical intervention:

• Meniscectomy;
• Partial Meniscectomy (incomplete);
• meniscus transplantation;
• arthroscopy;
• Arthroscopic sewing of meniscus rupture.

With any knee injury, after treatment, the rehabilitation period, which should occur under the control of a rehabilitologist or orthopedist, is very important.The doctor will compile an ideal joint recovery program.The main post -operative rehabilitation methods are massage and therapeutic gymnastics.Special simulators classes are also effective, gradually developing a knee joint.