Knee joint pain - causes, effective treatment, diagnosis

Every person experiences knee joint pain from time to time. This could be the result of sudden movement or a symptom of progressive pathology. The knee joint is the largest and most 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 tissues make every injury, even a small one, extremely painful. Injured nerves cause an infectious-inflammatory process, which is accompanied by swelling, skin discoloration, and an increase in local temperature.

As progress progresses, the joint itself, intra-articular fluid and connective tissues are drawn into the pathological state, which can have serious consequences - the development of arthritic diseases. 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 zone of the joint is formed by the patella, in a simpler language - the patella. It is connected with the quadriceps (fascicularis) muscle of the thigh, which continues into the patellar ligament and usually forms a ligament apparatus, which consists of the following types of fascia:

• Lateral branches of the tibia (small and large);
• rear support nodes - sickle-shaped, dorsal, median and lateral;
• transverse and cruciate ligaments of the knee joint.

Cruciate ligaments are more susceptible to injury - a sharp movement, a large degree of rotation, a fall with subluxation lead to ruptures of the interminimal joints.

Ligaments are divided into two types:

1. Anterior - have the function of stabilizing the ankle joint, in particular, preventing excessive forward displacement. They arise from the posterior part of the greater femur, intersect with the posterior ligaments in the knee cavity, and attach to the notch between the anterior ridges of the tibia.
2. Rear - prevent the lower leg from shifting backwards. They start at the anterior superior part of the femur, pass through the joint cavity and end between the dorsal ridges of the tibia.

On the surface of joint bones is cartilage. At the junction of the tibia and femur, there are menisci - a kind of joint lining that plays a role in shock absorption and stabilization.

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

• above the kneecap;
• deep popliteus;
• between the tendons of the long muscle of the thigh;
• hypodermic patella;
• in the recess below the knee joint.

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

Causes of pain

Inflammation can develop in the following structures:

• cartilage;
• joint sheath;
• synovial fluid;
• tibia bones;
• muscles and tendons surrounding the joint;
• 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 markedly worsen in the second stage. Pain in the knee joint occurs due to the growth of osteophytes that affect the nerve endings;
2. Arthritis is an inflammatory pathology that occurs acutely. It can be an independent disease - spondylitis, or a complication of other joint pathologies - arthrosis, rheumatism, etc. Arthritis is characterized by severe pain, accompanied by swelling and redness;
3. Osteochondritis - joint cartilage becomes inflamed over time with degenerative arthrosis, mechanical injuries;
4. Periarthritis is a disease that occurs in the context of obesity (more often in women). The pathology affects the tendons, muscles and later passes to the shell of the knee joint. Pain is moderate, pulling (as in a sprain).
5. Chondromatosis is the formation of nodules in hyaline cartilage tissue, which eventually spread throughout the knee joint capsule. In this case, soft tissue impingement with a large number of nerve cells occurs. Because of this, the knee constantly hurts, even during the rest period.
6. Bursitis - the synovial capsule of the knee joint rarely becomes inflamed, only as a result of injuries or complications from collateral joint diseases, hence the pain.
7. Cellulitis - subcutaneous fatty tissue can cause pain only in the case of very close concomitant foci of 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 - the bone marrow becomes inflamed due to bacteria that have entered the gelatinous body along with the lymph flow. It can also be the result of open injuries or a complication of surgical operations.
10. Synovitis - the capsule of the knee joint is most often affected in elderly people over 55 years old, as a result of rheumatism or other chronic pathologies. At a young age, you can get sick from a serious injury.

Types of pain depending on location

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

• Severe, excruciating pain - reactive arthritis, torn menisci and tendons, bursitis in the acute phase;
• Tolerable but constant pain - synovitis, bursitis in the initial degree;
• Pinching pain - gonarthrosis, arthrosis;
• Vibratory - degenerative arthrosis, in the joint deformation phase;
• Sharp burning pain - compression of the sciatic nerve, bone tuberculosis;
• Sting - osteoporosis, progression of inflammation of the synovial bursa, exacerbation of chronic meniscus injury;
• Cramps - inflammation in the soft tissues of the knee joint, muscles and tendons;
• Shooting pain - damage to nerve roots.

diagnostic measures

If you experience severe pain in your knee joints, you should not put off visiting the doctor, hoping that "everything will pass". Early diagnosis guarantees the success of 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 (which happens in 70% of cases of knee pain complaints) or prescribes a comprehensive laboratory and hardware examination, with the involvement of highly specialized specialists.

Running, suspicious pains are studied in different directions:

• Traumatology: if you suspect arthrosis, congenital or acquired dysplasia, joint fracture, dislocation, dislocation, radiography, MRI, ultrasound, biopsy of fluid in the synovial sac is prescribed to find out where the pain in the knee joint comes from.
• Surgery: cyst under the patella, thrombosis, arthritis with purulent formations, tears in the tendons, menisci, ligaments, stones within the joint, hemarthrosis, abscesses are diagnosed by ultrasound, fluoroscopy, CT or MRI, blood tests, factor general and rheumatoid, hyaline puncture cartilage in 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 test, uric acid level.
• Neurology and psychiatry: pinched sciatic nerve does not require a long diagnosis. 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 torment (so-called somatic pain), specific studies for mental abnormalities are prescribed.

Basic diagnostic methods

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

• X-ray - allows you to view the knee joint in various projections and determine the location of the injury. The images show lesions already in early stages, in particular changes in the bone, synovial bursa or the appearance of osteophytes.
• Ultrasound examination - a modern and highly accurate examination determines the thickness of the articular 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 determines the possible risks and condition of the inner walls of blood vessels in percentage terms.
• MRI is currently the most accurate form of diagnosis. It allows to see a clear three-dimensional image of the knee joint, pathological changes in the synovial fluid, even a slight deformation of the bone tissue, etc. It is rarely prescribed, due to the high cost and contraindications for many. It is forbidden to carry out examinations for patients with implants, metallic prostheses and weighing more than 150 kg.
• CT - the working principle is based on x-rays, only in a more modern way. The images are taken in a circular projection, which allows a more accurate image of the knee joint to be obtained and thus to determine the nature and extent of the injury.
• Angiography is a method of examining the permeability of blood vessels by injecting a contrast fluid. It determines the functionality of metabolic processes and allows the diagnosis of joint failure in the early stages.
• Complete blood count - is prescribed to identify inflammation and pain. The totality of indicators can even lead to the trail of specific diseases and determine joint pathologies only at the beginning of the 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 to determine the causes of pain and the stage of exacerbation of gout or infectious arthritis. A high level indicates accumulation of salt deposits in the joints.
• Wasserman reaction - is prescribed for suspected sexual infections, syphilis, gonorrhea, chlamydia, etc. The development of joint diseases in the context of specific diseases or as their complications is very common. Therefore, a positive test will allow you to prescribe the correct treatment, taking into account the type of infection.
• Tumor markers - help to identify special substances in the blood that are secreted by a cancerous neoplasm or its metastases. Thus, for synovial sac sarcoma, the presence of vimentin, cellular external antigen and pancytokeratin markers is characteristic.

Knee joint pain treatment

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

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

• the leg must be lifted - put on a rolled roller or a hard pillow;
• put an ice bandage on the knee and change it every 5-10 minutes;
• take an available pain reliever.

In all other cases, treatment is carried out after conducting comprehensive studies and establishing the causes. According to the anamnesis, drug therapy, physical therapy, exercise therapy, massage, homeopathic treatment, local applications, spa vacations and, in extreme cases, surgery are prescribed.

Conservative therapy

Traditional drug treatment of pain includes the following groups of drugs:

1. Anesthetics. To alleviate 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 unbearable pain require more serious medications that are only prescribed by a doctor and are available by prescription.
2. Ines. It helps to quickly relieve inflammation and swelling.
3. Chondroprotectors. Modern drugs, despite the long course of administration, provide the regeneration of cartilage tissue. The effect is cumulative and lasting (up to 10 years, joint pain may not bother after a six-month course, subject to treatment in the early stages).
4. Glucocorticosteroids. Indicated for patients with autoimmune pathologies to reduce the production of the hormone cortisol and stop the progress 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 defense system, thus stabilizing the progress of dangerous diseases such as rheumatoid arthritis, lupus erythematosus and vasculitis. They are rarely prescribed, just in case of an accurate diagnosis and the inability to eliminate knee pain in other ways.
6. Hyaluronic acid injections. They are injected directly into the cavity of the knee joint and eliminate pain and deficiency of synovial fluid. They also contribute to the restoration of hyaline cartilage, thus restoring knee mobility.

popular recipes

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

The following plants and substances have anti-inflammatory effects:

• Coltsfoot;
• Saint John's herb;
• oak bark;
• Burdock root;
• bay leaf;
• Chamomile flowers;
• Calendula;
• White and black kaolin clay;
• A salt and soda solution;
• Honey products.

For example, mix 10 aspirin tablets, previously crushed, and a glass of liquid honey. Apply a thick layer to the knee in the area where the pain is located. Cover with cling film and wrap with wool material (handkerchief), preferably left overnight. 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 clay and water mixture to prevent hardening and severe tightening of the skin.

An effective recipe that includes honey, salt and soda. Mix 1 teaspoon of salt and soda with honey, in sufficient quantity to abundantly cover the knee joint. This method performs three actions at once - it removes excess fluid, relieves inflammation and pain, enriches it with nutrients.

Oak bark in the form of a decoction or tincture of alcohol well strengthens blood vessels, promotes normal blood circulation. For a decoction, pour 1 tablespoon of dry bark with 1 cup of boiled water, cook in a water bath for 20 minutes. Soak the decoction gauze and apply to the knee in a warm (not hot) way for 30 to 50 minutes to eliminate pain in the knee joint. For alcohol tincture, use the same proportions, just replace the water with vodka. Insist in a cool, dark place for 10-14 days. Apply in the same way.

By switching various means and methods, you can preserve 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 knee joint pain

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, 1-2 group disability, housewives, etc. ).

Gymnastics can be performed independently, at a slow pace and in a viable way. Gradually increase the number of exercises or, conversely, reduce it, depending on how you feel.

1. From a lying position or sitting on a chair, slowly bend and unfold your legs until a state of mild fatigue appears.
2. Bending the leg at the knee, perform rotational movements in small amplitude, repeat the same on the second leg.
3. Lying on your back, gently pull your legs bent at the knees to your stomach.
4. Place a cushion on the chair and sit so that the legs "hang", make circular movements clockwise and vice versa.
5. Sitting on a chair, slowly straighten your leg and hold this position for 2-5 seconds, slowly lower it, repeat on the second leg.
6. Stand up straight, straighten your back, slowly bend your leg at the knee and remain in the "heron" position for several seconds. If possible, every 2 days, increase the delay time.
7. If there are no contraindications and health allows, then you can complicate the complex. Set the gym pole to the maximum level, which can be reached with one leg bent at the knee. Throw your leg over the "barrier" 10-15 times, then change your position.
8. A small complex for stretching the leg also contributes to the quick recovery of the knee joint. Support your palms on the wall, bend your right leg at the knee, put your left leg behind you. The feet rest completely on the floor. Hold the pose for 30 seconds. Switch legs.

Regularly performing simple gymnastics, accessible to anyone, will give visible results in a month - pain in the knee joint will cease to bother, 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. It is worth remembering 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 cause joint displacement and worsen the pathological condition. 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 pain in the knee. If you feel discomfort, the procedure should be stopped.

home treatment

Treating knee pain at home is a prerequisite for outpatient therapy. The patient by all permitted methods should help himself to relieve pain and recover as quickly 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 - be sure to take prescribed medications, do feasible gymnastics, arrive in time for physical therapy.
• 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 on the knee joint - a cane, crutch and other special devices.
• Do not use, without prior consultation with a doctor, recipes of traditional medicine, even tested by time and neighbors. What helps one person may be categorically contraindicated for another.
• During the treatment period, if possible, avoid physical activity and ensure bed rest so that the pain does not return (therapeutic exercises are an exception).
• Provide a comfortable place to sleep and rest - orthopedic mattresses, comfortable chairs and armchairs, preferably with small supports so you can comfortably lift your aching legs.
• Light self-massage is allowed. Stroking, rubbing promotes 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 completely insure against injuries, sprains or dislocations of the most heavily loaded joint in the body. Everyday life forces you to do your household chores, go to work, etc. In the course of normal activities, it is quite possible to receive an unexpected injury. But reducing the risk of developing joint disease is within the reach of every person. Leading rheumatologists have developed several recommendations that will help protect yourself from dangerous pathologies:

• Establish and strictly adhere to a rational regime - rest from work. This is especially true for people whose activities are associated with increased physical activity (athletes, builders, salespeople, metal workers, miners, etc. ).
• Treat timely and undergo rehabilitation after any infectious diseases. This rule applies even to "harmless" cases 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 years, it is desirable to undergo treatment with chondroprotectors.
• Carefully monitor your weight. Increasing your body weight will inevitably increase the load on your knees, it's worth remembering when eating another loaf of bread.
• To maintain a normal weight, follow the principles of a healthy diet. More vegetables and dairy - less sweet, spicy, salty, fatty and starchy foods.
• Reconsider your lifestyle - quitting smoking, drinking alcohol and other toxic addictions will have a positive impact not only on your knee joints, but on life in general. To overcome addictions, you can ask your relatives for help - the difficult stage will pass much faster and easier.

All people have experienced knee joint pain, regardless of age, gender, or social status. From the very 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 complex until old age.