Knee pain: causes, diagnosis and treatment

Knee pain caused by injury or disease

Knee pain occurs in patients of all ages and lifestyles. Such pain is observed during physical activity for various reasons: from an injury or bruise to significant disease and inflammation. Ignoring it can lead to serious consequences. A common question is what to do if you are in pain? At the first painful sensation, it is recommended to consult a doctor to prevent hospitalization, the treatment should be carried out only by a doctor.

The first manifestation of knee pain is usually caused by heavy loads, wear and tear and deformation of the joint. The disease is felt not only with excessive stress, but also at rest, during rest and during daily activities. In this article we will consider why the knee hurts, the main methods of diagnosis and treatment.

What is the knee joint?

The knee joint of our body carries a lot of load and body weight, it is responsible for most injuries and stress during falls, sports and weight lifting. The knee joint itself is one of the largest in our body.

The knee joint includes:

  • the joint itself;
  • muscles;
  • knee cap;
  • menisci;
  • joint capsule;
  • the ends of the femur and tibia,
  • vessels,
  • nerves,
  • connections
A model of the knee joint that allows you to appreciate its structure

Each of these components is susceptible to damage, although pain is not always immediately felt. For example, with a displaced or torn meniscus and a torn ACL, mobility will be reduced and vascular damage will cause a hematoma. Infection can start in the joint capsule of the knee after infectious diseases. If the patient has a neurological disease, a shooting pain may be felt in the knee. It can also radiate into the joint with pain in the femur, tibia and muscles.

Causes of joint pain

The nature of pain can be divided into two groups: acute and chronic. Acute pain is characterized by rapidly developing and progressive pathologies. Chronic diseases, on the contrary, progress rather slowly and require lifelong treatment. The causes of such pain and, accordingly, the treatment are also different.
Let's look at the main causes of pain.

Pain due to injuries

The cause of acute pain is injuries and various traumatic actions. You can injure yourself due to a bad fall, playing sports or wearing uncomfortable shoes. The pain starts to be felt a few days after the injury. Usually, the knee is slightly swollen and victims experience quite tolerable pain. Depending on the severity of the injury, there may be abrasions on the surface of the skin. In addition, overweight, the abuse of bad habits and the peculiarities of the profession and work increase the risk of injury.

Types of injuries:

  • Knee bruise.Frequent and light damage. Swelling and redness appear in the knee area, the surface temperature rises. Even a minor injury to the knee can cause destruction of joint tissue cells.
  • Sprains.Sometimes the strain of a muscle, ligament or tendon goes unnoticed and causes shooting and sharp pain in the knee, and the joint itself becomes unstable when stepping on the foot.
  • Breaking ties.It can appear due to a strong twisting of the leg in an unnatural direction and causes severe pain, swelling and swelling.
  • Meniscus tear. It occurs as a result of a heavy load, a blow to the knee, a twisting of the leg and due to its unnatural position. A torn meniscus causes your legs to stop moving normally. It often occurs in athletes and is accompanied by swelling, hemorrhage and inability to bend the leg. There is one rule regarding sports: the knee may hurt, but it should be gone the next morning after training. If the disease does not disappear, you should consult a doctor.
  • Joint fracture.As a result of the fracture, the soft tissues are also damaged, which leads to severe pain and deformity of the knee.

Unpleasant sensations in the knee are not always characterized by a disease in this department. Sometimes a herniated disc can cause knee pain at night. Discomfort can also occur if the knee joint is used too little and the muscles associated with it lose tone.

Asymmetry of the sacrum and pelvic bones can also provoke the appearance of pain in the knee joint. It occurs as a result of a difference in the length of the lower limbs, which can be a consequence of congenital features or curvature of the pelvis, including due to scoliosis.

Diseases of the knee

Any inflammation or damage to the structure of the knee causes discomfort, especially when moving. And the infection is not always localized in the knee itself. In general joint diseases, the whole body is affected, with the knees being more damaged due to severe stress. Also, with injuries or diseases of the spine or fracture of the neck of the femur, pain in the knee joint may occur. Let's look at some of them:

  1. Arthritisis an inflammatory process that develops after trauma from infection or metabolic problems. If left untreated, the cartilage in the knee joints continues to wear down, resulting in increased pain.
  2. Rheumatoid arthritis– an autoimmune disease in which the body's defense cells negatively affect tissues. The joint loses mobility, edema appears, the pain is constant and is expressed in an increased feeling of stiffness.
  3. rheumatism- as a rule, teenagers are susceptible to it, as well as people who have recently had streptococcal diseases. It is characterized by alternating unpleasant sensations.
  4. Gonarthrosis (arthrosis).It develops in one or both knees. This disease is characterized by the appearance of degenerative-dystrophic processes with the growth of connective and bone tissue, which interferes with movement. At the beginning of the disease, the discomfort starts to be felt only after a long walk, but as the disease progresses, the pain begins to appear even after walking short distances. Difficulty getting up from a chair, squatting, or climbing stairs. Pain doesn't just bother you at rest. Destruction or thinning of the cartilaginous cushioning tissue occurs. With the development of gonarthrosis, there is a creaking in the knee and deformation of the joint.
  5. Reactive arthritis– starts a few days after an intestinal infection. Severe pain combined with swelling and redness of the skin over the right or left knee usually indicates reactive arthritis.
  6. bursitis– inflammation of the joint capsule, leading to severe pain and discomfort when moving.
  7. Periarthritis– inflammation of the tendons, muscles and ligaments around the knee joint. Painful sensations appear with increased load on the bent leg.
  8. Chondropathy– destruction of the cartilage that surrounds the knee joint and cushions friction and impact.
  9. New formations– when they appear, the vessels are compressed and the joint capsule is deformed, which causes pain and limits mobility.
  10. osteoporosis- the tissues weaken, become more fragile, the calcium content in the bones gradually decreases.
  11. Osteomyelitis- inflammation of the bone tissue occurs in the affected area, accompanied by swelling, fever and acute severe pain.
  12. Osteoarthritis– the inflammation in the joint capsule is gradually localized to the heads of the bones. The cartilage wears down and thins, causing the bone heads to not slide easily when the limb moves. An aching pain occurs.
  13. Osteoarthritis– a disease that affects all components of the joint.
  14. Patellofemoral pain syndrome– often occurs in young patients. During physical activity, the knee cap moves forward. This happens due to incorrect position of the foot, excessive and heavy loads with unprepared muscles.
  15. Osgood-Schlatter disease– knee pain when bending over, walking up stairs, squatting.
  16. Nerve damage and nerve tissue disorders.There are shooting pains, numbness and tingling of the lower limb, loss of mobility. A pinched nerve occurs due to inflammation, neoplasms or previous injuries. Or neuritis develops - inflammation of the nerve in one or more areas. Severe pain is felt, mobility and sensitivity decrease, the limb involuntarily contracts.
  17. Impaired blood supply.
  18. Various other infectious diseases.The resulting complications contribute to the appearance of weakness and pain.

In addition to the listed diseases, others can contribute to the appearance of pain: synovitis, ligamentitis, tendinitis, gout, neuropathy, cyst and others.

Thus, knee pain is always a sign of a pathological process that affects the cartilage, bone or soft tissue structures of the knee itself or damage to the nerve that innervates it.

Diagnosis of knee pain

The diagnosis of knee pain involves palpation of the affected joint

In order to start treatment, it is necessary to establish an accurate diagnosis by a doctor in the clinic, using diagnostic measures.

The patient seeks an appointment with an osteopath, orthopedic traumatologist, surgeon or rheumatologist. If necessary, after an examination and examination, the patient can be sent to another specialist.

When registering, the doctor collects anamnesis - complaints, symptoms and problems that concern the patient, infections and chronic diseases. The doctor can then palpate the affected area and ask the patient to perform various movements and tests. For example, bend and straighten your knee. This will give initial information about the extent of the malaise.

In order to obtain additional information and determine an accurate diagnosis, the patient is sent to one or more tests:

  • radiography (x-ray);
  • ultrasound examination (ultrasound);
  • magnetic resonance imaging (MRI);
  • computed tomography (CT);
  • arthroscopy (a special instrument, an endoscope, is inserted into the joint);
  • puncture to collect synovial fluid;
  • laboratory tests (general and biochemical blood tests, serological tests).

For the diagnosis of nerve diseases, MRI and CT are used, depending on the contraindications. Some diagnoses require more precise tests.

To relieve knee pain, you can visit an osteopath, physiotherapist, chiropractor or massage therapist. The osteopath will help to restore the normal position of the pelvic bones and internal organs, which has a positive effect on their functioning, will improve the nutrition of all spinal structures by activating blood circulation, and improve posture by eliminating spinal deformities.

Treatment of knee pain

It is impossible to choose the best medicine for knee pain on your own. This is due to the fact that it is necessary to first establish the true cause of the symptoms and determine the type of pathological disorders in the body.

The treatment of the knee joint is carried out complexly. This set of measures includes:

  • medicinal (non-steroidal anti-inflammatory agents or chondroprotectors - their effectiveness consists in preserving moisture in cartilage cells, inhibiting enzyme action and stopping the degenerative process);
  • preparations, solutions for external use;
  • osteopathy;
  • performing special exercises and gymnastics, physical therapy;
  • physiotherapy techniques;
  • massages;
  • vitamin complexes are drugs designed to improve metabolic processes in the body.

Different types of physical therapy treatments can be used to treat musculoskeletal conditions that cause knee pain.

Exercise therapy classes are simple and accessible to people of any age, as the individually developed program ensures the creation of a precisely dosed load. For complex therapy, local pain relievers are also prescribed, for example, ointment with dimethylsulfoxide (there are contraindications: severe diseases of the kidneys, liver, cardiovascular system, pregnancy, breastfeeding) or anti-inflammatory gel - it is immediately absorbed into the skin, penetrates into its deep layers, relieves swelling and pain.

Pain can also be eliminated with the help of high-frequency techniques: the morphological changes remain, but the pain decreases and becomes lighter. Also, special orthoses are often prescribed - bandages, knee braces, splints, tapes, casts and other similar devices. This allows you to transfer the load from the knee and unload it, reducing the risk of re-injury and promoting rapid rehabilitation. Rarely, plasmalifting is used - injection of plasma obtained from the patient's own blood directly into the affected knee joint or the soft tissues around it.

Sometimes a bone realignment procedure or surgery is performed (for example, if bone fragments need to be removed).

In addition, the doctor prescribes painkillers that do not have a negative effect on the articular cartilage.

Pay attention to your diet - a balanced diet can prevent inflammation.

If you have knee problems, you should not self-medicate and attend various procedures to avoid surgical intervention (operation) and possible complications. This attitude can only worsen the situation and more serious and complex therapy will be required. That is why it is important to consult a doctor who will make an accurate diagnosis and prescribe competent treatment, procedures and drugs that will give an effect. Take care of yourself and your health!