Knee pain (knee joint)

Knees are more susceptible to injuries and various diseases than other joints.A significant proportion of orthopedic-traumatologist and rheumatologist patients complain of severe knee pain.From this article you will learn what to do if you suddenly feel severe pain.She is being treated, the main thing is to consult a doctor in time to solve her problems. 

What exactly causes knee pain?

The knee joint is the most complex joint, because it bears the main load.Structure: three bones (femur, tibia and patella form a single trochlear joint, made up of two interconnected joints: femorotibial (tibiofemoral) and patellofemoral (patellofemoral).

The patella is a flat sesamoid bone (additional in the joint) that attaches to the head of the femur, slides into its concave groove, and acts as a block.Structural characteristics: the anterior surface of the patella is covered with periosteum, the posterior surface, connected to the femur, is covered with hyaline cartilage.The patella is reinforced by ligaments: main and lateral – vertical (upper and lower) and horizontal (lateral – internal and external).

O transmits the force of the quadriceps femoris muscle to the musculoskeletal formations of the lower leg, ensuring extension of the lower leg at the knee joint.The surface of the bones forming the joints is covered in cartilage which acts as a shock absorber.Additional shock absorbers that protect the joint from injury are two crescent-shaped cartilaginous menisci located between the femur and tibia.The joint is held in its correct position by the ligaments, tendons and capsule that surrounds it.

Injuries and diseases affect various joint tissues.Not everyone can get sick.Thus, the cartilage tissue does not have nerve endings and can therefore be destroyed imperceptibly and painlessly.But the ligaments and the synovial membrane have many nerve endings and in case of injury or inflammatory processes, they immediately begin to react, which manifests itself in the form of severe pain.In cases of significant destruction of articular cartilage, pain may be associated with the involvement of the periosteum, the outer layer of bone that has good innervation, in the process.

What to do if you have severe knee pain

Severe knee pain may appear suddenly or develop gradually.In any case, it often becomes unbearable.If you experience severe pain, you should calm down and seek medical attention immediately.All this can be treated, specialists will be able to help even in cases of advanced illness.If you can't see a doctor right now, you can temporarily relieve the pain on your own.

But remember that if you feel pain in the knee joint, this is a temporary measure;you should always consult a doctor;you can't do without it.And it's better not to delay.

How to Treat Knee and Leg Pain at Home

To relieve your condition of severe pain in the knee joint, you can take the following emergency measures:

• Treat pain with tablets.
• Use external painkillers (ointments, gels).
• Injections.If there is no effect from tablets and external agents, the drug is administered by intramuscular or subcutaneous injection.

Many medications can be purchased at pharmacies without a prescription.

For chronic pain in the knee joints, when there is no significant inflammation, you can perform physical exercises that strengthen the musculo-ligamentous system, improve blood circulation and metabolism.Systematic training leads to a gradual decrease in pain, despite the fact that the legs are rather crusty.

An approximate set of exercises for knee pain:

1. Fixed knee.Lie on your back, bend one leg at the knee, raise it and hold it in this state for a minute;the second leg is still at this time;straighten and lower your leg very slowly, rest for 10 seconds and repeat the exercise with the other leg;repeat 10 times;
2. Double leg curl with knees close to face.Lie on your back, bend your legs at the hips and knees, fix the latter near your face and hold it like this for a minute.Then slowly straighten and lower your legs, rest for 10 seconds and repeat;do 5-6 sets, gradually increasing the load.

Acute knee pain requires a state of rest;any physical activity and training are contraindicated.

In case of acute pain in the knee joint, accompanied by swelling and redness of the skin, a violation of the general condition, fever, you cannot move the leg, it must be kept at rest.And only after the inflammation begins to subside, you can move first to passive exercises (performed by an assistant), and then to active exercises (performed by the patient himself).

What not to do if you are in pain

For chronic pain, the following should not be allowed:

• bruised knee - you can avoid this by organizing your life in a way that minimizes the risk of injury;
• excess weight places an additional burden on the knees, especially in the elderly;
• intense physical activity, jumping, strength sports;You shouldn't run either;
• any intoxication, it is therefore necessary to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and foci of infection;
• wear uncomfortable tight shoes, high-heeled shoes;
• stress, lack of sleep;
• sedentary lifestyle - you need to force yourself to move at certain intervals.

It is also impossible to apply hot compresses without a doctor's prescription: in case of purulent and hemorrhagic processes (with intra-articular bleeding), they can cause irreparable damage.

When you need to see a doctor urgently

If you have knee pain, urgent medical attention is needed if the following symptoms appear:

• swelling, redness, and tenderness of the knee associated with fever and general malaise;
• severe knee pain immediately after the injury or some time after;
• gradual increase in pain intensity;
• pain appearing periodically after physical exertion, prolonged standing, sharp straightening of the leg;
• nocturnal pain and associated insomnia;
• if the knee pain is very strong, constant, feeling of pain inside the kneecap.

In any case, knee pain should be a reason to see a doctor.There is no point in self-medication: it may temporarily alleviate or even eliminate the pain, but it will not stop the progression of the disease and the destruction of the joint.Treatment should be entrusted to a specialist.

What to do with severe knee pain of different types

Painful sensations in the knee can vary in nature and duration depending on the person.They may be constantly painful or develop only under certain loads, at night, etc.For example, some pathological processes are characterized by knee pain when bending, others - knee pain when walking, etc.Only a specialist can understand what exactly hurts and why, and how to help the patient.

Knee pain due to coronavirus and other viral illnesses

Viral infections can cause joint inflammation.As a rule, these diseases develop against the background of an existing infection and disappear without any consequences when completed.So, with influenza and other acute respiratory viral infections accompanied by acute fever, short-term joint and muscle pain as well as acute arthritis with inflammation and swelling of the knee joints may appear.Their development is favorable.

Coronavirus infection has its own characteristics: it occurs differently in each patient.Why this happens is unknown.During the disease, aching joint pain, swelling and redness sometimes appear - a sign of acute arthritis, but then they disappear.

Arthritis, which appears about a month after infection with the coronavirus, is more dangerous.The fact is that it has a significant effect on the immune system.Malfunctions of the immune system lead to the development of autoimmune processes.This is especially dangerous for people whose loved ones suffer from chronic arthritis.Experts note a high risk of developing rheumatoid arthritis (RA) in these patients.The first sign of RA is stiffness of movements in the morning (difficulty bending the knee).

If arthritis appears after recovery from a viral infection, you should immediately contact a rheumatologist.

Severe pain below the knee

This may be a sign of the development of a Baker's cyst - a distended synovial bursa with fluid located in the popliteal region.The cyst and associated pain below the knee appear because it is connected to the socket of the knee joint and is filled with synovial fluid.In this case, reverse flow of liquid is difficult for various reasons.Most often, the cyst develops against the background of bruises, arthrosis and arthritis of the knee.

A small cyst can go unnoticed for years.But with its large size, the surrounding tissues begin to be compressed, causing pain below the knee, which intensifies with physical activity, including walking and running.Women get sick more often.Sometimes the cyst disappears on its own, but often it progresses and increases in size, which can lead to rupture or suppuration.

If you experience pain below the knee, it is best to see a doctor as soon as possible.Conservative (removal of fluid from the cyst, injection of glucocorticoids into it) and surgical (removal of the cyst) treatment is carried out.

Severe pain in left or right knee

Severe pain associated with swelling and redness of the skin in the right or left knee area usually indicates the development of an acute inflammatory process.It can be acute nonspecific arthritis (the process can become purulent), reactive arthritis, which begins a few days after a urogenital or intestinal infection.Both diseases have similar symptoms;a correct diagnosis can only be made after a complete examination.

The right or left knee can suffer from microtrauma, for example in athletes or workers in certain professions who use one knee more (usually the right).

It is important not to use folk remedies at an early stage, but to carry out the appropriate treatment, this will allow you to fully recover and forget about the pain forever.But even in cases of advanced diseases, a specialist will always be able to provide assistance and relieve pain.

Knee and leg pain

Depending on the cause of the disease, its course and the presence of complications, severe knee pain may include:

• in the shin below the knee– are rare, this may indicate compression of the nerve branches innervating the muscles of the lower leg by the inflamed and swollen periarticular tissues at the knee;pain below the knee in the back indicates compression of the branches of the sciatic nerve, and pain below the knee in the front indicates that the nerves innervating the anterior aspect of the leg are affected;These diseases are treated by a rheumatologist, but a consultation with a neurologist is necessary;
• above the knee, in the thigh– is often a sign of a post-traumatic inflammatory process at the patellofemoral joint;in this case, patellofemoral pain syndrome develops;the pain is strong, aching, sometimes jerking, aggravated by walking;an orthopedist-traumatologist and a rheumatologist will help you cope with pain;
• from the side, from the inside– pain can develop with an injury and damage to the internal lateral articular ligament;the pain in the side is strong, jerking, with hemarthrosis (intra-articular hemorrhage) - bursting, accompanied by an imbalance of the joint, the whole leg cracks when moving;the same pain appears in the event of a sprain of the external collateral ligament;assistance will be provided by an orthopedist-traumatologist.

To eliminate pain, you need to accurately determine its cause, which is impossible to do on your own.Need help from a doctor.

Patellar pain on the back, front and sides

Patellar pain is almost always the result of acute or chronic injuries:

• back knee pain- the causes are associated with damage to the patellofemoral joint with the development of patellofemoral pain syndrome;the pain is painful, constant, aggravated by walking;
• Before– these painful sensations are caused by superficial contusions of the knee or frequent prolonged stay on the knees with microtrauma of the patella;the pain is significant, because the periosteum, rich in nerve endings, is injured;
• lateral knee painin case of rupture or injury of the internal or external horizontal patellar ligaments;an injury can develop with frequent long-term microtrauma of the ligaments, for example, when jumping;accompanied by bleeding into the joint cavity (hemarthrosis);the pain is strong, constant, accompanied by swelling;leg movements are impaired.

To prevent the development of permanent dysfunction of the joint at the site of injury, you should immediately seek help from an orthopedic traumatologist.

Knee pain radiating to the leg, heel, groin

The causes of acute radiating knee pain need to be understood.The reason may be:

• femoral nerve entrapment;the pain is sharp, piercing in nature, begins sharply in the groin region, spreads along the anterointernal surface of the thigh and knee, along the nerve branches, it can reach the inner edge of the foot and heel;sometimes the patient has the impression that the knee hurts, but this is not the case;
• arthritis (gonarthritis) of various origins: swelling of the joint leads to pinching of the nerves and the spread of acute pain in the knees to the groin and to the heel;in this case, mainly aching pain is felt in the knee area, which, with sharp movements, turns into sharp pain with radiation above and below the knee;
• ecchymosis accompanied by hemarthrosis, rupture of ligaments, severe swelling and compression of nerves;
• bruising with fracture or dislocation of the patella and imbalance of the joint;sharp knee pain extends along the thigh to the groin, along the inner surface of the shin - lower, to the heel.

Severe knee pain of this nature requires immediate medical attention.No folk remedies will help you, you need to call an ambulance.

Knee pain when extending and flexing

Most often, knee pain during flexion and extension, as well as when squatting, is a sign of tendinitis - an inflammatory process in the tendon-ligamentous apparatus of the knee joint.It develops mainly in young men playing sports and is a consequence of frequent repeated microtrauma associated with jumping and constant shaking of the limb.The first sign is the inability to straighten the knee without pain.

The cause of painful flexion and extension of the knee can also be osteoarthritis - degenerative-dystrophic changes in the joint with the growth of connective and bone tissue that interferes with movement.

Only the treatment of tendinitis or osteoarthritis can relieve the patient of intense knee pain during flexion and extension.

Severe knee pain at night

Night pain is characteristic of inflammatory processes.It may be latent arthritis, periodic inflammation of the knee joint due to osteoarthritis (osteoarthritis-arthritis).During sleep, joint and periarticular tissues heat up, blood vessels dilate, which increases swelling.

The periarticular tissues swell, compress the nerve endings and pain appears.If at the same time there is pain behind the knee, this may be a sign of a Baker's cyst.How to get rid of swelling and pain at night?Treating the underlying disease is helpful.

Knee pain when walking

Pain during movement, jogging, shooting pains below the knee are characteristic of degenerative-dystrophic processes in the knee - osteoarthritis, since during movement the joint surfaces are injured, completely or partially devoid of shock-absorbing cartilage.The periosteum, which has good innervation, suffers.Knee pain when going down stairs is also very common.After exercise, patients find that the knee pain continues to hurt for some time.Over time, pain appears in the foot.

Long-term rehabilitation treatment using chondroprotectors - drugs that restore cartilage tissue - will be useful.In case of complete destruction of the joint - endoprostheses.

Pain after exercise - squats, running, weight training

This indicates long-term microtrauma of the knee joints and the gradual formation of degenerative-dystrophic processes.Sometimes pain appears in a right or left knee.Joints creak.

If there is severe pain in the knee after training, the athlete needs rehabilitation treatment.Otherwise, there will be a gradual decrease in joint function, accompanied first by periodic and then constant pain.

Knee pain and cracking

Sudden, sharp knee pain and crackling (crackles) sounds indicate a rupture of the meniscus – the shock-absorbing cartilaginous pads in the knee joint.This may be the result of injury or age-related wear and tear of the cartilage structures.

Severe joint pain may disappear, but knee pain will persist when squatting, then limb dysfunction will gradually increase, accompanied first by pain during exercise, and then by constant pain, which intensifies when going down the stairs.Over time, the entire limb suffers and cracks, including the foot.Long-term rehabilitation treatment under the supervision of an orthopedist-traumatologist is useful.

Knee pain and swelling

Pain accompanied by swelling always indicates the presence of an inflammatory process.It can be aseptic (without the presence of infection, generally after an injury), infectious, infectious-allergic and autoimmune (with an allergy to one's own tissues).

To get rid of these pains, you need to identify their cause and carry out the treatment prescribed by a specialist.

Injuries and illnesses causing knee pain

The most common pathologies accompanied by knee pain are:

1. Closed and open knee injuries with intra-articular fractures, dislocations, meniscus tears.All of them lead to the development of inflammatory processes (arthritis), which subsequently turn into degenerative-dystrophic processes (osteoarthritis) with the formation of constant pain and dysfunction of the knee.It is the most common cause of knee pain.Athletes are in danger.Even a minor knee injury can cause the destruction of joint tissue cells, which leads to the development of an inflammatory process.In case of significant injuries, all these processes are pronounced and are accompanied by prolonged pain.Of great importance is knee instability, which develops when the ligamentous apparatus is damaged.Over time, instability increases, nearby tissues are injured, which leads to increased pain in the knee joint, especially when descending stairs.In the absence of appropriate treatment, the process can be complicated by infection, become purulent, threatening the patient's life, or become chronic with progression and gradual destruction of the joint, accompanied by severe pain.
2. Arthritis of the knee joint is an inflammatory process of various origins, accompanied by an increase in body temperature and a violation of the general condition of the patient.Patients complain that knee pain is constant.The disease can be infectious, infectious-allergic, autoimmune and metabolic in nature.The inflammatory process also occurs differently, depending on the cause that caused it (purulent, rheumatoid, psoriatic, gouty and other arthritis).Sometimes arthritis can be complicated by a Baker's cyst located in the popliteal region.Then there is pain behind the knee.Only adequate treatment prescribed by a traumatologist or rheumatologist will prevent joint destruction and disability.
3. Osteoarthritis of the knee joint is a degenerative-dystrophic process in the joint that develops after injuries, acute and chronic inflammatory processes and against the background of age-related metabolic disorders in elderly people.There is destruction or thinning of the shock-absorbing cartilaginous tissue (menisci and cartilaginous layer covering the articular surfaces of the bones).The destruction of the joint progresses slowly but steadily.I fear pain and crunching when I move.In older people, it is the main cause of knee pain.The bones rub against each other, their structure is destroyed, the joint is deformed, all this is accompanied by severe pain.
4. Cysts and tumors.

How to Treat Severe Knee Pain

Injuries and diseases of the knee often lead to the development of patellofemoral pain syndrome (PFPS), pain in the anterior part of the knee joint.Joint changes gradually destroy the patellar cartilage, contributing to the development of joint instability and intense, constant knee pain.Only rehabilitation treatment prescribed by a qualified specialist can help.

Diagnosis

Knee pain has different causes and requires an individual approach to treatment.First of all, it is necessary to make a correct diagnosis, which will require examination in the clinic.And only after that treatment is prescribed for knee pain.

Some diseases cannot be completely cured, but the doctor can eliminate the pain and stop the destruction of the joint.

To establish the causes of pain and diagnose the disease, the following examination is carried out:

• Laboratory tests– clinical, biochemical, immunological blood test, if necessary – collection and examination of intra-articular fluid (microscopy, culture on nutrient medium to determine the sensitivity of the identified infection to antibiotics).
• Instrumental studies: Ultrasound– reveals soft tissue pathology and intra-articular fluid volume x-ray– changes in the bone tissue of the knee; CT and MRI– a more detailed study of the pathology of soft and hard tissues; diagnostic arthroscopy– the appearance and modifications of the synovial membrane of the knee.

Methods to treat severe knee pain

Treatment measures are prescribed individually.Pain associated with a knee injury is treated by an orthopedic traumatologist;if the disease becomes chronic, a consultation with a rheumatologist is necessary.If a purulent inflammatory process is suspected, then the surgeon will be better able to treat the disease.All chronic inflammatory processes in the joints are treated by a rheumatologist, but specific infectious processes, for example, tuberculosis of the knee, are treated by a phthisiatrician or other specialist in close contact with a rheumatologist.

First of all, they try to eliminate pain as much as possible, using for this purpose both drug therapy (modern drugs for knee pain, including ointments) and non-drug remedies for knee pain (manual therapy, massage, therapeutic exercises, reflexology courses and other traditional methods, folk remedies).To reduce the load on the joint and create rest, various methods of immobilization are used (splints, splints), as well as tape - fixing the joint using special adhesive tapes.

For all acute joint pain, an emergency examination of the patient is carried out with simultaneous anesthesia.All modern and traditional methods of pain treatment are used in the treatment.After that, depending on the indications, the patient is either hospitalized or outpatient treatment followed by rehabilitation is prescribed.No patient suffering from pain is left without the attention of specialists.