Knee Pain - Causes, Effective Treatment, Diagnosis

Everyone experiences knee pain from time to time. This may be the result of sudden movement or a symptom of a progressive pathology. The knee joint is the largest and anatomically complex element of the musculoskeletal system. It accounts for 80% of body weight, leading to increased physical activity and risk of injury. The multitude of capillaries, nerve fibers, and muscle tissue makes every injury, even minor, extremely painful. Injured nerves cause an infectious inflammatory process with swelling, skin discoloration, and increased local temperature.

As the progression progresses, the joint itself, intra-articular fluid and connective tissue are sucked into the pathological state, which can have serious consequences - the development of arthritic disease. A general understanding of the knee joint anatomy will help you understand which elements cause pain and what to do to get rid of it.

anatomy

The anterior region of the joint is formed by the patella, in simpler language - the patella. It is connected to the quadriceps (fascicular) thigh muscle, which continues in the patellar ligament, and usually combines to form a ligamentous apparatus, consisting of the following types of fascia:

• Lateral branches of the tibia (small and large);
• Posterior Support Nodes - Sickle, Dorsal, Medial and Lateral;
• The transverse and cruciate ligaments of the knee joint.

The cruciate ligament is the most vulnerable to injury - vigorous exercise, lots of rotation, subluxation and falls with minimal joint rupture.

There are two types of ligaments:

1. Anterior - They have the function of stabilizing the ankle joint, especially preventing excessive forward displacement. They originate from the posterior portion of the greater femur, intersect with the posterior ligament within the knee joint cavity, and attach to the incision between the anterior processes of the tibia.
2. Rear - stops the calf from moving backwards. They start at the anterior upper part of the femur, pass through the joint cavity and end between the dorsal protrusions of the tibia.

The surface of the articular bone is cartilage. At the junction of the tibia and femur, there is the meniscus—a joint lining that acts as a shock absorber and stabilizer.

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

• above the kneecap;
• deep popliteal;
• between the long tendons of the thigh;
• subcutaneous patella;
• in the depression below the knee joint.

Thanks to the knee, a person can step, flex, and extend as far as the ligaments dictate.

cause of pain

Inflammation can develop in the following structures:

• cartilage;
• joint sheath;
• synovial fluid;
• tibia;
• muscles and tendons around the joints;
• ligament device;
• 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, gradual destruction of the hyaline cartilage. It can be asymptomatic for a long time, and it gets worse in the second stage. Knee pain is caused by the growth of osteophytes affecting nerve endings;
2. Arthritis is an inflammatory pathology that occurs in an acute form. It can be an independent disease - spondylitis, or it can be a complication of other joint diseases - arthropathy, rheumatism, etc. Arthritis is characterized by severe pain with swelling and redness;
3. Osteochondritis - Over time, articular cartilage becomes inflamed due to degenerative joint, mechanical damage;
4. Arthritis is a disease that occurs in the context of obesity (more common in women). The pathology affects tendons, muscles, and subsequently the outer shell of the knee joint. Pain is moderate, pulling (as in a sprain).
5. Chondromatosis is the formation of nodes on hyaline cartilage tissue that eventually spreads throughout the knee capsule. In this case, squeezing of soft tissue with a large number of nerve cells occurs. As a result, the knee often hurts even during rest.
6. Bursitis - The knee's synovial sac itself is rarely inflamed, only painful as a result of injury or a complication of an incidental joint disease.
7. Cellulite - Subcutaneous adipose tissue causes pain only in the presence of closely spaced foci of accompanying disease. Septic arthritis, soft tissue abscesses can cause inflammatory and painful processes of the protective layer.
8. Dermatitis - in case of infectious lesions (eczema, erysipelas, psoriasis) or allergic reactions to external stimuli, the epidermis is affected.
9. Osteomyelitis - The bone marrow is inflamed by bacteria entering the jelly-like body with lymph. It can also be the result of an open injury or a surgical complication.
10. Synovitis - Due to rheumatism or other chronic disease, the knee joint capsule is most commonly affected in older adults over the age of 55. At a young age, you can get sick from serious injuries.

The type of pain depends on the location

Diseases that cause the development of negative processes also form types of pain:

• severe, unbearable pain - reactive arthritis, meniscus and tendon tears, bursitis in the acute phase;
• Tolerable but persistent pain - synovitis of the initial degree, bursitis;
• Pinch pain - arthropathy, arthropathy;
• Vibration - degenerative joint disease, in the stage of joint deformation;
• Acute burning pain - compression of the sciatic nerve, bone tuberculosis;
• Tingling - osteoporosis, progression of inflammation of the synovial bag, exacerbation of chronic meniscal damage;
• cramps - inflammation of the soft tissues of the knee joint, muscles and tendons;
• Shooting pain - damage to the nerve root.

Diagnostic measures

If you experience severe knee pain, you shouldn't put off seeing your doctor in the hope that "everything will pass. "Early diagnosis ensures successful treatment and prevents 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 occurs in 70% of knee pain cases) or prescribe a comprehensive laboratory and hardware examination involving highly specialized specialists.

Research running from a different direction, suspicious pain:

• Traumatology: If you suspect arthropathy, congenital or acquired dysplasia, joint fracture, dislocation, displacement, X-ray, MRI, ultrasound, synovial sac liquid biopsy to find the source of knee pain.
• Surgery: Subpatellar cyst, thrombosis, septic arthritis, tendon, meniscus, ruptured ligament, intra-articular stones, hemoarthrosis, abscess by ultrasound, fluoroscopy, CT or MRI, blood tests, general and rheumatoid factor diagnosis, Knee joint transparent puncture cartilage, etc.
• Rheumatology: exclude systemic diseases (lupus erythematosus, rheumatoid arthritis, gout) with the help of laboratory tests. Complete blood count, hematology, rheumatoid protein, DNA testing, uric acid levels.
• Neurology and Psychiatry: Sciatica compression does not require a prolonged diagnosis. Already on an ultrasound, muscle tone and sites of inflammation will be visible. In the case of psychiatric disorders, when knee pain is not proven by a single fact, but the patient continues to experience torment (so-called somatic pain), specific research is done on psychiatric disorders.

basic diagnostic methods

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

• X-ray - Allows you to see the knee joint in multiple projections and determine the location of lesions. These images show lesions that are already at an early stage, particularly changes in the appearance of bones, synovial pockets, or osteophytes.
• Ultrasonography - a modern, high-precision examination to determine the thickness of the joint shell, the state of the ligamentous structures, the presence of any type of inflammation, and general changes in the knee joint.
• Doppler angiography - to check veins and arteries for aneurysms, plaques, and blockages. Quickly and efficiently determine possible risks and conditions in the lining of blood vessels as a percentage.
• MRI is currently the most accurate diagnostic method. Allows you to see clear three-dimensional images of the knee joint, pathological changes in synovial fluid, and even slight deformation of bone tissue. Because of the high cost and contraindications for many people, it is rarely prescribed. Examination of patients with implants, metal prostheses and weighing more than 150 kg is prohibited.
• CT - The principle of operation is based on X-rays, just in a more modern way. The images are taken in a circular projection, allowing you to get a more accurate picture of the knee joint to determine the nature and extent of the lesion.
• Angiography is a method of checking the patency of blood vessels by injecting a contrast agent. Determines the function of metabolic processes and allows early diagnosis of joint insufficiency.
• Complete blood count - used to identify inflammation and pain. A population of indicators can even lead to a trail of specific diseases and identify joint lesions only at the onset of progression.
• Blood for rheumatoid antibodies - also indicates inflammation, but is specific, systemic or hereditary. For example, to establish a diagnosis of rheumatoid arthritis, this analysis is used as the basis.
• Uric acid is an important test to determine the cause of pain and the stage of exacerbation of gout or infectious arthritis. Elevated levels indicate accumulation of salt deposits in the joints.
• Wasserman reaction - for suspected infections, syphilis, gonorrhea, chlamydia, etc. The development of joint diseases in the context of a specific disease or as a complication of it is very common. Therefore, given the type of infection, a positive test will likely prescribe the correct treatment.
• Tumor markers - help identify specific substances in the blood that are secreted by cancerous tumors or their metastases. Thus, the presence of vimentin, extracellular antigen and pan-cytokeratin markers is characteristic for synovial bag sarcoma.

Knee Pain Treatment

Knee pain can be classified as pain requiring urgent medical attention. and those that are pre-diagnosed. Emergencies include all injuries, fractures, dislocations, abscesses, purulent inflammation, and hemoarthrosis (bleeding in joints). Symptoms were the same in all cases - excruciating pain, swelling, redness, inability to move, hot knee and feverish state.

Until an ambulance arrives, treatment is limited to providing primary care:

• Legs should be raised - put a roller or hard pillow;
• put an ice bandage on the knee and change it every 5-10 minutes;
• Take available pain relievers.

In all other cases, treatment is administered after thorough research and determination of the cause. Medication, physiotherapy, exercise therapy, massage, homeopathy, topical application, spa holidays and in extreme cases surgery, according to medical records.

Conservative treatment

Traditional pain medication treatments include the following groups of medications:

1. Anesthetic. To relieve initial symptoms and reduce pain, you can take simple over-the-counter pain relievers. Severe cases associated with reduced mobility and intolerable pain require more severe medications, which can only be prescribed by a doctor and are available by prescription.
2. Non-steroidal anti-inflammatory drugs. Helps quickly relieve inflammation and swelling.
3. chondroprotective agent. Modern drugs, despite the lengthy course of administration, still provide regeneration of cartilage tissue. The effects are cumulative and long-lasting (up to 10 years, joint pain may not appear after a six-month course, but needs to be treated at an early stage).
4. Glucocorticoids. Indicated in patients with autoimmune diseases to reduce the production of the hormone cortisol and stop the progression of the disease. Dosages and treatment regimens are prescribed strictly by the physician on an individual basis.
5. Immunosuppressants. They inhibit the abnormal functioning of the defense system, thereby stabilizing the progression of dangerous diseases such as rheumatoid arthritis, lupus erythematosus and vasculitis. They are rarely prescribed, only when accurately diagnosed and when knee pain cannot be eliminated in other ways.
6. Hyaluronic acid injection. They are injected directly into the knee joint cavity, eliminating pain and lack of synovial fluid. They also help restore hyaline cartilage, thereby restoring mobility to the knee joint.

folk recipes

Most people who begin to experience knee pain try folk methods to relieve the discomfort. You can use homemade ointments or tinctures for lotions, compresses, and nighttime applications. Herbal decoctions, alcoholic tinctures applied topically will help prevent exacerbations over time and relieve compulsive pain.

The following plants and substances have anti-inflammatory properties:

• coltsfoot;
• St. John's wort;
• oak bark;
• burdock root;
• bay leaf;
• chamomile flower;
• Calendula;
• white and black kaolin;
• a solution of salt and soda;
• honey products.

For example, mix 10 previously crushed aspirin tablets with a cup of liquid honey. Apply a thick layer to the knee in the pain-located area. Cover with plastic wrap and wrap in wool material (scarf), preferably overnight. The pain disappeared after the first use.

Likewise, you can apply clay where the pain occurs. Add a little olive oil to the clay and water mixture to prevent the skin from hardening and tightening badly.

A potent recipe that includes honey, salt, and soda. Mix 1 teaspoon of salt and soda with honey, enough to fully cover the knee joint. This method performs three actions at once - removes excess fluid, relieves inflammation and pain, and enriches nutrients.

Oak bark in the form of a decoction or alcoholic tincture works well to strengthen blood vessels and promote normal blood circulation. For the decoction, pour 1 tablespoon of dried bark with 1 cup of boiling water and cook in a water bath for 20 minutes. Dampen gauze with the decoction and apply it to the knee in warm (not hot) form for 30-50 minutes to relieve knee pain. For the alcohol tincture, use the same proportions, just replace the water with vodka. Keep in the shade for 10-14 days. Apply in the same way.

By alternating various means and methods, the disease can be preserved for a long time, forgetting pain and swelling. Despite eliminating the main symptom - knee pain, the effectiveness of alternative medicine has not been proven.

Massage and therapeutic exercises for knee pain

Integrative traditional therapy necessarily includes exercise therapy and massage. Recommended for all with or with knee injuries, diagnosed with arthritis, arthropathy and other joint disorders, living an inactive lifestyle (sedentary static work, group 1-2 disabilities, housewivesetc. ) to exercise.

Gymnastics can be done independently, at a slow pace, and in a workable pattern. Gradually increase the number of exercises, or conversely, decrease, depending on how you feel.

1. From lying down or sitting in a chair, slowly bend and straighten your legs until you experience mild fatigue.
2. Bend the leg at the knee and perform small rotational movements, repeating the same movement on the second leg.
3. Lie on your back and gently pull your leg with your knees bent to your belly.
4. Sit down with a pillow on a chair, "hanging" your legs, and do a clockwise circular motion, and vice versa.
5. Sit in a chair, slowly extend your leg and hold this position for 2-5 seconds as you slowly lower it, repeating on the second leg.
6. Stand up straight, with your back straight, slowly bend your legs at the knees, and hover in the "heron" position for a few seconds. If possible, increase the delay every 2 days.
7. You can complicate if there are no contraindications and your health permits. Put the gymnastic stick at the highest level, which can be reached with the leg bent at the knee. Move the leg over the "barrier" 10-15 times, then change position.
8. The small complex used to stretch the calf also aids in the quick recovery of the knee joint. With your palms against the wall, bend your right leg to your knee and bring your left leg back. Your feet are completely on the floor. Hold the pose for 30 seconds. Switch legs.

Regularly do simple gymnastics that anyone can do, and within a month you will see noticeable results—knee pain will no longer be bothersome, range of motion will improve, and swelling will disappear.

If you combine gymnastics with massage sessions, the effects of gymnastics will be significantly improved. It can be either a traditional exposure method or manual treatment of pain. It should only be remembered that only experienced professionals with good advice should perform such procedures. Otherwise, manual manipulation will have little effect at best and, at worst, cause joint displacement and aggravate the pathology. Massage should be done regularly, no more than 10 times, 25-30 minutes per month. Routine procedures are strictly prohibited. During the session, there should be no pain in the knee. If you feel unwell, the surgery should be stopped.

treatment at home

Treating knee pain at home is a prerequisite for outpatient treatment. Patients should help themselves to reduce pain and recover as quickly as possible by all means allowed.

Therefore, for these purposes, it is necessary to follow some rules for treating all types of pain:

• Follow all the advice of your attending physician - don't miss taking your prescription medication, do possible gymnastics, and be on time for physical therapy.
• Check your diet. Add plenty of fresh vegetables, herbs and fruits to your diet. Excludes fatty meats, fried foods and semi-finished products.
• If necessary, use assistive tools to reduce the load on the knee joint - canes, crutches and other special devices.
• Don't use traditional medicine recipes, even tried-and-true neighbors, without first consulting your doctor. What helps one person may be absolutely no-no for another.
• During treatment, if possible, avoid physical activity and ensure bed rest to avoid recurrence of pain (except for therapeutic exercise).
• Provide a comfortable place to sleep and rest - orthopedic mattresses, comfortable chairs and armchairs, preferably with small supports so you can comfortably lift your sore legs.
• Light self-massage is allowed. Stroking and rubbing promote blood circulation, thereby enriching tissues with oxygen. As a result, muscle spasms are eliminated and pain becomes less intense.

Precaution

It is almost impossible to completely ensure that the most loaded joints in the body will not be injured, sprained or dislocated. Everyday life forces you to do housework, go to work, etc. During normal activities, accidental injury is likely. But reducing the risk of joint disease is within everyone's reach. Leading rheumatologists have some advice that will help protect yourself from dangerous diseases:

• Establish and strictly abide by a reasonable work and rest system. This is especially true for those whose activities are associated with increased physical activity (athletes, builders, sellers, metallurgists, miners, etc. ).
• Treat and recover in a timely manner after an infectious disease occurs. This rule applies even to "harmless" diseases such as acute respiratory infections or seasonal SARS.
• Avoid exposure to low temperatures, drafts. Dress for the weather to prevent hypothermia.
• By age 35, it is best to receive a course of chondroprotective agents.
• Monitor your weight carefully. Gaining weight will inevitably increase the load on your knees, which is worth keeping in mind when eating another bun.
• To maintain a normal weight, stick to the principles of a healthy diet. Eat more veggies and dairy products - eat less sweet, spicy, salty, fatty and starchy foods.
• Reconsider your lifestyle – quitting smoking, alcohol and other drug addictions can have a positive impact not only on the knee joint, but on your entire life. To overcome addiction, you can ask your relatives for help - the difficult stages will pass faster and easier.

Everyone experiences knee pain, regardless of age, gender or social status. From the very first step, the joints are subjected to various tests - falls, bruises, injuries, sports, hypothermia. Still, many people manage to keep the main compounds fluid, healthy and functional well into old age.