Pain in the knee (knee joint)

Knees are more susceptible to injuries and various diseases than other joints.A significant proportion of patients of orthopedists, traumatologists and rheumatologists complain of severe knee pain.In this article you will learn what to do if you suddenly experience severe pain.She is being treated, the main thing is to seek medical help in time with her problems. 

What exactly hurts in the knee?

The knee joint is the most complex, as it carries the main load.Structure: three bones (femur, tibia and patella form a single trochlear joint, which consists of two interconnected joints: femorotibial (tibiofemoral) and femoral-patellofemoral (patellofemoral).

The patella is a flat sesamoid bone (extra in the joint) that is attached to the head of the femur, sliding in its concave groove and acting as a block.Structural features: the anterior surface of the patella is covered by periosteum, the posterior surface, which connects with the femur, is covered by hyaline cartilage.The kneecap is reinforced by ligaments: main and lateral – vertical (upper and lower) and horizontal (lateral – internal and external).

Or it transmits the force of the quadriceps femoris muscle to the musculoskeletal formations of the lower leg, ensuring the extension of the lower leg in the knee joint.The surface of the bones that form the joints is covered with 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 ligaments, tendons, and the surrounding capsule.

Injuries and diseases affect various joint tissues.Not everyone can get sick.Therefore, cartilaginous 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 process, they immediately begin to react, which manifests itself in the form of severe pain.With 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 can appear suddenly or develop gradually.In any case, it is often unbearable.If severe pain occurs, you should calm down and seek medical help immediately.All of this can be treated, specialists will be able to help even with advanced disease.If you cannot see a doctor at this time, you can temporarily relieve the pain yourself.

But you must remember that if you have pain in the knee joint, this is a temporary measure;you still need to seek medical help;you can't do without it.And it is better not to delay.

How to treat knee and leg pain at home

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

• Treat pain with tablets.
• Use external pain relievers (ointments, gels).
• Injections.If tablets and external agents do not produce any effect, the drug is administered by intramuscular or subcutaneous injection.

Many medications can be purchased at a pharmacy without a prescription.

For chronic pain in the knee joints, when there is no significant inflammation, physical exercises can be performed that strengthen the musculoligamentous system, improve blood circulation and metabolism.Systematic training leads to a gradual decrease in pain, despite the fact that the legs are quite crunchy.

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 one minute;the second leg is motionless 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 curls with knees close to the face.Lie on your back, bend your legs at the hips and knees, fix the latter near your face and hold for a minute.Then slowly straighten and lower your legs, rest for 10 seconds and repeat;Perform 5-6 approaches, gradually increasing the load.

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

In case of acute pain in the knee joint, accompanied by swelling and redness of the skin, alteration of general condition, fever, inability to move the leg, you should 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 have pain

For chronic pain, the following should not be allowed:

• bruised knee - this can be avoided by organizing your life in such a way as to minimize the risk of injury;
• Excess body weight places additional stress on the knees, especially in older people;
• intense physical activity, jumping, strength sports;You shouldn't run either;
• any poisoning, so it is necessary to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and foci of infection;
• wearing tight and uncomfortable shoes, high-heeled shoes;
• stress, lack of sleep;
• Sedentary lifestyle: You must force yourself to move at certain intervals.

It is also impossible to apply warm 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 your knee hurts, urgent medical attention is required if the following symptoms appear:

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

In any case, knee pain should be a reason to consult a doctor.There is no point in treating yourself: it may temporarily reduce or even eliminate pain, but it will not stop the progression of the disease or the destruction of the joint.Treatment should be entrusted to a specialist.

What to do with severe knee pain of various types.

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

Knee pain from coronavirus and other viral diseases

Viral infections can cause joint inflammation.As a rule, these diseases develop against the background of an existing infection and disappear without consequences after its completion.Therefore, with influenza and other acute respiratory viral infections with acute fever, short-term joint and muscle pain and acute arthritis with inflammation and swelling of the knee joints may appear.Its course is favorable.

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

Arthritis, which begins about a month after coronavirus infection, is more dangerous.The fact is that it has a significant effect on the immune system.Dysfunctions of the immune system lead to the development of autoimmune processes.This is especially dangerous for people who have close relatives who suffer from chronic arthritis.Experts point out a high risk of developing rheumatoid arthritis (RA) in these patients.The first sign of RA is stiffness of motion in the morning (difficulty bending the knee).

If arthritis appears after recovering 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 sac with fluid located in the popliteal area.The cyst and associated pain below the knee appear because it is connected to the knee joint cavity and is filled with synovial fluid.In this case, reverse flow of liquid is difficult for several reasons.Most often, the cyst develops against the background of bruises, osteoarthritis and arthritis of the knee.

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

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

Severe pain in the left or right knee.

Severe pain combined with swelling and redness of the skin of the right or left knee 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 present with similar symptoms;A correct diagnosis can only be established after a complete examination.

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

It is important at an early stage not to use folk remedies, but to carry out the correct treatment, this will allow you to fully recover and forget about pain forever.But even in 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:

• on the shin below the knee– are rare, this may indicate compression of the nerve branches innervating the muscles of the lower leg by inflamed and swollen periarticular tissues in the knee area;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 surface of the leg are affected;These diseases are treated by a rheumatologist, but consultation with a neurologist is necessary;
• above the knee, up to the thigh– is often a sign of a post-traumatic inflammatory process in the femoral-patellar joint;in this case, patellofemoral pain syndrome develops;the pain is strong, painful, sometimes spasmodic, aggravated when walking;an orthopedist-traumatologist and a rheumatologist will help you cope with pain;
• from the side, from the inside– pain can develop with injury and damage to the internal lateral articular ligament;the pain in the side is strong, spasmodic, with hemarthrosis (intra-articular hemorrhage): bursting, accompanied by imbalance of the joint, the whole leg creaks when moving;the same pain appears when the external collateral ligament is sprained;Assistance will be provided by an orthopedist-traumatologist.

To eliminate pain, it is necessary to accurately determine its cause, and this cannot be done yourself.You need help from the doctor.

Patella pain in the back, front and sides.

Pain in the kneecap is almost always the result of acute or chronic injuries:

• back pain in knee- the causes are associated with damage to the patellofemoral joint with the development of patellofemoral pain syndrome;the pain is aching, constant, aggravated when walking;
• forehead– these painful sensations are caused by superficial bruises on the knee or by frequent and prolonged stays on the knees with microtrauma to the patella;The pain is significant, since the periosteum, rich in nerve endings, is injured;
• lateral knee painin case of rupture or injury to the internal or external horizontal patellar ligaments;injuries can develop with frequent prolonged microtrauma of the ligaments, for example, when jumping;accompanied by bleeding into the joint cavity (hemarthrosis);the pain is strong, constant and accompanied by swelling;Leg movements are affected.

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

Knee pain that radiates to the leg, heel, and groin.

It is necessary to understand the causes of acute radiating pain in the knee.The reason may be:

• femoral nerve entrapment;the pain is sharp, stabbing in nature, begins sharply in the groin area, spreads along the anterior-inner 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 his knee hurts, but this is not the case;
• arthritis (gonarthritis) of various origins: swelling of the joint causes pinching of the nerves and the spread of sharp pain in the knees to the groin and to the heel;in this case, pain is mainly felt in the knee, which with sudden movements turns into sharp pain when it radiates above and below the knee;
• hematoma accompanied by hemarthrosis, rupture of ligaments, severe swelling and compression of nerves;
• hematoma with fracture or dislocation of the kneecap and imbalance of the joint;Acute knee pain extends from 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, it is necessary to call an ambulance.

Knee pain during extension and flexion.

Most often, pain in the knee during flexion and extension, as well as when squatting, is a sign of tendonitis - an inflammatory process in the area of the tendon-ligamentous apparatus of the knee joint.It develops mainly in young men who play 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 knee flexion and extension can also be osteoarthritis - degenerative-dystrophic changes in the joint with growth of connective and bone tissue that interferes with movement.

Only the treatment of tendonitis or osteoarthritis helps to relieve the patient of intense pain in the knee when flexing and extending.

Severe knee pain at night.

Night pain is characteristic of inflammatory processes.This may be latent arthritis, periodically swollen knee joint due to osteoarthritis (osteoarthritis-arthritis).During sleep, joint and periarticular tissues warm 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 Baker's cyst.How to get rid of bloating and night pain?Treating the underlying disease helps.

Knee pain when walking

Pain when moving, jogging, persistent pain below the knee are characteristic of degenerative-dystrophic processes in the knee - osteoarthritis, since during movement the articular 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 notice that knee pain continues for some time.Over time, pain appears in the foot.

Long-term rehabilitation treatment with the use of chondroprotectors (drugs that restore cartilage tissue) will help.In case of complete destruction of the joint: endoprosthesis.

Pain after exercise: squats, running, weight lifting.

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

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

Knee pain and crunching.

Sudden, sharp pain in the knee and popping (crunching) sounds indicate a tear of the meniscus, the cartilaginous pads that absorb impacts in the knee joint.This may be the result of injury or age-related wear and tear of cartilage structures.

Severe pain in the joints may disappear, but the pain in the knee will remain when squatting, then the dysfunction of the limb 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 creaks, including the foot.Long-term rehabilitation treatment under the supervision of an orthopedist-traumatologist helps.

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 allergy to the tissues themselves).

To get rid of this pain, it is necessary to identify its cause and carry out the treatment prescribed by a specialist.

Injuries and diseases that cause 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 then turn into degenerative-dystrophic processes (arthrosis) with the formation of constant pain and dysfunction of the knee.This is the most common cause of knee pain.Athletes are at risk.Even a minor injury to the knee can lead to the destruction of joint tissue cells, which leads to the development of an inflammatory process.In case of major injuries, all these processes are pronounced and accompanied by prolonged pain.Of great importance is the instability of the knee, which develops when the ligamentous apparatus is damaged.Over time, instability increases and nearby tissues become injured, causing increased pain in the knee joint, especially when descending stairs.In the absence of adequate treatment, the process can be complicated by infection, become purulent, threatening the patient's life, or become chronic with gradual progression and 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 an alteration in the general condition of the patient.Patients complain that the pain in the knee hurts constantly.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 arthritis and others).Sometimes arthritis can be complicated by a Baker's cyst located in the popliteal region.Then there is pain behind the knee.Only proper treatment prescribed by a traumatologist or rheumatologist will save you from 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 older people.There is destruction or thinning of the impact-absorbing cartilage tissue (menisci and the cartilage layer that covers the articular surfaces of bones).The destruction of the joint progresses slowly but steadily.I am concerned about the pain and crunching when moving.In old age, this 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

Knee injuries and diseases often lead to the development of patellofemoral pain syndrome (PFPS), pain in the anterior part of the knee joint.Changes in the joint gradually destroy the patellar cartilage, contributing to the development of joint instability and severe, constant pain in the knees.Only a course of rehabilitation treatment prescribed by a qualified specialist can help.

Diagnosis

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

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 performed:

• Laboratory tests– clinical, biochemical and immunological blood tests, if necessary – sampling 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 radiography– 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– appearance and changes in 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, consultation with a rheumatologist is necessary.If there is a suspicion of a purulent inflammatory process, the surgeon will be able to better 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 phthisiatrist or other specialist in close contact with a rheumatologist.

First of all, they try to eliminate pain as much as possible, using for this 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 (splints, splints) are used, as well as adhesive tape, fixing the joint with special adhesive tapes.

For all acute joint pain, an emergency examination of the patient is performed with simultaneous anesthesia.All modern and traditional methods of pain therapy are used in the treatment.After this, according to indications, the patient is hospitalized or prescribed outpatient treatment followed by rehabilitation.No patient with pain is left without the attention of specialists.