Pain in the knee (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 most important thing is to seek medical help for her problems in time. 

What exactly hurts the knee?

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

The patella is a flat sesamoid (an accessory in the joint) bone that is attached to the head of the femur, sliding in the concave groove and acting as a block.Structural features: the front surface of the patella is covered with periosteum, the back surface connecting to the femur is covered with hyaline cartilage.The patella is strengthened by ligaments: main and lateral - vertical (upper and lower) and horizontal (lateral - internal and external).

O transmits the force of the quadriceps muscle to the musculoskeletal structures of the lower leg, providing extension of the lower leg at the knee joint.The surface of the articular bones is covered with cartilage, which acts as a shock absorber.Additional shock absorbers that protect the joint from injury are two crescent-shaped cartilage menisci located between the femur and tibia.The joint is held in its proper position by ligaments, tendons, and the surrounding capsule.

Injuries and diseases affect different joint tissues.Not all of them can get sick.In this way, cartilage tissue has no nerve endings and can therefore be destroyed imperceptibly and painlessly.But the ligaments and 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.With significant destruction of the articular cartilage, the pain can be related to the involvement of the periosteum, the outer layer of the bone, which 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 often becomes unbearable.If severe pain occurs, you should immediately calm down and seek medical help.All this can be treated, specialists will be able to help even with an advanced disease.If you can't see a doctor right now, you can temporarily relieve the pain yourself.

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

How to treat knee and leg pain at home

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

• Treat the pain with tablets.
• Use external pain relievers (ointments, gels).
• injections.If there is no effect from tablets and external means, the drug is administered in the form of an intramuscular or subcutaneous injection.

Many medicines can be bought at a pharmacy without a prescription.

With 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 quite brittle.

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 position for a minute;the second leg at this moment is motionless;raise and lower the leg very slowly, rest for 10 seconds and repeat the exercise with the other leg;repeat 10 times;
2. Double leg bend 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 that for a minute.Then slowly straighten and lower your legs, rest for 10 seconds and repeat;do 5-6 approaches, gradually increasing the load.

Acute pain in the knee requires a state of rest;all physical exertion and training are contraindicated.

In the case of acute pain in the knee joint, accompanied by swelling and redness of the skin, a disturbance in the general condition, fever, you cannot move the leg, it must be 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 have pain

In chronic pain, the following should not be allowed:

• bruised knee - you can avoid this by arranging your life in such a way as to reduce the risk of injury to a minimum;
• excess body weight is an additional burden on the knees, especially in the elderly;
• heavy physical exertion, jumping, strength sports;You don't have to run either;
• any intoxication, so you need to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and foci of infection;
• wearing uncomfortable narrow 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 warm compresses without a doctor's prescription: in the case of purulent and hemorrhagic (with intra-articular bleeding) processes, they can cause irreparable harm.

When you need to see a doctor urgently

If your knee hurts, emergency medical attention is needed if the following symptoms occur:

• swelling, redness and tenderness in the knee, accompanied by fever and general malaise;
• severe pain in the knee immediately after the injury or some time after it;
• gradual increase in pain intensity;
• periodically appearing pain after physical exertion, prolonged standing, sudden straightening of the leg;
• night pain and associated insomnia;
• if the pain in the knee is very strong, constant, the feeling that the inside of the patella hurts.

In any case, knee pain should be a reason to consult a doctor.There is no point in self-medicating: it may temporarily reduce or even eliminate 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 various types

Painful sensations in the knee can vary in nature and duration among people.They can hurt constantly or develop only with 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 understand what exactly hurts and why and how to help the patient.

Knee pain due to 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 pass without any consequences after its completion.Thus, with flu and other acute respiratory viral infections with acute fever, both short-term pain in the joints and muscles, and acute arthritis with inflammation and swelling of the knee joints can occur.Their course is auspicious.

The coronavirus infection has its own characteristics: it proceeds differently in each patient.Why this happens is not known.During the disease, joint pain, swelling and redness sometimes appear - a sign of acute arthritis, but then disappear.

More dangerous is arthritis, which begins about a month after the coronavirus infection.The fact is that it has a significant effect on the immune system.Improper functioning of the immune system leads to the development of autoimmune processes.This is especially dangerous for people who have close relatives suffering from chronic arthritis.Experts note a high risk of developing rheumatoid arthritis (RA) in such patients.The first sign of RA is morning stiffness (difficulty bending the knee).

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

Severe pain below the knee

This may be a sign of the development of a Baker's cyst - a swollen synovial bursa with fluid located in the popliteal region.The cyst and the associated pain below the knee occur due to the fact that it is connected to the cavity of the knee joint and is filled with synovial fluid.In this case, the reverse flow of the 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 considerable size, the surrounding tissues begin to compress, causing pain below the knee that worsens 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 volume, which can lead to rupture or suppuration.

If you have pain below the knee, it is better to consult 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 the left or right knee

Severe pain in combination with swelling and redness of the skin above 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 that begins a few days after a urogenital or intestinal infection.Both diseases present with similar symptoms;the correct diagnosis can only be established 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 (usually right) knee more.

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 the pain forever.But even with advanced diseases, the specialist will always be able to help and relieve the pain.

Pain in knees and feet

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 mean compression of the nerve branches innervating the muscles of the lower leg by inflamed, swollen periarticular tissues in the knee area;pain under the knee at the back indicates compression of the branches of the sciatic nerve, and pain under the knee at the front indicates that the nerves innervating the front surface of the leg are affected;Such diseases are treated by a rheumatologist, but consultation with a neurologist is necessary;
• above the knee, in 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 twitching, intensifies when walking;an orthopedic traumatologist and a rheumatologist will help you deal with pain;
• from the side, from the inside– pain can develop with injury and damage to the internal lateral joint;the pain in the side is strong, sharp, with hemarthrosis (intra-articular hemorrhage) - bursting, accompanied by an imbalance of the joint, the whole leg crunches when moving;the same pain occurs with dislocation of the external collateral ligament;an orthopedist-traumatologist will help.

To eliminate pain, you need to accurately determine the cause of it, and this is impossible to do on your own.You need medical attention.

Patella pain in back, front and side

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

• back knee pain- the causes are related to damage to the femoral-patellar joint with the development of patellofemoral pain syndrome;the pain is painful, constant, worse when walking;
• in front– such painful sensations are caused by superficial bruises of the knee or frequent prolonged kneeling with microtraumas of the knee cap;the pain is considerable, because the periosteum, rich in nerve endings, is injured;
• lateral knee painwith rupture or injury of the horizontal internal or external patellar ligaments;injury can develop with frequent long-term microtrauma to the ligaments, for example, during jumping;accompanied by bleeding in the joint cavity (hemarthrosis);the pain is strong, constant, accompanied by swelling;movements in the leg 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.

Pain in the knee, radiating to the leg, heel, groin

It is necessary to understand the reasons for radiating sharp pain in the knee.The reason may be:

• femoral nerve entrapment;the pain is sharp, piercing in nature, begins sharply in the groin area, spreads along the front-inner surface of the thigh and knee, along the nerve branches it can reach the inner edge of the foot and the heel;sometimes the patient gets 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 sharp pain in the knees to the groin and down to the heel;in this case, pain is mainly felt in the knee, which during sudden movements turns into sharp pain with irradiation above and below the knee;
• bruising accompanied by hemarthrosis, rupture of ligaments, severe swelling and compression of nerves;
• contusion with fracture or dislocation of the patella and imbalance of the joint;sharp pain in the knee extends down the thigh to the groin, on the inner surface of the tibia - lower, to the heel.

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

Knee pain when extending and bending

Most often, pain in the knee when bending and unfolding, as well as when squatting, is a sign of tendinitis - an inflammatory process in the area of the tendon-ligament apparatus of the knee joint.It develops mainly in young men involved in sports and is a consequence of frequent repetitive microtraumas 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 bending and extension of the knee can also be arthrosis - 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 helps to relieve the patient from severe pain in the knee when bending and extending.

Severe pain in the knee at night

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

Periarticular tissues swell, press the nerve endings and pain occurs.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 night pain?Treating the underlying disease helps.

Knee pain when walking

Pain during movement, jogging, nagging pain under the knee are characteristic of degenerative-dystrophic processes in the knee - arthrosis, because during movement the joint surfaces are injured, completely or partially deprived of shock absorber cartilage.The periosteum, which has good innervation, suffers.Knee pain when going down stairs is also very common.After training, patients note that the pain in the knee 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 help.In case of complete destruction of the joint - endoprosthesis.

Pain after exercise - squats, running, lifting weights

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

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

Knee pain and crunch

Sharp, sudden pain in the knee and a crunch (pop) indicates a tear in the meniscus - the cartilaginous shock-absorbing pads in the knee joint.This may be the result of injury or age-related wear and tear on cartilage structures.

The severe joint pain may disappear, but the knee pain will remain when squatting, after which the dysfunction of the limb will gradually increase, accompanied first by pain during exercise, and then by constant pain that increases when going down the stairs.Over time, the entire limb suffers and crunches, including the foot.Long-term rehabilitation treatment under the supervision of an orthopedic 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, usually after an injury), infectious, infectious-allergic and autoimmune (with an allergy to one's own tissues).

To get rid of such pain, you need to identify the cause and carry out 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, sprains, 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 slight injury to the knee can cause destruction of the cells of the joint tissue, which leads to the development of an inflammatory process.With significant injuries, all these processes are expressed and are accompanied by prolonged pain.Of great importance is the instability of the knee, which develops with damage to the ligament apparatus.Over time, instability increases, nearby tissues are injured, which leads to increased pain in the knee joint, especially when going down 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 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 a disturbance 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, metabolic in nature.The inflammatory process also proceeds differently, depending on the cause that caused it (purulent, rheumatoid, psoriatic, gouty and other arthritis).Arthritis can sometimes 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 save you from joint destruction and damage.
3. Knee arthrosis 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 the elderly.There is destruction or thinning of the cartilaginous cushioning tissue (menisci and the cartilage layer covering the articular surfaces of the bones).The destruction of the joint progresses slowly but steadily.I am concerned about the pain and the crunch 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

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

Diagnosis

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

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

In order to determine the causes of the pain and diagnose the disease, the following examination is performed:

• Laboratory studies- clinical, biochemical, immunological blood test, if necessary - sampling and examination of intra-articular fluid (microscopy, culture on nutrient media 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 soft and hard tissue pathology; diagnostic arthroscopy- appearance and changes in the synovial membrane of the knee.

Treatment methods for 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 there is a suspicion of a purulent inflammatory process, then the surgeon will be better able to deal with 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 phthisiologist or other specialist in close contact with a rheumatologist.

First of all, they try to eliminate the pain as much as possible, using for this purpose both drug therapy (modern drugs for knee pain, including ointments) and non-drug treatment for knee pain (manual therapy, massage, therapeutic gymnastics, 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 taping - fixing the joint with special patches.

In all acute joint pains, an urgent examination of the patient is performed with simultaneous anesthesia.In the treatment, all modern and traditional methods of pain-relieving therapy are used.Then, according to the indications, the patient is hospitalized or prescribed a course of outpatient treatment, followed by rehabilitation.No patient with pain is left without the attention of specialists.