Why your knees hurt: the reasons for what to do

Knee pain is a widespread symptom signaling distress in the body - the appearance of joint disease or simply increased loading of the legs.

It is difficult to find a person who has never experienced pain in the knees over a period of life.Discomfort, clicks or pain of different intensity in the knee joints are found in both adults and children for many reasons.The more adult becomes a person, the greater the likelihood of various diseases, the first sign of which is knee pain.This is due to the age characteristics of the body: slowing the metabolic processes, wear of cartilage tissue of the joints, joining other problems with the musculoskeletal system, blood vessels, nerves.

Due to the complex anatomical structure, many structures and significant loads and frequent overloads, the knee joints are very vulnerable.Damage to each element of the structure, for example, a synovial bag, leads to a disorder of the motor function of the knee and the pain syndrome, respectively.Ligments and menis are considered to be the most vulnerable, they are injured in 80-85% of cases.

The anatomical structure of the knee

The knee consists of a knee joint, a distal end of the femur with two tumors and jackets, the tube bone of the shin, muscles, nerves, vessels, ligaments, patella (knee glass), joint bags and meniscus.

The knee joint is one of the large joints of the body.The bone of the femur approaches it from above.The joint surfaces of its lateral (external) and medial (internal) warts are articulated with patel and tibia.Meniski, which are cartilage of connective tissue, serve as shock absorbers of the joint.Thanks to them, a rational distribution of the human weight of the tiger plateau arises and the stability of the joint increases.Fine, two-headed, midfieldable and other muscles synchronize capsule-ligament structures, guaranteeing the motor activity of the knee joint.

The knee elements are interconnected by many connections.There are two crossed ligaments inside the joint - back and front.The bones of the hobby are associated with fiber and tibal bones with collateral connections.The inclination of the poplial ligament is located in the back of the bursa of the knee joint.The main synovial capsule, which does not communicate with the joint, differs from a number of joint cavities.The blood supply to the knee elements is carried out by a noble network of blood vessels and innervation is carried out by nerve fibers.

Causes of knee pain

There are many reasons for soreness of the knee joints that can be conditionally divided into several groups.

Traumatic lesions of knee elements:

1. Bitterly from the kneeSAs a result of the gap of blood vessels, local hemorrhage occurs in the soft tissue of the joint.The redness, swelling, damage to the nerve endings lead to pain, difficulty in movement.
2. Complete or partial rupture of the ligamentSMore often, a partial disorder of the integrity of the internal lateral ligament, which arises from excessive twisting of the lower leg, is diagnosed.

The external ligament breaks down less than the inner.This is due to a strong deviation of the lower part inwards when you rotate your legs, for example.The rupture of the cross ligaments is inevitably accompanied by hemarthrosis.

The complete rupture of both ligaments is often combined with damage to the joint bag, tearing the inner meniscus.Such injury leads to unnecessary mobility of the knee joint, accompanied by severe pain, the intensity of which depends on the degree of precipice.

1. Knee hemarthrosis - pouring blood into the joint cavity.There is traumatic and not human nature.Traumatic hemarthrosis is observed with meniscus ruptures, complete or incomplete tissue ruptures, intra -articular fractures, bruises of the knee area.The non -human option is one of the symptoms of diseases characterized by increased shortness of the walls of the blood vessels or a violation of the blood coagulation system.These include hemophilia, scurvy, severe forms of hemorrhagic diathesis.The blood accumulated in the joint cavity compresses the tissue, disrupting the bloodstream in them.Special pigment - hemosiderin - adversely affects the ligaments, hyaline cartilage, synovial bag, which leads to a loss of their elasticity.The result of the lesion of the joint storm is the swelling of her villas and the increased production of joint fluid.The result of multiple hemorrhages is dystrophy and destruction of the joint.
2. Meniscopathy - Disruption of the integrity of the meniscus of the knee joint.In the lateral form, the outer meniscus is damaged, with the medial - internal.This is one of the most common but difficult to diagnose damage to the knee joint.Not only athletes involved in intensive education, but also ordinary people are in the risk zone of the disease.Understanding the meniscus can come from a sharp unusual movement when the body is rotated, a rotation of the legs, a strong stroke in the knee.
3. The dislocation of the knee cup - pathological displacement of the patella.The injury is diagnosed in no more than 0.7% of cases of the total number of dislocations.More often, there is an external dislocation, more rarely - internal, very rare - vertical or torsion.With incomplete dislocation, the knee glass is determined above the lateral (external) wart, with full - outside from the side wart.
4. Closed or open fractures of the knee joint, the top of the bones of the lower part or the lower spine. Such injuries are often combined with damage to the soft tissues of the knee, causing massive bleeding, excessive mobility in the knee area, its deformation.

Inflammatory and degenerative dystrophic diseases of the joint elements of the knee:

1. Arthritis - inflammatory damage to the knee joint.A similar mechanism for the development of pathology is observed in osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, gout (with the deposition of urate in the joints).
2. Osteoarthrosis (gonarthrosis) With the defeat of the knee joint with an insatiable nature, affecting all its structures and leading to serious degenerative changes.
3. Bursit With inflammation of the synovial bursa leads to pain during bending and lengthening the movements in the knee.
4. Knee Periarthritis tendons joint - Inflammation of the paw's goose capsule, knee tendons, as well as muscles and ligaments around the joint.In this case, the pain occurs mainly during the stairs, especially with a heavy load and focuses on the inner surface of the knee.
5. Patella's chondropathy -Degenerative-no-chic changes in the cartilage of the joint (posterior) surface of the patella.The degree of destruction may be different: from areas of light softening to cracks and complete abrasion.

6. Chondromatosis - Serious chronic disease due to the dysplastic process with the degeneration of the islands of the joint membrane sections in cartilage - chondroma.The ossification of individual cartilage bodies is not excluded.
7. Baker's cyst - The formation of a thick elastic circular tumor formation in the poppy pit, located on the opposite side of the patella.The cyst is clearly visible in the open state of the knee.Causes discomfort, pain in the poplial region.With considerable size, it squeezes the blood vessels and nerves, leading to impaired innervation and circulation.
8. Waffle - A disease accompanied by damage and more and more degeneration of the adipose tissue located around the knee joint.Clips, edema and other damage to the fat cells - adipocytes - end with their replacement with thick fibrous tissue.As a result, the buffer function of the "fat pillow" is impaired, the adipose tissue itself cannot play the role of the shock absorber.
9. Osgud -Swerter disease - Pathology characterized by the killings of the bug part of the shin.Diagnosis in adolescents from 10 to 18 years of age who are playing sports.A painful impact occurs under the patella, in the absence of treatment, leading to limitation of the legs or complete immobilization as well as muscle hypotrophy.

Diseases where knee pain is possible:

1. Cokeartrosis of the hip joint - Chronic damage to the hip joint, accompanied by progressive degeneration and dystrophic changes in it.Often the pain spreads along the outer surface of the thigh to the knee or bottom.
2. Neuropathy of the seductive nerve - Non -inflammatory nerve damage as a result of compression or spasm of blood vessels.This nerve reaches the legs, beginning at the lower back and passing through the tail and pelvis.The blockade at any point for its length leads to impaired sensitivity or throbbing pain.
3. Fibromyalgia - extravagation of soft tissue damage to a non -inflammatory nature with a combination of symptoms in the form of arthralgia, muscle weakness, depression, etc.

Some systemic diseases leading to knee pain:

1. Osteoporosis - The disease of the bone system of a chronic progressive course, changing the mineral composition and bone density.The "bone" "leaning" leads to their fragility.The process is accompanied by smoke or sick pain in the limbs.
2. TuberculosisSTuberculosis lesion in the bone place leads to constant severe pain.
3. Osteomyelitis -Toing an infectious and inflammatory nature affecting all structural elements of the bones.The result of both specific, for example, tuberculosis and non -specific, more cocclic, osteomyelitis, is hyperemia of the skin, edema, local acute pain in the bones and muscles, febrile fever.
4. Some infectious diseasesSWith Reiter syndrome, in addition to the inclusion of the urogenital tract and mucous membranes of the eyes, the joints are influenced.One of the manifestations of Lyme disease is arthralgia.

Kind of knee pain

Depending on the etiology, the nature and intensity of the pain may be different.

• PainSWith arthritis, osteoarthrosis.
• Sharp, strongSWith fractures of the knee elements, rupture of the ligaments, acute catastrophe, knee bruise, exacerbation of meniscopathy, deformation of osteoarthrosis.
• PulsatingSWith the deformation of arthrosis meniscus injures.
• DrillingSWith osteomyelitis.
• DumbSWith funeral, chronic osteochondritis.
• BurningSWith compression of the sciatic nerve, the process of tuberculosis in the bone.
• Shooting. When pinching the nerve trunk.
• Walking painSWith a cockroach cyst, ecom, arthritis, gonarthrosis, periarthride.
• The pain itself. With gout, arthritis.

Diagnosis of pathologies that cause knee pain

Physical examination:

• collecting history and complaints;
• Visual knee palpation check.

Laboratory tests:

• Biochemical and clinical blood tests;
• Serological blood test;
• Immunological blood test;
• rheumatological tests;
• Bacteriological analysis of synovial fluid.

Invasive instrumental methods:

• arthroscopy;
• drilling the joint bag;
• Bone puncture biopsy.

Non -invasive instrumental diagnosis:

• Radiography of the knee joint;
• densitometry;
• Ultrasound joint study;
• MRI or CT.

Treatment of knee pain

If the pain in one or the two knees of the non -human nature of the event, then you should first contact the therapist, who, based on the patient's complaints and the results of an objective examination, will refer to a narrow specialist - an orthopedist, rheumatologist, phlebologist or neurologist.In case of injury, you should contact a surgeon or orthopedic trauma.

The treatment in each case is different, depending on the cause of the pain, that is, on the type of injury or illness.Each disease has its own treatment regimen.But first, the patient must follow several general rules:

• Significantly reduce the duration of tourism and the stay of your feet during the day;
• Athletes temporarily (before recovery) abandon workouts, and ordinary people from running or jumping;
• When you increase the pain, completely abandon the movements, apply a fixing bandage from an elastic bandage to the knee;
• Wear a dressing or dressing for immobilization of the knee joint;
• With bruising cold at the site of traumatic effects.

Rheumatoid, psoriatic arthritis, systemic autoimmune diseases need serious integrated treatment for many months.The basic therapy consists of immunosuppressants, non -steroidal anti -inflammatory and hormonal drugs, gold preparations, etc.

In the treatment of bursitis, painkillers and anti -inflammatory drugs are used.If an infection is detected, then an antibiotic course.The therapeutic puncture of the bag is performed to remove excess fluid from the synovial cavity and/or the introduction of one of their corticosteroids.Surgery helps to get rid of chronic brush inflammation - the surgical cutting of the synovial sac.

With the deformation of osteoarthrosis, internal -articular injections of glucocorticosteroids, prolonged administration of NSAIDs and chondroprotectors are effective.To relieve the pain syndrome, compresses with demexide or bishofit, ointments and gels with anti -inflammatory effects are prescribed topically.Massage, physiotherapy, therapeutic gymnastics helps.Severe knee -growing lesions require surgery - joint endoprothetics.

The treatment of osteoporosis consists in the course of the administration of bisphosphonates, calcitonins, calcium preparations, vitamin D and others.

Treatment for meniscus rupture can be conservative or surgical.Conservative therapy consists of analgesics, NSAIDs, hyaluronic acid, chondroprotectors.But first, joint repositioning is performed.

Types of surgery:

• Menisctomy;
• partial (incomplete) menisectomy;
• Meniscus transplantation;
• arthroscopy;
• Arthroscopic seams of rupture of the meniscus.

With any injury to the knee, after treatment, the rehabilitation period to be performed under the control of a rehabilitologist or orthopedist is very important.The doctor will form an optimal joint recovery program.The main methods of postoperative rehabilitation are massage and therapeutic gymnastics.Special simulators classes are also effective, gradually developing the knee joint.