Pain in the knee (knee joint)

The 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 feel severe pain.She is being treated, the main thing is to seek medical help for her problems in a timely manner. 

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, consisting of two interconnected joints: femorotibial (tibiofemoral) and femoral-patellofemoral (patellofemoral).

The patella is a flat sesamoid bone (additional 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 with periosteum, the posterior surface, connected to the femur, is covered with hyaline cartilage.The patella is strengthened by ligaments: main and collateral ligaments - vertical (top and bottom) and horizontal (side - inside and outside).

O transmits the force of the quadriceps femoris muscle to the musculoskeletal formations of the lower leg and thus ensures the extension of the lower leg at the knee joint.The surface of the joint-forming bones 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 the correct position by ligaments, tendons and the surrounding capsule.

Injuries and illnesses affect various joint tissues.Not everyone can get sick.Cartilage tissue therefore has no nerve endings and can therefore be destroyed imperceptibly and painlessly.But the ligaments and the synovial membrane have many nerve endings and react immediately to injuries or inflammatory processes, which manifests itself in severe pain.If there is significant destruction of articular cartilage, pain may be associated with involvement of the periosteum, the outer layer of bone with good innervation.

What to do if you have severe knee pain?

Severe knee pain can come on suddenly or develop gradually.In any case, it often becomes unbearable.If severe pain occurs, you need to calm down and immediately seek medical attention.All of this can be treated; specialists can also help with advanced disease.If you can't see a doctor at the moment, you can temporarily relieve the pain on your own.

However, you should remember that knee joint pain is a temporary measure;You still need to seek medical attention;you can't do without it.And it's better not to hesitate.

How to treat knee and leg pain at home

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

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

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

With chronic pain in the knee joints, when there is no significant inflammation, you can do physical exercises that strengthen the muscle-ligament system, improve blood circulation and metabolism.With systematic training, the pain gradually subsides, although the legs are quite tight.

An approximate set of exercises for knee pain:

1. Fixed knee.Lie on your back, bend one leg at the knee, lift it up and hold it in this state for a minute.the second leg is motionless at this time;Very slowly straighten and lower your leg, rest for 10 seconds and repeat with the other leg.Repeat 10 times;
2. Double bend your legs with your knees close to your face.Lie on your back, bend your legs at the hips and knees, fix the latter near your face and hold them 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 knee pain requires 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, the leg must not be moved, it must be kept at rest.And only when the inflammation subsides can you 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

If you have chronic pain, the following should not be allowed:

• Bruised knee – You can avoid this by arranging your life to minimize the risk of injury;
• Excess weight puts additional strain on the knees, especially in older people.
• heavy physical activity, jumping, weight training;You shouldn't 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 tight shoes and high-heeled shoes;
• stress, lack of sleep;
• Lack of exercise – you have to force yourself to move at certain intervals.

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

If you need to see a doctor urgently

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

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

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

What to do if you have severe knee pain of various kinds?

Pain in the knee can be of different types and durations in people.They can hurt constantly or only develop under certain stress, 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 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 have no consequences once the infection is over.Influenza and other acute respiratory viral infections with acute fever can cause short-term joint and muscle pain as well as acute arthritis with inflammation and swelling of the knee joints.Its course is favorable.

A coronavirus infection has its own characteristics: it progresses differently for each patient.Why this happens is unknown.During the illness, aching joint pain, swelling and redness sometimes occur - a sign of acute arthritis - but then disappear.

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

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

Severe pain under the knee

This may be a sign of the development of a Baker's cyst - a bloated bursa with fluid in the back of the knee.The cyst and the associated pain under the knee arise because it is connected to the cavity of the knee joint and filled with synovial fluid.In this case, the backflow 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.However, due to its significant size, the surrounding tissue begins to compress, resulting in pain below the knee that increases 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 your knee, you should see a doctor as soon as possible.Conservative (removal of fluid from the cyst, injection of glucocorticoids) and surgical (removal of the cyst) treatments are carried out.

Severe pain in the left or right knee

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

For example, the right or left knee can be affected by microtrauma in athletes or workers in certain jobs that put more strain on one (usually the right) knee.

It is important not to use folk remedies early, but to carry out the correct treatment so that you can fully recover and forget about the pain forever.But even with advanced illnesses, a specialist can always help and relieve pain.

Knee and leg pain

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

• in the shinbone below the knee– are rare, this may indicate compression of the nerve branches innervating the lower leg muscles by the inflamed, swollen periarticular tissue in the knee area;Pain under the knee in the back indicates compression of the branches of the sciatic nerve, and pain under the knee in the anterior region 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, into 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 severe, aching, sometimes twitching and worse when walking;an orthopedist-traumatologist and a rheumatologist will help you manage pain;
• from the side, from the inside– Injuries and damage to the inner lateral joint ligament may cause pain;Pain in the side is severe, jerky, with hemarthrosis (intra-articular hemorrhage) - bursting, accompanied by imbalance of the joint, the whole leg crunches when moving;the same pain occurs when the lateral collateral ligament is sprained;Support is provided by an orthopedist-traumatologist.

To eliminate pain, you need to accurately determine the cause, which is not possible on your own.Need medical attention.

Patellar pain in the back, front and sides

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

• Pain in the back knee- The causes are associated with damage to the femoral-patellar joint with the development of patellofemoral pain syndrome.the pain is aching, constant and aggravated by walking;
• in front– such painful sensations are caused by superficial knee bruises or frequent prolonged lying on the knees with microtrauma of the kneecap;the pain is significant because the periosteum, which is rich in nerve endings, is injured;
• Pain in the side of the kneein case of rupture or injury to the horizontal internal or external patellar ligaments;Injuries can develop with frequent long-term microtraumas to the ligaments, for example when jumping;accompanied by bleeding into the joint cavity (hemarthrosis);The pain is severe, constant and accompanied by swelling.Movements in the leg are impaired.

In order to prevent permanent joint dysfunction from developing at the site of the injury, you should immediately consult an orthopedic traumatologist.

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

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

• Entrapment of the femoral nerve;The pain is acute, stabbing, begins sharply in the groin, spreads along the anterior inner surface of the thigh and knee, and can extend along nerve branches to 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 pinched nerves and the spread of stabbing pain in the knees to the groin and to the heel;in this case, a mainly aching pain is felt in the knee, which, with sudden movements, turns into an acute pain radiating above and below the knee;
• Bruise accompanied by hemarthrosis, rupture of ligaments, severe swelling and nerve compression;
• Bruise with fracture or dislocation of the kneecap and imbalance of the joint;Acute pain in the knee extends down the thigh to the groin, along the inner surface of the shinbone - deeper to the heel.

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

Knee pain during extension and flexion

Most often, pain in the knee when bending and stretching as well as when squatting is a sign of tendonitis - an inflammatory process in the area of the tendon-ligament system of the knee joint.It develops mainly in young men who play sports and is a consequence of frequently repeated microtraumas associated with jumping and constant tremors of the limbs.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 joint changes with connective and bone proliferation that restricts movement.

Only treatment of tendonitis or arthrosis helps to relieve the patient of severe pain in the knee when bending and extending.

Severe knee pain at night

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

The periarticular tissue swells, compresses the nerve endings and causes pain.If pain occurs in the back of the knee at the same time, this may be a sign of a Baker's cyst.How to eliminate swelling and night pain?Treating the underlying disease helps.

Knee pain when walking

Pain when moving, jogging, stabbing pain under the knee are characteristic of degenerative-dystrophic processes in the knee - arthrosis, since during movement the articular surfaces are injured, completely or partially without shock absorber cartilage.The well-innervated periosteum suffers.Knee pain when climbing stairs is also very common.After training, patients note that the pain in the knee persists for some time.Pain in the foot occurs over time.

Long-term rehabilitation treatment with chondroprotectors - drugs to restore cartilage tissue - helps.In case of complete destruction of the joint - endoprosthetics.

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 occurs in a right or left knee.Joints crunch.

If severe pain occurs in the knee after training, the athlete needs to undergo rehabilitation treatment.Otherwise, there will be a gradual deterioration in joint function, which will initially be accompanied by periodic and then persistent pain.

Knee pain and crunching

Sharp, sudden knee pain and grinding (crackling) indicate a torn meniscus – the cartilaginous, shock-absorbing pads in the knee joint.This can be the result of an injury or age-related wear and tear of the cartilage structures.

Severe joint pain may disappear, but when squatting, the pain in the knee persists, then the dysfunction of the limb gradually increases, accompanied first by pain during exercise and then by constant pain, which increases when climbing stairs.Over time, the entire extremity, including the foot, suffers and grinds.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, 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 its cause and carry out treatment prescribed by a specialist.

Injuries and illnesses that cause knee pain

The most common pathologies associated with knee pain are:

1. Closed and open knee injuries with intra-articular fractures, dislocations, meniscus tears.They all lead to the development of inflammatory processes (arthritis), which then turn into degenerative-dystrophic processes (arthrosis) with the development 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 severe injuries, all of these processes are pronounced and are accompanied by persistent pain.Knee instability, which occurs when the ligamentous system is damaged, is of great importance.Over time, instability increases and surrounding tissue becomes injured, leading to increased pain in the knee joint, especially when climbing stairs.Without adequate treatment, the process can be complicated by infection, become purulent and endanger 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, which is accompanied by an increase in body temperature and a disruption in the general condition of the patient.Patients complain that the knee pain hurts constantly.The disease can be infectious, infectious-allergic, autoimmune or metabolic in nature.The inflammatory process also proceeds differently depending on the cause (purulent, rheumatoid, psoriatic, gout and other arthritis).Sometimes arthritis can be complicated by a Baker's cyst in the popliteal area.Then there is pain behind the knee.Only appropriate treatment by a traumatologist or rheumatologist can 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 shock-absorbing cartilage tissue (menisci and the cartilage layer that covers the articular surfaces of the bones).The destruction of the joint progresses slowly but steadily.I'm afraid of pain and grinding when moving.This is the main cause of knee pain as we age.The bones rub against each other, their structure is destroyed, the joint becomes deformed, everything 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 part of the knee joint.Changes in the joint gradually destroy the patellar cartilage, contributing to the development of joint instability and persistent severe pain in the knees.Only rehabilitation treatment prescribed by a qualified specialist can help.

diagnosis

Knee pain has different causes and requires individual treatment.First, a correct diagnosis must be made, which requires an examination in a clinic.And only after that treatment for knee pain is prescribed.

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

To determine 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 study of intra-articular fluid (microscopy, culture on nutrient media to determine the sensitivity of the identified infection to antibiotics).
• Instrumental studies: Ultrasonic– reveals the pathology of soft tissues and the volume of intra-articular fluid 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 for treating severe knee pain

Treatment measures are prescribed individually.Pain associated with a knee injury is treated by an orthopedic traumatologist;If the disease is chronic, consultation with a rheumatologist is necessary.If a purulent inflammatory process is suspected, a surgeon can 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 doctor 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 therapies (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 peace, various immobilization methods (splints, splints) as well as taping - fixing the joint with special adhesive tapes - are used.

For all acute joint pain, the patient is examined in an emergency manner with simultaneous anesthesia.All modern and traditional methods of pain therapy are used in the treatment.After that, depending on the indications, the patient is either admitted to the hospital or is prescribed outpatient treatment followed by rehabilitation.No patient with pain is left without the attention of specialists.