Knee pain (knee joint)

Knees are more susceptible to injuries and various diseases than other joints.A significant percentage of orthopedic-traumatology and rheumatology patients complain of severe knee pain.From this article you will learn what to do if you suddenly feel severe pain.He is undergoing treatment, the important thing is to seek medical help in time for his problems. 

What exactly hurts your knee?

The knee joint is the most complex joint, as 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 patellofemoral (patellafemoral).

The patella is a flat sesamoid bone (additional to the joint) that attaches to the head of the femur, sliding into 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 to the femur, is covered by hyaline cartilage.The patella is strengthened by ligaments: main and lateral – vertical (top and bottom) and horizontal (lateral – inside and outside).

Or transmits the force of the quadriceps femoris muscle to the musculoskeletal formations of the lower leg, ensuring the extension of the lower leg at 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 has no nerve endings and therefore can 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, manifesting themselves in the form of severe pain.With significant destruction of the articular cartilage, pain may be associated with involvement of the periosteum, the outer layer of the bone that has good innervation, in the process.

What to do if you have severe knee pain

Severe knee pain may appear suddenly or develop gradually.In any case, it often becomes unbearable.If severe pain occurs, you should calm down and seek medical attention immediately.All this can be treated, specialists will be able to help even with advanced disease.If you can't see a doctor at the moment, you can temporarily relieve the pain yourself.

But you should 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's better not to delay.

How to treat knee and leg pain at home

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

• Treat pain with compresses.
• Use external painkillers (ointments, gels).
• Injections.If there is no effect from tablets and external agents, the medicine is administered by intramuscular or subcutaneous injection.

Many drugs can be purchased in pharmacies 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-ligament 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, lift it and hold it in this state for a minute;the second leg is immobile at this moment;straighten and lower the leg very slowly, rest for 10 seconds and repeat the exercise with the other leg;repeat 10 times;
2. Double leg bends 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;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, violation of the general condition, fever, it is not possible to move the leg, it should be kept at rest.And only after the inflammation begins to decrease, it is possible to 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

For chronic pain, the following should not be allowed:

• bruised knee - you can avoid it by organizing your life in such a way as to minimize the risk of injury;
• excess body weight places an additional burden on the knees, especially in the elderly;
• heavy physical activity, jumping, strength sports;You also shouldn't run;
• any intoxication, then it is necessary to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and foci of infection;
• wearing tight, uncomfortable shoes, high-heeled shoes;
• stress, lack of sleep;
• sedentary lifestyle: you have to force yourself to move at certain intervals.

It is also impossible to apply hot compresses without a doctor's prescription: in case of purulent and hemorrhagic processes (with intraarticular bleeding), they can cause irreparable damage.

When you need to urgently consult a doctor

If the knee hurts, urgent medical attention is needed 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 appearing periodically after physical exertion, prolonged standing, strong straightening of the leg;
• night pain and associated insomnia;
• if the knee pain is very strong, constant, the sensation 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 can temporarily reduce or even eliminate the 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 in case of severe knee pain of various types

Painful sensations in the knee can vary in nature and duration from person to person.They can be constantly sore or develop only under certain loads, at night, etc.For example, some pathological processes are characterized by knee pain when bending, others - knee pain 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 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.Their course is favorable.

Coronavirus infection has its own characteristics: it manifests itself 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.

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.Malfunctions of the immune system lead 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 these patients.The first sign of rheumatoid arthritis is stiffness of movement in the morning (difficulty bending the knee).

If arthritis appears after recovery 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 bursa with fluid located in the popliteal area.The cyst and associated pain below the knee appears because 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 significant size, the surrounding tissues begin to compress, causing pain below the knee, which intensifies 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 best to see a doctor as soon as possible.Conservative (removal of fluid from the cyst, injection of glucocorticoids) and surgical (removal of the cyst) treatment is carried out.

Severe pain in the left or right knee

Severe pain combined with swelling and redness of the skin on 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), reactive arthritis, which begins a few days after a urogenital or intestinal infection.Both diseases manifest themselves with similar symptoms;a correct diagnosis can only be established after a comprehensive examination.

The right or left knee can suffer microtraumas, for example, in athletes or workers of certain professions who use an extra knee (usually the right).

It is important at the initial 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, 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:

• in the shin below the knee– are rare, this may indicate compression of the nerve branches that innervate the muscles of the lower leg by the 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 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– it is often a sign of a post-traumatic inflammatory process at the level of the patellofemoral joint;in this case patellofemoral pain syndrome develops;the pain is strong, aching, sometimes spasmodic, aggravated by walking;an orthopedist-traumatologist and a rheumatologist will help you deal with pain;
• from the side, from the inside– pain can develop with injuries and damage to the internal lateral articular ligament;pain on the side is strong, jerky, with hemarthrosis (intraarticular hemorrhage) - bursting, accompanied by imbalance of the joint, the whole leg creaks during movement;the same pain appears in case of distortion of the external collateral ligament;assistance will be provided by an orthopedic-traumatologist.

To eliminate pain, it is necessary to accurately determine its cause, and this is impossible to do alone.You need your doctor's help.

Patella pain on the back, front and sides

Patella pain is almost always the result of acute or chronic injuries:

• knee back pain- the causes are associated with damage to the patellofemoral joint with the development of patellofemoral pain syndrome;the pain is aching, constant, aggravated by walking;
• front– these painful sensations are caused by superficial contusions of the knee or by frequent prolonged stay on the knees with microtraumas to the patella;the pain is notable, as the periosteum, rich in nerve endings, is damaged;
• lateral knee painin case of rupture or injury of the internal or external horizontal patellar ligaments;the injury can develop with frequent long-term microtraumas of the ligaments, for example during jumping;accompanied by bleeding in the joint cavity (hemarthrosis);the pain is strong, constant, accompanied by swelling;leg movements are impaired.

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

Knee pain radiating to the leg, heel, groin

It is necessary to understand the causes of irradiation of acute knee pain.The reason could be:

• femoral nerve entrapment;the pain is acute, penetrating in nature, begins abruptly in the inguinal area, spreads along the antero-internal surface of the thigh and knee, along the nerve branches can reach 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 compression of the nerves and the spread of sharp pains from the knees to the groin and down to the heel;in this case a predominantly painful pain is felt in the knee, which with sudden movements turns into acute pain with radiation above and below the knee;
• bruising accompanied by hemarthrosis, ligament rupture, severe swelling and nerve compression;
• bruising with fracture or dislocation of the patella and imbalance of the joint;sharp pain in the knee extends along the thigh to the groin, along the inner surface of the shin - lower, up 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 during extension and flexion

Most often, knee pain when flexing and extending, 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 people practicing sports and is a consequence of frequent repeated microtraumas associated with jumping and constant trembling of the limb.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 arthrosis: degenerative-dystrophic changes in the joint with growth of connective tissue and bone that interferes with movement.

Only treatment of tendinitis or arthrosis helps relieve the patient from severe knee pain during flexion and extension.

Severe knee pain at night

Night pain is characteristic of inflammatory processes.This may be latent arthritis, knee joint periodically inflamed due to arthrosis (arthrosis-arthritis).During sleep, joint and periarticular tissues heat up, blood vessels dilate, which increases swelling.

The periarticular tissues swell, compress the nerve endings, and pain develops.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 swelling and night pain?Treatment of 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, since during movement the joint 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 the knee pain continues to hurt for some time.Over time, pain in the foot appears.

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 microtraumas of the knee joints and the gradual formation of degenerative-dystrophic processes in them.Sometimes pain appears in a right or left knee.Creaking of the joints.

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

Knee pain and creaking

Sudden, sharp pain in the knee and a cracking sound (crepitus) indicate a tear in the meniscus, the cartilaginous pads that cushion shock in the knee joint.This may be the result of injury or age-related wear and tear of the cartilaginous structures.

Severe joint pain may disappear, but knee pain 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 aches and creaks, 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 allergy to one's own tissues).

To eliminate such 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.They all lead to the development of inflammatory processes (arthritis), which then transform 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 knee injury can cause the destruction of joint tissue cells, which leads to the development of an inflammatory process.With significant injuries, all these processes are pronounced and are accompanied by prolonged pain.Of great importance is the instability of the knee, which develops when the ligament system is damaged.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 adequate treatment, the process can be complicated by an infection, become purulent, putting the patient's life at risk, 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 of the patient's general condition.Patients complain that knee pain constantly hurts.The disease can be infectious, infectious-allergic, autoimmune, 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 adequate treatment prescribed by a traumatologist or rheumatologist will save you from joint destruction and disability.
3. Arthrosis 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.Destruction or thinning of the shock-absorbing cartilaginous tissue (menisci and cartilaginous layer covering the articular surfaces of the bones) occurs.The destruction of the joint progresses slowly but steadily.I'm worried about pain and creaking when I move.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 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.

Diagnostics

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

Some diseases cannot be cured completely, 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, 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 the pathology of the soft tissues and the volume of intra-articular fluid radiography– changes in the bone tissue of the knee; CT and MRI– a more in-depth study of the pathology of soft and hard tissues; diagnostic arthroscopy– appearance and changes of the synovial membrane of the knee.

Methods for treating severe knee pain

Therapeutic 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 a purulent inflammatory process is suspected, the surgeon will be able to better deal with the disease.All chronic inflammatory processes of the joints are treated by a rheumatologist, but specific infectious processes, for example, tuberculosis of the knee, are treated by a physiatrist or other specialist in close contact with a rheumatologist.

First of all, they try to eliminate pain as much as possible, using for this purpose 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), as well as taping, which fixes the joint using special adhesive tapes, are used.

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