Severe knee pain means there is a problem with the joint. The peculiarity of the knee joint is that it assumes the main load during movement and physical exertion, therefore, it is often injured. The affected knee is difficult to correct, so it is very important to take steps to eliminate the cause of the pain in a timely manner.
main reasons
The causes of knee pain can be:
- Injuries (acute injuries).They are the most common cause. They occur after a strong blow, excessive flexion of the joint and a sharp fall on it. With a mechanical injury, there is a sharp pain, swelling, there may be a tingling sensation, numbness, the color of the skin in the joint area changes.
- Arthrosis (gonarthrosis)is the destruction of joint tissues. Gonarthrosis is primary and secondary. The primary disease affects the elderly, while the secondary causes the consequences of injuries or is a complication of other diseases (eg, rheumatoid arthritis). Symptoms: Pain and stiffness in the joint. With a long course of gonarthrosis, movement in the joint may become impossible.
- Arthritis (gonarthritis)- inflammatory disease. Distinctive signs: pain that increases with movement, increased joint size, fever in the affected knee, redness at times.
- meniscopathy- damage to the meniscus, which is manifested by sharp pain. In the absence of adequate treatment, a transition to a chronic form is possible as a result of the development of osteoarthritis.
- vascular diseases. Thrombosis or embolism (blockage) of the arteries that supply the knee joint leads to osteonecrosis of the articular cartilage, making walking impossible. There are no effective treatments for osteonecrosis. Arthroplasty of the affected joint is performed.
- periarthritis- it is an inflammation of the joint bag and the tissues that surround it. With periarthritis, there is pain in the knee joint area without a clear location. Periarthritis is most often a post-traumatic complication.
- bursitisis an inflammation of the synovial sac (bursa). Bursitis can be caused by overuse of the joint, infection, or injury. With this disease, intense and constant pain is observed, but freedom of movement is preserved.
- tendinitisIt is inflammation of ligaments and tendons. Symptoms are swelling and pain in the affected area. They increase with flexion-extension of the knees. Prolonged tendinitis symptoms are indicative of tendinosis.
- Baker's cyst- this is a complication after trauma, gonarthrosis or hemarthrosis. Baker's cyst is a collection of joint fluid in the popliteal sac. The pathology is characterized by pain when bending the knee and a feeling of discomfort during movement. To avoid complications, it is highly recommended not to squat.
- Osteomyelitis of the leg bonesis a purulent disease associated with infection, which is a consequence of hematogenous osteomyelitis, open fracture or postoperative complication. The most common infectious agent is staphylococcus.
varieties of pain
There are these types of knee pain:
- when crouching. It is usually caused by joint disease, viral infection, lack of physical activity, poor diet. seen in athletes. If the knees hurt when squatting, the exercises should be stopped. For prolonged and frequent pain, you should consult a doctor.
- when bending the legs. This is one of the most common joint problems. It is observed in Osgood-Schlatter disease, damage to ligaments and menisci, Baker's cyst, infectious lesions, etc. When pain occurs, it is necessary to limit the load on the leg, refuse to play sports and wear comfortable orthopedic shoes.
- after running. Associated with diseases such as osteoarthritis, bursitis, synovitis, etc. In this case, the normal functioning of the joint is interrupted, and under heavy loads it begins to collapse. It is necessary to carry out timely treatment of these diseases, otherwise a complete loss of motor functions is possible.
- Crunch. If there is no swelling, pain and stiffness in the movement, then there is nothing to fear. However, this symptom can be caused by a dangerous disease - osteoarthritis, in which joint cartilage is damaged and severe pain appears. It is very important to start timely treatment of this disease.
Diagnosis
You can diagnose the cause of the pain in the following ways:
- General blood analysis. Allows you to detect anemia, leukocytosis, etc.
- Blood chemistry. Detects an increase in uric acid in gout.
- X-ray study. This method makes it possible to detect the pathology of bone tissue. With his help, fractures, osteomyelitis and osteoarthritis are diagnosed. X-ray studies are complemented by computed tomography (CT). Menisci, ligaments, bursae, and other soft tissues are not visible on radiographs and CT scans.
- MRI (magnetic resonance imaging), NMRI (nuclear magnetic resonance imaging). This is modern research. With its help, the pathology of the soft tissues of the joint (menisci, ligaments, etc. ) is diagnosed.
- Bone biopsy puncture. It is performed in the presence of suspected osteomyelitis or bone tuberculosis.
- arthroscopy. It is performed both for diagnosis and for treatment, for example, with a meniscus tear.
- Ultrasound (ultrasound examination). This is a screening study performed in cases of suspected traumatic injuries, osteoarthritis, meniscus disease, etc. Ultrasound results need to be verified by radiography (CT) and/or MRI.
Treatment
Treatment should be comprehensive and include conservative methods and surgical intervention. Let's consider them in more detail:
conservative methods
During an exacerbation, treatment should relieve pain and swelling and then restore normal joint mobility. The first time after an injury, it is not recommended to move without assistance.
The mainstay of treatment is anti-inflammatory therapy. It involves the use of the following agents: non-steroidal anti-inflammatory drugs, pyrazolone derivatives, indoleacetic acid derivatives, oxicams, glucocorticoids.
To strengthen the immune system, the following procedures are prescribed: cryopheresis, plasmapheresis, hemosorption, plasma filtration, immunostimulants.
The specific drug and treatment method are chosen by the attending physician.
In addition, conservative treatment involves ice packs on the damaged area to relieve pain or hot packs to improve blood microcirculation.
With hemarthrosis, the joint is punctured and blood that has accumulated from the trauma is removed.
In addition, conservative treatment includes physiotherapeutic methods: massage, therapeutic exercises and spa rehabilitation. If necessary, the doctor prescribes a special diet that provides for a limited calorie content.
Chondroprotectors are used to nourish cartilage and reduce destructive processes.
The most common physiotherapy methods are magnetotherapy, laser therapy, cryotherapy, acupuncture.
With gonarthrosis, special shoes and knee pads - orthotics are used. These shoes contribute to the normalization of gait and knee pads fix the diseased joint.
Surgical intervention
If, after conservative treatment, it is not possible to achieve the necessary joint stability, surgical intervention is indicated.
The most common surgical techniques are arthroscopy and arthroplasty.
Arthroscopy is a technique that can relieve pain in a joint and increase its mobility. This method of treatment not only eliminates the underlying disease, but also allows you to insert medications into the joint cavity that reduce inflammation.
doctor's advice
A pronounced therapeutic effect in osteoarthritis of the 2nd and even the 3rd stage is given by hyaluronic acid preparations, which are administered intra-articularly. The introduction of hyaluronic acid is considered an alternative to arthroplasty when it is not possible due to therapeutic contraindications. This is a medical manipulation, it has contraindications.
The technique is carried out with such problems:
- damage to the meniscus and cartilage;
- ligament rupture;
- the presence of foreign bodies in the joint;
- rheumatoid arthritis;
- intra-articular fractures.
During the postoperative rehabilitation period, it is recommended to strictly follow the medical recommendations, performing therapeutic exercises, avoiding unreasonable early loading on the limb.
Endoprosthesis (arthroplasty) is an operation in which the damaged parts of the knee joint are replaced with an artificial implant (endoprosthesis).
More than 95% of endoprostheses that are placed under the mandatory medical insurance function for 10-15 years, and then need to be replaced. Today, far from all regions, the replacement of an endoprosthesis, unlike the primary operation, can be issued under mandatory medical insurance. Not all patients after 10-15 years are able to undergo a second operation due to cardiovascular and other somatic risks. Therefore, it is not worth rushing with endoprostheses. I recommend resorting to this operation only when all other treatment options are exhausted.
Endoprosthesis is performed when painless restoration of knee joint function is not possible with conservative methods and with the help of arthroscopy. After arthroplasty, purulent complications are possible. Antibiotics are prescribed for its prevention. After endoprosthesis, long-term rehabilitation of the patient (up to 6 months) is required.
Folk remedies
Folk remedies can be helpful in relieving pain, but they should be done in parallel with conventional treatments.
When using folk remedies, be sure to consult a doctor.
Let's look at some popular methods:
- Ointment. For knee pain, prepare 1 tbsp. I. hypericum and 2 tbsp. I. yarrow, crushing them. In a water bath, melt 1 tbsp. I. Vaseline. Grass is poured on hot petroleum jelly and rubbed into a homogeneous mass. This ointment should be rubbed into the sore knees at night.
- Rye seed mix. You must take 250 g of rye seeds, pour them with 2 liters of water and bring to a boil. After the mixture has cooled, it is filtered and 500 g of vodka, 1 kg of honey, 3 tsp are added to it. barberry root. The mixture is shaken well and left for 21 days in a dark place. It is recommended to use a mixture of 3 tbsp. I. before eating. It is necessary to drink 9 liters of the mixture during the treatment period.
If you have knee pain, don't panic. However, if the pain persists for a long time, you should definitely see a doctor. This will avoid many problems.