Why do your knees hurt: the reasons for what to do

Knee pain is a common symptom, signaling distress in the body - the occurrence of joint disease or simply an increased leg load.

It is difficult to find a person who has never felt pain in the knees in a certain period of life.Differential, clicks or pains of different intensity in knee joints occur in adults and children for many reasons.The older an aged person, the higher the probability of various diseases, the first sign of the knee.This is due to the characteristics of the age of the body: slow down metabolic processes, wear of the articulation cartilage tissue, joining other problems with the musculoskeletal system, blood vessels, nerves.

Due to the complex anatomical structure, many important structures and charges suffered and often overloads, the knee joints are very vulnerable.Damage to any element of the structure, for example, a synovial bag, lead to a violation of the motor function of the knee and, therefore, of the pain syndrome.Ligaments and menisci are considered the most vulnerable, they are injured in 80 to 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, a tubular bone of the tibia, muscles, nerves, vessels, ligaments, a ball joint (knee cup), joint and meniscus bags.

The knee joint is one of the large joints of the body.The femoral bone approaches him from above.The joint surfaces of its lateral (external) and medial (internal) condyles are articulated with the patella and the tibia.The meniski, which are the cartilage of the connective tissue, serve as shock absorbers of the joint.Thanks to them, a rational distribution of human weight on a tiger plateau occurs and the stability of the joint increases.Subtle muscles, double-headed, half-dos and other synchronize the capsule-ligament structures, ensuring the motor activity of the knee joint.

The elements of the knee are interconnected by many ligaments.Inside the seal, there are two cross -shaped ligaments - the rear and the front.The pastime bones are connected to the fiber and tibia bones with collateral ligaments.The inclination of the popliteal ligament is located at the rear of the knee joint grant.The main synovial capsule, not communicating with the joint, differs from a certain number of joint cavities.The blood supply to the knee elements is carried out by a noble network of blood vessels and the innervation is carried out by nerve fibers.

Causes of knee pain

There are many causes of knee joint pain, which can be divided conditionally into several groups.

Traumatic lesions of the elements of the knee:

1. Kneely.Due to the gap of blood vessels, local hemorrhage occurs in the soft tissues of the joint.Rouge, swelling, damage to nerve endings cause pain, difficulties in movement.
2. Break in the complete or partial ligament.More often than not, a partial violation of the integrity of the internal lateral ligament, which results from excessive torsion of the lower leg, is diagnosed.

The external ligament breaks less often than the intern.This is due to a strong deviation from the lower leg inward, when filming the leg for example.The break in the cross -shaped ligaments is inevitably accompanied by hemarthrosis.

A complete break in the two ligaments is often combined with damage to the joint bag, tearing the interior meniscus.Such an injury leads to excessive mobility of the knee joint, accompanied by intense pain, the intensity of which depends on the degree of deviation.

1. Knee joint hemarthrosis - Pour blood into the joint cavity.There is traumatic and not human nature.Traumatic hemarthrosis is observed with meniscus breaks, complete or incomplete ruptures of ligaments, intra-articular fractures, bruises in the knee area.The non -human option is one of the symptoms of diseases characterized by an increased drop in 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 that has accumulated in the joint cavity compresses the fabric, disturbing blood circulation.A special pigment - hemosiderine - negatively affects ligaments, hyalin cartilage, a synovial bag, resulting in the loss of their elasticity.The result of the lesion of the joint bource is the swelling of its villi and the increase in the production of joint fluid.The result of repeated hemorrhages is the dystrophy and the destruction of the joint.
2. Knee mennisopathy - violation of the integrity of the meniscus of the knee joint.In the lateral form, the external meniscus is damaged, with the medial - internal.It is one of the most common damage, but difficult to diagnose the knee joint.In the risk area of the disease are not only athletes involved in intensive training, but also ordinary people.The rupture of the meniscus can come from a lively unusual movement when it turns the body, turning the leg, a strong blow to the knee.
3. Grinding cup dislocation - Pathological displacement of the patella.Trauma is diagnosed in no more than 0.7% of cases of the total number of dislocations.More often, there is an external dislocation, less often - internal, very rarely - vertical or torsion.With an incomplete dislocation, the knee cup is determined on the lateral condyle (external), with full - from the outside of the lateral condyle.
4. Closed or open fractures of the knee joint, the upper section of the bones of the lower leg or the lower spine. These injuries are often combined with damage to soft knee tissue, causing massive hemorrhages, excessive mobility in the knee area, its deformation.

Dystrophic inflammatory and degenerative diseases of the joint knee elements:

1. Arthritis - Inflammatory damage to the knee joint.A similar mechanism for the development of pathology is observed with osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, gout (with the deposit of uras in the joints).
2. Osteoarthrosis (gonarthrosis) With the defeat of the knee articulation of a non -inflammatory nature, affecting all its structures and leading to serious degenerative changes.
3. Bursitis With the inflammation of the synovial, the stock market causes pain during flexion and extension of movements in the knee.
4. Knee joint periarthritis tendons - Inflammation of the leg goose capsule, knee tendons, as well as muscles and ligaments surrounding the joint.In this case, the pain occurs mainly during the descent into the stairs, in particular with a heavy load, and is concentrated on the inner surface of the knee.
5. PRUTULE CHONDROPATHY -non-chic freezing generation in the cartilage of the joint surface (rear) of the patella.The degree of destruction may be different: areas of softening light to cracks and complete abrasion.

6. Chondromatosis - A serious chronic disease due to the dysplastic process with the degeneration of the islets of the sections of the joint membrane in the cartilage - chondrome.The ossification of individual cartilaginous bodies is not excluded.
7. Baker cyst - The formation of a formation of dense elastic round tumors in a popliteal pit located on the other side of the patella.The cyst is clearly visible in the exposed state of the knee.Causes discomfort, pain in the popliteal region.With significant sizes, he tightens blood vessels and nerves, leading to an alteration of innervation and blood circulation.
8. Goff's disease - A disease, accompanied by additional damage and degeneration of adipose tissue located around the knee joint.Pinks, edema and other damage to fat cells - Adipocytes - finish with their replacement with a dense fibrous tissue.Consequently, the "fat pillow" buffer function is disturbed, the adipose tissue itself does not become able to play the role of the shock absorber.
9. Osgud-SWERTER disease - A pathology characterized by murders of the buggy part of the Tibia.Diagnosis in adolescents aged 10 to 18 practice sports.A painful bump appears under the ball joint, in the absence of treatment, leading to a restriction of the leg or to a complete immobilization, as well as to a muscular hypotrophy.

Diseases in which pain irradiation in the knee is possible:

1. Hip joint -cokeartrosis - Chronic damage to the hip joint, accompanied by progressive degeneration and dystrophic changes.Often the pain spreads to the outer surface of the thigh to the knee or below.
2. Centuries -old nerve neuropathy - Non -inflammatory damage to the nerve following the compression of compression or spasm of the blood vessels.This nerve reaches the feet, starting in the lower back and passing through the coccyx and the pelvis.The blockade at a given time for its length leads to altered sensitivity or pulsed pain.
3. Fibromyalgia - Extracted defeat of soft tissues of a non -inflammatory nature with a combination of symptoms in the form of arthralgia, muscle weakness, depression, etc.

Certain systemic diseases leading to knee pain:

1. Osteoporosis - The bone system disease of a chronically progressive course, modifying mineral composition and bone density.The "leachate" of the calcium of the bones leads to their fragility.The process is accompanied by smoke or painful pain in the limbs.
2. Bone tuberculosis.The tuberculous lesion of the bone site leads to intense constant pain.
3. Osteomyelitis -A infectious and inflammatory disease, affecting all the structural elements of the bones.The result of specific tuberculosis, for example, and non -specific osteomyelitis, more often, more often coccale, is hyperemia of the skin, edema, acute local pain in bones and muscles, febrile temperature.
4. Certain infectious diseases.With Reiter's syndrome, in addition to involving urogenital tracks and the eye mucosa, the joints are affected.Arthralgia is one of the manifestations of Lyme disease.

Knee pain types

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

• Painful.With arthritis, osteoarthrosis.
• Acute, strong.With the fractures of the knee elements, the rupture of the ligaments, the acute mass, the bruise of the knee, the exacerbation of meniscopathy, distorting osteoarthrosis.
• Exciting.With a deforming launched osteoarthritis, meniscus lesions.
• Drilling.With osteomyelitis.
• Silly.With fusion, chronic osteochondritis.
• Burning.With compression of the sciatic nerve, the process of tuberculosis in the bone.
• Cooking. When you pinch the nervous trunk.
• Pain while walking.With a baker, rude, arthritis, gonarthrosis, periarthride.
• Pain alone. With drop, arthritis.

Diagnosis of pathologies that cause knee pain

Physical examination:

• collect anamnesis and complaints;
• Visual inspection with knee palpation.

Laboratory research:

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

Invasive instrumental methods:

• Arthroscopy;
• Puncture of the spouse bag;
• Bone perforation bone biopsy.

Non -invasive instrumental diagnosis:

• radiography of the knee joint;
• densitometry;
• Joint ultrasonic study;
• MRI or CT.

Knee pain treatment

If the pain in one or two knees of the non -human nature of the occurrence, you should first turn to the therapist, which, depending on the complaints of the patient and the results of an objective examination, will be directed towards a close specialist - an orthopedicist, a rheumatologist, a phlebologist or a neurologist.In the event of an injury, you should contact a surgeon or orthopedic trauma.

Treatment in each case is different, depends on the cause of pain, that is to say the type of injury or illness.Each disease has its own treatment diet.But first, the patient must observe several general rules:

• considerably reduce the duration of the hike and stay on the legs during the day;
• Temporarily athletes (before recovery) abandon training and ordinary people to run or jump;
• When you increase the pain, completely abandon the movements, apply an elastic bandage bandage to the knee;
• Wear a bandage or bandage for the immobilization of the knee joint;
• With bruising, cold instead of traumatic effects.

Rheumatoids, psoriatic arthritis, systemic autoimmune diseases require serious integrated treatment, carried out for several months.Basic therapy consists of immunosuppressants, anti-inflammatory drugs and non-steroidal hormones, gold preparations, etc.

In the treatment of bursitis, pain relievers and anti-inflammatory drugs are used.If an infection is detected, then an antibiotic course.The therapeutic puncture of the bag is carried out to eliminate excess liquid from the synovial cavity and / or the introduction of one of their corticosteroids.The operation helps get rid of chronic brush inflammation - surgical excision of the synovial bag.

With distorting osteoarthrosis, intra-articular injections of glucocorticosteroids, prolonged consumption of NSAIDs and chondroprotectors is effective.To relieve pain syndrome, compresses with Diméxide or Bischofit, ointments and gels with anti-inflammatory effects are prescribed locally.Massage, physiotherapy, therapeutic gymnastics help.Severe lesions of the knee joint require surgery - joint endoprosthetics.

The treatment of osteoporosis consists in taking bisphosphonates, calcitonins, calcium preparations, vitamin D, etc.

The treatment of the meniscus rupture can be conservative or surgical.Conservative therapy consists of pain relievers, NSAIDs, hyaluronic acid, chondroprotectors.But first, joint repositioning is carried out.

Surgical intervention types:

• Meniscusctomy;
• partial meniscus (incomplete);
• transplantation of the meniscus;
• Arthroscopy;
• Arthroscopic sewing of the rupture of the meniscus.

With any knee injury, after treatment, the rehabilitation period, which should take place under the control of a rehabilitation or an orthopedist, is very important.The doctor will compile an optimal joint recovery program.The main methods of postoperative rehabilitation are massage and therapeutic gymnastics.Course on special simulators are also effective, gradually developing a knee joint.