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The knee joint experiences enormous loads every day, because with its help we walk, run, squat and perform a lot of other movements. Therefore, it is not surprising that knee pain causes discomfort and interferes with the usual way of life. Painful sensations are different: constant and periodic, weak and intense, occur at rest and during movement. The causes that cause pain syndrome are also diverse.
Our experts talked about the most common causes of knee pain, methods of diagnosis and treatment. They also advised preventive measures that help prevent the onset of knee pain.
Causes of knee pain
The most obvious cause of knee pain is a domestic or sports injury. They most often affect people who are involved in athletics and team sports. But even an ordinary person is not immune from knee injuries due to bruises, falls and twisting of the leg. In addition to injury, knee pain can be caused by inflammation, autoimmune disease, and bone and joint destruction. Doctors identify at least a dozen reasons that can provoke pain. Consider the most common of them.
Knee bruises
A bruise is a soft tissue injury in the area of the knee joint. At the moment of injury, a person feels a sharp pain in the knee, which subsequently becomes aching and intensifies with movement. Bruising may appear at the site of injury, while maintaining support on the leg.
Ligament rupture
Ligament rupture occurs if you twist your leg, bend or straighten it in an unnatural position1. Pain with a torn ligament is stronger than with a bruise, it is concentrated in the “depth” of the knee, on its inner or outer surface. Pain intensifies if you press on the damaged ligament, and the affected knee joint becomes unstable and the leg “staggers” when supported1.
Meniscus tear
When the meniscus is torn, the cartilage tissue suffers, which serves as a “shock absorber” for the knee joint. The rupture most often occurs with a sharp turn or flexion of the lower leg or as a result of a blow to the knee.1. During an injury, a click is usually heard and a sharp pain is felt deep in the joint.1. Then the pain becomes less severe, but captures a larger area, and the injured knee swells. A person cannot lean on a sore leg, freely bend and unbend the lower leg1.
Rheumatoid arthritis
This is a chronic autoimmune disease in which several joints become inflamed at once, among which there may be knees.2. Patients with rheumatoid arthritis usually have both knees affected.2. This disease is characterized by morning stiffness of the joints and aching, pressing or pulling pain during movement and at rest.2.
Reactive arthritis
Reactive arthritis is called inflammation of the joints, which develops against the background of infectious diseases of the intestines and urinary organs.3. Most often, reactive arthritis is diagnosed in men aged 20-40 years.3. The inflammatory process usually affects one knee, the affected joint turns red and swells3.
In reactive arthritis, there is a throbbing and jerking pain that increases during movement and when the joint is touched. The disease is often accompanied by urethritis (inflammation of the urethra) and conjunctivitis (inflammation of the mucous membrane of the eyes)3.
Osteoarthritis of the knee joint (gonarthrosis)
Pain in the knee is a characteristic symptom of gonarthrosis. With this disease, the cartilage tissue of the knee joint is gradually destroyed. Pain in gonarthrosis increases during movement and with a load on the joint, by the end of the day, with hypothermia and in wet weather4. If the disease progresses, the pain becomes permanent, it becomes difficult for a person to get up, go down and climb stairs4. In the later stages of gonarthrosis, the knee joint deforms and increases in size.4.
Treatment for knee pain
Complaints of knee pain are usually referred to general practitioners who prescribe treatment or refer the patient to subspecialists. If the pain in the knee appeared as a result of an injury, traumatologists and surgeons are involved in the treatment. Rheumatoid arthritis is treated by rheumatologists and allergists, and reactive arthritis is treated by orthopedists with the involvement of specialized specialists: urologist, gynecologist, otolaryngologist.
Diagnostics
Any diagnosis begins with a study of the clinical picture. During the examination, the doctor asks the patient about the nature of the pain, examines and palpates the knee, and checks motor activity. After examination, the patient may be assigned the following types of examinations:
- radiography of the knee joint to identify or exclude fractures, dislocations, torn ligaments, damage to cartilage, bone tumors;
- Ultrasound – allows you to assess the condition of the knee joint and soft tissues around it, detect inflammation, cysts, tumors, deformity of ligaments and cartilage, fluid accumulation in the joint cavity;
- CT is an additional research method that allows you to diagnose fractures, meniscus ruptures, displacement of bones and other changes in bone structures;
- MRI is prescribed to check the condition of cartilage, muscles and ligaments in the knee joint;
- general and biochemical blood tests – with the help of these studies, infectious and inflammatory processes and autoimmune diseases are diagnosed;
- joint puncture – for research, fluid is taken from the joint bag to determine the presence of an inflammatory process, tumor, infection.
In some cases, patients may be prescribed arthroscopy. During the procedure, an arthroscope is inserted into the joint cavity through micro-incisions – a device with which the joint is examined from the inside, material is taken for a biopsy and, if necessary, surgical manipulations are performed. Arthroscopy is used to diagnose various diseases and injuries of the knee joint, such as torn ligaments and meniscus.
Modern treatments
Modern methods of treating knee pain can be divided into two groups – surgical and conservative. Surgery is usually indicated for trauma and emergencies. During operations, tumors and bone fragments are removed, ligament plastic surgery is performed, the damaged part of the meniscus is partially excised, and healthy cartilage tissue is sutured. For knee injuries, fixative bandages and plaster splints are often applied to fix the limb and speed up healing.
For conservative treatment of knee pain, orthopedic appliances, physiotherapy and medications are used:
- non-steroidal and steroidal anti-inflammatory drugs to reduce pain, swelling and inflammation;
- antibacterial and antifungal drugs to suppress pathogenic microflora3;
- chondroprotectors that improve the condition of cartilage tissue;
- genetically engineered biologicals, synthetic and biological basic anti-inflammatory drugs that reduce inflammation and prevent the destruction of bone and cartilage tissue2;
- orthoses – orthopedic devices that fix the knee in a physiologically correct position and reduce the load on the damaged joint;
- UHF, electrophoresis, magnetotherapy, laser exposure – these procedures stimulate the blood supply to the joint and help restore its mobility.
During the rehabilitation period after an injury and in case of chronic diseases of the knee joint, massage sessions and physiotherapy exercises are recommended. Exercises to strengthen the muscles of the thigh and lower leg improve joint function, reduce the risk of relapses and complications4. In the treatment of diseases such as gonarthrosis, yoga and tai chi classes give good results, during which motor activity is combined with the concentration of consciousness and breathing.4.
Prevention of knee pain at home
To prevent knee pain, doctors recommend wearing comfortable shoes, taking precautions during sports, and avoiding excessive physical exertion. Overweight people should lose weight to reduce stress on their joints. In case of injury and exacerbation of the disease, you need to move as little as possible and follow the recommendations of the doctor. In the acute period of the disease, you can not massage the knee and use warm compresses.
Popular questions and answers
Knee pain is a very common symptom that occurs in men and women, young and old. However, many do not pay attention to painful sensations, especially if they occur from time to time and do not cause much discomfort. Our experts answer popular questions and tell you how dangerous knee pain is and when to see a doctor.
When can knee pain be dangerous?
When to See a Doctor for Knee Pain?
How can you relieve knee pain?
Sources:
- Damage to the ligaments of the knee joint. Clinical guidelines. 2017 Russian Association of Traumatologists and Orthopedists. https://disk.yandex.ru/i/VUQMI0JxiKdzLg
- Rheumatoid arthritis, principles of diagnosis and treatment. Clinical recommendations for general practitioners. 2021
- reactive arthritis. Article. Author: doctor of medical sciences Kunder E.V. https://cyberleninka.ru/article/n/reaktivnyy-artrit
- Gonarthrosis. Clinical recommendations 2021-2023. Russian Association of Traumatologists and Orthopedists. Association of Rheumatologists of Russia. https://clck.ru/akpe7