Knee pain (knee joint)

Knees are more susceptible to injuries and various diseases than other joints.A significant proportion of orthopedic-traumatologist and rheumatologist patients complain of severe knee pain.In this article you will learn what to do if you suddenly feel severe pain.She is undergoing treatment, the main thing is to seek medical help for her problems in time. 

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

The patella is a flat sesamoid bone (additional to the joint) that attaches 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, connecting to the femur, is covered with hyaline cartilage.The patella is strengthened by ligaments: main and lateral – vertical (superior and inferior) and horizontal (lateral – internal and external).

Transmits the strength of the quadriceps femoris muscle to the musculoskeletal formations of the leg, ensuring extension of the 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 all of them can get sick.Thus, cartilaginous tissue does not have 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, which manifests itself in the form of severe pain.With significant destruction of the articular cartilage, pain may be associated with the 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 need to calm down and seek medical help immediately.All of this can be treated, specialists will be able to help even with advanced disease.If you are unable to see a doctor at the moment, you may be able to temporarily relieve the pain on your own.

But remember that if you feel pain in the knee joint, this is a temporary measure;you still need to seek medical help;you can't live without it.And it's better not to delay.

How to treat knee and leg pain at home

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

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

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

For chronic pain in the knee joints, when there is no significant inflammation, physical exercises can be performed that strengthen the musculo-ligamentous system, improve blood circulation and metabolism.Systematic training leads to a gradual reduction in pain, despite the legs being 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 keep it in this state for a minute;the second leg is motionless at this time;stretch and lower your leg very slowly, rest 10 seconds and repeat the exercise with the other leg;repeat 10 times;
2. Double bending of the legs with the knees close to the face.Lie on your back, bend your legs at the hips and knees, fix the latter near your face and hold like this 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 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, a violation of the general condition, fever, it is not possible to move the leg, it must be kept at rest.And only after the inflammation begins to subside, you can 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 feel pain

For chronic pain, the following should not be allowed:

• injured knee - you can avoid this by organizing your life in such a way as to reduce the risk of injury to a minimum;
• excess body weight is an additional burden on the knees, especially in the elderly;
• intense physical activity, jumping, strength sports;You shouldn't run either;
• any intoxication, then you need to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and foci of infection;
• wear tight, uncomfortable shoes, high-heeled shoes;
• stress, lack of sleep;
• sedentary lifestyle - you need 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 intra-articular bleeding), they can cause irreparable damage.

When you need to see a doctor urgently

If your 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 that appears periodically after physical exertion, prolonged standing, sharp straightening of the leg;
• nighttime pain and associated insomnia;
• if the pain in the knee is very strong, constant, the feeling that the inside of the patella hurts.

In any case, knee pain should be a reason to see a doctor.There is no point in treating it: it may temporarily reduce or even eliminate pain, but it will not prevent the progression of the disease and destruction of the joint.Treatment must be entrusted to a specialist.

What to do for severe knee pain of various types

Painful sensations in the knee can vary in nature and duration between people.They can hurt constantly 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.

Knee pain due to coronavirus and other viral illnesses

Viral infections can cause joint inflammation.As a rule, these diseases develop against the background of an existing infection and pass without any consequences after its end.So, with flu 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 occurs differently in each patient.Why this happens is unknown.During the illness, joint pain, swelling and redness sometimes appear - a sign of acute arthritis, but then disappear.

Arthritis, which begins approximately a month after coronavirus infection, is more dangerous.The fact is that it has a significant effect on the immune system.Malfunction of the immune system leads to the development of autoimmune processes.This is especially dangerous for people who have close relatives who suffer from chronic arthritis.Experts note a high risk of developing rheumatoid arthritis (RA) in these patients.The first sign of RA is stiffness of movement in the morning (difficulty bending the knee).

If arthritis appears after recovering 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 distended synovial sac with fluid located in the popliteal area.The cyst and associated pain under the knee appears due to the fact that it is connected to the knee joint cavity and is filled with synovial fluid.In this case, the reverse flow of the liquid is difficult for several 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 be compressed, causing pain under 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 experience pain below your knee, it is best to see a doctor as soon as possible.Conservative treatment (removal of fluid from the cyst, injection of glucocorticoids) and surgical treatment (removal of the cyst) is carried out.

Severe pain in the left or right knee

Severe pain combined with swelling and redness of the skin in the right or left knee often indicates the development of an acute inflammatory process.It 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 have similar symptoms;a correct diagnosis can only be established after a complete examination.

The right or left knee can suffer microtrauma, for example, in athletes or workers in certain professions who use one more 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 illnesses, a specialist can always help and alleviate the pain.

Knee and leg pain

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

• on the shin below the knee– are rare, may indicate compression of the nerve branches that innervate the leg muscles by the inflamed and swollen periarticular tissues in the knee region;pain under the knee in the back indicates compression of the branches of the sciatic nerve, and pain under the knee in front indicates that the nerves innervating the anterior surface of the leg are affected;These diseases are treated by a rheumatologist, but consultation with a neurologist is necessary;
• above the knee, on the thigh– is often a sign of a post-traumatic inflammatory process in the patellar-femoral joint;in this case, patellofemoral pain syndrome develops;the pain is strong, aching, sometimes spasmodic, aggravated when walking;an orthopedist-traumatologist and a rheumatologist will help you cope with pain;
• sideways, inside– pain can develop with injury and damage to the internal lateral articular ligament;the side pain is strong, spasmodic, with hemarthrosis (intra-articular hemorrhage) - rupture, accompanied by imbalance of the joint, the entire leg crunches when moving;the same pain appears when the external collateral ligament is sprained;care will be provided by an orthopedist-traumatologist.

To eliminate pain, you need to accurately determine its cause, and this is impossible to do alone.Need medical help.

Patella pain in 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 femoral-patellar joint with the development of patellofemoral pain syndrome;the pain is strong, constant, aggravated by walking;
• front– such painful sensations are caused by superficial bruises on the knee or frequent prolonged stay on the knees with microtrauma on the kneecap;the pain is significant, as the periosteum, rich in nerve endings, is injured;
• side knee painin case of rupture or injury to the internal or external horizontal patellar ligaments;injuries can develop with frequent and prolonged ligament microtraumas, for example, during jumps;accompanied by bleeding in the joint cavity (hemarthrosis);the pain is strong, constant, accompanied by swelling;leg movements are impaired.

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

Knee pain radiating to leg, heel, groin

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

• compression of the femoral nerve;the pain is sharp, piercing in nature, begins sharply in the groin area, spreads along the antero-inner surface of the thigh and knee, along the nerve branches it can reach the inner edge of the foot and heel;Sometimes the patient gets 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 pain in the knees to the groin and down to the heel;in this case, there is mainly aching pain in the knee, which with sudden movements turns into sharp pain radiating above and below the knee;
• hematoma accompanied by hemarthrosis, ligament rupture, intense swelling and nerve compression;
• hematoma with fracture or dislocation of the patella and joint imbalance;sharp pain in the knee extends down the thigh to the groin, along the inner surface of the shin - in the lower part, 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, pain in the knee during flexion and extension, as well as when squatting, is a sign of tendonitis - an inflammatory process in the area of the tendon-ligamentous apparatus of the knee joint.It develops mainly in young men who play sports and is a consequence of frequent and repeated microtraumas associated with constant jumping and shaking 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 arthrosis - degenerative-dystrophic changes in the joint with the growth of connective and bone tissue that interfere with movement.

Only the treatment of tendonitis or osteoarthritis helps to relieve the patient of severe knee pain when flexing and extending.

Severe knee pain at night

Night pain is characteristic of inflammatory processes.It could be latent arthritis, periodic inflammation of the knee joint due to osteoarthritis (arthrosis-arthritis).During sleep, articular and periarticular tissues heat up, blood vessels dilate, which increases swelling.

The periarticular tissues swell, compress the nerve endings and pain appears.If at the same time there is pain behind the knee, this may be a sign of a Baker's cyst.How to get rid of swelling and nighttime pain?Treating the underlying condition helps.

Knee pain when walking

Pain when moving, running, dull 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 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 knee pain continues for some time.Over time, pain appears in the foot.

Long-term rehabilitation treatment with the use of chondroprotectors - drugs that restore cartilaginous tissue - will help.In case of complete destruction of the joint - endoprosthesis.

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 the pain appears in a right or left knee.Joints creak.

If there is severe pain in the knee 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 crushing

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

Severe joint pain may disappear, but knee pain will remain when squatting, then limb dysfunction will gradually increase, accompanied first by pain during exercise and then by constant pain, which intensifies when going down stairs.Over time, the entire limb suffers and grinds, including the foot.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 injury), infectious, infectious-allergic and autoimmune (with allergy to the tissues themselves).

To get rid of these pains, you need to identify their cause and carry out the treatment prescribed by a specialist.

Injuries and illnesses that cause knee pain

The most common pathologies accompanied by knee pain are:

1. Closed and open injuries of the knee with intra-articular fractures, dislocations, meniscus tears.All of them lead to the development of inflammatory processes (arthritis), which then turn into degenerative-dystrophic processes (arthrosis) with the formation of constant pain and knee dysfunction.This is the most common cause of knee pain.Athletes are at risk.Even a minor injury to the knee can cause the destruction of articular tissue cells, which leads to the development of an inflammatory process.With significant injuries, all these processes are pronounced and accompanied by prolonged pain.Knee instability, which develops when the ligamentous apparatus is damaged, is of great importance.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 infection, become purulent, threatening 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, accompanied by an increase in body temperature and changes in the patient's general condition.Patients complain that knee pain hurts constantly.The disease can be infectious, infectious-allergic, autoimmune and metabolic in nature.The inflammatory process also proceeds 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 the elderly.There is destruction or thinning of the shock-absorbing cartilaginous tissue (menisci and the cartilaginous layer covering the articular surfaces of bones).The destruction of the joint progresses slowly but steadily.I'm worried about the pain and crushing when moving.In old age, this is the main cause of knee pain.The bones rub together, their structure is destroyed, the joint becomes deformed, all accompanied by severe pain.
4. Cysts and tumors.

How to treat severe knee pain

Knee injuries and illnesses often lead to the development of patellofemoral pain syndrome (PFPS), pain in the anterior part of the knee joint.Changes in the joint gradually destroy the patellar cartilage, contributing to the development of joint instability and intense and constant pain in the knees.Only rehabilitation treatment prescribed by a qualified specialist can help.

Diagnosis

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 a clinic.And only after that is treatment for knee pain prescribed.

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

To establish the causes of pain and diagnose the disease, the following examination is carried out:

• Laboratory tests– clinical, biochemical, immunological blood tests, if necessary – sampling and examination of intra-articular fluid (microscopy, culture on nutrient medium to determine the sensitivity of the identified infection to antibiotics).
• Instrumental studies: Ultrasound– reveals soft tissue pathology and intra-articular fluid volume x-ray– changes in the bone tissue of the knee; Computed tomography and magnetic resonance imaging– 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 to treat severe knee pain

Treatment 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 better able to deal with 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 phthisiatrician 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 medicines 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) are used, as well as taping - fixing the joint with special adhesive tapes.

For all acute joint pain, an emergency examination of the patient is performed with simultaneous anesthesia.All modern and traditional pain therapy methods are used in the treatment.After that, depending on indications, the patient is hospitalized or prescribed outpatient treatment followed by rehabilitation.No pain patient is left without specialist attention.