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

Knys pain is a widespread symptom that signalizes distress in the body - the occurrence of joint disease or simply increased bone load.

It is difficult to find a person who has never experienced pain in the knees for a certain period of time in life.Discomfort, clicks or pain at different intensities of the knee joints occur in both adults and children due to many reasons.The older a person gets, the higher the probability of different diseases if the first sign is the pain in the knees.This is due to the body's age characteristics: to slow down metabolic processes, wear of the cartilage tissue in the joints that end up with other problems with musculoskeletal system, blood vessels, nerves.

Due to the complex anatomical structure, many structures and significant stresses experienced and often overloaded, the knee joints are very vulnerable.Damage to any element of the structure, for example, a synovial bag, leads to a violation of the knee's motor function and consequently pain syndrome.Ligaments and menisci are considered the most vulnerable, they are injured in 80-85% 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 tibia, muscles, nerves, vessels, ligaments, a patella (knee cup), articular bags and meniscus.

The knee joint is one of the big joints in the body.The femur approaches him from above.The articular surfaces of its lateral (external) and medial (internal) condyles are articulated with patella and tibia.Menish, which is connective tissue cartilage, serves as shock absorbers of the joint.Thanks to them, a rational distribution of human emphasis is a tiger plateau and the stability of the joint increases.Subtle, double-headed, semi-back and other muscles synchronize capsule-ligamentous structures, ensuring the motor activity of the knee joint.

The elements of the knee are connected to many ligaments.Inside the joint there are two cross -affiliated ligaments - the back and in front.The hobbies are connected to fiber and tibia bones with safety tapes.Scratched by the popliteal ligament is located at the back of the bursa in the knee joint.The most important - synovial capsule that does not communicate with the joint is separated from a number of articular cavities.The blood supply to the elements of the knee is carried out by a precious network of blood vessels and innerving is performed by nerve fibers.

Causes of knee pain

There are many causes of soreness in the knee joints, which can be conditionally divided into several groups.

Traumatic lesions of the elements of the knee:

1. Bitter of the knee.As a result of the cavity in blood vessels, local bleeding occurs in the soft tissues of the joint.Redness, swelling, damage to the nerve endings leads to pain, difficulties in motion.
2. Full or partial ligament breach.More often, a partial violation of the integrity of the inner sidelament that occurs by excessive twisting of the lower leg is diagnosed.

The outer ligament breaks less often than the internal.This is due to a strong deviation from the lower leg inward when, for example,Turning the leg.The rupture of the cross -shaped ligaments is inevitably accompanied by hemarthrosis.

A complete fracture of both ligaments is often combined with damage to the common bag and tears the inner meniscus.Such damage leads to excess mobility in the knee joint accompanied by severe pain whose intensity depends on the degree of hole.

1. Hemarthrosis in the knee joint - Pour blood into the common cavity.There is a traumatic and non -human nature.Traumatic hemarthrosis is observed with fractures of meniscus, full or incomplete ligaments, intra -articular fractures, bruises in the knee area.The non -human option is one of the symptoms of diseases characterized by increased short -term duration of the walls of blood vessels or a violation of the blood coagulation system.These include hemophilia, scurvy, severe forms of hemorrhagic diathesis.The blood accumulated in the joint cavity, compresses the tissue and interferes with blood circulation in them.A special pigment - hemosiderin - affects the ligaments, hyaline cartilage, a synovial bag that leads to loss of their elasticity.The result of the lesion in the common bource is the swelling of her villi and the increased production of common fluid.The result of repeated bleeding is dystrophy and destruction of the joint.
2. Knee Meniscopathy - Violation of the integrity of the meniscus in the knee joint.In the lateral form, the external meniscus is damaged with the medial - internal.This is one of the most common but difficult to diagnose damage to the knee joint.In the disease zone, the disease is not only athletes involved in intensive exercise, but also ordinary people.The bride of the meniscus can come from a sharp unusual movement when turning the body, turning the leg, a strong blow to the knee.
3. Dislocation of the knee cup - Pathological displacement of patella.Trauma is diagnosed at a maximum of 0.7% of cases of the total number of dislocations.More often there is external dislocation, less frequently - internal, very rarely - vertical or torsion.With an incomplete dislocation, the knee top is determined over the lateral (external) condyle with full - from the outside from the lateral condyle.
4. Closed or open rupture of the knee joint, the upper part of the bones on the lower leg or the lower spine. Such damage is often combined with damage to the soft tissues of the knee causing massive bleeding, excessive knee mobility, its deformation.

Inflammatory and degenerative-dystrophic diseases of the articular elements of the knee:

1. Arthritis - Inflammatory damage to the knee joints.A similar mechanism for the development of pathology is observed with osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, arthritis (with deposition of urates in the joints).
2. Osteoarthrosis (Gonarthrosis) With the defeat of the knee joint of non -inflammatory nature, which affects all its structures and leads to serious degenerative changes.
3. Bursitis With inflammation of the synovial, Bursa leads to pain during bending and extension of movements in the knee.
4. Periiarthritis tendons in the knee joint - Inflammation of the capsule in the goose of paw, knee tendons as well as muscles and ligaments that surround the joint.In this case, the pain occurs mainly during the descent on the stairs, especially with a heavy load, and focuses on the inner surface of the knee.
5. Chondropathy of Patella -Degenerative-not-chic changes in the cartilage of the articular (rear) surface of the patella.The degree of destruction may be different: from areas with light softening to cracks and complete wear.

6. Chondromatosis - A serious chronic illness due to the dysplastic process of Holmen Degeneration of the sections of the articular membrane in cartilage - chondrome.Ossification of individual shower bodies is not excluded.
7. Baker's cyst - The formation of a densely elastic round tumor formation in a popliteal fossa located on the opposite side of the patella.The cyst is clearly visible in the exposed state of the knee.Causing discomfort, pain in the popliteal region.With significant sizes, it squeezes blood vessels and nerves, leading to decreased innervation and blood circulation.
8. Goff disease - A disease accompanied by damage and further degeneration of adipose tissue located around the knee joint.Pinches, edema and other damage to fat cells - adipocytes - end with their replacement with dense fibrous tissue.As a result, the buffer function of the "fat pillow" is disturbed, the fat tissue itself is unable to play the role of the shock absorber.
9. Osgud -sverter disease - A pathology characterized by the murder of the Bugrous part of the tibia.Diagnostic in young people from 10 to 18 years old plays sports.A painful shock appears during the patella, in the absence of treatment, leading to limiting the bone or complete immobilization as well as muscle hypotrophy.

Diseases where irradiation of knee pain is possible:

1. Cookes arthritis of the hip joint - Chronic damage to the hip joint, accompanied by progressive degeneration and dystrophic changes in it.Often the pain spreads down the outer surface of the thigh to the knee or below.
2. Sedular nerve neuropathy - Non -inflammatory damage to the nerve as a result of compression pressing or spasm of blood vessels.This nerve reaches the feet, starting in the crucifix and passes through the tailbone and the pelvis.The blockade at any time of its length leads to decreased sensitivity or pulsating pain.
3. Fibromyalgia - Extracting defeat of soft tissue of non -inflammatory nature with a combination of symptoms in the form of arthrhagia, muscle weakness, depression, etc.

Some systemic diseases leading to knee pain:

1. Osteoporosis - The disease of the bone system in a chronically progressive course that changes the mineral composition and bone density."Leaching" of calcium from bones leads to their fragility.The process is accompanied by a smoke or sore pain in the limbs.
2. Bones tuberculosis.The tuberculous lesion at the bone site leads to constant severe pain.
3. Osteomyelitis -An disease of an infectious and inflammatory nature that affects all structural elements of bones.The result of both specific, such as tuberculosis and non -specific, more often coccal, osteomyelitis is hyperemia of the skin, edema, local acute pain in bones and muscles, fever temperature.
4. Some infectious diseases.With Reiter -Syndrome, in addition to involving the urogenital duct and the glimmer of eye, joints are affected.One of the manifestations of Lyme's disease is Arthralgia.

Types of knee pain

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

• Sore.With arthritis, osteoarthrosis.
• Acute, strong.With fracture of the elements of the knee, rupture of ligaments, acute buckhrough, marked in the knee, worsening of meniscopathy, deforming osteoarthrosis.
• Pulsing.With a launched deforming arthrosis, meniscus damage.
• Drilling.With osteomyelitis.
• Stupid.With burit, chronic osteochondritis.
• Burning.With the compression of the sciatic nerve, the tuberculosis process in the bone.
• Firing. When you squeeze the nerve strain.
• Pain when you go.With a bakery cyst, buckhrough, arthritis, gonarthrosis, periarthride.
• The pain alone. With arthritis, arthritis.

Diagnosis of pathologies causing knee pain

Physical examination:

• Collection of Anamnesis and Complaints;
• Visual inspection with palpation of the knee.

Laboratory Survey:

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

Invasive instrumental methods:

• Arthroscopy;
• puncture of the common bag;
• Puncture of bone biopsy.

Not -invasive instrumental diagnosis:

• Radiography of the knee joint;
• Densitometry;
• Ultrasonic Ledy Survey;
• MRI or CT.

Treatment of knee pain

If the pain of one or both knees of the non -human nature of the occurrence, first turn to the therapist, which, based on the patient's complaints and the results of an objective examination, will refer to a narrow specialist - an orthopedic, a rheumatologist, a phlebologist or a neurologist.In case of injury, contact a surgeon or an orthopedic trauma.

Treatment in both cases is different, depends on the cause of the pain, ie the type of injury or illness.Each disease has its own treatment regimen.But first, the patient must observe several general rules:

• Reduce the duration of hiking and staying on the legs during the day;
• Athletes (before recovery) give up training and ordinary people from running or jumping;
• As you increase the pain, completely giving up movements completely a fastening bandage from an elastic bandage to the knee;
• Carry a bandage or a bandage for immobilization of the knee joint;
• With a bruise, cold on the site of traumatic effects.

Rheumatoid, psoriasis arthritis, systemic autoimmune diseases need severe integrated treatment, performed for many months.The basic therapy consists of immunosuppressors, non -steroidal anti -inflammatory and hormonal drugs, gold preparations, etc.

In the treatment of bursitis, painkillers and anti -inflammatory drugs are used.If an infection is detected, there is a course of antibiotics.The therapeutic puncture of the bag is performed to remove excess fluid from the synovial cavity and/or the introduction of one of their corticosteroids.The operation helps to get rid of the chronic inflammation of the brush - the surgical excision of the synovial bag.

With deforming osteoarthrosis, intra -articular injections of glucocorticosteroids, prolonged intake of NSAIDs and chondroprotectors are effective.To relieve pain syndrome, compactions with dimexide or bischofit, ointments and gels with anti -inflammatory effects locally prescribed.Massage, physiotherapy, therapeutic gymnastics helps.Serious lesions in the knee joint require surgical intervention - common endoprotetics.

Treatment of osteoporosis consists during taking bisphosphonates, calcitonins, calcium preparations, vitamin D, etc.

The treatment of meniscus fractures may be conservative or surgical.Conservative therapy consists of painkillers, NSAIDs, hyaluronic acid, chondroprotectors.But first, the common reposition is performed.

Types of surgical intervention:

• MeniCectomy;
• partial (incomplete) MeniSkectomy;
• Meniscus transplantation;
• Arthroscopy;
• Arthroscopic sewing of the bride of meniscus.

With any injury to the knee, after treatment, the rehabilitation period to take place under the control of a rehabilitologist or orthopedist is very important.The doctor prepares an optimal joint recovery program.The main methods of post -operative rehabilitation are massage and therapeutic gymnastics.Classes on special simulators are also effective and gradually develop a knee joint.