Knee pain: causes, diagnosis and treatment

Knee pain caused by injury or disease

Knee pain occurs among patients of all ages and lifestyles. Such pain is observed during physical activity for a variety of reasons: from injury or bruise to significant illness and inflammation. Ignoring it can lead to serious consequences. A common question is what to do if you have pain? At the first painful sensation, it is recommended to consult a doctor to prevent hospitalization; treatment should only be carried out by a doctor.

The first manifestation of pain in the knee is usually caused by heavy loads, joint wear and deformation. The disease is felt not only during excessive stress, but also at rest, during rest, and while performing everyday activities. In this article we will look at why the knee hurts, the main methods of diagnosis and treatment.

What is the knee joint?

The knee joint of our body bears a large load and body weight; it accounts for most of the injuries and stress during falls, sports, and heavy lifting. The knee joint itself is one of the largest in our body.

The knee joint includes:

  • the joint itself;
  • muscles;
  • knee cap;
  • menisci;
  • joint capsule;
  • ends of the femur and tibia,
  • vessels,
  • nerves,
  • ligaments
Model of the knee joint, allowing you to evaluate its structure

Each of these components is susceptible to damage, although pain is not always felt immediately. For example, with a dislocated or torn meniscus and a torn anterior cruciate ligament, mobility will be reduced, and vascular damage will cause a hematoma. Infection may begin in the joint capsule of the knee after infectious diseases. If the patient has a neurological disease, shooting pain may be felt in the knee. In addition, it can radiate into the joint with pain in the femur, tibia and muscles.

Causes of joint pain

The nature of pain can be divided into two groups: acute and chronic. Acute pain is characterized by rapidly developing and progressive pathologies. Chronic diseases, on the contrary, are rather sluggish and require lifelong treatment. The causes of such pain vary and the treatment, accordingly, too.
Let's look at the main causes of pain.

Pain due to injuries

The cause of acute pain is injuries and various traumatic actions. You can get injured due to a bad fall, playing sports, or uncomfortable shoes. Pain begins to be felt a few days after the injury. Usually the knee has slight swelling, and victims experience quite tolerable pain. Depending on the severity of the injury, abrasions may be present on the surface of the skin. In addition, excess weight, abuse of bad habits, and peculiarities of the profession and work increase the risk of injury.

Types of injury:

  • Knee bruise.Frequent and mild damage. Swelling and redness appear in the knee area, and the surface temperature rises. Even a minor injury to the knee can cause destruction of joint tissue cells.
  • Sprains.Sometimes a muscle, ligament or tendon sprain goes unnoticed and causes shooting and sharp pain in the knee, and the joint itself becomes unstable when stepping on the leg.
  • Ligament rupture.It can appear due to strong twisting of the leg in an unnatural direction and causes severe pain, swelling, and swelling.
  • Meniscus tear.Appears as a result of heavy load, a blow to the knee, twisting of the leg and due to its unnatural position. A torn meniscus causes your legs to stop moving normally. Often occurs in athletes and is accompanied by swelling, hemorrhage and the inability to bend the leg. There is one rule regarding sports: the knee may hurt, but it should go away the next morning after training. If the illness does not go away, you need to consult a doctor.
  • Joint fracture.Due to the fracture, soft tissues are also damaged, causing severe pain and deformation of the knee.

Unpleasant sensations in the knee are not always characterized by a disease in this department. Sometimes a herniated disc can cause pain in the knee at night. Discomfort can also occur if the knee joint is used too little and the associated muscles lose tone.

Asymmetry of the sacrum and pelvic bones can also provoke the appearance of pain in the knee joint. It occurs as a result of a difference in the length of the lower extremities, which may be a consequence of congenital features or curvature of the pelvis, including due to scoliosis.

Knee diseases

Any inflammation or damage in the structure of the knee causes discomfort, especially when moving. And the infection is not always localized in the knee itself. With general joint diseases, the whole body is affected, and the knees are more damaged due to heavy stress. Also, with injuries or diseases of the spine, or a fracture of the femoral neck, pain may occur in the knee joint. Let's look at some of them:

  1. Arthritisis an inflammatory process that develops after trauma from an infection or metabolic problems. If left untreated, the cartilage of the knee joints continues to progressively wear out, which leads to increased pain.
  2. Rheumatoid arthritis– an autoimmune disease in which the body’s defense cells negatively affect tissue. The joint loses mobility, swelling appears, pain is constantly present, and manifests itself in an increased feeling of stiffness.
  3. Rheumatism– as a rule, teenagers are susceptible to it, as well as people who have recently had streptococcal diseases. Characterized by alternating unpleasant sensations.
  4. Gonarthrosis (arthrosis).It develops in one or both knees. This disease is characterized by the occurrence of degenerative-dystrophic processes with the growth of connective and bone tissue that interferes with movement. At the beginning of the illness, discomfort begins to be felt only after a long walk, but as the disease progresses, pain begins to appear even after walking short distances. It’s hard to get up from a chair, squat, or walk up the stairs. The pain does not bother you only at rest. Destruction or thinning of the cartilage shock-absorbing tissue occurs. As gonarthrosis develops, a crunch in the knee and deformation of the joint are noticed.
  5. Reactive arthritis– begins a few days after an intestinal infection. Severe pain combined with swelling and redness of the skin over the right or left knee usually indicates reactive arthritis.
  6. Bursitis– inflammation of the joint capsule, leading to severe pain and discomfort during movement.
  7. Periarthritis– inflammation of the tendons, muscles and ligaments surrounding the knee joint. Painful sensations appear with increased load on the bent leg.
  8. Chondropathy– destruction of the cartilage that surrounds the knee joint and cushions friction and shock.
  9. Neoplasms– when they appear, the vessels are compressed, and the joint capsule is deformed, causing pain and limiting mobility.
  10. Osteoporosis– tissues weaken, become more fragile, calcium content in bones gradually decreases.
  11. Osteomyelitis– inflammation of the bone tissue appears in the affected area, accompanied by swelling, fever, and acute severe pain.
  12. Osteoarthritis– inflammation in the joint capsule is gradually localized to the heads of the bones. The cartilage wears down and thins, causing the bone heads to no longer slide easily when moving the limb. Aching pain occurs.
  13. Osteoarthritis– a disease that affects all components of the joint.
  14. Patellofemoral pain syndrome– often occurs in young patients. During physical activity, the kneecap moves forward. This happens due to incorrect position of the foot, excessive and heavy loads with unprepared muscles.
  15. Osgood-Schlatter disease– knee pain when bending, walking up stairs, squats.
  16. Nerve damage and nerve tissue disorders.Shooting pains, numbness and tingling in the lower limb, and loss of mobility appear. A pinched nerve appears due to inflammation, neoplasms or previous injuries. Or neuritis develops - inflammation of the nerve in one or more areas. Severe pain is felt, mobility and sensitivity are reduced, and the limb involuntarily contracts.
  17. Impaired blood supply.
  18. Various other infectious diseases. Complications that arise contribute to the appearance of weakness and pain.

In addition to the listed diseases, others can contribute to the appearance of pain: synovitis, ligamentitis, tendinitis, gout, neuropathy, cyst and others.

Thus, pain in the knee is always a sign of a pathological process that affects the cartilaginous, bone or soft tissue structures of the knee itself, or damage to the nerve that innervates it.

Diagnosis of knee pain

Diagnosis of knee pain includes palpation of the affected joint

In order to begin treatment, it is necessary to establish an accurate diagnosis from a doctor in the clinic using diagnostic measures.

The patient seeks an appointment with an osteopath, orthopedic traumatologist, surgeon or rheumatologist. If necessary, after examination and examination, the patient may be sent to another specialist.

At the appointment, the doctor collects anamnesis - complaints, symptoms and problems that concern the patient, infections and chronic diseases. After this, the doctor may palpate the area of concern and ask the patient to perform various movements and tests. For example, bend and straighten your knee. This will provide initial information about the degree of malaise.

In order to obtain additional information and determine an accurate diagnosis, the patient is sent for one or more examinations:

  • radiography (x-ray);
  • ultrasound examination (ultrasound);
  • magnetic resonance therapy (MRI);
  • computed tomography (CT);
  • arthroscopy (a special instrument, an endoscope, is inserted into the joint);
  • puncture for collecting synovial fluid;
  • laboratory tests (general and biochemical blood tests, serological tests).

To diagnose nervous diseases, MRI and CT are used, depending on contraindications. Some diagnoses require more precise tests.

To relieve knee pain, you can see an osteopath, physiotherapist, chiropractor or massage therapist. An osteopath will help restore the normal position of the pelvic bones and internal organs, which has a positive effect on their functioning, improve nutrition of all spinal structures by activating blood circulation, and improve posture by eliminating spinal deformities.

Treatment of knee pain

It is impossible to choose the best medicine for knee pain on your own. This is due to the fact that it is necessary to first find out the true cause of the symptoms and determine the type of pathological disorders in the body.

Treatment of the knee joint is carried out comprehensively. This set of measures includes:

  • medicinal (non-steroidal anti-inflammatory drugs or chondroprotectors - their effectiveness lies in preserving moisture in cartilage cells, inhibiting enzymatic action and stopping the degenerative process);
  • preparations, solutions for external use;
  • osteopathy;
  • performing special exercises and gymnastics, physical therapy;
  • physiotherapeutic techniques;
  • massages;
  • vitamin complexes are drugs indicated to improve metabolic processes in the body.

Various types of physical therapy treatments can be used to treat musculoskeletal disorders that cause knee pain.

Exercise therapy classes are simple and accessible to people of any age, since an individually designed program ensures the creation of a precisely dosed load. For complex therapy, local painkillers are also prescribed, for example, ointment with dimethyl sulfoxide (there are contraindications: severe diseases of the kidneys, liver, cardiovascular system, pregnancy, breastfeeding) or an anti-inflammatory gel - it is instantly absorbed into the skin, penetrates into its deep layers, relieves swelling and pain.

Pain can also be eliminated using high-frequency techniques: morphological changes remain, but the pain decreases and becomes easier. Also, special orthoses are often prescribed - bandages, knee pads, splints, tapes, casts and other similar devices. This allows you to transfer the load from the knee and unload it, reduce the risk of re-injury and promote rapid rehabilitation. Plasmolifting is rarely used - injections of plasma obtained from the patient’s own blood directly into the affected knee joint or the soft tissue around it.

Sometimes a bone realignment procedure or surgery is performed (for example, if bone fragments need to be removed).

The doctor also prescribes painkillers that do not have a negative effect on the articular cartilage.

Pay attention to your diet - a balanced diet can prevent inflammation.

If you have problems with your knee, you should not self-medicate and attend various procedures in order to avoid surgical intervention (operation) and possible complications. This attitude can only worsen the situation and more serious and complex therapy will be required. Therefore, it is important to consult a doctor who will establish an accurate diagnosis and prescribe competent treatment, procedures and medications that will give effect. Take care of yourself and your health!