Knee pain (knee joint)

Knees are more susceptible to injury and various diseases than other joints.A significant proportion of orthopedic, traumatologist, and rheumatologist patients complain of severe knee pain.From this article, you will learn what to do if you suddenly experience severe pain.She is receiving treatment, which mainly involves timely medical attention to resolve the problem. 

Why does the knee hurt?

The knee joint is the most complex joint and bears the main load.Structure: Three bones (femur, tibia, and patella) form a trochlear joint, which consists of two interconnected joints: the tibiofemoral and patellofemoral joints.

The patella is a flat piece of sesamoid (additional) bone in a joint that attaches to the head of the femur, sliding in its groove and acting as a block.Structural features: The anterior surface of the patella is covered with periosteum, and the posterior surface is connected to the femur and covered with hyaline cartilage.The patella is strengthened by ligaments: cardinal and lateral ligaments - vertical (superior and inferior) and horizontal (lateral - internal and external).

O Transmits the force of the quadriceps to the musculoskeletal structure of the calf, ensuring extension of the calf at the knee joint.The bones that form the joints are covered with cartilage, which acts as a shock absorber.Additional shock absorbers that protect the joint from injury are the two crescent-shaped cartilage menisci located between the femur and tibia.Joints are held in the correct position by ligaments, tendons, and the surrounding joint capsule.

Injury and disease can affect various joint tissues.Not everyone gets sick.Therefore, cartilage tissue has no nerve endings and can therefore be destroyed imperceptibly and painlessly.But ligaments and synovial membranes have many nerve endings, and once they are injured or inflamed, they immediately begin to react with severe pain.With severe destruction of articular cartilage, pain may be related to the involvement of the periosteum (the outer layer of bone with good innervation).

What to do if your knee pain is severe

Severe knee pain may appear suddenly or develop gradually.Regardless, it often becomes unbearable.If you experience severe pain, you need to calm down and seek medical attention immediately.All of these are treatable, and experts can help even with advanced disease.If you can't see a doctor at the moment, you can temporarily relieve pain on your own.

But you should remember that if you have knee pain, this is only a temporary measure; you still need to seek medical help; you cannot live without it.And it’s best not to procrastinate.

How to treat knee and leg pain at home

To relieve severe knee pain, you can take the following emergency measures:

• Treat pain with pills.
• Use topical pain relievers (ointments, gels).
• injection.If tablets and topical medications are not effective, the drug is given as an intramuscular or subcutaneous injection.

Many medications can be purchased at pharmacies without a prescription.

For chronic pain in the knee joint, in the absence of obvious inflammation, physical exercises that strengthen the muscle-ligament system, improve blood circulation and metabolism can be performed.Although the legs are fragile, systematic training can gradually reduce the pain.

A set of approximate exercises for knee pain:

1. Immobilize the knee.Lie on your back, bend one leg at the knee, lift and hold this position for one minute; keep the second leg motionless at this time; slowly straighten and lower one leg, rest for 10 seconds, then repeat the exercise with the other leg; repeat 10 times;
2. Bend your legs and bring your knees close to your face.Lie on your back, bend your legs at the hips and knees, hold the latter near your face and hold for a minute.Then slowly straighten and lower your legs, rest for 10 seconds, and repeat; do 5-6 times and gradually increase the load.

Acute knee pain requires rest; all physical activity and training are contraindicated.

If there is acute pain in the knee joint, accompanied by swelling and redness of the skin, violation of the general condition, and fever, the legs cannot be moved and must be kept at rest.Only after the inflammation begins to subside, first passive exercises (performed by an assistant) and then active exercises (performed by the patient himself) can be performed.

What not to do if you are in pain

For chronic pain, the following should not occur:

• Bruised knees – You can avoid this by arranging your life to minimize the risk of injury;
• Excess weight can put extra strain on the knees, especially in older adults;
• Heavy physical activity, jumping, strength sports; you should also not run;
• Any poisoning, so you need to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and infections;
• Wearing uncomfortable tight shoes or high heels;
• stress, lack of sleep;
• Sedentary lifestyle – You need to force yourself to move at regular intervals.

It is also impossible to apply hot compresses without a doctor's prescription: in the event of purulent bleeding (bleeding within the joint), irreversible damage may result.

When you need to see a doctor urgently

If you injure your knee and experience the following symptoms, you need urgent medical attention:

• Swelling, redness, and tenderness of the knee, along with fever and general malaise;
• Severe knee pain immediately after the injury or some time later;
• Pain intensity gradually increases;
• Periodic pain occurs after physical exertion, standing for a long time, and sharp straightening of the legs;
• Nocturnal pain and associated insomnia;
• If the pain in your knee is very strong and persistent, it may be pain on the inside of your patella.

Regardless, knee pain should be a reason to consult a doctor.There is no point in self-medication: it may temporarily reduce or even eliminate the pain, but it will not stop the progression of the disease and the destruction of the joints.Treatment should be entrusted to a specialist.

What to do with various types of severe knee pain

The nature and duration of knee pain vary from person to person.They may be painful continuously or only occur under certain loads, such as at night.For example, some pathological processes are characterized by knee pain when bending, others by knee pain when walking, etc.Only an expert can figure out exactly what pain is, why it hurts, and how to help the patient.

Knee pain caused by coronavirus and other viral illnesses

Viral infections can cause joint inflammation.Usually, these diseases occur against the background of an existing infection and disappear after the infection is completed without any consequences.Therefore, short-term joint and muscle pain and acute arthritis with knee inflammation and swelling may occur when influenza and other acute respiratory viral infections are accompanied by acute fever.Their route is favorable.

Coronavirus infection has its own characteristics: each patient’s situation is different.Why this happens is unclear.During the disease, joint soreness, swelling, and redness are sometimes present—signs of acute arthritis—but then disappear.

Arthritis, which begins about a month after being infected with the coronavirus, is more dangerous.The fact is that it has a significant impact on the immune system.Immune system dysfunction leads to the development of autoimmune processes.This is especially dangerous for people who have close relatives with chronic arthritis.Experts point out that such patients are at high risk of developing rheumatoid arthritis (RA).The first symptom of RA is stiffness (difficulty bending the knee) in the morning.

If you develop arthritis after recovering from a viral infection, you should contact a rheumatologist immediately.

severe pain below the knee

This may be a sign of the development of a Baker's cyst - a swollen synovial sac in the popliteal area that contains fluid.The cyst and associated pain below the knee occurs because it is connected to the knee joint cavity and filled with synovial fluid.In this case, it is difficult for the liquid to flow back due to various reasons.Most often, cysts form against the background of bruises, joint disease and arthritis in the knee.

Small cysts may go unnoticed for years.But due to its large size, surrounding tissue begins to compress, causing pain below the knee that worsens with physical activity such as walking and running.Women are more likely to get sick.Sometimes cysts go away on their own, but often they progress and increase in size, which can lead to rupture or suppuration.

If you have pain below the knee, it's best to see a doctor as soon as possible.Conservative treatment (removal of fluid from the cyst, injection of corticosteroids into it) and surgical treatment (removal of the cyst) are performed.

Severe pain in your left or right knee

Severe pain and swelling and redness of the skin of the right or left knee usually indicate an acute inflammatory process.This may be acute nonspecific arthritis (the process may turn into septic arthritis), reactive arthritis, starting a few days after a genitourinary or intestinal infection.Both diseases have similar symptoms; a correct diagnosis can only be made after a thorough examination.

For example, athletes who frequently use one (usually the right) knee or workers in certain occupations may suffer microtrauma to the right or left knee.

It is important not to use folk remedies in the early stages, but to carry out the right treatment, which will allow you to fully recover and forget the pain forever.But even with advanced disease, experts are always able to help and relieve pain.

knee and leg pain

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

• on the tibia below the knee– Rarely, this may indicate that the nerve branches that innervate the calf muscles are being compressed by inflamed, swollen periarticular tissue in the knee area; pain below the knee in the back indicates compression of sciatic nerve branches, and below the knee pain in the front indicates that the nerves that innervate the front surface of the leg are affected; such conditions are treated by a rheumatologist, but consultation with a neurologist is required;
• Above the knee, into the thigh– Often a sign of the inflammatory process after trauma to the femoral-patellar joint; in this case, patellofemoral pain syndrome occurs; pain is severe, sore, sometimes twitching, worsened with walking; orthopedic surgeons, traumatologists and rheumatologists will help you cope with the pain;
• from the side, from the inside– Damage and damage to the medial joint ligaments may cause pain; strong, throbbing pain on one side, with hemarthrosis (bleeding within the joint) - bursting, with joint imbalance, the whole leg creaking when moving; the same pain can occur with a sprain of the external collateral ligament; an orthopedic traumatologist will help.

To eliminate pain, you need to pinpoint its cause, which is impossible to do on your own.Doctor's help is needed.

Pain in the back, front, and sides of the patella

Patella pain is almost always the result of an acute or chronic injury:

• back knee pain- The cause is related to femoral-patellar joint injury and the occurrence of patellofemoral pain syndrome; the pain persists and worsens when walking;
• Front– This pain is caused by bruises on the surface of the knee or microtrauma to the kneecap caused by frequent kneeling on the knee for a long time; the pain is obvious due to injury to the periosteum, which is rich in nerve endings;
• pain on one side of kneeRupture or injury of the internal and external horizontal ligaments of the patella; frequent long-term microtrauma to the ligaments that may result in damage, for example during jumping; associated bleeding into the joint space (hemarthrosis); severe, persistent pain with swelling; impairment of leg movement.

To prevent permanent joint dysfunction in the injured area, you should seek immediate help from an orthopedic traumatologist.

Knee pain radiating to legs, heels, groin

The causes of severe knee pain need to be understood.The reasons may be:

• Femoral nerve entrapment; severe, stabbing pain, starting from the groin area, spreading along the front inner surface of the thigh and knee, and along the nerve branches to the inner edge of the foot and heel.Sometimes patients have the impression of knee pain, but this is not the case;
• Arthritis of various origins (knee arthritis): swelling of the joints leads to compression of the nerves, severe pain that spreads from the knee to the groin and up to the heel; in this case, the pain is mainly felt in the knee, with sudden movements, irradiation above and below the knee can turn into acute pain;
• Bruising with hemarthrosis, ligament rupture, severe swelling, and nerve compression;
• Bruising from a fractured or dislocated kneecap and an imbalance in the joint; severe pain in the knee that extends down the thigh to the groin and along the inner surface of the shinbone to the heel.

Severe knee pain of this nature requires immediate medical attention.None of the folk remedies will help and you need to call an ambulance.

Knee pain during extension and flexion

Most commonly, 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-ligament apparatus of the knee joint.It occurs primarily in young men involved in sports and is the result of frequently repeated microtrauma caused by jumping and constant shaking of the limbs.The first sign is the inability to straighten the knee without pain.

Pain during knee flexion and extension may also be caused by arthrosis - degenerative dystrophic changes in the joints and the growth of connective and bone tissue that interfere with movement.

Only treating tendinitis or joints can help patients relieve severe pain when bending and extending their knees.

severe knee pain at night

Nocturnal pain is characteristic of the inflammatory process.This may be underlying arthritis, a periodic inflammation of the knee joint due to arthrosis (arthritis).During sleep, joints and surrounding tissue heat up and blood vessels dilate, exacerbating swelling.

The tissue around the joint swells, compressing the nerve endings and causing pain.If you also experience pain behind your knee, then this could be a sign of a Baker's cyst.How to get rid of swelling and nighttime pain?Treating the underlying disease can help.

Knee pain when walking

Pain when moving, jogging, persistent pain below the knee is characteristic of the degenerative dystrophic process of the knee joint, since during movement the joint surface is injured and there is a complete or partial lack of shock-absorbing cartilage.The periosteum, which is well innervated, is affected.Knee pain when walking down stairs is also common.After exercising, the patient noticed knee pain that persisted for some time.Over time, pain can develop in the feet.

Long-term rehabilitation with chondroprotectants (drugs that restore cartilage tissue) will help.If the joint is completely destroyed - endoprosthesis.

Pain after exercise—squatting, running, lifting weights

This indicates long-term microtrauma to the knee joint and the gradual development of a degenerative dystrophic process.Sometimes pain occurs in the right or left knee.The joints creaked.

If severe knee pain occurs after training, the athlete will need rehabilitation.Otherwise, joint function will gradually decline, accompanied by first periodic and then persistent pain.

Knee pain and creaking

Sudden, severe pain and a crunching sound in the knee can indicate a ruptured meniscus, the cartilage shock-absorbing pad in the knee joint.This can be caused by injury or age-related wear and tear on the cartilage structure.

Severe joint pain may disappear, but the knee will still hurt when squatting, and then the limb dysfunction will gradually increase, first with pain during movement, then persistent pain, and worsening pain when walking down stairs.Over time, pain and crunching can occur throughout the limb, including the feet.Long-term rehabilitation under the supervision of an orthopedic traumatologist can be helpful.

knee pain and swelling

Pain accompanied by swelling always indicates the presence of an inflammatory process.It can be sterile (absence of infection, usually after an injury), infectious, infectious allergy, and autoimmune (allergy to one's own tissue).

To get rid of this pain, you need to identify its cause and undergo expert treatment.

Injuries and diseases that cause knee pain

The most common pathologies accompanying knee pain are:

1. Closed and open knee injuries with intra-articular fractures, dislocations, and meniscal tears.All this leads to the development of inflammatory processes (arthritis), which then transform into degenerative dystrophic processes (arthrosis) and create persistent 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 lead to the destruction of joint tissue cells, leading to the development of an inflammatory process.If the injury is severe, all of these processes will be noticeable and accompanied by prolonged pain.This is very important when knee instability occurs when the ligamentous apparatus is damaged.Over time, instability increases and nearby tissues become injured, resulting in increased knee pain, especially when descending stairs.Without appropriate treatment, the process can be complicated by infection, become suppurative, threatening the patient's life, or become chronic with progressive progression and destruction of the joint, accompanied by severe pain.
2. Arthritis of the knee is an inflammatory process of multiple origins, accompanied by an increase in body temperature and a derangement of the patient's general condition.The patient complained of persistent knee pain.The disease can be infectious, infectious allergic, autoimmune, metabolic in nature.The inflammatory process also occurs differently, depending on the cause of the inflammation (septic arthritis, rheumatoid arthritis, psoriatic arthritis, gouty arthritis and other arthritis).Sometimes, arthritis may be complicated by a Baker's cyst located in the popliteal area.Then there will be pain behind the knee.Only proper treatment prescribed by a traumatologist or rheumatologist can save you from joint destruction and disability.
3. Knee arthropathy is a degenerative dystrophic process of joints that occurs in the elderly in the context of injuries, acute and chronic inflammatory processes, and age-related metabolic disorders.Cartilage shock-absorbing tissue (the meniscus and the layer of cartilage that covers the joint surfaces of bones) is damaged or thinned.The destruction of the joints proceeds slowly and steadily.I'm concerned about the pain and crunching when moving.In old age, this is the leading cause of knee pain.Bones rub against each other, structures are destroyed, and joints deform, all accompanied by severe pain.
4. Cysts and tumors.

How to Treat Severe Knee Pain

Injuries and diseases of the knee often lead to patellofemoral pain syndrome (PFPS), which is pain in the front of the knee joint.Changes in the joint gradually destroy the patellar cartilage, causing joint instability and persistent severe pain in the knee.Only a course of rehabilitation therapy prescribed by a qualified specialist can help.

diagnosis

Knee pain has different causes and requires an individualized approach to treatment.First, a correct diagnosis needs to be made, which requires a visit to a clinic for examination.Only after this can knee pain be treated.

Some diseases cannot be completely cured, but doctors can eliminate the pain and stop the destruction of joints.

In order to determine the cause of pain and diagnose the disease, the following tests are needed:

• laboratory testing– Clinical, biochemical, immunological blood tests, if necessary – Sampling and examination of intra-articular fluid (microscopic examination, culture in nutrient media to determine the susceptibility of the identified infection to antibiotics).
• Musical instrument studies:ultrasound– Reveal soft tissue pathology and intra-articular fluid volumeradiography– Changes in kneecap tissue;CT and MRI– A more detailed study of the pathology of soft and hard tissues;diagnostic arthroscopy– Appearance and changes in the synovium of the knee.

Ways to Treat Severe Knee Pain

Treatment measures are prescribed individually.Pain associated with a knee injury is treated by an orthopedic traumatologist; if the condition becomes chronic, consultation with a rheumatologist is required.If a purulent inflammatory process is suspected, the surgeon will be better able to manage the disease.All chronic inflammatory processes in the joints are treated by a rheumatologist, but specific infectious processes, such as tuberculosis of the knee, are treated by a pulmonologist or other specialist in close contact with the rheumatologist.

First, they try to eliminate pain as much as possible, for this purpose using pharmacotherapy (modern medicines for knee pain, including ointments) and non-pharmacological treatments for knee pain (manual therapy, massage, therapeutic exercises, reflexology courses and other traditional methods, folk remedies).To relieve the load on the joints and create rest, various fixation methods are used (splints, splints), as well as tape - special tapes are used to fix the joints.

For all acute joint pain, the patient is examined urgently while under anesthesia.All modern and traditional pain management methods are used for treatment.Thereafter, depending on the indication, patients are either hospitalized or receive outpatient treatment followed by rehabilitation.Any pain patient will receive expert attention.