Because your knees hurt: the reasons for what to do

Knee pain is a widespread symptom, signaling of anguish in the body - the presence of joint diseases or simply an increase in the load of the legs.

It is difficult to find a person who has never felt knee pain in a certain period of life.Discomfort, click or pains of different intensity in the knee joints occur both in adults and in children for many reasons.The older becomes a person, the greater the probability of various diseases, whose first sign is pain in the knees.This is due to the age characteristics of the body: slowdown of metabolic processes, wear of the tissue of the cartilage of the joints, combining other problems with the musculoskeletal system, blood vessels, nerves.

Due to the complex anatomical structure, many significant structures and loads experienced and often overloaded, the knee joints are very vulnerable.The damage to any element of the structure, for example a synovial bag, leads to a violation of the motor function of the knee and, consequently, pain syndrome.The ligaments and menisci are considered the most vulnerable, 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 tubular bone tibia, muscles, nerves, vases, ligaments, a patella (cup of knee), joint bags and meniscus.

The knee joint is one of the great joints of the body.The femoral bone approaches him from above.The joint surfaces of its lateral (external) and medial (interior) conduits are articulated with the patella and the tibia.Meniski, who are cartilage of the connective tissue, act as shock absorbers of the joint.Thanks to them, a rational distribution of human weight occurs on a tiger plateau and increases the stability of the joint.Thin structures, double-headed, half-back and other muscles synchronize the structures of the capsule-ligament, guaranteeing the motor activity of the knee joint.

The elements of the knee are interconnected by many ligaments.Inside the joint there are two cross -shaped ligaments: the rear and front.The hobby bones are connected to the fiber and tibia bones with collateral ligaments.The inclination of the poplitea ligament is on the back of the knee joint bag.The main synovial capsule, which does not communicate with the joint, differs from a series of joint cavities.The flow of blood to the elements of the knee is carried out by a noble network of blood vessels and the innervation is carried out by nerve fibers.

Causes of knee pain

There are many causes of soreness of the knees joints, which can be conditioned in different groups.

Traumatic injuries of the elements of the knee:

1. Bitter of the knee.As a result of the gap of the blood vessels, local bleeding occurs in the soft tissue of the joint.Rossor, swelling, damage to nerve endings lead to pain, difficulty in movement.
2. Running of the complete or partial ligament.More often, a partial violation of the integrity of the internal lateral ligament is diagnosed, which derives from the excessive twist of the lower part of the leg.

The external ligament breaks less often than etern.This is due to a strong deviation of the lower part of the leg inwards, when turning the leg for example.The rupture of cross -shaped ligaments is inevitably accompanied by eartrosis.

A complete rupture of both ligaments is often combined with damage to the joint bag, snatching the internal meniscus.This lesion leads to excess mobility of the knee joint, accompanied by severe pain, whose intensity depends on the degree of gap.

1. Emartrosis of the knee joint - Pour blood into the joint cavity.There is a traumatic and non -human nature.Traumatic emartrosis is observed with ruptures of meniscus, full or incomplete ruptures of ligaments, intra -articular fractures, bruises of the knee area.The non -human option is one of the symptoms of diseases characterized by a greater breeze of the walls of the blood vessels or by a violation of the blood clotting system.These include hemophilia, scurvy, serious forms of hemorrhagic diathesis.The blood that has accumulated in the joint cavity compresses the tissue, interrupting the blood circulation in them.A special pigment - Emosiderin - negatively affects the ligaments, the cartilage IALINA, a synovial bag, which leads to the loss of their elasticity.The result of the injury of the joint bource is the swelling of its villi and the increase in the production of joint fluid.The result of repeated bleeding is the dystrophy and destruction of the articulation.
2. Knee meniscopathy - violation of the integrity of the meniscus of the knee joint.In the side form, the external meniscus is damaged, with the medial - internal.This is one of the most common, but difficult to diagnose the knee joint damage.In the risk area of the disease there are not only athletes involved in intensive training, but also ordinary people.The breaking of the meniscus can come from a strong unusual movement when turning the body, turning the leg, a strong blow to the knee.
3. Dislocation of the knee cup - Pathological movement of the Rotula.The trauma is diagnosed in no more than 0.7% of cases of the total dislocation number.More often there is external dislocation, less often - internal, very rarely - vertical or twist.With an incomplete dislocation, the cup of the knee is determined on the side condille (external), with full - from the outside by the side condilo.
4. Closed or open fractures of the knee joint, the upper part of the bones of the lower part of the leg or lower spine. These lesions are often combined with damage to the soft tissues of the knee, causing huge bleeding, excessive mobility in the knee area, its deformation.

Inflammatory diseases and degenerative dystrophic of the joint elements of the knee:

1. Arthritis - inflammatory damage to the knee joint.A similar mechanism for the development of pathology is observed with osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, gout (with the deposition of undergrounds in the joints).
2. Osteoarthritis (gonartrosis) With the defeat of the articulation of the knee of a non -inflammatory nature, which affects all its structures and leading to serious degenerative changes.
3. Bursitis With the inflammation of the synovial, the bag brings to pain during the flexion and extension of movements in the knee.
4. Periartritis tendons of the knee joint - Inflammation of the capsule of the Zampa, knee tendons, as well as the muscles and ligaments surrounding the articulation.In this case, the pain occurs mainly during the descent on the stairs, in particular with a heavy load, and focuses on the internal surface of the knee.
5. Condropathy of the Rotula -Degenerative-non-chic changes in the cartilage of the (rear) joint surface of the patella.The degree of destruction can be different: from the softening areas of light to cracks and complete abrasion.

6. Chosen - a serious chronic disease due to the dysplastic process with the degeneration of the islet of the sections of the articular membrane in the cartilage - Condro.The ossification of the individual cartilage bodies is not excluded.
7. Baker's cyst - The formation of a dense formation of elastic round tumor in a popliteal pit located on the opposite side of the patella.The cyst is clearly visible in the exposed state of the knee.It causes discomfort, pain in the popliteal region.With significant dimensions, it shakes the blood vessels and nerves, leading to innervation and compromised blood circulation.
8. Goff disease - A disease, accompanied by damage and further degeneration of the adipose tissue located around the knee joint.Pinch, edema and other damage to fat cells - adipocytes - end with their replacement with a dense fibrous tissue.Consequently, the buffer function of the "fat cushion" is interrupted, the adipose tissue itself becomes able to play the role of the shock absorber.
9. OSGUD -SWERTER disease - A pathology characterized by murders of the bugro part of the tibia.Diagnostic in teenagers aged 10 to 18 by practicing sports.A painful giving appears under the patella, in the absence of treatment, leading to a limitation of the leg or complete immobilization, as well as muscle hypotrophy.

Diseases is possible in which the irradiation of knee pain is possible:

1. Cokes arthrosis of the hip joint - Chronic damage to the hip joint, accompanied by progressive degeneration and dystrophic changes in it.Often the pain spreads along the external surface of the thigh to the knee or underneath.
2. Neuropathia nervous seductive - Non -inflammatory damage to the nerve due to the compression or spasming of the blood vessels.This nerve reaches his feet, starting in the lower back and passing through the coccyx and the pelvis.The block at any point for its length leads to compromised sensitivity or pulsating pain.
3. Fibromyalgia - Extractive defeat of soft fabrics of a non -inflammatory nature with a combination of symptoms in the form of arthralgia, muscle weakness, depression, etc.

Some systemic diseases that lead to knee pain:

1. Osteoporosis - The disease of the bone system of a chronically progressive course, changing the mineral composition and bone density.The "legging" of calcium from the bones leads to their fragility.The process is accompanied by a smoke or painful pain in the limbs.
2. Tuberculosis of bones.The tuberculosis lesion of the bone site leads to severe serious pain.
3. Osteomyelitis -A infectious and inflammatory disease, which affects all the structural elements of the bones.The result of both specific tuberculosis, for example, tuberculosis and osteomyelitis not often specific, more often coccalted, is hyperemia of the skin, edema, acute local acute pain in the bones and muscles, feverish temperature.
4. Some contagious diseases.With the Reiter syndrome, in addition to involving the urogenital tract and the eye mucosa, the joints are interested.One of the manifestations of Lyme's disease is arthralgia.

Types of knee pain

Depending on theziology, nature and the intensity of pain can be different.

• Painful.With arthritis, osteoarthritis.
• Acute, strong.With fractures of the elements of the knee, rupture of ligaments, acute buckthrough, bruise of the knee, exacerbation of meniscopathy, deforming osteoarthritis.
• Button.With a deforming illegal launched, injury to the meniscus.
• Drilling.With osteomielite.
• Cushion.With Burit, chronic osteochondrite.
• Burning.With the compression of the sciatic nerve, the tuberculosis process in the bone.
• Shoot. When you pinch the nervous trunk.
• Pain when walking.With a baker's cyst, Buckthrough, arthritis, gonartrosis, periarthride.
• The only pain. With gout, arthritis.

Diagnosis of pathologies that cause knee pain

Physical exam:

• collect anamnesis and complaints;
• Visual inspection with knee palpation.

Laboratory search:

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

Invasive instrumental methods:

• arthroscopy;
• Sting of the joint bag;
• Bone bitter biopsy.

Non -invasive instrumental diagnosis:

• radiography of the knee joint;
• densitometry;
• Joint study in ultrasound;
• MRI or CT.

Treatment of knee pain

If the pain in one or both knees of the non -human nature of the occurrence, then you should first move on to the therapist, who, based on the patient's complaints and the results of an objective examination, will direct a rheumatologist, a phlegmologist or a neurologist to a small specialist: an orthopedist, an orthopedist.In case of injury, it is necessary to contact a surgeon or orthopedic trauma.

Treatment in each case is different, it depends on the cause of pain, that is, on the type of injury or disease.Each disease has its own treatment regime.But first, the patient must observe several general rules:

• significantly reduce the duration of the excursions and stay on the legs during the day;
• Athletes temporarily (before recovery) abandon training and ordinary people to run or jump;
• When they increase pain, they completely abandon movements, apply a fixing bandage from an elastic band to the knee;
• wear a bandage or a bandage for immobilization of the knee joint;
• With a bruise, cold to the place of traumatic effects.

Rheumatoid, psoriatic arthritis, systemic autoimmune diseases require a serious integrated treatment, conducted for many months.Basic therapy is made up of immunosuppressors, anti -inflammatory drugs and non -system, golden preparations, etc.

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

With deformation of osteoarthritis, intra -articular glucocorticosteroid injections are effective, prolonged intake of fans and chondroprotectors.To relieve pain syndrome, compositions with Dimexide or Bischofit, ointments and gel with anti -inflammatory effects are prescribed.Massage, physiotherapy, therapeutic gymnastics helps.The serious injuries of the knee joint require surgery - joint endoprothetic.

The treatment of osteoporosis consists during the intake of bifosphaon, calcium, calcium preparations, vitamin D, etc.

The treatment of meniscus breakage can be conservative or surgical.Conservative therapy consists of analgesics, fans, hyaluronic acid, chondroprotectors.But first, the joint redemption is performed.

Types of surgery:

• Menescntomy;
• partial menescstomy (incomplete);
• meniscus transplant;
• arthroscopy;
• Artroscopic seams of the meniscus breakage.

With any lesion to the knee, after treatment, the rehabilitation period, which should take place under the control of a reabbitologist or orthopedist, is very important.The doctor will compile an optimal joint recovery program.The main postoperative rehabilitation methods are massage and therapeutic gymnastics.Lessons on special simulators are also effective, gradually developing a knee joint.