Severe knee pain means there is a problem with the joint. The peculiarity of the knee joint is that it absorbs the main load during movement and physical exertion, so it is often injured. The affected knee is difficult to fix, so it is very important to take steps to eliminate the cause of the pain in a timely manner.
Main reason
Causes of knee pain can be:
- Injuries (acute injuries).These are the most common reasons. They occur after a strong blow, excessive bending of the joint, and a sharp fall. In case of mechanical injury, there is a sharp pain, swelling, tingling, numbness, changes in the color of the skin in the joint area.
- Arthrosis (gonarthrosis)destruction of joint tissues. Gonarthrosis is primary and secondary. The primary disease affects the elderly, while the consequences of secondary injuries or complications of other diseases (e. g. , rheumatoid arthritis). Symptoms: joint pain and stiffness. With a long course of gonarthrosis, joint movements may become impossible.
- Arthritis (gonarthritis)- inflammatory disease. Distinctive signs: increased pain with movement, increased joint size, fever in the affected knee, sometimes redness of the skin.
- Meniscopathy- damage to the meniscus, which manifests itself in sharp pain. In the absence of appropriate treatment, the transition to a chronic form is possible, resulting in osteoarthritis.
- Vascular diseases. Thrombosis or embolism (blockage) of the arteries that supply the knee joint leads to osteonecrosis of the articular cartilage, making it impossible to walk. There is no effective treatment for osteonecrosis. Arthroplasty of the affected joint is performed.
- periarthritis- it is an inflammation of the articular sac and the surrounding tissues. In periarthritis, there is pain in the knee joint without clear localization. Periarthritis is the most common post-traumatic complication.
- Bursitisinflammation of the bursa. Bursitis can be caused by excessive strain on the joint, infection or injury. With this disease, severe permanent pain is observed, but freedom of movement is retained.
- TendinitisIt is an inflammation of the ligaments and tendons. Symptoms include swelling and pain in the affected area. They grow by bending and stretching the knee. Prolonged symptoms of tendonitis suggest tendinosis.
- Baker's cyst- it is a complication after trauma, gonarthrosis or haemarthrosis. Baker cyst is a collection of joint fluid in the popliteal sac. Pathology is characterized by pain when bending the knee and discomfort during movement. To avoid complications, it is strongly recommended not to squat.
- Osteopyelitis of the bones of the footan infectious purulent disease resulting from hematogenous osteomyelitis, open fracture, or postoperative complication. The most common infectious agent is staphylococcus.
Types of pain
There are these types of pain in the knee:
- When squatting. It is usually caused by joint diseases, viral infections, lack of physical activity, malnutrition. seen in athletes. If your knee hurts when squatting, the exercises should be stopped. In case of prolonged and frequent pain, consult a doctor.
- When bending the legs. This is one of the most common joint problems. Osgood-Schlatter disease, damage to ligaments and meniscus, Baker's cyst, infectious lesions, etc. observed in the case of. In case of pain, the load on the foot should be limited, sports should be denied and comfortable orthopedic shoes should be worn.
- After running. It is associated with diseases such as arthrosis, bursitis, arthritis, etc. In this case, the joint stops working normally and crashes under heavy load. These diseases must be treated in time, otherwise complete loss of motor function is possible.
- Crunch. If there is no swelling, pain and stiffness during movement, there is nothing to fear. However, this symptom can also be caused by a dangerous disease - osteoarthritis, in which the articular cartilage is damaged and there is severe pain. It is very important to start treating the disease in time.
Diagnostics
You can diagnose the cause of pain in the following ways:
- General blood test. Allows for anemia, leukocytosis, etc.
- Blood chemistry. It senses an increase in uric acid in gout.
- X-ray examination. This method makes it possible to detect pathology of bone tissue. It is used to diagnose fractures, osteomyelitis and osteoarthritis. X-rays are supplemented by computed tomography (CT). Meniscus, ligament, bursa and other soft tissues are not visible on X-ray and CT scans.
- MRI (magnetic resonance imaging), NMRI (nuclear magnetic resonance imaging). This is modern research. It is used to diagnose the pathology of the soft tissues of the joint (meniscus, ligaments, etc. ).
- Puncture of the bone. It is performed when osteomyelitis or bone tuberculosis is suspected.
- Arthroscopy. It is performed for both diagnosis and treatment, such as meniscus injury.
- Ultrasound (ultrasound examination). This is a screening test for traumatic injuries, osteoarthritis, meniscus disease, etc. in case of suspicion. Ultrasound results should be confirmed by radiography (CT) and / or MRI.
Treatment
Treatment should be comprehensive and include both conservative methods and surgery. Let's take a closer look at them:
conservative methods
During exacerbation, treatment should relieve pain and swelling and then restore normal joint mobility. It is not recommended to move without assistance for the first time after injury.
Treatment is based on anti-inflammatory therapy. This includes the use of the following agents: non-steroidal anti-inflammatory drugs, pyrazolone derivatives, indoleacetic acid derivatives, oxicams, glucocorticoids.
The following procedures are prescribed to strengthen the immune system: cryoaferesis, plasmapheresis, hemosorption, plasma screening, immunostimulants.
The specific medicine and the method of treatment are chosen by the attending physician.
In addition, conservative treatment includes ice compression in the injured area to relieve pain or hot compression to improve blood microcirculation.
In hemarthrosis, the joint is pierced and the blood that has accumulated as a result of the trauma is removed.
Conservative treatment also includes physiotherapy methods: massage, therapeutic practices, and spa rehabilitation. If necessary, your doctor will prescribe a special diet that is low in calories.
Chondroprotectors are used to feed cartilage and reduce destructive processes.
The most common physiotherapy methods are magnetotherapy, laser therapy, cryotherapy, acupuncture.
In the case of gonarthrosis, special shoes and knee pads are used - orthoses. These shoes help to normalize gait and the knee pads secure the diseased joint.
Surgical intervention
If the desired joint stability cannot be achieved after conservative treatment, surgery is required.
The most common surgical techniques are arthroscopy and arthroplasty.
Arthroscopy is a technique that relieves joint pain and increases its mobility. This method of treatment not only eliminates the underlying disease, but also allows drugs to enter the joint cavity that reduce inflammation.
Medical advice
The therapeutic effect in stage 2 and 3 osteoarthritis is provided by intra-articular hyaluronic acid preparations. The introduction of hyaluronic acid is considered an alternative to joint surgery if this is not possible due to therapeutic contraindications. This is a medical manipulation, it has contraindications.
The technique is implemented with the following problems:
- damage to the meniscus and cartilage;
- ligament rupture;
- the presence of foreign bodies in the joint;
- rheumatoid arthritis;
- intraarticular fractures.
During the postoperative rehabilitation period, it is recommended to strictly follow the medical recommendations by performing therapeutic exercises, avoiding unreasonably early loading of the limb.
An endoprosthesis (arthroplasty) is a surgery in which damaged parts of the knee joint are replaced with an artificial implant (endoprosthesis).
More than 95% of those endoprostheses are subject to a mandatory health insurance function for 10-15 years and will need to be replaced. Today, the replacement of an endoprosthesis cannot be issued in almost any region under compulsory health insurance, in contrast to primary surgery. Not all patients may undergo a second surgery after 10 to 15 years due to cardiovascular and other somatic risks. Therefore, it is not worth rushing to endoprosthesis. I suggest that you only resort to this surgery if all other treatment options have been exhausted.
Endoprosthesis is performed when it is not possible to restore pain-free function of the knee joint using conservative methods and arthroscopy. Purulent complications are possible after arthroplasty. Antibiotics are prescribed to prevent them. After endoprosthesis, the patient needs long-term rehabilitation (up to 6 months).
Folk remedies
Folk remedies can help relieve pain, but these should be done in parallel with traditional treatments.
Be sure to consult a doctor when using folk remedies.
Let's look at some popular methods:
- Ointment. Make 1 tablespoon for knee pain. l. hypericum and 2 tbsp. l. yarrow, crushing them. Melt in a water bath 1 tbsp. l. Vaseline. The grass is poured into hot Vaseline and rubbed into a homogeneous mass. This ointment should be rubbed into sore knees at night.
- Rye seed based mixture. Take 250 g of rye seeds, pour 2 liters of water and bring to a boil. After the mixture has cooled, filter and add 500 g of vodka, 1 kg of honey, 3 tsp. barberry root. The mixture was mixed thoroughly and allowed to stand in the dark for 21 days. We recommend using 3 tablespoons of the mixture. l. before eating. 9 liters of mixture should be drunk during treatment.
If you have knee pain, don’t panic. However, if the pain persists for a long time, be sure to see a doctor. This will avoid a lot of trouble.