Causes of aching pain in the knee joint at rest. What to do if your knees ache

Update: December 2018

Discomfort in the knee area is a fairly common complaint of trauma patients. Sometimes such phenomena develop as a result of injury and are relatively easy to cure, with timely access to a specialist.

However, more often they are the result of diseases that occur in a latent form, require careful diagnosis and adequate medical and surgical treatment. Let's figure out which disease can act as a cause of pain in the knee joint, and what symptoms can signal various pathologies.

Osteoporosis

As a result of the predominance of the rate of bone destruction over the processes of their formation, a gradual decrease in their density occurs, such a disease is called osteoporosis (see).

• Along with severe pain in the knee, pain is observed in other joints: wrists, forearms, hips, along the spinal column, lower back, between the shoulder blades.
• A feature of the pain syndrome is its intensification with prolonged mechanical stress, being in an uncomfortable position of the body.
• Additional signs include: a change in posture, stunting, stoop, destruction of tooth tissue, frequent fractures, convulsions.

The diagnosis can be made after a thorough examination and the results of specialized studies, including radiography (the doctor may suspect a pathology after a long course of the disease), magnetic resonance and computed tomography, dual-energy x-ray absorptiometry.

Among the biochemical methods, studies of calcium-phosphorus metabolism, markers of the formation and degradation of bone tissue, and the amount of calcium-regulating hormones can be used.

flat feet

This is the name of the pathology of the development of the foot, which is expressed in a change in its shape (flattening of the arch), the result is the loss of its main function - the shock-absorbing ability.

• Pain in the knee joint during flexion has a pronounced character (it is easier for a person to bend to touch the floor than to sit down).
• There is pain in the hips, feet, back.
• The main sign is a visually noticeable deformation of the bones of the feet (unnaturally wide foot, protruding bone in the big toe area, flat foot, very long toes).
• A more detailed examination reveals a change in the location of the knee joints, disproportionately formed calf muscles compared to other muscle tissues of the leg, unnatural posture, "clubfoot", "heaviness" in the gait.

Diagnostics is carried out on the basis of X-ray images of the feet in the vertical position of the body (it is necessary to study 2 projections - direct and lateral). A preliminary diagnosis can be established based on the results of a visual and instrumental examination (podoscopy).

Vascular pain

Norm variant

Pain occurs as a result of difficult blood circulation, the problem is relevant for adolescents and is not a serious pathology. It is associated with insufficiently rapid growth of blood vessels and their throughput in comparison with the accelerated formation of bone tissue.

There is predominantly aching pain simultaneously on both joints, which does not lead to impaired mobility and limitation of movements. Gradually, the discomfort weakens and by the age of 19 years is reduced to zero. May be accompanied by aching pain in other joints (hip, shoulder, wrist, etc.).

As a result of atherosclerosis damage to blood vessels

With atherosclerosis of the vessels of the lower extremities, cholesterol is deposited on their surface (see). Subsequently, calcification of this part of the vessel and proliferation of connective tissue occur, physiologically this manifests itself in a significant decrease in its lumen (up to complete blockage).

If the vascular lesion occurred in the area near the knee, then the pain can be localized under the knee joint or located above it. In addition to local aching pains outside of physical activity, pains are observed over the entire surface of the leg, coldness of one limb, and rapid fatigue of muscle tissues. Often, the affected limb is prone to numbness after exertion and exercise. At later stages, when the lumen of the vessel is completely blocked, it can occur.

To make a diagnosis, it is necessary to conduct a Doppler study of the vessels of the lower extremities, an ultrasound duplex diagnosis of the vessels. Indicative may be the angioregime of the study using CT and MRI devices.

As a result of phlebitis (inflammation of blood vessels)

With inflammation of the vessels near the knee, pain is associated with hyperthermia of a localized area (with extensive damage - a general increase in body temperature), reddening of the skin, swelling. A characteristic feature of phlebitis of the venous vessels is the subsidence of the pain syndrome in the process of lifting the leg, in case of inflammation of the vessels carrying arterial blood, the pain weakens when the limb is lowered.

Ultrasound is the most informative study.

Legg-Calve-Perthes (Perthes) disease

The disease develops in children, is expressed in the form of necrosis of the femoral head of a non-infectious nature, due to a violation of the blood supply to the cartilage.

• It is observed along the entire length of the leg.
• Often the primary focus of pain is the knee joint (pain in the knee when walking).
• There is progressive lameness, possibly dragging the affected leg, falling on it.
• Subsequently, the hip joint swells, the gluteal muscles weaken.
• A certain difficulty is caused by turning the leg outward, extensor and rotational movements of the joint.
• There is wrinkling and pallor of the skin on the foot, profuse sweating and cooling.
• Body temperature can rise to 37.5 degrees.
• The disease often affects only one joint.

The diagnosis can be made after deciphering the results of computed tomography, ultrasound or radiography. The clinical manifestations of the disease are specific, difficulties may arise only in the detection of the first stage of the disease.

Rheumatoid arthritis

During the disease, chronic inflammation of the connective intraarticular tissue occurs. It is assumed that it develops as a result of autoimmune pathologies in the body.

• The disease affects not only the knee joints, it can also spread to other areas of the bone connection.
• A characteristic feature of the course of rheumatoid arthritis is symmetry (two knees are affected at once, identical joints on the areas of the right and left half of the body, etc.).
• Along with pain, stiffness of movements is observed, mainly after 2-3 am and in the morning (sometimes it is impossible to move the joint for up to half an hour or more).
• Additionally, the patient complains of muscle pain, fatigue, chronic weakness, ailments similar to a flu-like condition.
• Often there is a loss of desire to eat, a gradual drop in weight, a lack of lacrimal fluid and saliva, increased sweating of the feet and hands.
• On palpation, there is a slight swelling of the knee, hyperthermia of the skin and soreness.

Tuberculosis of the knee

Children under 10 years of age are more susceptible to the disease. The causative agent of tuberculosis from the primary distribution zone enters the articular tissues, where it begins to develop intensively, causing the disease.

There is swelling, pain during joint extension. Discomfort in the knee increases in the evening and at night (the child may cry out at night), gradually weakening in the morning. Progression of atrophy of the leg muscles is also noted. The gait changes, the child puts his foot incorrectly, often stumbles.

For diagnostics, a number of x-ray images are taken, and a conclusion from the tuberculosis dispensary about the condition of the patient's lungs is also obtained.

Osteoarthritis (arthrosis)

With arthrosis, cartilage tissues wear out in a person, which results in the launch of degenerative-dystrophic joint lesions.

• When the knee is affected by osteoarthritis (gonarthrosis), severe pain does not immediately begin to disturb, at first it appears when moving (especially going up or down stairs).
• Pain on the inside of the knee feels like a pull.
• A distinctive feature of arthrosis is the manifestation of symptoms immediately at the beginning of the movement (after a couple of steps they subside) and with prolonged exertion.
• With the development of osteoarthritis, discomfort mainly anterior to the knee during any movement, there is a limitation in the activity of the joint (when a person tries to bend the leg "at full strength", there is an acute pain in the knee).
• In the later stages, the pain practically does not subside, and the movements are accompanied by a rough crunch (more on that). Flexion-extensor movements are severely limited, the joint itself swells, and the person practically loses the ability to move without support (canes or crutches).
• Perhaps the appearance of pain, radiating to the knee, with the defeat of osteoarthritis of the hip joints (coxarthrosis). At the same time, pain syndrome is rarely observed in the area below the patella, more often it is observed in the area from the groin along the entire length of the thigh. In the case of coxarthrosis, the motor activity of the pelvis is disturbed with symptoms of gonarthrosis in this area.

In the diagnosis, X-ray images are used, however, in the early stages of the course of osteoarthritis, changes in the joint may be absent. Along with a non-instrumental examination, the doctor may resort to studying the results of CT and MRI (see).

meniscus cyst

The disease is localized in the inner or outer meniscus (rarely affects both at once) and is characterized by the formation of a cavity filled with liquid in its thickness.

Pain in the knee is noted after exercise, localized in the area of ​​the joint space. When the external meniscus is damaged, a tumor-like formation is noted that extends beyond the lateral surface of the joint (small cysts may remain unnoticed). The defeat of the internal meniscus, due to the anatomical features of the structure, is not observed outside the knee joint. Discomfort increases with knee extension and eases slightly with knee flexion.

The cavities in the menisci are clearly visible on the MRI images, on the screen of the ultrasound machine. Arthroscopy is also used to diagnose small cysts.

Baker's (Becker's) cyst

Half of the people in the popliteal fossa have intertendon bags (this is a variant of normal physiology), with inflammation of their mucosa, an influx of intraarticular fluid is observed. Such fluid stretches the bag from the inside, resulting in a cyst (see).

At the initial stages, the cyst practically does not manifest itself in any way, only with an increase in fluid pressure does it grow, and it can form a protrusion in the popliteal fossa. This formation is slightly painful on palpation. When squeezing the nerve endings of the cyst, the pain spreads to the area of ​​the entire knee, and when bending or staying in an upright position for a long time, they increase. The consequence of squeezing the vessels is often numbness of the lower part of the limb and a tingling sensation.

A cyst can be diagnosed with an ultrasound scan or an MRI machine. Often you have to resort to arthroscopy of the joint.

Tendonitis of the patellar ligament

It manifests itself in the form of an inflammatory process in the ligament due to age-related changes (in people over 40 years old) or in athletes (under 40 years old).

With tendinitis, the knee hurts downward from the patella. At first, discomfort appears after the load, then it begins to be noted at any time, but intensifies directly during the operation of the joint. Difficulty is extensor movements, there is a general stiffness in the knee.

Diagnosed by methods of radiography, tomography (computer and magnetic resonance). Ultrasound is informative enough.

Koenig's disease

The appearance in the articular cavity of detachments of a section of cartilage (in the later stages completely separated from the bone) is called osteochondritis dissecans (Koenig's disease).

Pain is aggravated by movement and even a slight load, the pain is characterized as aching or dull. The result of bone exposure is synovitis (accompanied by the accumulation of fluid inside the joint and inflammation of the synovial membrane). Involuntary blocks of movements may also occur, appearing simultaneously with a sharp pain, caused by the “wandering” of a section of cartilage tissue. Often a person changes his gait to facilitate movement - turns the injured leg outward. It is possible to develop lameness and, as a result, atrophy of the thigh muscles (visually noted as a decrease in the size of the thigh). It can develop synchronously on both joints of the knees.

In diagnostics, methods of computed and magnetic resonance imaging, X-ray studies are used.

Bursitis of the knee

The disease manifests itself in the form of inflammation of the bursa (intra-articular bag of the joint).

Periarticular tissues swell strongly, turn red, are warmer to the touch than those around them, when you press them, pain is noted. When moving the joint, stiffness is noted. Perhaps a general increase in body temperature, muscle weakness.

To make a diagnosis, a visual examination by a doctor is sufficient; a puncture of the fluid inside the joint capsule may be necessary to determine the nature of the disease (purulent bursitis, serous bursitis, etc., see).

Osgut-Schlatter disease

The disease is characterized by the destruction of tuberous tissues of the tibia during adolescence.

Pain is disturbing during physical exertion on the joint: squats, including low-amplitude squats, climbing and descending stairs, jumping, etc. Later, discomfort manifests itself even when walking, it can be in the nature of cramps at the bottom of the knee. Often, the tissues around the joint swell, hyperemia and hyperthermia are not observed.

Diagnosis is based on X-ray, CT and MRI data.

It is imperative to involve specialists in the treatment of knee pain - orthopedic traumatologists. You should not choose remedies for pain on your own, they only muffle the symptoms of the disease and lead to temporary relief of the condition. Meanwhile, the pathology of the knee joint progresses, which can lead to the transition of the disease to more advanced stages, which are often irreversible. A timely visit to a doctor and the appointment of medications will help not only relieve pain in the knee joint, but also stop degenerative processes (significantly slow them down).

What to do if your knees hurt? Thousands of sufferers are looking for the answer to the question every day. Discomfort, swelling, joint problems, nocturnal or persistent pain in the knees interfere with a normal life and work.

Many patients suffering from arthritis, arthrosis, inflammation of the ligaments, bursitis dream of finding a remedy for pain in the knee joint. At an early stage, folk recipes, ointments and gels with an anti-inflammatory effect, massage will help. Learn how to relieve pain, how to return the joy of movement.

Probable causes

The knee joint is under severe stress, takes the weight of the whole body. Bones, cartilage and ligaments gradually wear out, wear out, the volume of synovial fluid in the joint capsule decreases, age-related problems make themselves felt. The higher the load, the higher the likelihood of negative processes in the elements of the joint. One of the signs of degenerative-dystrophic changes is pain during the development of articular pathologies.

Why do knee joints hurt? In addition to natural aging, there are many reasons for the development of discomfort in the knee area:

• infectious diseases: osteomyelitis, septic bursitis, infectious arthritis;
• arthritis;
• osteoarthritis;
• tendinitis;
• rheumatism;
• autoimmune pathologies;
• injuries (stretching and, dislocation of the knee, displacement of the patella).

Provoking factors:

• acute and chronic systemic pathologies;
• the presence of extra pounds;
• professional sports;
• pregnancy;
• frequent weight lifting;
• poor diet, lack of vitamins;
• sedentary lifestyle;
• wearing uncomfortable shoes, addiction to high heels;
• high static loads on the knee joint;
• past trauma.

General rules and methods of treatment

With mild pain in the knee, patients rarely seek help, postpone a visit to a rheumatologist, arthrologist and orthopedist, use folk remedies and ointments at their discretion. This approach temporarily removes the symptoms, reduces discomfort, but does not eliminate the problem.

Helpful Hints:

• find out the cause of the pain syndrome. Be examined, take a test for a rheumatic complex, a biochemical blood test, do an ultrasound, x-ray, CT or MRI;
• at an early stage of many diseases, local treatment is effective: ointments, gels, compresses, rubbing, baths and massage;
• when confirming the infectious nature of the articular pathology, identifying the inflammatory process, antibiotics will be needed;
• agree on a treatment regimen with a doctor, pick up a few folk recipes;
• A combination of pharmaceutical preparations and home remedies will gradually relieve pain in the knee joint.

Local funds

The pharmaceutical industry offers effective gels and ointments with anti-inflammatory, anti-edematous, high analgesic effect. The doctor will prescribe the appropriate drug, taking into account the identified disease.

Ointments and gels for pain in the knee joint area:

• Voltaren.
• Menovazin.
• Fastum gel.
• Troxerutin.
• Apizartron.
• Troxevasin.
• Lyoton.
• Traumeel S.
• Kapsikam.
• Troxigel.
• Viprosal.

Do not buy topical formulations without a doctor's prescription: some drugs have a warming effect, which limits the use in acute inflammation with the release of purulent masses.

Massage

After eliminating the inflammation in the knee joint, the doctor will show simple techniques for strengthening the muscles, delicate treatment of the affected areas. Regular massage improves blood circulation, strengthens muscle tissue, and prevents salt deposits.

Be sure to massage your knees, if the work is associated with prolonged static loads (standing or sitting position). Massage will prevent blood stasis, reduce the risk of calcification, and give rest to tired joints. The effectiveness of the procedure will increase several times when using a massage cream or gel with a relaxing, anti-edematous effect (Troxevasin, Lyoton).

A selection of the best folk remedies and recipes

Choose a few home lineups, consult with your doctor. Many specialists involved in the treatment of diseases of the musculoskeletal system approve the use of products based on natural ingredients.

A warning! With purulent tissue damage, severe inflammation, it is forbidden to warm up the sore knee in any way. Heat accelerates the formation of exudate, increases the rate of infection.

Effective home remedies:

• recipe number 1. Tear off the leaves of burdock, wash well, pour boiling water over, remember to extract the juice. Apply with the outer side to the affected area, gently bandage. Keep an hour, change three burdock compresses a day;
• recipe number 2. Prepare a gruel from raw potatoes (grind with a blender or grate on a grater with small holes). Squeeze the juice lightly, put the mass on gauze, fix it on the sore joint. Potato compress quickly relieves swelling, reduces pain. The tool is safe, with a "soft" action, it is allowed to use 2 weeks in a row;
• recipe number 3. Herbal decoction for oral administration. It will take 3 tbsp. l. willow bark, parsley, nettle leaves, elder flowers. Select 2 tbsp. l. collection, pour in 250 ml of hot water, put on a quiet fire. After boiling, boil for 5 minutes, remove the saucepan from the stove. After half an hour, strain the infused broth. Drink 200 ml daily (divide into two doses);
• recipe number 4. Combine nettle seeds (6 parts) and sweet clover (1 part), add 7 parts of honey. Every day, 20 minutes before meals, eat a teaspoon of the healing mixture. The tool perfectly cleanses the blood, treats diseases of the joints from the inside. Course - 2 weeks, repeat after 7 days;
• recipe number 5. Rubbing against pain is prepared from 10 tablets of Analgin (crushed), 10 ml of camphor and 200 ml of medical alcohol. Infuse the remedy for 14 days, use for rubbing with arthrosis until the pain subsides;
• recipe number 6. Herbal ointment will help with knee pain and tissue inflammation. Take 1 tbsp. l. vaseline, add a tablespoon of crushed yarrow and St. John's wort. Before going to bed, gently massage the mixture into problem areas. Use the ointment for up to two weeks;
• recipe number 7. A decoction of burdock root restores the quality of cartilage tissue. For half a liter of boiling water, you need a couple of tablespoons of chopped roots. Boil the product for 10 minutes, remove from heat, wait an hour, strain. Drink a decoction every day for a third of a glass, frequency - three times a day;
• recipe number 8. Prepare a mixture for compresses: combine 100 g of thin honey with 2 g of mumiyo. Every evening, apply a little ointment to the affected knee, gently rub in. Duration of treatment - 14 days, break - a week. The effect will be enhanced by the use of a small amount of the healing mixture in the morning (at the tip of a teaspoon);
• recipe number 9. Tincture of lilac, chestnut and dandelion flowers is a proven remedy for improving blood circulation, relieving swelling, pain in the legs. Put a tablespoon of natural raw materials in a jar, pour in 500 ml of high-quality vodka, close the lid, put it in a dark place. The tincture is ready in 14 days. In the evenings, rub the healing liquid into sore joints, treat areas with dilated veins. Regular use will relieve varicose veins, eliminate pain, heaviness in the legs.

Learn about the characteristic signs and rules for the treatment of the knee joint.

Effective methods of treatment of scapular-shoulder periarthritis are collected on the page.

Go to the address and read about the rules for using the Akos Chondroitin complex for the treatment of joints.

This is only part of the formulations for the relief of knee pain. There are other recipes based on natural ingredients.

A few more proven tools:

• recipe number 10. Ointment with pork fat against pain in the knee joint. For 100 g of the base, take a tablespoon of dry raw materials: plantain, St. John's wort, coltsfoot. To the mixture, add pharmacy turpentine - 1 tablespoon. Then sweat the ointment in the oven for an hour, let it stand overnight in a warm room. Every other day, rub homemade ointment into the problem knee. The optimal course is 14 days, if the effect is insufficient, repeat the treatment after 5 days;
• recipe number 11. A decoction of lingonberry leaves actively dissolves salts. An important condition is the simultaneous intake of potassium orotate (three times a day, 1 tablet an hour before meals). Lingonberry decoction washes out not only heavy calcium salts, but also potassium: for this reason, body support is required. Decoction recipe: for 500 ml of hot water - 1 tbsp. l. berries. Boil for 3 minutes, cover, wait 20 minutes. Drink lingonberry tea in the morning and evening, 30 minutes before a meal;
• recipe number 12. Cabbage leaf to relieve swelling, pain. The easiest way to treat with minimal cost. Beat the washed cabbage leaf or cut it often: small droplets of juice should come out. Wrap a leaf around the affected knee, secure with a bandage. Keep the compress for half an hour, then change the dried, warm sheet. Repeat the procedure twice more. Cabbage leaf is allowed to be used even with severe inflammation;
• recipe number 13. Honey compress with healing aloe juice. Natural components remove inflammation, swelling, relieve joint pain. For 1 part of aloe juice or pulp, you will need 2 parts of any honey. Store the mixture in a cool place, treat the affected area daily with the composition, cover with cellophane on top. In case of an inflammatory process, replace the polyethylene with a clean knitted fabric to avoid overheating. The course will require 10-15 procedures;
• recipe number 14. Therapeutic baths are a great way to remove pain from arthrosis, rheumatism, after knee injury. In warm water, add a decoction of chamomile, eucalyptus, St. John's wort, calendula, 5-6 drops of lavender, mint, juniper, fir ether. Baths with coniferous elixir, oatmeal, hay dust are effective. The duration of a useful session is a third of an hour, the frequency is daily, the course is two weeks;
• recipe number 15. Cook viscous oatmeal, add a little butter, cool. Apply a thick layer of oatmeal to the problem area, cover with a clean cloth, and rest the sore leg. After half an hour, remove the porridge, wash your leg, moisten with a decoction of chamomile. Do an oatmeal compress every night before bed.

Sports, exercise, injuries can lead to deformation of the knee muscles, ligaments and cartilage. For some people, knee pain can be so severe that it limits daily activities, while for others, this discomfort becomes an obstacle to an active lifestyle. Therefore, it is important to know if your knees hurt, what to do in this case. But before starting the treatment of this discomfort, it is necessary to find out the main causes of the disease that has appeared.

Why knees hurt: possible causes

The resulting pain in the knees signals the appearance of a serious illness. But in order to decide what to do and how to treat, you must first find out the root causes. The main causes that provoke pain in the knees include the following factors:

1. Postponed injuries. As a result of a strong blow to the knee, a sharp fall, severe pain can occur, as well as inflammation in the knee joint.
2. Dislocation of the patella. The injury is accompanied by sharp pain and severe swelling of the knee.
3. Meniscus injury. The meniscus is a rounded cartilage in the knee joint that is easily damaged by a sharp squat or twist. The doctor diagnoses this cause after an internal examination, ultrasound, X-ray.
4. Rupture of knee ligaments. The reason may be a strong fall, blow, unsuccessful turn of the leg.
5. Arthrosis. A more serious cause is arthritis. This disease occurs due to age-related changes in the knee, bone tumors.
6. Rheumatoid arthritis. You can recognize this disease by swollen kneecaps and severe soreness.
7. Gout. This disease occurs from an excess of uric acid in the body, which leads to redness, pain in the joints.

What to do when your knees hurt and crunch

The appearance of acute or chronic pain in the knees should not be ignored, so it is necessary to go for a consultation with a doctor. After the diagnosis, the specialist will tell you what to do in a particular case. Treatment may consist of tablets, ointments, rubbing, physiotherapy, surgery.

How to deal with knee pain

The resulting pain in the knees requires immediate diagnosis and treatment. Complete therapeutic measures are aimed at eliminating the cause of pain and its further prevention. A compress of raw potatoes and onions, grated on a coarse grater, will help alleviate the inflammation that has arisen sharply. These components must be mixed, wrapped in a clean cotton cloth and applied to the inflamed area. After 20 minutes, the compress must be removed, and then the body should be washed with warm water.

Sometimes the reason why the joints hurt is overweight, so the patient needs to go on a low-calorie diet. If the pain is caused by arthritis, use a homemade ointment to rub the inflamed joint. To prepare this remedy, you need to mix the following ingredients:

• 100 g of vodka,
• 20 g of table salt,
• 100 g honey
• 200 g black radish juice.

When squatting

Soreness during squats appears as a result of strong physical exertion, intense sports exercises, bruises, sudden movements, rupture of ligaments, inflammation of the knee tendons, lack of vitamins, arthrosis, salt deposits. If your knees hurt a lot when you squat, our following recommendations will tell you what to do:

1. If you feel unpleasant discomfort in your knees at the time of squats, then you should immediately lie down on a flat surface and raise your legs to a hill.
2. Warm baths with essential oils can help relieve symptoms. After taking a relaxing bath, you need to wipe your knee dry and smear it with unrefined oil.
3. If soreness is accompanied by a crunch, then arthritis is suspected. In this case, you need to consult a doctor.
4. If your knees hurt from time to time, what to do in this case and you don’t know how to avoid it, then it is recommended to follow a diet, eat more vegetables, fruits, the vitamin complex glucosamine, chondroitin. Minimize the consumption of fatty foods, smoked meats, salty, sweet, starchy foods. During treatment, you can not play sports.

At night

Even being in a state of complete rest, the knees may not stop hurting. Aching, unpleasant pain may be accompanied throughout the night. In patients who complain about this problem, doctors diagnose venous congestion, vein thrombosis, vascular diseases, overweight, and joint injuries. The following tips will help you cope with this nighttime discomfort:

1. If the knee joints hurt at night, then a compress from a tablespoon of mustard helps well, 1 tbsp. vegetable oil. Mix everything, heat in a water bath. Then apply the resulting mixture on the knee and cover with a cloth.
2. If you know that you periodically experience pain attacks at night, then prepare in advance alcohol rubbing based on potato sprouts. To do this, put a handful of potato shoots in a half-liter jar, pouring vodka. Let it brew for three weeks, after the specified time, apply the remedy for each case of discomfort in the joints.

Swollen and sore knee after a fall: which doctor to contact

If the cause of knee pain is an injury resulting from a fall, then immediate medical attention is required. You need to visit a medical institution for an in-person consultation of the following specialists:

• rheumatologist,
• manual therapist,
• orthopedist,
• surgeon,
• traumatologist,
• physiotherapist,
• massage therapist.

The resulting swelling on the knee indicates the accumulation of a large amount of fluid in the joint. In this case, the doctor will perform a puncture to find out the etiology of this fluid and make an accurate diagnosis. Also, the specialist will give a referral for a blood test to confirm the conclusion. If there was a fall on the knee, and there is no way to urgently visit the hospital, you need to provide first aid yourself:

1. Take a supine position to provide complete rest for the injured leg.
2. Apply a cold object or ice to the swollen knee for half an hour.
3. To reduce symptoms if your knees hurt, you can use 10 crushed aspirin tablets, a tablespoon of iodine and vodka. Mix all the ingredients until smooth and apply the finished compress to the sore spot for half an hour. After 30 minutes, this mixture must be washed off the knee.

Even if with the help of the measures taken it was possible to minimize pain and relieve swelling, you still need to visit a doctor for an in-person examination and exclude serious problems. The sooner you contact a specialist, the faster the qualified treatment of the internal inflammatory process will be carried out.

Folk remedies for the treatment of knee pain

If your knees are constantly sore, traditional medicine will tell you what to do. Proven recipes of healers have a beneficial effect on this ailment and allow you to soon feel relief. The necessary ingredients for the preparation of folk remedies can be purchased at phyto-pharmacies or pre-prepared on their own. The following recipes are considered the most effective folk methods:

Recipe number 1. Rubbing, if the joints hurt. This remedy is prepared from three fresh burdock leaves and vodka. First you need to twist the leaves through a meat grinder and squeeze out the juice. Mix the resulting juice with vodka in a ratio of 1: 1. Rub the sore knees with the prepared remedy or make compresses out of it at night. When you do this procedure, do not forget to cover the top of the knee with plastic wrap and cover with a warm scarf.

Recipe number 2. Potion, if your knees hurt. For the treatment of acute pain, compresses are used from sea salt, water, ammonia and camphor alcohol. To prepare this remedy, adhere to the following proportions:

• 1 liter of warm water
• a tablespoon of sea salt
• 100 grams of 10% ammonia,
• a teaspoon of camphor alcohol.

First, dissolve sea salt in water, mix ammonia and camphor alcohol in a separate container. Next, combine the alcohol and saline solution and start shaking with a mixer until a homogeneous consistency is formed. This tool can be used for knee compresses at night. After 3 weeks, pain symptoms will stop bothering you.

Recipe number 3. Ointment if your knees hurt. To prepare this effective remedy, you will need to purchase St. John's wort, yarrow, and petroleum jelly at the phyto-pharmacy. Take a tablespoon of each medicinal plant and vaseline, previously melted in a water bath. Mix all components thoroughly, grinding to a homogeneous consistency. The resulting ointment should be used to wipe the knee before going to bed.

Video: Why do knees hurt and crunch and what to do about it?

Periodic or constant discomfort worries women and men of all ages. If your knees are crunching or hurting, experts in the video will tell you what to do about it. You will learn the main causes of this disease and the most effective ways to quickly treat it.

The knee is a complex and one of the most mobile and loaded joints of the human body, so it is not surprising that the knee mechanism breaks one day. The knee begins to give the first signals in the form of short-term arthralgia - quickly passing pain: such symptoms are familiar to many people from a young age. But in old age, knee pain ceases to be a small harmless nuisance: it becomes difficult to walk with it, go up and down stairs, the gait becomes like rearranging the legs of a compass. Surely everyone has seen such people.

Therefore, if the knee hurts, you need to think about it from a young age.

How exactly does the knee hurt - this is important

All pains in the knee can be conditionally divided according to their duration, intensity, nature and causes.

They can be divided into three categories based on duration:

• short-term, passing in a few days;
• long-term (can last three or more months);
• chronic (lasting constantly, with small shortening intervals of remission).

According to the intensity of pain are divided into weak, moderate, strong, intense.

The nature:

• pulling, aching;
• sharp sudden;
• shooting;
• pulsating, etc.

The intensity and color of pain is extremely important for diagnosis, since pain analysis allows one to suspect the presence of not only a certain pathology, but also to determine the areas affected by it and the stage of development.

short term pain

Who hasn't had knee pain at some point? Short-term pain may be due to:

• physical activity;
• sharp amplitude movements reaching critical points of joint limitation;
• prolonged immobility (sitting, squatting, kneeling);
• walking in high heels;

Such pain is the result of stretching of muscles or tendons, and usually goes away without treatment, or with the help of simple procedures: massage, kneading, gymnastics. Sometimes just lying down is enough to relieve the knee.

When it hurts really bad

1. Acute sudden pain in the knee that does not go away for several hours is a signal for immediate medical attention, as it may be associated with an injury.
2. Pain in the knee joint that does not go away for a long time, not associated with a previous injury, says: about ongoing degenerative-dystrophic or inflammatory (possibly infectious, autoimmune, reactive) processes in the joint or in its ligaments, tendons and bags; the formation of microtrauma in the meniscus or ligaments under the influence of fatigue stress, often occurring in athletes.
3. Chronic, near-constant pain, usually combined with limited range of motion where the knee cannot be flexed 90 degrees, is a sign of advanced arthropathy.

33 most important causes of knee pain

If your knees hurt, the reasons can be the most serious.

Pain may result from:

• traumatic or pre-traumatic condition of the knee;
• a consequence of hidden processes: gonarthrosis and periarthrosis;
• atritis and periarthritis;
• osteopathy and osteochondropathy.

Behind each name is a number of diseases with their own specifics. Consider the most common causes of knee pain.

Knee joint injuries

Injuries (dislocation, fracture, meniscus rupture, sprain/torn ligaments, etc.) are one of the most common problems in sports, as well as in childhood/adolescence.

meniscus tear

Meniscopathy at rupture manifests itself:

• sudden sharp pain;
• blockade of the joint;
• pain when pressing on the depression between the tibia and the patella;
• swelling, sometimes aggravated by hemarthrosis (bleeding into the joint bag).

The torn one must be removed, since its flap rubs against the cartilaginous tissue of the joint during movements and gradually destroys it. This process is called chondromalacia.

Rupture of ligaments is accompanied by:

• pain and swelling;
• a characteristic crack from a torn ligament;
• violations of the stability of the knee;
• with an injury to the anterior cruciate ligament, the lower leg moves forward;
• with an injury to the posterior cruciate ligament - back.

A triad injury is possible with simultaneous rupture of both ligaments and the medial meniscus with aggravated symptoms: pain, blockade, and instability.

Gonarthrosis

In second place in terms of prevalence is a degenerative-dystrophic disease (), which will gradually mutilate and deform the joint.

Initial symptoms:

• mild pain in the knees after exercise;
• after a long absence of movement, especially in a sitting position, the knee joints are stiff, they have to be “paced”;
• with the onset of periarthrosis, the first manifestations of synovitis are possible: the knee swells evenly due to the synovial fluid accumulating inside the joint bag.

In the future, with the progress of gonarthrosis, there is:

• increased pain, morning stiffness;
• when moving, a dull crunch appears;
• the knee is deformed with thickening of the subchondral bone;
• due to the narrowing of the interarticular gap, free movement of the knee, the angle of elevation is increasingly limited;
• synovitis becomes more frequent and more severe, may lead to a Baker's cyst, a collection of fluid in the posterior popliteal region

Late arthrosis of the knee can be determined:

• for unrelenting night pains; lameness
• axial deformity of the thigh and lower leg (X-shaped legs);
• bumpy surface of the knee due to the replacement of cartilage with calcium deposits;
• ossification of ligaments;
• myopathy.

Arthritis of the knee

Arthrosis is more often an age-related disease, but if knee joints hurt at a young and childhood age, then arthritis can be the cause.

Arthritis is a systemic disease that affects not only the joints, but the entire body.

The main differences between arthritis and arthrosis are:

• Pain attacks in the night/morning hours, passing with the beginning of movement (with arthrosis, on the contrary, the pain increases with movement).
• Breaking character of pain.
• Increasing the temperature to 38 - 40˚.
• The skin surface over the joint may be swollen, reddened, and hot to the touch.

General malaise is caused by intoxication with inflammatory infections that cause arthritis.

Rheumatoid arthritis

Rheumatoid arthritis is the most threatening form of arthritis, affecting the cardiovascular, nervous, urinary systems, blood-forming organs, vision, etc.

Destroys joints symmetrically and multiple times, turning into polyarthritis. The joints of the knees are affected less frequently than the small joints of the hands and feet, from which rheumatoid arthritis usually originates. More often suffer from rheumatoid arthritis in young and young years. The disease is accompanied by a number of syndromes (Still, Felty, pseudoseptic, allergoseptic), manifested in an increase in leukocytes, ESR, fever, rash, enlargement of the spleen, etc.

Reactive arthritis

Reactive arthritis causes a unilateral lesion, has a rapid character, quickly starting and ending in one joint and literally flying to another. Joint symptoms (pain, swelling, redness of the skin) appear late after recovery from an infectious disease (flu, chickenpox, rubella, etc.).

infectious arthritis

It is distinguished by a rapid onset, fever and deterioration of health caused by general intoxication. It is provoked by staphylococcal and streptococcal infections, as well as gonococci, meningococci, gram-negative intestinal bacteria. Pain in the joints is acute, accompanied by high fever, gives to other areas. In children, an infectious-allergic form is most often observed with skin rashes, conjunctivitis, Quincke's edema.

Gout

Gout rarely selects the knee, usually centering in the feet. It starts suddenly with very intense pain, usually at night. The skin over the joint turns red, soon tophi forms on it - protruding formations consisting of urate salts. The cause of gout lies in the increased content of uric acid in the blood - this is due to impaired metabolism.

Psoriatic arthritis

Psoriatic arthritis presents with severely swollen joints, thickening of the bone, and characteristic white, itchy, scaly patches on the skin of the body and scalp. It is less common in the knee joints than in the joints of the hands.

Osteoarthritis

Osteoarthritis is an inflammatory process caused by arthrosis, so it combines the symptoms of both diseases: pain during movement and rest, swelling and redness, deformities, crunching, periarthritis, etc. It develops slowly, joining the already existing arthrosis.

Traumatic arthritis

Traumatic arthritis is characterized by a latent course: sometimes it manifests itself years after the injury. The main symptom of post-traumatic injuries: constant aching pain at the site of injury; crackling, swelling of the joint.

Inflammation of the periarticular tissues of the knee joint

The knees hurt not so much because of the deformity of the joint, but because of the inflammation of its soft tissues (muscles, membranes, ligaments, tendons). It is periarthritis that causes swelling.

Synovitis

The most common cause of swelling in the knee joints is synovitis.

Signs of synovitis:

• uniform smooth swelling of the knee;
• pain on palpation of the knee and movements;
• in acute purulent or purulent-hemorrhagic form (septic synovitis), fever, nausea, and weakness are possible.

Septic synovitis requires urgent puncture with the evacuation of fluid contents from the joint cavity.

Baker's cyst

In some cases, synovial fluid collects in the posterior folds of the articular capsule, forming a Baker's cyst in the form of a ball in the popliteal fossa. At the same time, the knee area swells at the back, and when you try to bend it, there is posterior surface pain. If the pain radiates to neighboring areas, is accompanied by tingling or numbness, this indicates compression of the peripheral nerve by the cyst.

The rupture of the cyst is accompanied by a sharp intense pain, an increase in swelling, redness of the skin and high fever. This requires urgent aspiration (puncture).

Tendinitis

Tendinitis is inflammation of the tendons. If your knees hurt after constant training or hard work, then it is quite possible that the tendons have become inflamed. Most often, tendinitis affects the own ligament of the kneecap. This disease is not only sports: in a good half of people, the knees hurt not so much from osteoarthropathy, but from tendon-ligamentous inflammation, that is, periarthritis. And the reasons for this are simple:

• age-related tissue fibrosis with the appearance of pseudocysts;
• flat feet;
• dislocation of the knee joint;
• violations of the stability of the knee;
• myofascial syndrome of the muscles of the back of the thigh, in which there is a forced change in the anatomical position of the patella.

Tendonitis of the knee occurs almost always with any injury and often accompanies arthrosis of the knee.

Signs that the knee hurts due to tendonitis:

1. Tendinitis in the initial stages manifests itself as a dull pain under the patella and near the condylar tubercle of the tibia.
2. Initially, pain occurs only after movements or exertion, but then it begins to accompany all movements and becomes more and more intense.
3. Tension and stiffness arise in the knee, it becomes more difficult to unbend it.

Knee Tendinitis Test

The following test allows you to diagnose a partial or complete rupture of the ligament:

• In a sitting or lying position with a bent knee, clasp it with your hands.
• Try to straighten your knee, resisting with your hands according to the PIRM method.

If, when trying to straighten the knee, pain occurs under the patella or near the tubercle on the outside of the knee, then this indicates a possible inflammation of the tendon.

knee bursitis

Bursitis is an inflammation of the tendon bags that attach the muscles to the bones of the articular joints.

In contrast to synovitis of the knee, which always manifests itself as an evenly distributed swelling around the knee (the exception is a Baker's cyst), it gives localized swelling (one or more) in the near-knee region. The position of the edema corresponds to the topography of the tendon bags, which are very numerous in the knee joint: there are ten main ones. With a deep position of the bag, edema may not be visualized.

Symptoms depend on which bag is affected.

Osteopathy and osteochondropathy

If degenerative processes affect the patella itself, we are talking about chondropathy.

Chondropathy of the patella occurs with constant physical exertion, and can also be a consequence of a knee fracture. It is diagnosed by severe pain, a crunch in the knee, and the inability to lean on the affected leg.

Osteopathies (osteoporosis, osteomyelitis) are systemic, intractable pathologies.

Osteoporosis mainly affects the elderly, especially women. Accompanied by aching chronic pain and a continuous decrease in bone density, which can lead to a traumatic knee fracture - this injury is the second most common osteoporotic fracture in old age after a hip fracture.

is a rare infectious disease of the bones that affects the bone marrow.

It begins acutely with severe pain in the joint area, its swelling, redness of the skin, and temperatures up to 40. Then the disease becomes latent and can proceed almost asymptomatically in the initial stages. In the later stages, purulent abscesses begin with penetration into the surrounding tissues.

Joint pain can also be due to so many diseases, it is impossible to talk about all of them in one article. It presents the most common causes of pain in the knee joints.

How to treat knee pain

The causes and treatment of knee joint are closely related. It is impossible to give the same scheme for all pathologies.

What to do if your knee suddenly hurts

Do not try to diagnose a sudden onset of acute knee pain. Even if it subsides, you must definitely visit an orthopedist and make a diagnosis. First of all, it concerns a knee injury. How to treat a knee joint, only a doctor can decide.

In case of a traumatic lesion, first aid is provided in the form of immobilization of the knee with a tight bandage or orthosis. You can apply a bandage on your own at home before visiting a doctor and remove any load from the knee.

In case of dislocation, the orthopedist will simply adjust the knee. A fracture of the patella, a torn meniscus, or may require surgery, after which the doctor will also immobilize the knee with an orthopedic segment and prescribe a rehabilitation regimen.

If a sharp pain arose for no reason, and is accompanied by general incomprehensible symptoms, the orthopedist should redirect the patient to a rheumatologist.

What to do if your knee hurts all the time

You need to see a rheumatologist:

• with constant pain of any nature that does not go away for two months or more;
• arising motor dysfunctions;
• the appearance of swelling and redness in the knee area;
• the appearance of non-articular symptoms (fever, nausea, rash, diseases of the eyes and other organs), accompanying pain in the knees or appearing after it.

Diagnosis of knee pain

First of all, an x-ray is taken.

According to the results, the doctor may prescribe the following types of research:

• CT or MRI.
• Densimetry;
• Arthroscopy (with synovitis, Baker's cyst, damage to the meniscus and ligaments).

Laboratory diagnostics is carried out:

• general and biochemical blood test with a study on rheumatic factor;
• bacterial analysis (if infectious arthritis is suspected), etc.

Relief of knee pain

Pain during exacerbation of arthropathy (degenerative-inflammatory process in the knees) is stopped:

• NSAIDs (diclofenac, nimesil, ketonal, etc.).
• Post-traumatic pain is treated with novocaine/lidocaine blockade.
• To reduce spasm of the femoral and tibial muscles, antispasmodics (mydocalm, sirlalud) are prescribed.

Removal of edema in the knee

• The formation of effusion in the joint area with synovitis is reduced by injection of glucocorticosteroids (hydrocortisone / dexamethasone).
• In an emergency, fluid is evacuated from the joint (aspiration).
• Chronic synovitis is treatable with proteolytics (trypsin/lysozyme).

Treatment of infectious and inflammatory processes

In infectious arthritis, differentiated antibiotic therapy is performed taking into account the identified pathogen and the selection of the desired antibiotic.

Rheumatoid arthritis requires long-term complex treatment with the help of basic drugs (methotrexate/sulfasalazine), immunosuppressants (cyclophosphamide/cyclosporine) and modern means of genetically engineered biology.

The knee joints are among the largest and most complex joints in the human body. They account for more than 80% of body weight, and in some situations, the load on them can increase significantly. For example, when running or jumping, the articular cartilage and menisci are deformed 5 to 10 times more than when walking. In connection with this fact, the knee joints are considered the most susceptible to various types of damage. Almost all elements of this joint are well innervated, so their damage causes pain, as well as a range of other associated discomfort. The inflammatory reaction that develops in response to damage leads to increased pain due to soft tissue edema and increased pressure of the synovial fluid in the joint cavity.

However, not only damage to the knee joint can lead to pain in this area. Often the reason lies in the pathology of the structures surrounding the knee joint - blood vessels, nerve trunks, lymph nodes and muscles. A more rare cause of pain is a volumetric formation that forms in the popliteal fossa - a cyst, a benign and malignant tumor, aneurysm, etc. In medical practice, psychogenic pains in the knees occur periodically, without any real substrate ( basics).

Each disease has a number of external signs that are detected during examination and palpation of the knee area and the rest of the limb. Together with the patient's feelings ( the nature of the pain, the frequency and duration of its occurrence, etc.) it is often possible to accurately establish a preliminary diagnosis and start appropriate treatment. With an unclear clinical picture, they resort to the use of additional instrumental and laboratory studies, the most used of which are radiography, ultrasound and arthroscopy.

Treatment should always be focused on eliminating the cause of the pain. If it is ineffective, then you should think about the reliability of the initial diagnosis. The range of drugs for the relief of pain in the knee area is huge, since the causes of pain can be extremely diverse. The most commonly used anti-inflammatory, analgesic and anti-allergic drugs in the form of ointments, compresses, injections, tablets, suppositories, etc.

Anatomy of the knee area

Anatomy of the knee joint

Upon closer examination of the articular surfaces of this articulation, it becomes obvious that they are not congruent. In other words, the articular surfaces do not touch tightly and there are gaps between them. With such an architectonics, the stability of the joint would be in question, however, instead, the knee joint is one of the most reliable joints of the human body. The explanation lies in the menisci - paired triangular layers of cartilage that fill the above gaps, playing the role of a gasket or sealant.

Both the menisci and the surfaces of the adjacent bones are lined with hyaline cartilage, which provides a multiple reduction in the friction force in the joint. In addition, the friction force is reduced due to the synovial fluid that fills all the free space in the joint.

The capsule of the knee joint is tightly attached to all the bones that make up it. Like all joint capsules, it is two-layered. The outer layer is called fibrous and consists of densely formed connective tissue - one of the most durable types of tissue present in the body. In addition, numerous external ligaments of the knee are involved in strengthening the articular capsule of the knee joint. The greatest contribution to strengthening the capsule of the knee joint is made by the tendon of the quadriceps femoris, which is intertwined with the fibers of the capsule and forms the tendon of the patella upon exiting it. The inner layer of the capsule of the knee joint is called synovial, because it consists of stratified columnar epithelium. Due to its structural features, this epithelium provides a constant circulation of synovial fluid, which is extremely important for cartilage nutrition and maintaining joint performance.

Anatomy of muscles and ligaments in the knee joint

When feeling the knee joint from behind, the popliteal fossa, which has the shape of a rhombus, is clearly defined. The upper inner border of this rhombus is the biceps femoris muscle. The upper outer border is the semimembranosus muscle. The lower internal border is the internal head of the gastrocnemius muscle and a small part of the plantar muscle. The lower outer border of the popliteal fossa is the outer head of the gastrocnemius muscle. Deeper, under both heads of the gastrocnemius muscles, the popliteal muscle passes along the back surface of the capsule of the knee joint.

On the inside, the capsule of the knee joint is in contact with the rudimentary plantar muscle. The sartorius muscle is located more superficially. Some muscles are not in the projection of the knee joint, but their tendons are thrown over it and attached to the tuberosities and condyles of the tibia, fibula and femur. Among these tendons is the tendon of the gracilis muscle of the thigh, the semitendinosus muscle, and the semimembranosus muscle.

The most important role in the functioning of the knee joint is played by the ligamentous apparatus. Its main task is to limit the range of motion in the knee joint in such a way that dislocations do not occur. The ligaments of the knee joint are divided into internal ( located in the joint cavity) and external ( located outside the joint cavity). Part of the external ligaments is intertwined with the fibers of the capsule of the knee joint, significantly increasing its strength.

The most important intra-articular ligaments include:

• lateral ( internal and external);
• cruciform ( front and back);
• meniscofemoral ( front and back);
• transverse ligament of the knee.

With a lateral injury to the knee joint, the lateral ligaments are often affected. Damage to the transverse ligament of the knee is rare, since more often there is a rupture of one of the menisci, between which this ligament is located.

The most important extra-articular ligaments of the knee joint are:

• patellar ligament;
• collateral ligaments.

Collateral ligaments are located on the sides of the joint, preventing its excessive deviation from the axis of the leg in the frontal plane ( sideways). Injuries to these ligaments are extremely painful and rarely regenerate completely, so recurrent spontaneous dislocations are observed after sprain or rupture.

Anatomy of vessels and nerves in the knee joint

In addition to the above-mentioned largest blood vessels in the knee area, there is a developed vascular network designed to ensure the vital activity of the joint capsule and the pericapsular part of the menisci. In the formation of this network, not only the popliteal artery takes part, but also some branches of the femoral artery located above. In particular, we are talking about the superior and inferior medial arteries of the knee, the descending genicular artery, the superior and inferior lateral arteries of the knee, etc.

Among the nerves located in the area of ​​the knee joint, it should be noted the sciatic nerve and its branches - the tibial and peroneal nerve, into which it divides above the level of the knee. Small sensory cutaneous nerves may also be present.
All elements of the neurovascular bundle are covered from above with fatty tissue in order to protect them in case of injury.

What structures can become inflamed in the knee?

In the area of ​​​​the knee joint, the following structures can become inflamed:

• articular cartilage;
• arteries;
• veins;
• nerves;
• lymph nodes and blood vessels;
• joint capsule ( fibrous and synovial layer);
• bones ( femoral, tibial, patella);
• muscles and tendons;
• synovial bags;
• subcutaneous adipose tissue;

Main causes of knee pain

Causes of knee pain

Diagnosis of causes of knee pain

Which doctor to contact?

Approximately 80% of knee diseases can be treated by a family doctor. If there is a suspicion of a disease that is not within his competence or which he is not able to treat due to neglect, the family doctor refers the patient for a consultation with an appropriate specialist. If necessary, the family doctor or an appropriate specialist refers the patient for planned or urgent treatment to the appropriate department of the hospital.

Specialists involved in the treatment of diseases that cause pain in the knee area are:

• traumatologist;
• orthopedist;
• neuropathologist;
• surgeon;
• allergist/immunologist;
• rheumatologist;
• infectious disease specialist;
• gastrologist;
• oncologist;
• psychotherapist, etc.

Laboratory and instrumental research

Methods for diagnosing the causes of knee pain

Fluoroscopy is a similar instrumental method, but unlike radiography, it is performed in real time. In other words, the radiologist examines the skeleton of the knee joint in dynamics, turning the patient at different angles, and also asking him to make movements in the joint. As a rule, such a study is prescribed when the results of x-rays give questionable data for making a diagnosis.

With the help of radiography / fluoroscopy of the knee joint, it is possible to establish the cause of pain in its area. The most common of these are deforming arthrosis, intra-articular fracture, osteomyelitis and purulent arthritis.

X-ray of the chest in two projections
A chest x-ray may be prescribed by a doctor to exclude the development of tumor metastases in the lungs of cartilage, bone, synovial and other tissues. For their detection and localization, it is recommended to perform a chest x-ray in two projections ( posterior anterior and lateral).

ultrasound ( ultrasound procedure) joint and periarticular region
Ultrasound of the knee joint and periarticular space is modern, affordable, non-invasive ( not traumatic), a harmless and high-precision instrumental research method. The essence of the method is to register sound vibrations reflected from tissues of different density. Modern ultrasound devices provide a three-dimensional image of the structures of the joint, allow you to determine the thickness of the synovial membrane, cartilage, determine the state of the ligamentous-tendon apparatus, and register the presence of inflammatory changes in the synovial fluid. Also, with the help of this study, it becomes possible to study in detail the periarticular space and the structure of the popliteal fossa. In particular, with the help of ultrasound, it is possible to determine the presence of a cyst in the popliteal space, which restricts movement in it and is often the cause of pain.

With the help of ultrasound of the knee joint, most of the diseases associated with a change in its integrity, as well as the integrity of its auxiliary apparatus, are diagnosed. In addition, compared to CT and MRI, this study is much cheaper. However, unfortunately, this area has not yet been sufficiently studied and there are few specialists in this field, so ultrasound of the joints can be performed only in a few clinics.

Ultrasound of the pelvic organs
Ultrasound of the pelvic organs is carried out in two ways - transabdominally ( through the anterior abdominal wall) and intravaginally ( through the vagina). The most accurate is the study of the pelvic organs during intravaginal examination. This method is used if there is a suspicion of an endocrine cause of pain in the knees, with the so-called climacteric or post-castration ( after ovary removal) arthritis.

Dopplerography of the popliteal fossa
This study is focused on the study of blood flow. Dopplerography of the popliteal fossa determines the patency of the popliteal artery and vein, as well as the presence of wall defects in them ( aneurysm) that can cause pain in this localization. The advantages of this study are non-invasiveness, harmlessness and relative cheapness. To find out the causes of pain in the knee, a study of all large vessels of the lower extremities is performed, indicating the location and degree of blockage ( in percentages).

Arthroscopy with biopsy
Arthroscopy is an endoscopic examination method in which an LED conductor is inserted into the joint cavity, connected to a converting device and a monitor. The advantages of this method are that it can be used to visualize the articular surfaces, menisci, intra-articular ligaments and the synovial membrane as they really are. Moreover, with the help of an arthroscope, it is possible to carry out low-traumatic operations to remove foreign bodies from the knee joint and to restore the integrity of the menisci. If a joint mass is suspected, a sample may be taken ( biopsy) and examine its histological structure for malignancy. The synovial fluid obtained from the joint cavity can also be examined cytologically for the presence of atypical cells, leukocytes, uric acid crystals, etc.

MRI
MRI is by far the second most image-clear examination after PET ( positron emission tomography). The essence of this method lies in the registration of photons emitted by the human body in a large alternating magnetic field. A feature of MRI is a better visualization of structures rich in fluid ( in particular, hydrogen ions).

It should be noted that the use of this method for the diagnosis of diseases of the knee joint is extremely rare, due to the high cost of the study. However, sometimes, it is necessary to diagnose a systemic disease, one of the manifestations of which is arthritis.

A limitation to the use of MRI is the presence of metal implants in the patient's body ( dental crowns, spokes, pins, prostheses, etc.), as well as the weight of the patient more than 160 kg.

CT
CT is one of the most modern radiological research methods. Its essence is the circular performance of numerous X-ray images of a certain segment of the body with their subsequent comparison. As a result, a three-dimensional virtual reconstruction of the required body segment is created, which can be examined both in its entirety from any angle, and layer by layer in any required section. A feature of CT is better visualization of dense structures ( bones, metal, etc.). The limitation of this research method is the weight of the patient over 120 kg.

The use of CT to diagnose the cause of knee pain is also limited by high cost. As in the case of MRI, this method can be used if a systemic disease is suspected, one of the manifestations of which is inflammation of the knee joint.

When it comes to choosing between CT and MRI, several criteria are used. The most important criteria are the resolution of tomographs and their harmlessness ( exposure value). Also, one of the important factors is the competence of the doctor describing the results of the study.

Intravenous angiography
Intravenous angiography is one of the most specific radiological studies. Its essence is the introduction into a specific artery ( usually femoral or subclavian) a probe through which a radiopaque substance is injected at a certain point in time and radioscopy is carried out in parallel ( visualization of the internal structures of the body in real time). Thus, the researcher can monitor the spread of the contrast agent along the vascular bed and mark the sites of stenoses ( constrictions) with aneurysms ( extensions) that can cause pain to the patient.

In particular, obstruction of the femoral or popliteal artery can cause acute vascular insufficiency of the lower leg ( thrombosis, atherosclerotic plaque, etc.). Clinical signs of acute arterial insufficiency are sudden pallor of the skin, absence of a pulse, and severe pain below the supposed site of narrowing.

Scintigraphy
Scintigraphy is also one of the specific radiological methods, a feature of which is the use of labeled radiopharmaceuticals administered intravenously. As they spread throughout the body, radiopharmaceuticals settle in tissues to which they exhibit tropism ( affinity). Thus, when performing an x-ray after intravenous administration of the necessary drug, the places of its accumulation are visualized on the monitor screen. The main field of application of scintigraphy is the detection of malignant processes, as well as tumor metastases, which are difficult to visualize by other methods. For most malignant tumors, specific radiopharmaceuticals already exist.

Malignant tumors of the articular structures and periarticular space can cause pain, but such cases are rare. Moreover, due to the fact that the knee joint is well visualized by simpler research methods, the use of scintigraphy to diagnose a tumor in the knee joint area is only of scientific interest and is practically not used.

Colonoscopy
Colonoscopy is an instrumental endoscopic method for diagnosing the pathology of the rectum, sigmoid and colon. Some colonoscopes are able to pass through the ileocecal valve and visualize the terminal ileum. In this study, air is forced into the rectum, after which a flexible fiber-optic conductor is introduced into it, gradually moving up the intestine. Through the fiber, a certain area of ​​the intestine is illuminated in front of the end part of the apparatus, and an image of the inner wall of the large intestine is also transmitted to the screen.

Colonoscopy may be used to diagnose diseases such as Crohn's disease ( terminal ileitis) and ulcerative colitis. Usually, these diseases do not affect the musculoskeletal system in any way, however, in rare cases, arthritis develops, presumably through autoimmune mechanisms. Most often, such arthritis affects the hip, knee and ankle joints.

General blood analysis
A complete blood count is a screening method in any field of medicine. Without a doubt, this analysis will not indicate the exact cause of knee pain, but it can significantly narrow the search circle among a huge range of them. Some features of the shape, diameter, color index and number of red blood cells may lead the doctor to think about rare diseases in which arthritis can develop. Features of the leukogram ( percentage of different types of leukocytes in the blood) may indicate an autoimmune ( allergic), the viral or bacterial nature of inflammation of the joint.

Thymol test
Thymol test is one of the biochemical analyzes indicating the severity of the inflammatory process. This analysis is general, and its high rates may indicate an arbitrary localization of the inflammatory process.

C-reactive protein
C-reactive protein is also a common marker of the inflammatory process in the body, however, unlike the thymol test, an increase in its values ​​may also indicate the rheumatic nature of inflammation of the knee joints.

Determination of the level of VIII and IX coagulation factors
One of the manifestations of hemophilia ( congenital disease characterized by a deficiency in blood clotting) is intra-articular bleeding. As a rule, it is abundant and difficult to stop, as a result of which a large amount of blood enters the joint cavity. Together with the blood, biologically active substances enter the joint cavity, causing inflammation and pain. Since the knee joint is one of the most massive human joints, and according to statistics, its injuries are the most frequent. Bleeding into this joint in patients with hemophilia is the most likely and, as a rule, the most pronounced.

Diagnosis of hemophilia is helped by a carefully collected family history, an appropriate clinical picture, and the determination of blood levels of VIII and IX clotting factors. The tests included in the coagulogram may also be useful ( prothrombin, thrombin time, fibrinogen, etc.).

CEC
CECs are complexes of an antigen circulating in the blood with an antibody that attacked it. CECs are found in type 3 allergic reactions according to Gell and Coombs ( immunocomplex reactions). When this complex is deposited on the vascular wall, an inflammatory reaction develops in it, externally manifested by local redness and pain of varying severity. As a rule, such reactions are systemic in nature and their manifestations are not limited to the defeat of only certain parts of the body. In other words, damage to the knee joints, usually symmetrical, develops as part of a systemic allergic process in the body.

Fractions of immunoglobulins
Determination of the fraction of immunoglobulins is used in the differential diagnosis of some allergic and autoimmune diseases that can manifest as pain in the knee area.

ASL-O
ASL-O ( antistreptolysin-O) is a type of antibody against streptolysin - a proteolytic ( destroying proteins) an enzyme from a bacterium called beta-hemolytic streptococcus. In a certain category of patients, these antibodies cross-infect the cartilaginous tissue of the joints. In connection with the foregoing, a high titer of ASL-O is a diagnostic criterion for rheumatism.

Rheumatoid factor
Rheumatoid factor is also one of the tests needed to make a diagnosis of acute rheumatic fever, which is known to cause severe knee pain.

Uric acid
An increase in the level of uric acid in the blood is a substrate for a disease such as gout, in which joints ( more often large) deposits of salts of this acid are formed. As a result, acute arthritis develops, accompanied by fever and severe pain in the knee, up to the lack of movement in this joint.

Antibodies to DNA
The detection of these antibodies is the most accurate criterion for the laboratory diagnosis of systemic lupus erythematosus, one of the manifestations of which is pain in the knee joints.

LE cells
LE cells are certain types of leukocytes that have absorbed the nuclei or fragments of the nuclei of other cells in the body. These cells are found in 70% of children with systemic lupus erythematosus, which can cause bouts of knee pain.

Wasserman reaction
This analysis is positive for such a well-known venereal disease as syphilis. One of the complications of this infection is syphilitic arthritis, which develops with a direct lesion of the synovial membrane or the end of the bone with pale treponema ( the causative agent of syphilis) or indirectly through autoimmune mechanisms.

ELISA/ELISA
With the help of ELISA ( linked immunosorbent assay) searches for certain types of antibodies in the blood. In particular, the diagnosis of antibodies to chlamydia and gonococcus, which causes Reiter's syndrome, may be useful. With this syndrome, there is a triad of lesions of the conjunctiva of the eye, urethra ( as well as the prostate) and the synovial membrane of the joints ( more often large). If antibodies to pale treponema and pain in the knees are detected, a diagnosis of syphilitic arthritis can be made with a high probability.

Microscopy and culture of urethral smear
Microscopy and culture of the urethral smear allows the identification of the causative agent of sexually transmitted infections, which, directly or through autoimmune mechanisms, can cause pain in the knees.

Microscopy and culture of a nasopharyngeal swab
Diseases such as measles, typhoid, diphtheria or pneumococcal pneumonia can cause knee pain mediated, as in the cases above, by immunological cross-aggression. For bacterial diseases typhus, diphtheria, pneumococcal pneumonia, whooping cough, etc.) it is often possible to diagnose the pathogen with simple microscopy with appropriate staining of smears. If necessary, resort to specific diagnostic tests and inoculation on simple and enriched nutrient media. For viral diseases ( measles, rubella, etc.) to identify the pathogen is much more difficult. For this purpose, virus inoculation on live nutrient media or PCR is used ( polymerase chain reaction) , which make it possible to identify regions of the genome characteristic of a particular virus.

ASCA
Antibodies to saccharomycetes are a diagnostic criterion for Crohn's disease. These bacteria belong to the permanent microflora of the human intestine, since they are involved in the process of food fermentation and even secrete a number of vitamins. However, some patients develop an enhanced immune response to these bacteria, due to which a specific inflammatory process develops in the intestine, which is a substrate ( basis) Crohn's disease.

In even rarer cases, the formed pathological antibodies affect not only the intestinal tissues, but also the synovial membrane of the joints, which is why patients develop reactive arthritis. Their most common localization is the large joints of the lower extremities ( hip, knee, ankle).

pANCA
Antibodies to the cytoplasm of neutrophils are detected in a number of diseases, one of which is ulcerative colitis. With this disease, as well as with Crohn's disease, autoimmune arthritis can develop, manifested by pain in large joints and, in particular, in the knee joint.

kidney tests ( creatinine, urea)
These tests are performed to assess the excretory function of the kidneys. Their deviations may indicate amyloidosis, systemic lupus erythematosus, primary tumor, metastases, etc. All of the above pathologies can affect the functional integrity of the knee joints through various mechanisms. Thus, the study of kidney function can complement the clinical picture of a certain disease, one of the manifestations of which is inflammation of the knee joint.

liver tests ( total bilirubin and its fractions, ALT, AST, alkaline phosphatase, GTP)
The study of liver function is carried out for the same purpose as the study of kidney function. Due to the fact that the liver is a filter for blood collected from the intestines and pelvic organs, it is in it that metastases of malignant tumors of these organs are most often found. Malignant tumors, in addition to the classical clinical picture, can provoke the development of paraneoplastic syndrome, in which antibodies produced by the body against the tumor cross-attack tissues that are similar in antigenic structure. As a result, the kidneys, liver, lungs, brain, synovium of the joints, etc. can become the target of antitumor antibodies. In particular, the development of paraneoplastic arthritis of the knee joint is manifested by its swelling, redness, pain, and is almost always bilateral.

Tumor markers ( tumor markers)
While in the body, tumors of various tissues almost always secrete certain substances into the blood that are not normally found. Such substances are called tumor markers. Their detection helps in the diagnosis of the primary focus of a malignant neoplasm. Unfortunately, not all tumor markers have been discovered to date, and their diagnostic value is not always absolute, since for most of them there is a certain percentage of error.

The negative impact of the tumor on the knee joint can be mediated by direct and indirect influence. Direct influence involves the growth of a tumor directly from the cartilage, bone or connective tissue of the joint itself, leading to a change in congruence ( compliance) of its surfaces and the development of inflammation. Indirect influence is more often mediated by the paraneoplastic syndrome described earlier.

The markers specific for synovial sarcoma are vimentin, epithelial membrane antigen, and pancytokeratin. The marker of malignant schwannoma is vimentin, S-100, CD99, proliferative activity index Ki-67. A marker of myosarcoma is a high titer of antibodies to desmin, myoglobin, specific actin HHF-35, and vimentin. The markers of other tumors are either poorly studied or not informative enough.

Determination of the level of estrogen and progesterone in peripheral blood
This study is relevant only for the fair sex, since it is they who normally experience a change in the level of ovarian hormones ( estrogen and progesterone) throughout the utero-ovarian cycle. Violations of this cycle or its absence may indicate certain somatic diseases or the onset of menopause. In addition to the classic signs of menopause in some women, it can be manifested by climacteric arthritis, the nature of which, unfortunately, has been little studied. It is believed that estrogens accelerate the regenerative properties of articular cartilage, so their absence leads to its accelerated destruction, accompanied by inflammation and pain. A similar condition can develop after surgery to remove both ovaries, and in this case it is called post-castration arthralgia.

What to do for knee pain?

First aid for urgent conditions causing knee pain

• hemarthrosis ( intra-articular hemorrhage);
• purulent arthritis;
• stretching of the ligament-tendon apparatus;
• joint jamming;
• dislocation / subluxation of the joint;
• intraarticular fracture.

Almost always, the patient finds it difficult to independently establish a diagnosis, since the external signs of damage to the knee joint are always the same ( pain, redness, swelling, local increase in skin temperature). Therefore, for all emergencies associated with knee pain, there are some general first aid measures.

For urgent conditions associated with knee pain, it is recommended:

• call an ambulance;
• give the leg a position in which pain would be minimal;
• put an ice pack or cold bandage on the swollen knee ( change every 3 - 5 minutes);
• take any available pain reliever or anti-inflammatory drug ( ketanov, analgin, ibuprofen, paracetamol, etc.) in the amount of one dose ( see instructions for the drug), if it was not previously allergic.

• knee massage;
• applying an elastic bandage.

Treatment of non-urgent conditions associated with knee pain

For the treatment of pain in the knee of a traumatic nature, it is used:

• surgical or non-surgical restoration of the integrity of the joint;
• temporary immobilization of the joint plaster splint, orthosis, Ilizarov apparatus, etc.);
• skeletal traction method;
• painkillers and anti-inflammatory drugs ( in the form of ointments(diclofenac), lotions(dimethyl sulfoxide), injection(tramadol)and inside(ketorolac));
• chondroprotectors ( glucosamine hydrochloride, glucosamine sulfate, chondroitin sulfate, etc.);
• hormonal drugs ( in the form of ointments and injections - dexamethasone, betamethasone, triamcinolone, etc.).

For the treatment of pain in the knee of a neurogenic nature, the following are used:

• painkillers ( orally, by injection or in the form of blockades);
• anti-inflammatory drugs ( nimesulide, meloxicam, celecoxib, etc.);
• anticonvulsants ( carbamazepine, phenytoin, gabapentin, etc.);
• physiotherapy ( UHF, electrophoresis, magnetotherapy, etc.);
• B vitamins.

• opening of a purulent focus with appropriate treatment of the wound with antiseptics;
• restoration of the integrity of menisci, ligaments, tendons;
• removal of a foreign body, excision of a tumor;
• sclerotherapy and removal of varicose veins;
• popliteal cyst removal Baker);
• stenting ( artificial expansion of the site of narrowing of the vessel with the help of a cylindrical mesh implant - a stent) popliteal artery;
• elimination of an aneurysm of the popliteal artery

• the use of thrombolytics and antiplatelet agents ( urokinase, streptokinase, heparin, etc.).

• antihistamines ( loratadine, clemastine, cetirizine, etc.);
• hormonal drugs ( dexamethasone, prednisolone, etc.);
• adsorbents ( activated carbon, smectite, etc.);
• mast cell membrane stabilizers ( mast cells) (ketotifen, nedocromil, etc.);
• laxatives ( lactulose, bisacodyl, glycerin, etc.);

• bed rest 5 - 10 days ( to avoid complications from the cardiovascular system);
• glucocorticosteroids ( prednisolone);
• NSAIDs (non-steroidal anti-inflammatory drugs) ( indomethacin).

• NSPV;
• pain relievers ( lotions with dimethyl sulfoxide, ketorolac, etc.);
• antipyretics ( paracetamol, ibuprofen);
• antihistamines ( loratadine, clemastine, etc.);
• drugs for the treatment of the underlying disease ( antibiotics, antivirals).

For the treatment of knee pain associated with diseases of the digestive tract(Crohn's disease and ulcerative colitis), apply:

• glucocorticosteroids ( prednisolone - courses of short and medium duration);
• intestinal anti-inflammatory drugs ( mesalazine, sulfasalazine);
• NSPV;
• painkillers.

• painkillers of various strengths ( including opiates.(tramadol, morphine, fentanyl, etc.));
• anti-inflammatory drugs ( enhance the effect of painkillers);
• treatment of the underlying disease surgical removal of the tumor, chemotherapy, radiotherapy).

Features of knee pain

Most often, patients ask:

• Why does it hurt under the knee?
• Why does it hurt at the back of the knee?
• Why is my knee sore and swollen?

Why do my knees hurt after running?

The knee joint is one of the most complex joints in the human body. Its stable functioning is ensured by a system of intra-articular and extra-articular ligaments that prevent pathological displacement of the articular surfaces. During running, there is a multiple increase in the likelihood of subluxations and dislocations compared to walking. The reason lies in the increase in the impact force when the articular surfaces collide with each other. A slight deviation of the leg from the usual axis while running is compensated by the strength of the ligaments, which prevent dislocation in the joint. When the leg deviates from the usual axis to a degree exceeding the tensile strength of the ligament, it is stretched or completely torn.

Clinically, a ligament or ligament injury is manifested by pain in the corresponding part of the knee. If there is a rupture of one of the internal ligaments of the knee, inflammation of the synovial capsule often joins, and the pain becomes diffuse. Rupture of the intermeniscal ligament is often accompanied by a rupture of one of the menisci with free wandering of the torn fragment within the joint cavity. If this fragment gets between the articular surfaces in extreme positions, joint jamming may occur. At rest, the pain is often pulling, and when you try to move, it sharply increases. Complete rupture of the ligaments requires surgical restoration of their integrity.

Tendon sprain
Stretching tendons is a fairly common mistake beginner athletes make. The reason lies in the fact that the set of muscle mass, and, accordingly, the strength of the muscle fiber, occurs faster than the strengthening of the tendons. Thus, the load on the tendons and their attachments to the bone increases without increasing their strength, which eventually leads to their stretching or tearing. In order to avoid such injuries, it is recommended that, in addition to dynamic loads ( running, swimming, aerobics, etc.) at the end of the workout, perform several solo static exercises. Static loading rather leads to functional restructuring of the muscle tendon, reducing the likelihood of its stretching.

Pain during tendon sprain at rest, as a rule, constant, dull. When the corresponding muscle is tense, the pain intensifies. Tendon rupture is considered a more severe pathology, manifested by much more pronounced pain, hematoma ( interstitial bleeding), functional failure of the corresponding muscle ( inability to perform the movement for which she is responsible). With a complete rupture of the tendon, it is necessary to restore its integrity surgically.

Destruction of articular cartilage in deforming arthrosis
Deforming arthrosis is a dystrophic degenerative disease of cartilage with a complex mechanism. Its essence is a shift in the balance between the processes of formation of cartilage tissue and the processes of its destruction. As a result, the surface layers of the cartilage are gradually erased, and the nerve endings that were previously in the thickness of the cartilage are exposed. Even their slight irritation with a simple movement causes pain.

During rest, the exposed nerve fibers are covered with an inconspicuous layer of fibrin, which protects them from irritation. However, when running, fibrin is erased, again exposing the nerve endings. Thus, a patient with deforming arthrosis can start a run in good health, and finish it in pain. A few hours after running, the pain persists or even intensifies due to the development of aseptic inflammation in the capsule of the knee joint. However, after several days of rest, the pain gradually disappears, which is explained by the formation of another protective layer of fibrin on the articular surfaces.

Pain in deforming arthrosis manifests itself mainly after an increase in the load on the damaged joint and, as indicated above, disappears after rest. In more advanced stages of the disease, pain is absent in the morning, appears a few hours after waking up and reaches a peak in the evening, even in the absence of heavy loads throughout the day. The intensity of pain depends on the severity of pathological changes in the articular cartilage.

Why does it hurt under the knee?

Tension of the ligamentous apparatus
Stretching of the ligamentous apparatus of the knee joint, in particular, its posterior part, can occur with excessive forced extension of the leg. Often, injuries of this kind are associated with intra-articular fractures, since at the moment of stretching, the entire load that the ligaments carried is redistributed to the lateral parts of the articular surfaces of both bones ( femoral and tibial). Since the lateral parts of the articular surfaces are anatomically not adapted to the loads that fall on the share of the central parts, a split occurs in the weakest place with a crack extending deep into parallel with the axis of the bone. In other words, the so-called T-shaped impacted intra-articular fracture is formed.

When the ligaments and tendons behind the knee are stretched, there is excessive mechanical irritation of the proprioceptive nerve endings, which are normally responsible for the sense of displacement of body parts relative to each other. The edema that develops after some time increases the compression of these endings, causing a sensation of pain. The restoration of the integrity of the ligaments occurs on average after 2-3 weeks, however, the tone of the affected tendon or ligament is almost never fully restored, and therefore, even years later, repeated sprains, dislocations and fractures with the same mechanism can occur.

Inflammation of the neurovascular bundle in the area of ​​the popliteal fossa
The neurovascular bundle of the popliteal fossa most often consists of the popliteal artery, popliteal vein, and tibial nerve.

The main cause of inflammation of the popliteal artery is the formation of a blood clot in it. Less often, the cause of inflammation is an aneurysm and a traumatic factor. When a thrombus forms or enters in the area of ​​blockage, an acute oxygen deficiency develops, which is manifested by severe local pain and blanching of the affected area. Due to the fact that the popliteal artery is the main vascular highway that delivers blood to the lower parts of the leg, its blockage immediately affects the functional viability of the knee, lower leg and foot. However, since there is an extensive network of collaterals in the knee area, the deficiency may not be absolute, but relative, leading to pain during exercise and absence at rest. However, in fairness, it should be noted that in most cases these anastomoses turn out to be inconsistent, and in case of failure to provide urgent medical or surgical care, the patient develops gangrene of the leg below the blockage site, which is accompanied by monstrous pain and a pronounced syndrome of general intoxication.

Inflammation of the popliteal vein develops, as a rule, with its varicose veins. The blood flow at the site of varicose veins slows down, blood cells ( erythrocytes, leukocytes, platelets) are deposited on microscopic cracks in the vein wall. Then the density and size of the sediment increases, and it transforms into a thrombus. Blockage of blood flow in the popliteal artery, as well as blockage of the popliteal artery, can lead to gangrene of the leg, but more often this does not happen due to the developed system of superficial veins, through which blood flows back to the heart. Pain in the area of ​​a thrombus is caused by a lack of blood supply, as well as the addition of bacteria that gradually destroy the vascular wall. The intensity of pain in thrombosis of the popliteal artery, no doubt, is high, but an order of magnitude lower than pain in thrombosis of the popliteal artery.

Inflammation of the tibial nerve neuritis) is rarely isolated at knee level. Pain usually radiates along the sciatic nerve and its largest branch, the tibial nerve, from the sacrum down the back of the thigh, knee, and upper third of the leg. The cause of neuritis is the pinching of the nerve in one of the bone canals, bruise, sprain, as well as local cooling in the flow of cold air ( air conditioning, draft, etc.). Less common is a viral or autoimmune lesion of the above nerves, which develops, as a rule, systemically. Pain at rest is moderate, often pulsating. Their strengthening occurs when the nerve is stretched ( positive symptom of Lasegue's tension).

Growth of mass formation in the popliteal fossa
Among the volumetric formations found in the popliteal fossa, a cyst is determined ( Baker), an aneurysm of the popliteal artery, an enlarged lymph node, and a tumor formation.

Baker's cyst is an accumulation of synovial fluid in the synovial sac on the back of the knee joint. This cyst may communicate with the joint cavity, or may be isolated. In this regard, its consistency may be soft ( if there is a message) or dense ( if there is no message). As a rule, the cyst is mobile, not soldered to the surrounding tissues, slightly painful and protrudes when the knee is extended.

Popliteal artery aneurysm- the phenomenon is quite rare, but occasionally occurs in surgical practice. It is a local extension or additional cavity connected to the main trunk of the artery. The walls of the aneurysm are thinned, and therefore there is always a risk of its rupture and severe interstitial bleeding. As a rule, the aneurysm is not soldered to the surrounding tissues; it pulsates on palpation. Soreness can be felt periodically at the time of growth of this formation and with high blood pressure ( sports, arterial hypertension, etc.).

The lymph nodes The popliteal fossa can increase as a result of their local inflammation or inflammation of the underlying tissues of the leg. As a rule, they are painful, especially when bending the leg at the knee and when feeling. There may also be local redness and an increase in skin temperature. The inflamed lymph node is slightly mobile, elastic, with even contours.

Tumor processes popliteal fossa are not common. Their characteristics ( density, elasticity, cohesion with surrounding tissues, soreness, etc.) depend on the type of tumor.

Why does it hurt at the back of the knee?

Tendon ligament stretching
Both ligaments and tendons contain proprioceptive nerve endings that transmit information to the brain about how great the tension of these fibers is at any given time. In the brain, nerve impulses received from all proprioceptive receptors are summarized and processed, as a result of which a person can feel his position in space, even with his eyes closed.

When the fibers of a tendon or ligament are stretched, the proprioceptive receptors located between them experience irritation ten times greater than normal, which is why the impulses they send are perceived by the brain as pain.

Stretching of the ligamentous-tendon apparatus of the back of the knee joint can occur when a blow is struck on it in the anteroposterior direction, as well as when falling from a height onto straight legs. Often, such injuries are associated with intra-articular impacted fractures of the tibia and/or femur.

Inflammation of the nerve and vascular structures of the popliteal fossa
The neurovascular bundle of the popliteal fossa consists of the popliteal artery, vein, and tibial ( sometimes ischial) nerve. Inflammation of vascular structures most often occurs due to blockage of their lumen by thrombotic masses. The resulting oxygen deficiency in the surrounding tissues and in the vessel itself leads to acute ischemic pain ( due to lack of blood supply). Bacteria that are deposited on thrombotic masses and cause a local inflammatory process can lead to direct destruction of the vascular wall from the inside. Pain, as a rule, is clearly localized, acute. Their severity depends on the degree of oxygen deficiency in the surrounding tissues. Thus, with an increase in physical activity on the legs, the pain also increases in proportion.

Inflammation of the tibial nerve in most cases develops after a mechanical injury ( bruise, sprain). Frostbite of this nerve is also possible, however, in those of its segments that are located more superficially. In the popliteal fossa, this nerve is deep enough and covered with a layer of fatty tissue, so it rarely gets supercooled. In some cases, inflammation spreads to it from surrounding tissues with purulent arthritis, osteomyelitis, tendinitis, soft tissue phlegmon, etc. In rare cases, autoimmune damage to the nerve fiber by the body's own antibodies is noted. Pain in neuritis is acute and, as a rule, pronounced. Their weakening during immobility and strengthening, even with a slight movement of the leg, are characteristic.

Volumetric formation of the popliteal fossa
Among the volumetric formations that occur in the popliteal fossa, cysts, aneurysms, lymph nodes and tumor formations are distinguished.

Cysts are cavitary fluid formations that may be isolated or associated with the capsule of the knee joint. The elasticity of the cyst depends on the connection with the synovial cavity. Thus, if the cyst is soft, then most likely it is associated with the joint capsule and, conversely, if the cyst is dense, then it develops in isolation from the capsule. When trying to displace the cyst is quite mobile, smooth to the touch. In the bent position of the knee, the cyst is practically not felt, and when the leg is straightened, it protrudes from the popliteal fossa.

An aneurysm is a site of expansion of an artery or a sac-like outgrowth connected to it by a narrow mouth. Pain in an aneurysm occurs when its walls are stretched due to an increase in systemic blood pressure, for example, when running, squatting, etc. A distinctive feature of an aneurysm is a clear pulsation that coincides with heart contractions. Its surface is smooth, mobility is moderate. Elasticity may be different depending on the level of blood pressure at the time of the examination.

Lymph nodes are a kind of filters that trap bacteria and viruses that are in the lymph. In some diseases, the size of regional lymph nodes can increase tenfold compared to the norm. In this case, the node becomes dense, painful, smooth to the touch and almost motionless. Unlike an aneurysm, there is no pulsation. Often the skin over the knot is plethoric ( red), the local temperature is increased. Often a red, painful streak leads to an inflamed lymph node - an inflamed lymphatic duct ( lymphangitis).

Tumors of the popliteal fossa can grow from almost any type of tissue ( connective, muscle, fat, cartilage, bone, nervous, epithelial, etc.). Tumors of this localization are rare, but this is not a sufficient reason to exclude this disease from the differential diagnosis. The density of tumors is usually high. Benign tumors are usually more mobile than malignant ones because they do not have infiltrative growth. The surface can be difficult to define. Only lipomas have their own capsule, so they are smooth on palpation. Pain occurs when the tumor begins to compress surrounding tissues or disintegrate. In malignant tumors, there are corresponding clinical signs ( weight loss, lack of appetite, anemia, metastatic damage to other organs and systems).

Why do you have knee pain while walking?

Pain in deforming arthrosis
Deforming arthrosis is a complex dystrophic-degenerative disease of articular cartilage. Due to the fact that the knee joints are among the largest joints of the human body, their defeat by this disease is the most likely. Pain in deforming arthrosis is manifested due to the fact that the articular cartilage of the knee joint is gradually compressed and erased, exposing free nerve endings. Even with a slight impact on these endings, for example, with a simple movement or walking, there is an acute pain that disappears after a short rest.

As the disease progresses, the number of exposed nerve endings increases, the inflammatory process joins, the depreciation role of cartilage decreases and its nutrition worsens. As a result, the pain manifests itself more often, becomes more intense and disappears only after a long rest, combined with taking anti-inflammatory drugs and chondroprotectors.

Pain in obliterating arteritis
Arteritis obliterans is an inflammation of an artery. The main mechanism for the development of this pathology is blockage of the lumen of the artery ( in this case, popliteal) atherosclerotic plaque. As a result, there is an acute violation of the blood circulation of the lower limb after the blockage. Tissues that do not receive oxygen secrete biologically active substances and products of anaerobic ( anoxic) metabolism, which irritate the nerve endings and cause pain in the knee area. Almost always they are accompanied by pain in the lower leg and foot, they are extremely pronounced and do not go away until blood circulation is restored.

With incomplete blockage of the lumen of the artery, pain occurs only during exercise, when oxygen consumption increases, and its amount is not enough. After rest, the pain goes away. In severe cases, when the lumen of the artery is completely blocked and drug therapy does not help, the pain is constantly intensifying due to the ongoing destruction of tissues and the accumulation of their decay products in the limb. In the absence of appropriate medical and endoscopic treatment, gangrene develops over time.

Pain in varicose veins
With this pathology, a slow stretching of the superficial veins occurs, more often than the popliteal space, causing irritation of the nerve endings located in their wall. Excessive irritation of these receptors during an increase in venous pressure ( during pregnancy, hypothyroidism, heart failure, etc.) is manifested by moderate local pain. The addition of the inflammatory process leads to increased pain and progression of vein deformity.

Pain from an aneurysm
An aneurysm is an expansion of a certain section of an artery or the formation of a sac-like cavity formation connected to a given artery. The aneurysm has thin walls, and therefore the risk of its rupture with the development of severe interstitial bleeding increases many times over. Pain in an aneurysm is due to its stretching during an increase in blood pressure, and their intensity, as a rule, is not high.

Why is my knee sore and swollen?

In acute arthritis, inflammation of all structures located in the synovial cavity of the knee joint occurs. In particular, inflammation affects articular cartilage, intra-articular ligaments, menisci, and the synovial membrane. The causes of inflammation are varied - autoimmune, viral, bacterial damage, mechanical or thermal injury ( frostbite) and etc.

Inflammation of the synovial membrane leads to its significant swelling and thickening. In addition, there is a violation of the circulation of the synovial fluid, due to which its production increases, and the reabsorption slows down. Thus, fluid pressure gradually increases in the joint cavity, and the patient feels pain and a feeling of fullness in connection with this.

An increase in pressure in the knee joint is also dangerous because a free space is formed between the articular surfaces of the femur and tibia, which is normally absent. Because of this, the articular surfaces are no longer in close contact with each other, and the risk of dislocation or subluxation increases significantly.

Inflammation of the ligaments of the knee joint leads to increased pain during flexion or extension of the leg. Inflammation of the articular surfaces is also manifested by pain during movement, and their intensification is noted with compression of the articular cartilage during walking. Thus, for example, during an attack of gout, the inflammation of the knee joints is so pronounced that the patient is unable to stand up.

Why does the knee hurt when bending?

Osteophytes in deforming arthrosis
Deforming arthrosis involves damage to the articular cartilage. In response to damage, an inflammatory process develops, in which the rate of cell division increases. In the first phase of inflammation, the division of leukocyte cells is accelerated ( immune system cells). In the second and third phases of the inflammatory process, there is an increase in the rate of cell division, restoring the structure of destroyed tissues ( fibroblasts, chondroblasts, osteoblasts, etc.). As a result, the synovial membrane thickens, and cartilaginous growths form along the edges of the articular surfaces. After some time, these growths calcify, turning into bone growths - osteophytes. Thus, the articular surface, which should normally be smooth and round, becomes bumpy with bony outgrowths at the edges. When the joint is brought to an extreme position, for example, at maximum flexion, these growths injure the synovial membrane and the opposite cartilage, which causes the patient to feel sharp pains.

Tension of the ligamentous apparatus
The knee joint is held in a stable position by a system of internal and external ligaments. With their complete structural and functional integrity, movements in the joint occur only up to a certain limit. If, with the help of an external force, the joint is bent or unbent beyond the physiological aisle, stretching or rupture of the tendons and ligaments holding it develops.

Injured tendons form a focus of inflammation around themselves, into which leukocytes, platelets, mast cells, etc. migrate from peripheral blood. These cells secrete a number of biologically active substances that support the inflammatory process for as long as necessary to restore the damaged tendon or ligament. In particular, such a substance is bradykinin, which, in contact with nerve endings, causes their irritation, which is transmitted to the brain and causes a sensation of pain.

At rest, when the tendon is not stretched, pain is minimal. They are supported by the presence of the above bradykinin in the inflammatory focus, as well as soft tissue edema. When the patient performs a leg movement, the injured ligament or tendon is stretched and, in addition to the above stimuli, a mechanical factor is added.

Fracture of the patella
A fracture of the patella is a fairly rare injury, despite the fact that this bone is not protected from the front by anything other than a layer of connective tissue fibers and skin. The reason for the rare injury is that the patella is not tightly fixed to the articular surfaces of the femur and tibia, but freely ballots in front of them. The displacement of the patella up and down is carried out with the contraction and relaxation of the quadriceps femoris muscle, the tendons of which are woven into the capsule of the knee joint in front of the patella and exit it below in the form of a patellar ligament.

Thus, a patella fracture is more likely to occur when falling on bent knees. If a crack has formed after an injury, then the patella will remain in a physiological position, however, any attempt to bend the knee will lead to severe pain due to the distance between the edges of the crack from each other. If two fragments have formed after an injury, then, as a rule, they always move away from each other due to the fact that the tendon of the quadriceps muscle of the thigh pulls the upper fragment upward, and the patellar ligament pulls the lower fragment downward. Pain with such a fracture is much more pronounced. Often associated with intra-articular bleeding. The patient is practically unable to straighten the leg at the knee. If there is any suspicion of a fracture of the patella, it is recommended to immediately call an ambulance, immobilize the thigh and lower leg in a position that minimizes pain, and put an ice pack on the knee.

Why do my child's knees hurt?

Knee injuries in children
Knee injuries can vary in severity. Most often, children injure the knees only superficially due to their relatively small weight, as well as the higher flexibility of the bone tissue. In such cases, abrasions and bruises can be found on their surface, when touched, the child experiences pain. Abrasions must be detected in time and treated accordingly ( running water, hydrogen peroxide, iodine, brilliant green, etc.), otherwise they can fester and seriously aggravate the general condition of the child.

If the knee joint is swollen, reddened, felt hot to the touch and hurts a lot, then it is necessary to call a family doctor, an ambulance as soon as possible or bring the child to the nearest emergency room on your own for examination by specialists.

This disease is characteristic of both adults and children who often had a sore throat in the past. In their body, antibodies are produced against group A beta-hemolytic streptococcus, which cross-infect endocardial tissues similar in antigenic composition ( inner lining of the heart), synovial membrane and cartilage of large joints ( knee, hip, ankle). Thus, in acute rheumatic fever, a child may complain of pain and swelling of the knees, severe general weakness, fatigue, palpitations and a feeling of heat. Body temperature can reach 38 - 40 degrees.

This condition is dangerous for its complications, because with improper treatment it often leaves behind acquired heart defects and persistent changes in the shape of large joints. In connection with the foregoing, it is recommended that a doctor examine a child in this condition, and preferably at home, since in the acute phase of the disease, complete physical rest and bed rest are necessary to avoid excessive stress on the heart muscle.

Orthopedic pathology
Orthopedic diseases mean various violations of the correct growth of the skeleton. These diseases include scoliosis, hip dysplasia, congenital clubfoot, varus or valgus deformity of the knee joints, etc.

Normally, such diseases should be detected at the age of a child up to 2-3 years during routine examinations by an orthopedic traumatologist. The type of treatment for a particular pathology depends on how much it has progressed and is prescribed individually in each case. In particular, almost any deviation of the growth of the lower limb from the usual axis poses a threat to the knee joints. This is due to the fact that in order to maintain balance, the child unconsciously bends his knees and initially learns to walk incorrectly. The load on the knee joints is uneven, that is, certain areas of the articular surfaces experience more pressure than they are designed for. As a result, these areas of cartilage wear out and become thinner. Nerve endings are exposed, and the child experiences pain, which intensifies after running, and later after a short walk. Treatment of these pathologies can last the entire period of bone growth, that is, theoretically, up to 30 years. The earlier it starts, the more effective it ends up being.

Are folk remedies effective for knee pain?

It should be noted right away that these recipes are applicable only for chronic pain in deforming arthrosis, osteochondrosis, etc. If pain occurs for the first time, then it is imperative to find out their cause and not self-medicate blindly.

To reduce the inflammatory process, mainly local dosage forms are used, such as compresses, lotions and ointments. The compress means making an infusion ( on the water), tinctures ( on alcohol) or decoction ( pouring boiling water) followed by impregnation of a piece of cloth or cotton wool with them. The material impregnated with a medicinal solution is placed on the knee and wrapped in layers with oilcloth and a dry cloth. The compress is on the knee from half an hour to 6 - 8 hours and is applied daily or every other day. Lotions involve placing a drug-soaked cloth on the knee and changing it every 10 to 15 minutes. Homemade ointments contain crushed plants, mud or concentrated aqueous or alcoholic extracts from them as an active substance. Honey, petroleum jelly, coconut oil, and even melted beeswax are used as a thickener.

On the Internet and countless books on traditional medicine, there is a huge variety of recipes for preparing medicines to relieve inflammation in the knee area. The ingredients used in them are available or rare and cost so much that a more effective finished product could be purchased at the pharmacy for the same price. In connection with this fact, in order to make life easier for the patient, the main methods for the manufacture and use of dosage forms for topical use were previously described. As the main ingredient, you can take any of the available plants with anti-inflammatory properties ( listed below). In this way, you can create your own recipe for an effective remedy, while using the minimum amount of cheap ingredients.

Substances and plants with anti-inflammatory properties are:

• lilac flowers;
• blue and yellow clay;
• flowers and fruits of chestnut;
• flowers and tubers of potatoes;
• olive oil;
• leaves and flowers of St. John's wort;
• leaves, flowers and yarrow root;
• Bay leaf;
• chamomile flowers;
• calendula flowers;
• raspberry leaves and stems;
• horseradish root, etc.

Why do knees and fever hurt?

Acute rheumatic fever
This disease is a consequence of the imperfection of the immune system, in which antibodies created to combat group A beta-hemolytic streptococcus mistakenly attack endocardial tissues similar in antigenic structure ( inner lining of the heart), articular cartilage and synovium of large joints. At the same time, patients have a triad of symptoms - disorders of the cardiovascular system ( strong and rapid heartbeat, shortness of breath, severe weakness), knee inflammation ( swelling, redness, stiffness, and pain with movement) and an increase in body temperature to 38 degrees or more.

In the acute period of the disease, which corresponds to the onset of fever, the patient is advised to receive appropriate treatment from a family doctor or rheumatologist and to observe bed rest, which provides for the complete exclusion of any physical exertion.

Purulent arthritis
Purulent arthritis is usually a bacterial inflammation of the joint. The entry of pathogenic microorganisms into its capsule occurs either by direct or hematogenous route. The direct route involves infection of the cavity of the knee joint with an open fracture, surgery, or infection during an injection. The hematogenous route of infection involves the entry of pathogenic microorganisms into the cavity of the knee joint along with the blood flow from another focus of infection located in the body ( purulent otitis, tonsillitis, chronic osteomyelitis, etc.).

With this disease, there is a pronounced swelling and redness of the knee, a local increase in the temperature of the skin. The pain is characteristic both at rest and when trying to bend and unbend the leg. The temperature rises in proportion to the severity of the inflammatory process and can reach 38 degrees or more.

Why does knee pain occur in pregnant women?

During pregnancy, almost all women recover significantly. It is considered normal to increase the weight by 12 kg for all 40 weeks of gestation. However, according to statistics, more than half of expectant mothers overcome this milestone, being still 5-6 months old. Some even manage to double their weight.

The reasons for weight gain are extremely diverse. The simplest option is when a woman simply starts to eat more because of an increased appetite or, even worse, just like that. It is more difficult when a woman eats the same way as before, and the weight is steadily growing. This condition is usually caused by a condition called preeclampsia. This disease has a complex mechanism, but its manifestations are always the same - slowly rising edema and increased blood pressure. This condition can lead to partial or complete abruption of the placenta, which is definitely dangerous for both the mother and the child, and this problem must be dealt with in advance with the doctor in charge of the pregnant woman.

So, as mentioned earlier, knee pain in a pregnant woman most often occurs due to excess weight, to which her osteoarticular apparatus is not adapted. Increasing pressure on the articular cartilage of the knee joints leads to their more pronounced deformation and compression. At the same time, the capillaries located in the subcartilaginous base are compressed, blocking the blood supply and nutrition of the cartilage themselves. As a result, the processes of cartilage destruction begin to prevail over the processes of its restoration, the thickness of the articular cartilage decreases, and the nerve endings become exposed. Due to excessive friction, an aseptic inflammatory process develops, in which the exposed nerve endings are irritated both mechanically ( due to friction and swelling) and chemically ( through exposure to inflammatory mediators). Further, nerve impulses are summed up, transmitted to the brain and perceived by it as pain sensations.

A similar mechanism for the occurrence of pain in pregnant women is relevant not only for the knees. Often associated with excess weight, pain also appears in the hip, ankle, intervertebral and other joints.