Why do their knees hurt?The reasons for doing

Knee pain is a generalized symptom, pointing to anguish in the body, the appearance of joint disease or simply a leg load.

It is difficult to find a person who has never experienced knee pain in a certain period of life.Braying, clicks or pains of different intensities in the knee joints occur in both adults and children due to many reasons.The greater a person, the greater the probability of various diseases, whose first sign is the pain in the knees.This is due to the age of the body: decelerate the metabolic processes, the wear of the tissue of the joint cartilage, joining other problems with the musculoskeletal system, the blood vessels, the nerves.

Due to the complex anatomical structure, many experienced structures and loads experienced, and often overloads, knee joints are very vulnerable.The damage to any element of the structure, for example, a synovial bag, leads to a violation of the motor function of the knee and, consequently, the pain syndrome.Ligaments and meniscs are considered the most vulnerable, they are injured in 80-85% of cases.

The anatomical structure of the knee

The knee consists of a knee joint, a distal end of the femur with two tumors and jackets, a tubular bone of the tibia, muscles, nerves, vessels, ligaments, a bruise (knee cup), articular bags and meniscus.

The knee joint is one of the great joints of the body.The femoral bone approaches him from above.The articular surfaces of their lateral (external) and medial (internal) condyles are articulated with the kneecap and the tibia.Meniski, which are connective tissue cartilage, serve as joint shock absorbers.Thanks to them, there is a rational distribution of human weight on a tiger plateau and increases the stability of the joint.Subtle, double-headed structures, socks and other muscles synchronize capsules-light structures, ensuring the motor activity of the knee joint.

The knee elements are interconnected by many ligaments.Inside the joint there are two cross -shaped ligaments: the rear and front.Hobby bones are connected to fiber and warm bones with collateral ligaments.The inclination of the popliteal ligament is located in the back of the bursa of the knee joint.The main synovial capsule, which does not communicate with the joint, is distinguished from a series of joint cavities.The blood supply to the elements of the knee is carried out by a noble network of blood vessels, and the nerve fibers carry out the innervation.

Causes of knee pain

There are many causes of pain in the knees, which can be distributed conditionally into several groups.

Traumatic lesions of the elements of the knee:

1. Bitter of the knee.As a result of the blood vessel gap, local hemorrhage occurs in the soft tissue of the joint.Redness, swelling, damage to nerve endings lead to pain, difficulty in movement.
2. Complete or partial ligament rupture.More often, a partial violation of the integrity of the ligament of the inner side is diagnosed, which arises from the excessive torsion of the lower part of the leg.

The outer ligament breaks less frequently than the internal.This is due to a strong deviation from the bottom of the leg inward, when turning the leg, for example.Cross -shaped ligament rupture is inevitably accompanied by hemartrosis.

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

1. Knee joint hemartrosis - Pour blood into the joint cavity.There is traumatic and non -human nature.Traumatic hemartrosis is observed with meniscus ruptures, complete or incomplete ligament ruptures, intra -articular fractures, bruises in the knee area.The non -human option is one of the symptoms of diseases characterized by a shorter of the walls of blood vessels or a violation of the blood coagulation system.These include hemophilia, scurvy, severe forms of hemorrhagic diases.The blood that has accumulated in the joint cavity compresses the tissue, interrupting the blood circulation in them.A special pigment, halmosiderin, negatively affects ligaments, hyaline cartilage, a synovial bag, leading to the loss of its elasticity.The result of the injury of the joint bource is the swelling of its villi and the increase in the production of joint fluid.The result of repeated bleeding is dystrophy and destruction of the joint.
2. Knee meniscopathy - Violation of the integrity of the knee joint meniscus.In the lateral form, the external meniscus is damaged, with the internal medial.This is one of the most common, but difficult to diagnose damage to the knee joint.In the disease risk zone there are not only athletes involved in intensive training, but also common people.The meniscus rupture can come from an unusual acute movement when turning the body, turn the leg, a strong blow to the knee.
3. Dislocation of the knee - Pathological turnover of the kneecap.Trauma is diagnosed in no more than 0.7% of cases of the total number of dislocations.More often there is external dislocation, less frequently, internal, very rarely, vertical or torsion.With an incomplete dislocation, the knee cup is determined on the lateral (external) condyle, with the exterior of the outside from the lateral condyle.
4. Closed or open fractures of the knee joint, the upper section of the bones of the bottom of the leg or the lower column. Such injuries are often combined with damage to soft knee, causing massive bleeding, excessive mobility in the knee area, their deformation.

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

1. Arthritis - Inflammatory damage to the knee joint.A similar mechanism for the development of pathology with osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, gout (with the deposition of urates in the joints) is observed.
2. Osteoarthrosis (gonarrosis) With the defeat of the knee joint of non -inflammatory nature, affecting all its structures and leading to serious degenerative changes.
3. Bursitis With the inflammation of the synovial, the bursa leads to pain during flexion and extension of the knee movements.
4. Periartritis tendons of the knee joint - Inflammation of the strain goose capsule, knee tendons, as well as the muscles and ligaments surrounding the joint.In this case, the pain occurs mainly during the descent on the stairs, especially with a heavy load, and focuses on the internal surface of the knee.
5. Bonding of the kneecap -Te chiceneration in the cartilage of the articular (rear) surface of the kneecap.The degree of destruction can be different: from the areas of softening of light to cracks and complete abrasion.

6. Condomatosis - A severe chronic disease due to the displastic process with the degeneration of the islets of the articular membrane sections in the cartilage - Condrom.The ossification of individual cartilaginous bodies is not excluded.
7. Baker's cyst - The formation of a dense formation of elastic round tumors in a popliteal grave located on the opposite side of the kneecap.The cyst is clearly visible in the exposed state of the knee.It causes discomfort, pain in the popliteal region.With significant sizes, squeeze blood vessels and nerves, which leads to deteriorated innervation and blood circulation.
8. Goff's disease - A disease, accompanied by damage and greater degeneration of adipose tissue located around the knee joint.Pinches, edema and other damage to fat cells (adipocytes) end their replacement with dense fibrous tissue.As a result, the function of the "fat pillow" is interrupted, the adipose tissue itself does not become able to play the damping role.
9. Osgud's disease -Swerter - A pathology characterized by murders of the bugal part of the tibia.Diagnosis in adolescents from 10 to 18 years practicing sports.A painful protuberance appears under the bruise, in the absence of treatment, which leads to the restriction of the leg or complete immobilization, as well as muscle hypotrophy.

Diseases in which the irradiation of knee pain is possible:

1. Hip joint cokerosarthrosarthritis - Chronic damage to the hip joint, accompanied by progressive degeneration and distribution changes in it.Often, the pain extends through the outer surface of the thigh to the knee or below.
2. Sedular nervous neuropathy - Non -inflammatory damage to the nerve as a result of compression squeezing or spasm of blood vessels.This nerve reaches the feet, starting in the lower back and passing through the coxis and the pelvis.The blockade at any point for its length leads to a deteriorated sensitivity or to the pulsating pain.
3. Fibromyalgia - Extractive defeat of soft tissues of non -inflammatory nature with a combination of symptoms in the form of arthralgia, muscle weakness, depression, etc.

Some systemic diseases that lead to knee:

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

Types of knee

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

• Pain.With arthritis, osteoarthrosis.
• Sharp, strong.With fractures of the knee elements, rupture of the ligaments, the acute loop, the knee hematoma, the exacerbation of the meniscopathy, deforming osteoarthrosis.
• Pulsor.With a deforming osteoarthritis launched, meniscus injury.
• Drilling.With osteomyelitis.
• Dumb.With Burit, chronic osteochondritis.
• Fire.With the Compression of the sciatic nerve, the tuberculosis process in the bone.
• Shot. When the nervous trunk.
• Pain when walking.With a bakery cyst, packages, arthritis, gonarrosis, periartide.
• The pain alone. With gout, arthritis.

Diagnosis of pathologies that cause knee pain

Physical examination:

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

Laboratory Research:

• Biochemical and clinical blood analysis;
• serological blood analysis;
• Immune blood analysis;
• rheumatological tests;
• Bacteriological analysis of the synovial fluid.

Invasive instrumental methods:

• arthroscopy;
• articular bag puncture;
• Puncture bone biopsy.

Non -invasive instrumental diagnosis:

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

Knee pain treatment

If the pain in one or both knees of the non -human nature of the occurrence, it must first resort to the therapist, who, depending on the patient's complaints and the results of an objective exam, will direct a narrow specialist: an orthopedist, a rheumatologist, a phlebologist or a neurologist.In the case of any injury, you must communicate with a surgeon or orthopedic trauma.

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

• significantly reduce the duration of hiking and remain in the legs during the day;
• Athletes temporarily (before recovery) leave training and common people to run or jump;
• By increasing pain, abandoning the movements, apply a fixing bandage of an elastic bandage to the knee;
• Use a bandage or bandage for the immobilization of the knee joint;
• With a bruise, cold in the place of traumatic effects.

Rheumatoid, psoriatic arthritis, systemic autoimmune diseases need a serious integrated treatment, performed for many months.Basic therapy consists of immunosuppressants, anti -inflammatory drugs and non -steroid hormonal, gold preparations, etc.

In the treatment of bursitis, analgesics and anti -inflammatory medications are used.If an infection is detected, then an antibiotic course.The therapeutic puncture of the bag is carried out to eliminate excess fluid from the synovial cavity and/or the introduction of one of its corticosteroids.The operation helps to get rid of chronic brush inflammation: the surgical split of the synovial bag.

With deforming osteoarthrosis, intra -articular injections of glucocorticoids, prolonged NSAIDs and condoprotectors are effective.To relieve pain syndrome, compresses with diamexide or bischofit, ointments and gels with anti -inflammatory effects are prescribed locally.Massage, physiotherapy, therapeutic gymnastics helps.Serious knee joint injuries require surgical intervention: joint endoprotics.

The treatment of osteoporosis consists of the course of bisphosphonates, calcitonins, calcium preparations, vitamin D, etc.

The treatment of meniscus rupture can be conservative or surgical.Conservative therapy consists of analgesics, NSAIDs, hyaluronic acid, condoprotectors.But first, joint replacement is performed.

Types of surgical intervention:

• Menisctomy;
• Partial (incomplete) menisctomy;
• meniscus transplant;
• arthroscopy;
• Arthroscopic sewing of the meniscus rupture.

With any knee injury, after treatment, the rehabilitation period, which must take place under the control of an orthopedist rehabilitologist, is very important.The doctor will compile an optimal joint recovery program.The main postoperative rehabilitation methods are massages and therapeutic gymnastics.Classes in special simulators are also effective, gradually developing a knee joint.