Knee joint is one of the most complicated joints of the human body. Its “difficult” structure in combination with constant stress makes the joint extremely vulnerable. It is therefore not surprising that each of us has experienced knee pain at least once in our lives.
The pain may be aching, dull, obtuse, sharp or even unbearable. Sometimes people experience discomfort only while walking or flexion and extension of the leg, sometimes the pain is permanent. The nature of pain in the knee joint, as well as its causes, can be very different.
- When knee pain is not connected to any disease?
- What conditions and diseases can cause pain in the knee?
- Sore knee, what to do?
- Pain in the knee joint: treatment
1When knee pain is not connected to any disease?
Knee pain is not always a symptom of the disease. For example, discomfort and pain in the joints are common in adolescents. At this age children grow at a high rate, however, vascular development is slower than skeletal growth. The result is a so-called vascular pain.
Another cause of pain in the knee joint in a healthy person can be a simple physical overload of the knee. This often happens to athletes. Due to the excessive load, knee tissues become irritated, which causes unpleasant sensations.
The body sends this signal when it is time to slow down. For those who ignore it and does not adjust the load, the risk of development of chronic diseases that require serious treatment increases in times.
2What conditions and diseases can cause pain in the knee?
Even a light knee injury may be accompanied with hemorrhage into soft tissues, swelling and some soreness. All this can hinder movements and cause a lot of inconvenience. If the intensity of pain is gradually decreasing, it is not exacerbated during flexion-extension movements of the leg and doesn’t become unbearable during palpation of the bruised place, then, it is most likely that the person won’t even remember about the trauma in a few days.
But in case of exacerbation of pain during movements and the increase of temperature in the area of the joint, it is necessary to see a doctor. It cannot be ruled out that we are talking about a more serious injury here, such as a shift of the patella.
Meniscopathy is any damage of the meniscus (flattening or a tear). This is a fairly frequent injury, besides, not only professional athletes and extreme sports lovers are at risk, but alsopeople who lead a normal life. The very first symptom of meniscopathy is a click, after which there appears such an acute pain in the knee that the limb is losing mobility for a while.
Ligament injuries (both full and partial) are always fraught with sharp and unbearable pain. Ligament rupture is often accompanied by bone fracture. Anything can cause such injury – a simple twisted ankle, failed jump or an accident. In any case, all this is accompanied by a sharp severe pain, swelling and an unnatural position of the knee joint clearly visible even to the nonprofessional.
Chronic patellar luxation
This pathology does not occur too often and has a high risk of recurrence in the future. When it comes to children, the knee joint deformation (outwardly manifested through the X-shaped tibia deviation) and dysfunction of the leg is possible.
Inflammation of the tendon
Inflammation of a tendon or tendinitis is manifested through pain in the joint and limiting of its mobility. The symptoms remain for a long period of time and are of a highly assiduous nature. There is an increased sensitivity of the inflamed tendon during palpation of the painful area. Causes of the disease are very diverse:
- joint overload for an extended period of time;
- bacterial infections;
- knee injury;
- pathology in the body structure – for example, unequal leg length;
- allergic response of the body to the intake of certain drugs;
- a history of rheumatic diseases (gout, arthritis);
- posture disorders;
- various pathologies in the development of tendons;
- weakened tendons.
Bursitis is an excessive accumulation of fluid in the joint capsule. As a result, there is a noticeable increase of the knee joint. There occurs pain, which can extend along the entire limb down to the foot. There is acute or chronic bursitis.
Acute form of the disease is characterized by a strong, sharp and nagging pain, flushing of the skin and limitation of motion of the limbs. The swelling has a clear outline, and the accumulated liquid is well felt during palpation.
Chronic bursitis causes induration of the joint capsule, which leads to deformation of the knee joint.
The most common causes of bursitis are:
- infectious diseases;
- recurrent injuries of the knee joint;
- constant overload of the joint;
- improper distribution of weight while weight lifting.
It is an inflammatory disease of the knee joint, which manifests itself through an increase in temperature in the affected area and severe pain, intensity of which increases while walking (however, the pain does not disappear while at rest), joint swelling and stiffness of movements, progressive joint deformity. The common causes of arthritis are heredity, invasion of the infections into the knee joint, lack of physical activity in everyday life, unbalanced diet.
During this disease, the inflammatory process affects not only the knee joint, but also the surrounding tendons, other joints and even the eyes. Reactive arthritis is often caused by urogenital infectious diseases (Gonorrhea, Ureoplazma, Chlamydia) or gastrointestinal diseases (Salmonellosis, Dysentery).
Inflammatory disease of the lining of the inside cavity of the joint called the synovial membrane is characterized by the formation of the so-called effusion, which is collected in the joint capsule. Common causes of synovitis are trauma, autoimmune processes, metabolic disorder and so on.
The disease has an aseptic character (that means there isn’t any infection that causes synovitis), but in the case the infection invades the synovial fluid, there appears pus, and in this case we are talking about purulent synovitis. The disease is accompanied by dull ache and unpleasant feeling of fullness from inside.
This disease is accompanied by degeneration and damaging of the surrounding fatty tissue of the joint. Hoff’s disease is quite difficult to diagnose, it is often mistakenly taken for meniscopathy or other pathology. The danger of the disease is that adipose tissue gradually loses its “buffer” protective function.
A common cause of the disease is a knee injury, during which fat lobules are getting pinched and swollen. The damaged cells are replaced by fibrous tissue, which has a completely different structure comparing to fat tissue, thus, it cannot serve as a buffer.
It is a serious severe disease which is manifested through a change in the bone structure. As a result, the bone becomes very fragile and vulnerable. The person suffers from frequent fractures. Therefore, the pain in the knee joint (along with aching pain in the spine and nocturnal cramps) is often the first sign of osteoporosis.
In this case, activators of purulent necrotic processes in the bone tissue are the bacteria. Almost from the beginning of the disease the patient feels a sharp, piercing, as if bursting from the inside pain, the intensity of which increases even by the slightest movement. In addition, the other symptoms are weakness and increased body temperature. The sore knee swells, and the skin becomes red.
This serious disease starts with the melting of bone stock. The process progresses slowly, invading new areas. Bone tuberculosis proceeds with the formation of purulent fistula or a cavity opening outwards.
3Sore knee, what to do?
It is extremely dangerous to ignore knee pain. It is unknown what is causing the problem – maybe the disease that is to blame may be effectively treated only in the early stages. Therefore, it is advisable to seek help from a doctor at the first disturbing signs. Which doctor should you see?
It all depends on the situation. If the knee was injured, you should consult a surgeon. Otherwise, it’s okay to visit a therapist, who will decide on your further actions. Most often, the patient is sent to an orthopedist, neurologist, rheumatologist or osteopath.
The following procedures may be necessary for an accurate diagnosis:
- patients interview (the doctor clarifies their feelings, behavior of pain during the limb movement, he\she gets to know patient’s history, particularly their work and lifestyle prior to the onset of pain conditions, etc…);
- examination – sometimes an experienced physician may establish a diagnosis or at least suspect a particular disease even by the external appearance of the painful area;
- CBC (reveals leucocytosis, anemia, increased erythrocyte sedimentation rate, help conclude if there is inflammation, etc…);
- Biochemistry (elevated uric acid level, for example, signals of the gout);
- microbiological studies (for example, in cases of suspected reactive arthritis, the scrape from the urethra to detect Chlamydia may be necessary);
- serological tests;
- x-ray is a highly informative method of investigation in the presence of pain in the knee joint; the pathology and the changes characteristic of a particular disease are usually visible on the picture;
- magnetic resonance imaging;
- ultrasound is especially informative in case of a suspected damage of the knee joint of traumatic nature, meniscopathy, or osteoarthritis;
- arthroscopy is carried out with the help of special equipment for diagnostic and therapeutic purposes;
- puncture bone biopsy (is necessary to confirm osteomyelitis, or bone tuberculosis diagnosis);
- arthrocentesis – using a special needle the part of the exudate from the knee is collected for further study (it is checked for the transparency of the material, the level of blood cells and proteins, the presence of microorganisms, etc…);
- densitometry – this method lets the doctor see the bone density in case of osteoporosis (or if the disease is suspected to be present).
4Pain in the knee joint: treatment
A specific list of remedial measures depends on the reason that caused the pain in the knee joint. As mentioned above, there are so many of such diseases and conditions. Therefore, self-medication of the knee trouble is ineffective and even dangerous. Only a specialist can establish an accurate diagnosis and treatment and if the visit is delayed delayed:
- knee pain does not subside for a long time;
- amount of pain is not reduced or, especially, is growing;
- pain occurred suddenly and without a reason;
- the knee is red;
- there is a change in the sensitivity of the knee and surrounding areas;
- there is a deformity of the knee.
Each case requires individual approach as to what examinations and medical activities should be prescribed.
So, depending on the cause of the knee pain, the doctor may apply the following measures and recommendations in the treatment of the patient:
- reduction or even the complete restriction of physical activity (sometimes this requires the imposition of a special fixing bandage that holds the knee at rest);
- using of an elastic bandage or brace in order to help stabilize the joint;
- thorough warm up of the knee before training, a gradual increase in load;
- compresses – in some cases, the doctor may recommend warm compresses or warming ointments (to improve the microcirculation of tissues); sometimes the imposition of cold compresses is beneficial (for example, in order to remove acute pain, moreover, the procedure time should not exceed 15 minutes);
- medical therapy – for example, if there is an inflammatory disease of the knee joint, inflammatory drugs complexes are prescribed, and in case the trauma occurred, rehabilitation medication is used;
- surgical intervention;
In particularly severe cases, patients are put in a hospital for further examination and treatment.