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Why knees hurt: reasons for what to do


Knee pain is a widespread symptom that signals trouble in the body - the occurrence of joint disease or simply increased stress on the legs.

It is difficult to find a person who has never experienced pain in the knees in a certain period of life. Discomfort, clicks or pains of different intensity in the knee joints occur in both adults and children due to many reasons. The older a person becomes, the higher the likelihood of various diseases, the first sign of which is pain in the knees. This is due to the age characteristics of the body: slowing down of metabolic processes, wear of the cartilage tissue of the joints, joining other problems with the musculoskeletal system, vessels, nerves.

Due to the complex anatomical structure, many structures and experienced significant loads, and often overload, the knee joints are very vulnerable. Damage to any element of the structure, for example, the synovial sac, leads to disruption of the motor function of the knee and, consequently, pain syndrome. Ligaments and menisci are considered the most vulnerable, they are injured in 80–85% of cases.

Anatomical structure of the knee

The knee is hurt The knee consists of the knee joint, the distal end of the femur with two condyles and armpits, the tibial tubular bone, muscles, nerves, vessels, ligament apparatus, the patella (patella), articular bags and menisci.

The knee joint is one of the large joints of the body. On top of it comes the femur bone. The articular surfaces of its lateral (external) and medial (internal) condyles articulate with the patella and tibial bone. The menisci, which are connective tissue cartilages, serve as joint absorbers. Thanks to them, a rational distribution of human weight on the tibial plateau occurs and the stability of the joint increases. Thin, biceps, semimembranosus, and other muscles synchronize the capsular-ligamentous structures, providing the motor activity of the knee joint.

The elements of the knee are interconnected by a multitude of bundles. Inside the joint there are two cruciate ligaments - posterior and anterior. The dorsum of the femur is connected to the colibular ligaments of the fibula and tibial bones. Oblique popliteal ligament is located in the back of the knee bursa. From a number of articular cavities, the main one is distinguished - the synovial capsule, which is not connected with the joint. The blood supply to the elements of the knee is carried out by the nobility of the blood vessel network, and the innervation - to the nerve fibers.

Causes of pain in the knees

There are many causes of pain in the knee joints, which can be divided into several groups.

Traumatic lesions of the elements of the knee :

  1. Knee injury . As a result of rupture of the vessels, local hemorrhage into the soft tissues of the joint occurs. Redness, swelling, damage to nerve endings leads to pain, difficulty in movement.
  2. Full or partial rupture of ligaments . Often diagnosed as a partial violation of the integrity of the inner lateral ligament, arising from excessive inversion of the lower leg to the outside.

The outer ligament breaks less frequently than the inner one. This is due to the strong deflection of the tibia inward, when the leg is tightened, for example. Cruciate ligament rupture is inevitably accompanied by hemarthrosis.

Complete rupture of both ligaments is often combined with damage to the articular sac, tearing of the inner meniscus. This injury leads to excessive mobility of the knee joint, accompanied by severe pain, the intensity of which depends on the degree of rupture.

  1. Hemarthrosis of the knee joint - the discharge of blood into the joint cavity. It happens traumatic and non-traumatic nature. Traumatic hemarthrosis is observed when meniscuses are broken, complete or incomplete ligament ruptures, intra-articular fractures, knee area bruises. Non-traumatic variant is one of the symptoms of diseases characterized by increased fragility of the vascular walls or impaired blood clotting system. These include hemophilia, scurvy, severe forms of hemorrhagic diathesis. The blood accumulated in the joint cavity squeezes the tissues, disrupting blood circulation in them. A special pigment - hemosiderin - negatively affects the ligaments, hyaline cartilage, synovial bag, leading to a loss of their elasticity. The result of the defeat of the articular bursa is the swelling of its villi and increased production of articular fluid. The result of repeated hemorrhage is dystrophy and destruction of the joint.
  2. Knee meniscopathy is a violation of the integrity of the knee meniscus. In the lateral form, the external meniscus is damaged, and in the medial form, the internal one. This is one of the most frequent, but difficult to diagnose injuries of the knee joint. Not only athletes engaged in intensive training, but also ordinary people are in the risk zone of the disease. Rupture of the meniscus can occur from a sharp unusual movement when turning the torso, turning the leg, a strong blow to the knee.
  3. Dislocation of the patella - pathological displacement of the patella. Injury is diagnosed in no more than 0.7% of cases of total dislocation. Often there is an external dislocation, less often - internal, very rarely - vertical or torsion. In case of incomplete dislocation, the patella is defined above the lateral (external) condyle, and in full, outside the lateral condyle.
  4. Closed or open fractures of the knee joint, upper portion of the bones of the leg or lower part of the thigh bone. Such injuries are often combined with damage to the soft tissues of the knee, causing massive hemorrhages, excessive mobility in the area of ​​the knee, and its deformation.

Inflammatory and degenerative-dystrophic diseases of the articular elements of the knee:

  1. Arthritis is an inflammatory lesion of the knee joint. A similar mechanism of pathology is observed in osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, gout (with deposition of urates in the joints).
  2. Osteoarthritis (gonarthrosis) with a lesion of the knee joint of a non-inflammatory nature, affecting all its structures and leading to serious degenerative changes.
  3. Bursitis with inflammation of the synovial bursa leads to pain during flexion-extension movements in the knee.
  4. Periarthritis of the knee joint tendons - inflammation of the goose foot capsule, knee tendons, as well as muscles and ligaments surrounding the joint. In this case, the pain occurs mainly during the descent of the stairs, especially with a heavy load, and focuses on the inner surface of the knee.
  5. Patella chondropathy - degenerative necrotic changes in the cartilage of the articular (back) surface of the patella. The degree of destruction may be different: from areas of easy softening to cracks and complete abrasion.
  6. Chondromatosis is a serious chronic disease caused by a dysplastic process with islet degeneration of areas of the membrane of the articular membrane in cartilage - chondroma. It is possible the ossification of individual cartilaginous bodies.
  7. Baker's cyst is the formation of a dense, elastic, rounded tumor-like formation in the popliteal fossa, located on the opposite side of the patella. The cyst is clearly visible when the knee is unbent. Causes discomfort, pain in the popliteal area. With a significant size squeezes blood vessels and nerves, leading to a violation of innervation and blood circulation.
  8. Hoff's disease is a disease accompanied by a lesion and further degeneration of adipose tissue located around the knee joint. Pinching, swelling and other damage to fat cells - adipocytes - ends with their replacement by dense fibrous tissue. As a result, the buffer function of the "fat pad" is violated, the fatty tissue itself becomes unable to act as a shock absorber.
  9. Osgood – Schlatter disease is a pathology characterized by the death of the bumpy part of the tibia. It is diagnosed in adolescents from 10 to 18 years involved in sports. Below the patella, a painful bump appears, with no treatment, leading to restriction of leg movement or complete immobilization, as well as muscle wasting.

Diseases for which radiating pain in the knee area is possible:

  1. Coxarthrosis of the hip joint is a chronic lesion of the hip joint, accompanied by progressive degeneration and dystrophic changes in it. Often the pain spreads down the outside of the thigh to the knee or below.
  2. Neuropathy of the sciatic nerve is a non-inflammatory lesion of the nerve as a result of compression squeezing or spasm of blood vessels. This nerve reaches the feet, starting in the lumbar region and passing through the tailbone and the pelvis. A blockade at any one point along its length leads to an impaired sensitivity or pulsating pain.
  3. Fibromyalgia is an extra-articular lesion of soft tissues of a non-inflammatory nature with a combination of symptoms in the form of arthralgia, muscle weakness, depression, etc.

Some systemic diseases that cause knee pain:

  1. Osteoporosis is a disease of the bone system of a chronically progressive course that changes the mineral composition and density of bone tissue. "Washout" of calcium from the bones leads to their fragility. The process is accompanied by aching or aching pain in the limbs.
  2. Tuberculosis of the bones . Tuberculous lesion of the bone area leads to persistent severe pain.
  3. Osteomyelitis is an infectious-inflammatory disease that affects all the structural elements of the bones. The result of both specific, for example, tuberculosis, and nonspecific, often coccal, osteomyelitis becomes hyperemia of the skin, swelling, local acute pain in the bones and muscles, febrile temperature.
  4. Some infectious diseases . In Reiter's syndrome, in addition to involvement in the process of the urogenital tract and eye mucosa, the joints are affected. One of the manifestations of Lyme disease is arthralgia.

Types of pain in the knees

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

  • Aching . With arthritis, osteoarthritis.
  • Sharp, strong . With fractures of the knee elements, rupture of ligaments, acute bursitis, knee injury, exacerbation of meniscopathy, deforming osteoarthritis.
  • Throbbing When running deforming arthrosis, meniscus injury.
  • Drilling . With osteomyelitis.
  • Stupid . With bursitis, chronic osteochondritis.
  • Burning . When compression of the sciatic nerve, the tuberculous process in the bone.
  • Shooting. With pinching of the nerve trunk.
  • Pain when walking . With Baker's cyst, bursitis, arthritis, gonarthrosis, periarthritis.
  • Pain at rest. With gout, arthritis.

Diagnosis of pathologies that cause pain in the knees

Physical examination:

  • collection of anamnesis and complaints;
  • visual inspection with palpation of the knee.

Laboratory research:

  • biochemical and clinical blood tests;
  • serological examination of blood;
  • immunological blood test;
  • rheumatological tests;
  • bacteriological analysis of synovial fluid.

Invasive instrumental methods:

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

Non-invasive instrumental diagnostics:

  • radiography of the knee joint;
  • densitometry;
  • ultrasound of the joint;
  • MRI or CT scan.

Treatment of pain in the knees

If the pain in one or both knees is of a non-traumatic nature of occurrence, then you should turn first to the therapist, who, based on the patient's complaints and the results of an objective examination, will refer to a specialist - orthopedist, rheumatologist, phlebologist or neurologist. For any knee injury, you should contact a surgeon or traumatologist-orthopedist.

The treatment in each case is different, depending on the cause of the pain, that is, on the type of injury or illness. For each disease has its own treatment regimen. But first, the patient must follow a few general rules:

  • significantly reduce the duration of walking and standing on the legs during the day;
  • athletes temporarily (until recovery) refuse training, and ordinary people from running or jumping;
  • when increasing pain completely abandon movements, put on his knee fixing bandage of elastic bandage;
  • wear a bandage or bandage to immobilize the knee joint;
  • when bruised cold in place of the traumatic impact.

Rheumatoid, psoriatic arthritis , systemic autoimmune diseases require serious complex treatment, carried out for many months. Basic therapy consists of immunosuppressants, nonsteroidal anti-inflammatory and hormonal drugs, gold medications, etc.

In the treatment of bursitis apply painkillers and anti-inflammatory drugs. If an infection is detected, then a course of antibiotics. Medical puncture of the bag is performed to remove excess fluid from the synovial cavity and / or the introduction of one of their corticosteroids. An operation, a surgical excision of the synovial sac, helps to eliminate chronic inflammation of the bursa.

In deforming osteoarthrosis, intra-articular injections of glucocorticosteroids, long-term use of NSAIDs and chondroprotectors are effective. To relieve pain syndrome, locally prescribed compresses with dimexide or bischofite, ointments and gels with anti-inflammatory action. Massage, physiotherapy, therapeutic exercises help. Severe lesions of the knee require surgery - joint arthroplasty.

Treatment of osteoporosis consists of taking bisphosphonates, calcitonins, calcium supplements, vitamin D, etc.

Treatment for meniscus rupture may be conservative or surgical. Conservative therapy consists of the use of analgesics, NSAIDs, hyaluronic acid, chondroprotectors. But first, the joint is repositioned.

Types of surgery:

  • meniscectomy;
  • partial (incomplete) meniscectomy;
  • meniscus transplantation;
  • arthroscopy;
  • arthroscopic stitching of meniscus tear.

For any knee injury after treatment, the rehabilitation period is very important, which should take place under the supervision of a rehabilitologist or orthopedist. The doctor will make the best program to restore joint function. The main methods of postoperative rehabilitation are massage and physiotherapy. Also effective are special exercises that gradually develop the knee joint.

| 19 June 2015 | | 1 837 | Joint diseases
  • | Oleg | November 23, 2015

    useful information saved for going to the ultrasound.

Leave your feedback

Seevetee Tee: Have had chronic pain now in the back of knee (abit deep). Can really feel it when I pull put in for a quad stretch. There is no swelling and I have taken pain killers. When i am sat for long periods of time and try to walk it's so bad i walk with a limp. I cannot seem to pinpoint what the issue is going through youtube and google. I have given it so much time for rest but soon as i begin activities again (even just a brisk walk) the pain returns. I need to know what the issue is so i can seek out rehab measures. Fiji is kinda hopeless for rehab and physiotherapy thus my seeking all kinds of help and being here.

Single Coil: I had a injury where a piece of my knee was chipped off and its floating round my knee area 6mm to be exact and my acl was fraid apparently this was about a year ago and the pain and discomfort went away for ages now im lay up in bed again cant bed my knee feels like it will explode something is pushing me knee cap up HELP

Kaw Umaru: ok so what should I do if I have a kinda sharp pain and crackling sound when i bend it or try to unbend it? and first it was only the pain but after a few years hoping it would go away it started crackling again. i didnt excercise because it hurt and i am a teen so everyone told me its normal it will go away but it got worse and i am not physcially active. do yall think i can still fix it? because only now i started excercised after a few years but even tho i do start excercising i get even a sharper pain ::D I dont think i hit my knee anywhere when it all started i think it just started naturally one day. HELP and i didnt excercise cuz i thought resting would help clearly not

puneet sunny: Very nice , u can also read my article how to get rid of knee pain fast https://www.yogishiv.in/2020/01/get-rid-of-knee-pain-fast.html?m=1

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Colin Rich: My pain started 2 weeks ago when i noticed lower back pain on my left side. I could barely walk as above my knee front thigh area became numb, my left knee felt like it was being pushed in towards my right leg, and the ligament on outside right of left knee felt stretched. I slept on the floor which sorted my back but now i cannot walk on my knee more than a few meters. No swelling. No pain at night. Just very little walking mobility and nothing seems to help. Rest stops the pain but doesnt aid the next few steps. Pain seems concentrated on inside right part of left knee

Wilber nieto lozada: hey ,if anyone else wants to learn about joint aches and pains try Bablim Pain Relief Booster (do a search on google ) ? Ive heard some pretty good things about it and my brother in law got cool success with it.