Knee hurts

Knee pain is a very annoying nuisance that most people experience. They can be sharp, painful, burning, throbbing, limiting joint mobility, appearing only during physical activity or even at rest. But many people, instead of going to the doctor, try to get rid of them with the help of painkillers, namely ointments, gels or tablets of non-steroidal anti-inflammatory drugs. Such drugs, although they have anti-inflammatory properties, are unlikely to affect the pathogenesis of knee pain, and therefore only temporarily contribute to their elimination. Therefore, they can only be considered as a means of symptomatic treatment.

But the cause of discomfort in the knee joint can lie in the presence of various disorders, both directly in the knee, and in the spine or other parts of the body. Therefore, it is possible to develop an effective treatment strategy that will truly eliminate pain only after the exact cause of their occurrence is identified. To do this, you will need to go through a series of diagnostic procedures and get expert advice, but this is the only way you can truly improve your health and avoid the development ofcomplications.

Reason

Knee pain can be associated with a variety of conditions, from osteoarthritis of the knee to conditions of the lumbar spine, sacrum, and pelvis. In addition, the causes of discomfort or even acute pain in the knee can be chondropropathy, arthritis, neuritis and other similar diseases.

The obvious cause of the development of pain syndrome is trauma ranging from bruises and dislocations, to rupture of ligaments, damage to meniscus, or fractures in the joint. But in such situations, the pain is almost always acute and present at the time of impact, fall, or other traumatic factors. Therefore, in such cases, the victim should contact a trauma specialist to treat the consequences of the injury.

So, knee pain is always a sign of a pathological process affecting the cartilage, bone or soft tissue structure of the knee itself, or damage to the nerves within it. Consider the main reasons for their appearance.

Knee arthritis or gonarthrosis

Osteoarthritis, or degenerative joint disease, is one of the most common causes of knee pain. The disease is characterized by the appearance of degenerative-dystrophic processes in the cartilage structure of the joints, as a result of a violation of the outflow of metabolic processes, the effects of traumatic factors in the joints. past, etc. v. Very often, gonarthrosis is diagnosed in middle-aged and elderly people, athletes, and people who do heavy labor.

This disease has a chronic course, tends to progress slowly and eventually leads to marked limitation of joint mobility, violation of the supporting function of the extremities (usually both), as well as pain. . Initially, they are dull, painful, have a pulling nature and appear when moving, accompanied by a crunching sound in the knees, especially when climbing stairs. But if left untreated, the cartilage of the knee joint continues to wear down, leading to increased pain even at rest. Then the destruction of the joint surfaces occurs, which further aggravates the situation and can even cause disability.

A typical feature of rheumatic diseases of the knee joint is the onset of pain, which the patient needs to "relieve" to get rid of these pains. Thanks to this, an improvement is observed within 15-30 minutes.

Gonarthrosis is often complicated by additional inflammatory processes that can affect synovial sacs, ligaments, and tendons. This leads to intense pain, characterized by flare-ups, swelling of soft tissues, and increased local temperature.

Diseases of the spine and asymmetry of the pelvis are the causes of knee pain

At first glance, there is no connection between the lumbar spine and the knees. But in reality that is not the case. They are closely connected by the sciatic nerve (nervus ischiadicus), which is the main nerve of the leg. It originates in the spine and is formed simultaneously by fibers extending from the spinal cord through natural openings in the vertebrae of nerves:

• L4;
• L5;
• S1;
• S2;
• S3.

These nerves pass through the eponymous vertebrae, merging at the level of the sacrum into the neural plexus. From there, the sciatic nerve departs along the back of each leg and enters the inside of the knee. At the same time, this nerve is responsible for sensory (sensory) and motor (motor) functions. Therefore, a violation at any point in its path, especially at the level of the lumbar region, can cause the appearance of pain in the knee. Usually it is associated with the development of:

• Bone tumors, bulging eyes and herniated discs. These diseases are based on degenerative-dystrophic changes in the intervertebral discs located between almost all vertebrae. They are characterized by a systematic decrease in the height of the intervertebral disc and its dehydration, which leads to a decrease in the elasticity of its structures and an increased risk of rupture when subjected to loads. As a result, the vertebrae move closer together, which can lead to compression of the nerve roots that pass through them. If such changes occur in the lumbar region, compression of the fibers that form the sciatic nerve and, as a result, pain in the knee can occur. But this symptom is more common when the process of bone degeneration is complicated by the formation of a protrusion (protrusion) of the disc or its herniation (break of the outer sheath of the disc), because the protrusions can strongly compress the root. the spine directly in the spinal canal and cause the occurrence of serious neurological complications, including knee pain.
• Spondylolisthesis. This is a disease that often develops against the background of osteonecrosis and is a chronic disease. With it, there is an overgrowth of the surfaces of the vertebral bodies adjacent to the discs, and the formation of bony protrusions (bone-forming bones) on them. In severe cases, adjacent vertebrae can grow together, leading to their immobilization and severe compression of the nerves that pass through them.
• Degenerative spine. This term refers to a pathology of the spine, in which the upper vertebra is displaced relative to the vertebra below it. Usually, it is the lumbar region that is affected, leading to encroachment of the nerves that form the sciatic nerve.

Signs that one can suspect the cause of the development of pain in the knee due to the appearance of pathologies of the lumbar spine may also include:

• pulling, aching, sharp pain in the lower back;
• strain, hamstring, quadriceps muscle, occupying the entire front of the thigh and part of the outer surface;
• pain and stiffness in the hip;
• diffuse pain in the legs;
• pain in the upper thigh.

In each case, the set, nature, and severity of symptoms will be different. This largely depends on the individual characteristics of the organism and the degree of nerve compression.

Directly on the defeat of the sciatic nerve can indicate (symptoms can be observed in both only one limb and both at the same time):

• pain in the knees, hips and lower back;
• spasms of the muscles in the back and legs;
• burning on the back of the leg;
• loss of control over bladder and bowel functions.

With violations of the activity of the sciatic nerve, there is often a feeling of instability in the knees, their compression. As a result, the patient complained that he could not fully lean on his legs.

Asymmetry of the sacrum and pelvis can also cause pain in the knee joint. It occurs due to differences in the length of the lower extremities, which may be due to congenital features or curvature of the pelvis, including scoliosis. This leads to one of the legs being overloaded and the cartilage in the knee joint to wear down faster, leading to osteoarthritis.

The abdominal muscles, which are attached to the pubic bone, are responsible for ensuring the stability of the pelvis. When they are weakened by being overweight, a sedentary lifestyle, or other factors, the muscles of the hamstrings become overloaded. This in turn causes overload for the knee joint.

Foot and ankle disease

The ankle joints, as well as the knees, can be affected by osteoarthritis. Often it is diagnosed in athletes, especially ballet dancers, gymnasts, as well as in the elderly. This leads to a violation of the biomechanics of movements, which increases the load on the knee joint and contributes to faster wear of the knee joint. In such situations, a person will be plagued by pain not only in the knee but also in the ankle, which significantly affects gait due to limited range of motion.

Diseases of the feet, especially flat feet and scoliosis, can also increase the load on the knees and cause pain in them. These orthopedic conditions are very common today and in most cases begin to develop in childhood, and worsen in adulthood. Valgus deformity is characterized by a violation of the axis of the ankle joint due to an inward collapse of the foot. This is associated with increased leg fatigue, pain in them, but can then lead to knee pain.

Diagnose

If you experience pain in your knee, especially if it happens often or comes on all the time, you should consult your doctor. If the patient has recently experienced traumatic factors, he should contact an orthopedic surgeon. In other cases, you may be able to sign up for a consultation with a therapist at first. The doctor will assess the patient's condition, collect medical history, and prescribe diagnostic procedures. This will allow him to make a preliminary diagnosis and refer the patient to a specialist whose help will be most effective in a particular case.

But you can immediately contact a neurologist if a person notices the appearance of lower back pain, radiating pain in the legs, burning on the back surface, or other symptoms described above. This will save time and money, as quickly as possible to identify the real cause of the change in well-being and initiate treatment. If the patient notices changes in the foot condition, in addition to knee pain, worry about ankle pain, they should make an appointment with an orthopedist immediately.

In all cases, the physician will study the situation in detail, assess the nature of the complaints, and refer the patient for examination, which may include:

• laboratory tests (UAC, biochemical blood tests) necessary to identify signs of inflammatory processes occurring in the body;
• X-rays of the knee in two views (with suspected pathology of the foot or spine, they are also checked by radiography), are required to evaluate the condition of the bony structures, as well as toidentify indirect signs of a number of diseases;
• CT is used for a more accurate diagnosis of joint diseases, as well as the most reliable assessment of their degree of destruction;
• Ultrasound of the knee joint, which is used to visually evaluate all the structures of the knee, their size, location;
• MRI, is currently the best method for diagnosing various pathologies of soft tissue structures, including knee cartilage and discs.

In some cases, patients may be prescribed arthroscopy, which is an invasive method to diagnose and treat diseases of the knee joint. As a rule, it is required for severe joint disease and injuries caused by injuries to ligaments, meniscus, etc. v.

Treatment

Since there are many conditions that can manifest with pain in the knee, there is no single treatment strategy. In each case, it is developed individually, based only on the nature of pathological changes, their severity, the presence of concomitant pathologies, individual characteristics of the patient, agehis, v. v.

In cases where the pathology of the spine causes pain in the knee, treatment is carried out under the supervision of a neurologist. If they are the result of joint disease, other pathologies of the knee, ankle, or foot joints, then treatment is indicated by an orthopedist.

When diagnosing pathologies of the spine or pelvis, the patient, in addition to consulting a neurologist, may also be recommended to see an endocrinologist, who will help with the problem of overweight.

All patients with diseases of the spine, orthopedic pathologies, including osteoarthritis of the knee joint, receive complex treatment, which may include:

• drug treatment;
• physical therapy;
• exercise therapy;
• manual therapy.

Each measure was individually rigorously selected for diagnosis and degree of ignoring pathological changes. And with grade 2-3 knee osteoarthritis, knee manipulation is often indicated additionally.

Medical therapy

Drug treatment usually includes 2 areas: treatment of symptoms and treatment of the cause. The first is aimed at quickly improving the patient's health, eliminating knee pain and other existing symptoms. The goal of the latter is to act directly on the causes of the development of disorders and to normalize the patient's condition in the long run.

Therefore, in most cases, the patient is prescribed a complex of drugs:

• NSAIDs are symptomatic therapy that allows you to quickly get rid of pain in the knees, lower back, feet and have an anti-inflammatory effect.
• Corticosteroids are drugs with strong anti-inflammatory effects, are indicated in severe inflammation and are usually injected into the joint cavity. They are applied in short courses.
• Chondroprotectors are products that contain components that are used by cartilage tissue for regeneration. They are appointed by long courses, usually at least 2-3 months in duration.
• Muscle relaxants are medications prescribed to contract the muscles in the back and hips, which is usually a reflex response of the body to pain-causing impulses.
• Complex vitamins are drugs indicated to improve metabolic processes in the body, as well as to transmit bioelectric nerve impulses along the nerves.

Plasmolifting

Plasmolifting is the injection of plasma taken from the patient's own blood directly into the affected knee joint or the soft tissues around it. Due to the saturation of plasma with platelets, cytokines and growth factors, it contributes to:

• stimulates the flow of natural regeneration processes;
• restore the normal composition and volume of synovial fluid;
• activates blood circulation and nutrition of articular cartilage;
• eliminate inflammation;
• pain relief;
• restore normal range of motion in the affected joint;
• reduce the treatment time by 2-3 times.

PRP therapy, also known as plasmolifting, is the perfect complement to the treatment of osteoarthritis of the knee, so it is often included in the treatment regimen for this disease. It can also be used in the treatment of osteonecrosis of the spine and trauma, complementary medicine therapy, physical therapy, exercise therapy and other treatments.

Physical therapy

To treat diseases of the musculoskeletal system that cause knee pain, various types of physical therapy procedures can be used. They increase the effectiveness of other treatments and have a positive effect on the affected area. Physiotherapy is always prescribed in courses of 7-15 courses, individually selected. Usually they seek help:

• acupuncture therapy;
• therapeutic ultrasound;
• UHF;
• phonophoresis;
• electrophoresis;
• SMT therapy or amplipulse therapy;
• vibration massage.

exercise therapy

Physical therapy exercises play an important role in the treatment of diseases of the joints in general and the spine in particular. It allows you to doseably increase the range of motion, as well as stimulate blood circulation, which leads to the nutritional activation of all the structural elements of the knee joint and thus contributes to their regeneration.

But it is important to choose the optimal set of exercises that will be most useful in this situation and will not cause harm. Patients may be advised to perform stretching exercises, which are especially important for spinal conditions. In addition, exercises are almost always indicated to strengthen the musculoskeletal system. They contribute to the formation of a strong muscular frame, helping to reduce the load on damaged joints and facilitate their recovery.

Physiotherapy classes are simple and accessible to people of all ages, as a tailor-made program ensures a dose that has a positive effect on the diseased joints and eliminates the problems. Exercise can be harmful. But in order to master the methodology of each proposed exercise as accurately as possible, it is advisable to conduct the first classes under the supervision of an exercise therapy instructor.

In the future, you can practice at home, in nature or any other suitable place, but every day. Systematicity is one of the basic rules for the success of physical therapy exercises. So it must be added to your list of daily activities and given the appropriate time - usually 20-30 minutes is enough. During classes, it is important to avoid sudden and hasty movements, as this can cause pain and worsen the condition.

Manual therapy

Manual therapy plays one of the important roles in correcting pelvic asymmetry and treating spinal diseases. It involves an in-depth study of the muscles of the back, ligaments and joints of the spine, pelvic region under the hands of a specialist. There are many methods and techniques of manual influence. They are selected depending on the type and severity of the existing pathology.

Thanks to the course of manual therapy sessions, you can:

• eliminates back pain by reducing pressure on nerve fibers;
• improves nutrition of all structures of the spine due to activation of blood circulation;
• increased mobility of the spine;
• improve posture by eliminating spinal deformities;
• restores the normal position of the pelvis and internal organs, has a positive effect on their functioning.

But the most important effect of manual therapy for knee pain patients in consultation with their doctor is to remove the compression of the sciatic nerve and the fibers that form it. This leads to a gradual improvement of the condition and elimination of the pain syndrome, as well as other neurological disorders.

Patients notice the first positive changes after the first session. Other procedures contribute to its growth and stability for a long time. The first procedures can be performed only after the elimination of acute inflammation with the help of drug therapy, physiotherapy and other methods of treatment.

So, knee pain is not only indicative of its failure, but also a sign of problems in other parts of the musculoskeletal system, namely the spine and feet. In any case, they cannot be ignored, since existing pathologies, without competent treatment, tend to progress over time. This will lead to increased pain levels, appearance of other unpleasant symptoms, and generally a decrease in the person's quality of life. Therefore, if discomfort occurs in one or both knees, you should consult a doctor: an orthopedist or a neurologist. Timely treatment at an early stage of the development of pathological changes will allow you to reverse them and completely restore the normal functioning of the joints, ensuring freedom of movement for many years.