Pain under the knee. Why does my knee hurt? Causes and treatment of soreness in the knee region

Pain under the knee is caused by many reasons, because the knee joint, according to physicians, is considered the largest joint of the human body and complex in its structure. Our knees are subjected to daily stresses, which is why their greater susceptibility to injury and vulnerability for all kinds of inflammation occur. And following them and the degenerative processes in the cartilage, as in the knee joint itself - the rubbing heads of the femoral and tibia bones, and its articular bag.

Complaints about pain sensations under the knee, directly in the knee joint, according to experts, account for about a third of all complaints of all ailments in the lower extremities. Of course, people who lead an active lifestyle - professional athletes, middle-aged people with the presence of chronic foci of infection in the nasopharynx, elderly citizens with diseases, whose treatment requires special drugs with a pronounced adverse side effect, suffer, primarily from painful manifestations in the knee area.on bone and cartilaginous tissue. Well, plus the age changes. What can you do!

1. Question: "Which doctor should be treated with the problem in question?"
2. Answer: "To the surgeon, traumatologist, if lucky, to the doctor orthopedic trauma".

Why the knee aches: what causes the pain under the knee can be

Pain sensations in the knee are due to the change, damage to the cartilage, periarticular bag, tendons, muscles, vascular system and are associated with various provoking factors, among which may be:

1. Traumatic injuries as a result of intense physical exertion, non-observance of the rules of warm-up before active, long training.
2. Injuries caused by injury, stroke, accident, fall.
3. Inflammatory process in the joint - osteoarthritis, gout, rheumatoid arthritis.
4. The inflammatory process in the periarticular bag is bursitis.
5. Cyst Becker( popliteal growth) caused by arthritis.
6. Rheumatoid arthritis, systemic lupus erythematosus.
7. Infectious process in the joint( psoriasis, venereal diseases).
8. Shift of the patella.
9. Meniscus damage.
10. Tendonitis( inflammation in the tendons).
11. Tendonosis( tendon rupture).
12. Schlatter disease.
13. Stretching, rupture of ligaments.
14. Fracture of the kneecap.
15. Patella patella( knee cap) - deformation, softening of articular cartilage.
16. Tumor of bone tissue.
17. Excess body weight as a factor provoking damage to the patella-femoral joint.
18. Osteochondrosis of the lumbosacral spine.
19. Diseases of the hip joint.
20. Syndrome "knee bicyclist" - syndrome of ileal-tibial ligaments.
21. Varicose veins.

Despite all the variety, the causes of pain under the knee are most often associated with inflammatory or traumatic damage to the tendons, as indicated by the localization of the pain symptom.

Pain in the leg below the knee

The pain symptom area below the knee in the diagnostic sense is quite specific, in contrast to the pain in the joint itself. The most common pain in the leg under the knee, associated with diseases or damage to the tendon-ligament apparatus.

Tendons are the textus connectivus or connective tissue of striated muscles, responsible for the compatibility and attachment of bone and muscle tissue. Tendons are very strong, but not capable of strong stretching, this causes their sensitivity to inflammation, trauma, sprains and tears. In addition, leg pains below the knee may be associated with a serious condition - meniscus rupture, patellar fracture, dislocation or inflammation in the periosteum( schinsplint).

Diseases of the knee tendons are typical problems of professional athletes, in rheumatological practice there are even definitions describing the strictly specific symptomatology and etiology of pain in the knee region:

1. STIT is runner syndrome or friction syndrome of the orotibial tract.
2. Tendonitis of the patella - "knee jumper"( less often a basketball player).
3. Chronic tenosynovitis is the "swimmer's knee".

In addition, pain in the leg under the knee is often associated with varicose veins, which is manifested by pulsation, severity, pulling sensations, increasing with the static position of the body - while standing, sitting.

Pain under the knee, how is it manifested?

Signs and symptoms of pain under the knee should be differentiated for more accurate diagnosis.

Types and nature of pain symptom below the knee joint:

No.	Variety of pains	Reasons, comments
1	Aching, drawing pain	Signs of the developing inflammatory process in the arthrosis joint, arthritis of rheumatoid etiology.
2	Strong, sharp pain	Characteristic in cases of traumatic injury, ligament tears, tendons, and also for fracture.
3	Acute pain below the knee	May be a sign of meniscus damage or be a reflected pain in the radicular syndrome( lumbar radiculopathy).

In addition to the pain sign of the disease of the knee joint are accompanied by a decrease in functional mobility, stiffness, when extension, flexion of the foot is greatly hampered.

Symptoms of pain under the knee, along with other clinical manifestations - reddening of the skin, swelling, bruising, atypical position or appearance of the knee are important diagnostic indicators that help the doctor to accurately establish the root cause and prescribe adequate treatment.

There are certain conditions that can not be treated independently, as they can lead to serious complications and loss of motor function.

Symptoms and signs requiring medical attention

1. If the pain below the knee is not intense, however, it does not go away within 3-5 days.
2. If the pain increases during the day and is accompanied by an increase in body temperature, a general malaise.
3. If the pain symptom below the knee joint does not allow you to step on the leg, it immobilizes a person.
4. When the pain is accompanied by a strong swelling of the joint.
5. The pain symptom is acute, intolerant, the knee is deformed, the leg becomes uncharacteristic.
6. If severe pain occurs when you descend or climb up.

Pain under the knee when flexing

Pain in the joint itself, pain under the knee during flexion is associated with the fact that the muscles of the knee joint work in two directions - concentric and eccentric. Bending is an eccentric contraction of the muscular apparatus.

The pain symptom may be due to poor preparation, insufficient warm-up, warm-up before training, when sudden movements occur. Less often the cause of pain during eccentricity( flexion) is a prolonged static tension of the muscles, ligaments and tendons( stagnation).In addition, undergoing a load, the patella squeezes the inflamed articular surface, which complicates the normal slip of the structural parts of the knee and provokes a pain symptom.

As a rule, in such cases, pain under the knee during flexion is associated with gonarthrosis, the inflammatory process of the knee. Painful sensations are dull, permanent, if they are not diagnosed in time and not treated, arthrosis of the knee can lead to serious deformation of the joint structure, damage to the cartilaginous tissue and a state in which it is difficult, and sometimes impossible, to straighten the legs completely. There is a typical gait "on the half-bent" legs, characteristic for gonarthrosis in the advanced stage.

Pain under the knee in the front

The front part of the knee joint, pain under the knee in the front is most often provoked by the following functional disorders, diseases:

1. Weakness of the medial head( caput mediale) of the extensor, which causes pressure on the lateral parts of the patella and disturbs its movement. If head atonias and mechanical pressure become chronic, softening develops, deformation - chondromalacia of the patella.
2. Patella instability, its displacement due to constant rotation of the tibia. Most often, this violation is associated with sports.
3. Tendonitis, which manifests as pain in the knee, pain under the knee in front. The pain symptom can be aggravated by physical exertion, lifting or descending the stairs.

Pain sensations under the knee at the back

The causes that cause pain under the knee from behind are clinically well studied and are usually caused by meniscus damage or sprains, ligament rupture.

In addition, the pain symptom, localized behind the knee, indicates a neoplasm - Becker's cyst. The cyst is formed in the inflamed tendon-ligamentous apparatus of the knee, in the popliteal fossa due to the long, chronic inflammatory process in the mucous bag - arthrosis. There exudate accumulates, which, when assembled, protrudes into the interior.

This not only prevents the normal movement, but also causes first transient, tingling pain, then numbness. In the deepening of the knee joint, the formation, a painful touch, is clearly palpable. The Becker cyst is diagnosed with the help of an X-ray and the introduction of a contrast medium into the soft tissues.

In the initial stage, pain under the knee from behind is treated with conservative methods, in severe, neglected cases, puncture is required, in which exudate is pumped from the cavity, a corticosteroid drug is administered inside.

It is possible and surgical intervention, when the cyst grows to a large size and contains pus. In addition, after relief of the pain symptom, a basic treatment of the inflammatory process in the joint itself and in the body as a whole is necessary.

Drawing pain under the knee

Drawing pain under the knee is associated with arthritis or degenerative processes in the meniscus. The zone of the inner part of the knee is considered the projection of the medialis, the inner meniscus, and the inner collateral ligament.

A characteristic symptom of damage to the medial meniscus is the pulling pain under the knee when descending from the elevation, the stairs. As a rule, X-ray examinations in the initial stage of the process do not show cartilage degeneration, therefore, with persistent, prolonged pains, arthroscopy is appointed, which helps to accurately establish and confirm the deformation of the internal meniskos - the cartilaginous joint lining.

Also, the pulling pain under the knee can be caused by osteochondrosis of the lumbar spine or a more commonplace cause - flatfoot.

Also drawing painful sensations at the bottom of the knee joint are typical for venous congestion - varicose, which develops in office workers who are forced to sit for more than 7-8 hours in the same position, such symptoms are typical for drivers spending most of the time behind the wheel. In these situations, regular workouts, preventive massages and examinations are shown.

Arthritis, which provokes the pulling character of pain under the knee, is most common in the elderly, since this process is associated with age-related changes in bone and muscle tissues.

Pain under the knee while walking

A common cause of persistent pain under the knee is progressive gonarthrosis. This is especially true for people older than 40-45 years old, who, according to statistics, have a knee joint deforming lesion of 30% causing pain under the knee when walking. The symptom can develop as in one knee, and be felt in both legs.

The onset of the disease is asymptomatic, the person practically does not feel any discomfort, only the temporary aching pain can signal the development of arthrosis, but, as a rule, they are "written off" for fatigue, fatigue. The cause of gonarthrosis is intraarticular progressive deformation of cartilage and bone tissue, associated with age-related changes, including hormonal changes.

Associated pain symptoms are:

1. Periodic crunch in the knee joint when walking, squats.
2. Slight limited mobility of the knee( knee).
3. The knee begins to hurt not only when walking for long distances, but also when getting out of bed, chair.
4. The zone below the knee is very sore when lifting weights from the position - squatting.
5. Pain under the knee during walking is accompanied by painful sensations when climbing the elevated terrain, the stairs, and also during descent.
6. The pain begins to acquire a character that is constant, aching and subsides only in the supine position, at rest.
7. In the acute stage of gonarthrosis, pain can manifest at night as acute, severe.

The differentiation of pain below the knee during walking is simple enough:

1. Vascular changes do not provoke pain intensification over time, with age.
2. Pain associated with fatigue, passes at rest and does not recur.

Severe pain under the knee

Severe pain under the knee can be caused by multiple causes, but most often they refer to injuries, ruptures, fractures.

If the knee is seriously injured by a bruise, stroke or fall, it is the severe pain under the knee, in the joint itself, in the surrounding tissues that serves as the first signal requiring immediate medical attention. The cross-section of a strong pain symptom develops puffiness, there may be hematomas.

Also a factor provoking strong painful sensations below the knee, there may be such diseases:

1. Purulent infectious process in the joint, which, in addition to pain, causes hyperthermia of the body, febrile state, general intoxication of the body.
2. Bursitis in the stage of exacerbation, which is accompanied by severe pain in squats, moving up or down the stairs, often with prolonged walking.
3. Osteoarthritis, manifested as severe pain under the knee in the morning or at bedtime. During the day, the pain symptom, as a rule, subsides, but the knee is edematous, can hurt with palpation, is limited in mobility.
4. Rheumatoid arthritis, which is considered an autoimmune disease, affects not only the knee joints, but also other joints of the human body. In addition to severe, intolerable pain, rheumatoid arthritis provokes hyperemia of the skin around the knee, deformity of the knee.
5. Dislocation of the kneecap is full or incomplete, associated with a professional factor( sport, dance, ballet).Severe pain under the knee, above the joint, almost complete immobilization, joint deformation, swelling are characteristic signs of a traumatic patellar injury.
6. Sprain or complete rupture of ligaments in a fall, impact in the area below the knee. In addition, ligament rupture can be caused by a sharp turn of the foot with a strong knee stroke( most often - a collision in the sport).
7. Damage, rupture of the meniscus, which is accompanied not only by a strong pain symptom, but also hemorrhage( hemarthrosis), swelling of the joint. Balloting( loss of stability) of the patella is due to the fact that exudate and blood accumulate in the cavity of the joint bag.

Pain under the knee of the knee

The knee is a patella, as it is called rheumatologists, osteopaths, surgeons. The patella is a structural part of the knee system, which is held by Musculus quadriceps femoris, the tendons of the quadriceps femoris. The calyx is responsible for the normal slip of the tendon-ligament apparatus.

If the cartilaginous patella of the patella is damaged, chondropathy develops, smooth and painless gliding, joint movement is disturbed, pain under the calyx is increasing. Symptoms of chondropathy can be such clinical manifestations:

1. Pain under the calyx, in the joint itself with intense physical activity.
2. Characteristic sound of "friction" under the cup.
3. Painful sensation when palpating in the area under the kneecap.
4. Puffiness of the joint, accumulation of exudate.
5. Decreased muscle tone, atrophy.

In addition, pain under the knee can be triggered by patellar instability with complete or incomplete subluxation. The causes that cause a pathological slope or a subluxation of the patella may be as follows:

1. Does overgrowth a detachment of the outer ligament that supports the knee cap.
2. Atrophy of the outer ligament.
3. Atrophy of Musculus vastus medialis - internal( medial) wide thigh muscle.
4. Anatomically irregular structure, the shape of the legs.
5. Valgus form of legs( X-form).
6. Hip dysplasia of the hip joint, condyles of the hip.
7. The displacement( luxe) or too high a patellar position is patella alta.
8. Anatomical pathology of the lower leg, flatfoot - rotation of the shin( "zagrebvanie" stops inward when walking).

Apart from the fact that the slope, subluxation causes pain under the calyx, a person can feel a painful symptom pouring under the patella or in the entire joint, hear a crunching or clicking. But the most characteristic sign of subluxation is the feeling of instability, the mobility of the patella.

Drawing pain under the knee at the back

The pulling character of the pain in the zone under the knee joint can be associated with the osteochondrosis of the lumbosacral spine. Infringement of the nerve roots provokes an irradiation symptom, which feels like a aching, pulling pain under the knee at the back in the course of the arrangement of the nerve endings.

Varicose veins

Also, pain associated with the posterior zone under the knee can be caused by varicose veins, vascular pathology. These diseases need differential diagnostics with the help of angiography, ultrasound of the vessels and x-ray of the knee joint, lumbosacral zone.

Cyst Becker

Drawing pain under the knee from the back is a characteristic sign of Becker's developing cyst, which at the initial stage is formed asymptomatically, only occasionally manifesting as pulling, periodic pains. As the formation increases, there is pressure on the nearby nerve endings, this is accompanied by painful sensations behind the knee joint, numbness and a feeling of tingling in the feet. Movement of the knee becomes limited, especially difficult to bend the leg. A large sized cyst can be seen with the naked eye, it is painful on palpation and often causes swelling of the entire joint.

Aching under the knee

The aching nature of pain can be associated with an inflammatory process in the periosteum of the knee joint. Aching under the knee, a constant, lasting for hours, poured into the thigh gives a lot of unpleasant sensations to the patient, and can also be accompanied by a restriction of leg mobility during the extension process. Inflammation of the periosteum requires accurate diagnosis and timely treatment, as it can lead to complications up to the complete immobility of the legs.

In addition, aching pain under the knee can be caused by such factors, diseases:

1. Rheumatoid arthritis, which provokes debilitating, aching pains in the affected joints, including the knee, under it. To date, medicine has studied more than 100 species of arthritis, but rheumatism is one of the most difficult in terms of therapy, since it affects all joints, even small ones, and is considered a systemic disease. Rheumatoid arthritis rarely affects one knee, most often it develops immediately in several large joints.
2. Osteoarthritis is a type of osteoporosis, which also has the definition of degenerative arthritis. This is the most common type of arthritis, which provokes aching pain under the knee. Wear of cartilage tissue develops gradually over many years and manifests itself in the form of aching, periodic sensations. In the stage when the cartilaginous tissue of the knee deforms and practically disappears, strong paroxysmal pains appear, which again replaces the aching pain under the knee. Osteoarthritis "reacts" to many factors - changes in weather conditions, heat, cold, overstrain, static stress and so on.
3. The initial stage of chondramalation is another form of arthritic deformation of the cartilage, which is manifested by pain under the knee and is often localized between the thigh and the patella. Chondromalacia is also provoked by injuries that have not been treated, "neglected."The consequence of such traumatic injuries of the cartilaginous tissue is softening of the cartilage, aching pain of the popliteal with active movements - running, jumping. In neglected form, this pathology can lead to disability and complete immobilization of a person.

Pain under the left knee

Most often knee joints hurt at the same time - right and left. However, pain under the left knee is a rather common phenomenon in such diseases:

1. Irradiating symptom, characteristic of radicular syndrome with lumbargia, radiculopathy, osteochondrosis of the lumbosacral spine. Lumbago can signal himself shooting pain in the knee region, not showing up at the primary site of the infringement of the intervertebral disc.
2. Vascular symptom, which indicates venous congestion, occlusion of the artery. Pain under the left knee can grow with physical exertion - walking for long distances. The painful sensations are aggravated by the bending of the leg when climbing upwards - along the stairs, with the raising of the foot when stepping over the obstacle. A characteristic feature of the pain symptom - a quietness at rest or when the movement stops, because of this, the clinical syndrome of this disease was called the "sickness of the windows": you go sore, stop to consider the window - there is no pain. It is for varicose and vascular pathologies of the lower extremities that unilateral pains, such as pain under the left knee, are characteristic.

Pain under the right knee

Unilateral pain under the knee is most likely associated with vascular pathologies or with the formation of the popliteal cyst.

Cyst Becker( Baker) is a neoplasm that has an inflammatory, less often traumatic, infectious etiology. The cyst is formed in the posterior part of the knee joint, if it is formed in the right leg, pain under the right knee is an unavoidable symptom that initially is not manifested, but as the cyst grows, it grows.

In the popliteal fossa, a noticeable densification develops, the skin is not hyperemic, it easily shifts over the formation, it is not soldered to it. The cyst is noticeable with a straight leg, an unbent knee, if the knee joint is bent, the cyst seems to fall into it and can not be seen.

Cyst Becker can cause injury, meniscus damage in mild form, synovitis, osteoarthritis, rheumatoid arthritis. Pain under the right knee, associated with a small cyst, usually does not cause severe discomfort, only a feeling of pressure. There are slight difficulties with the movements, but they do not limit the mobility of the knee.

A large cyst provokes a sensation of tingling, numbness, and cold, which indicates a clear violation of blood circulation in the tissues of the foot. As a possible complication of the developing cyst can be called thrombosis, thrombophlebitis.

Pain under the right knee is also provoked by arthrosis in the initial stage, which can "start" with one leg, but then spread to both joints. Complicate the condition with arthrosis overweight, varicose veins, which can be an independent cause of pain in the knee joint of one leg.

Varicose is characterized by aching, drawing pains, which can increase with exercise. Usually, varicose dilation develops more intensively in the supporting leg, which is the main load when walking, performing exercises. At rest, in a horizontal position with raised legs( leg), the pain subsides, and it goes away if a person "pushes", that is, activates the blood circulation consciously.

Severe pain under the knee

Severe pain under the knee is a symptom that requires not only medical advice, examination, diagnosis, but also immediate help.

Among the reasons provoking sharp, severe pain in the knee, under the knee, the most dangerous are injuries, injuries and diseases:

Traumatic cartilage damage - meniscus

To damage, tear the meniscus, you can not only engage in professional sports, but also in everyday life with a sharp, unsuccessful turn, jump( landing) and even bending over or crouching.

Violation of the structure of the meniscus is manifested by sharp pain, immobilizing all knees, especially its extensor function. The knee joint swells quickly, it hurts even when touched. The meniscus injury should be treated as quickly as possible, since in a neglected form it leads to complete immobilization of the leg.

cold , reception of analgesic preparation ( non-steroidal anti-inflammatory drug) and immediate contact with is indicated as first aid. As a rule, an x-ray of the knee is prescribed, which shows the state of bone tissue, not cartilage. The state of the meniscus is checked by ultrasound.

The treatment depends on the severity of the injury. If the sharp pain under the knee is accompanied by extensive swelling and flushing of the skin, a dislocation is possible, it is corrected. A meniscus rupture may involve surgery, in which parts of the cartilage are reconstructed and sewn together. After the first stage of treatment, therapeutic exercises, physiotherapy, observance of the gentle exercise on the knee are shown.

Tears in the ligaments of the

A sharp pain under the knee is also characteristic for rupture of ligaments, which can be triggered by a fall on the knee joint, a blow to the joint, and a turn in some sports( hockey, football).

Symptoms of knee ligament rupture may be severe, acute pain, swelling of the joint, tenderness when flexing or flexing, clicks or crunching when moving. If the ligament is broken completely, a hematoma develops gradually at the site of the lesion.

As first aid, can apply ice, cold, take an anesthetic and immobilize the knee at right angles to the .Cold compress is designed to relieve edema, prevent intraarticular hemorrhage, a tight bandage helps reduce the pain symptom. Obligatory is a visit to the doctor, diagnosis of damage and treatment. It is believed that the most dangerous rupture is the violation of the integrity of the cruciate anterior ligament, which is restored and heals extremely slowly and difficultly.

Acute pain under the knee

Any acute pain is a signal that the disease is acute, the inflammation quickly or the injury requires urgent medical attention. Not an exception and acute pain under the knee, which is provoked by the factors described below.

Knee joint fracture

The patella is most often injured as a result of a fall from a height or a bent knee. In traumatology, horizontal fractures of the patella are most often diagnosed, which manifest themselves as acute pain under the knee, in the region of the knee itself.

Horizontal fracture is accompanied by a displacement of fragments and is treated only with fixation( gypsum).

Complex fractures may require surgery, complications can lead to endoprosthetics.

Also, a fracture can be accompanied by a detachment of the kneecap, when the injury line passes down and provokes severe pain just under the knee.

Multiple patellar fracture of the patella is less often diagnosed, it is provoked by the impact of a very large force, requiring high speed, application energy.

The vertical fracture is located from top to bottom, it does not lead to displacement.

The most rare variant of a patella fracture is an osteochondral type of trauma caused by the already developing process of deformation and degeneration of bone tissue in arthritis and osteoarthritis.

Symptoms of fracture are typical:

1. A sharp, sharp pain under the knee.
2. Puffiness, which develops rapidly.
3. Internal bleeding in the joint bag, in the cavity - hemarthrosis.
4. Leg deformity.
5. Deformation of the joint( zapadenie inward fragments).
6. Hematoma, penetration of blood into the subcutaneous tissue. The bruise extends down the leg, up to the foot.
7. Possible loss of knee and leg sensitivity in general.

First aid for a fracture - a doctor's call, cold on the place of injury, immobilization of the knee and legs. The prognosis of patella fractures is usually favorable, provided timely medical assistance is provided.

Synovitis of the knee joint

Synovitis of the knee - inflammation of the inner part of the joint and accumulation of exudate in the cavity. Sharp, acute pain under the knee, febrile condition, immobility of the foot requires immediate treatment, in the advanced stage the synovitis can provoke deformation of bone and cartilaginous tissue, development of arthrosis.

Professional injuries of those who are familiar with sports, ballet, dancing - dislocation, subluxation, incomplete dislocation of the knee cap( patella).Symptoms that demonstrate dislocation - severe pain under the knee, in the joint, difficulty in moving, pain in the leg when advancing. The knee strongly swells, deforms.

As first aid cold packs are shown, fixing the knee with the help of the tire on the location from the buttock to the ankle, taking an anesthetic drug. Self-directed dislocation is unacceptable, as this can provoke rupture of ligaments and further surgical intervention. Only the traumatologist, orthopedist, surgeon can inspect the injured patella after examination, and the diagnosis of damage. Medical measures for dislocation, subluxation suggest the relief of a sharp pain symptom, fixation of the joint for a month or more. Even massage, physiotherapy procedures are prescribed.

Acute pain under the knee can be caused by other pathologies of bone tissue, tendon-ligament apparatus in the stage of exacerbation - arthritis, bursitis, osteoarthritis, tendinitis.

Pain under the knee with a squatting

Pain in the knee, pain under the knee during squats due to excessive strain on the joint, which may already be inflamed or injured.

The cause of the pain is microdamage of the cartilaginous tissue, tendonitis, bursitis in the initial stage. If the pain is felt periodically and does not bother, it indicates that the disease is only developing, forming and there is the possibility to stop it at an early stage. Pain symptom when squatting - this is a fairly common, typical complaint of people involved in sports, fitness. Causes of pain when squatting:

Illiterate performance of strength exercises, non-compliance with technology. For example, there are training options, during which the knees should be parallel to the foot, looking forward. A sharp angle when squatting, breeding the knees can provoke an additional load on the joint and cause painful sensations.

Acute, severe pain in the sitting indicates a traumatic injury - a rupture, or at least a sprain. If, after straightening, the pain does not go away, you must apply a cold compress to your knee and seek medical help and get a diagnosis.

Constant pain under the knee when squatting signals a possible disease - Schlatter disease. Especially if the pain symptom is accompanied by a descent from the staircase, from the threshold. Schlätter's disease is poorly understood and is most often diagnosed in young people.

Pain under the knee when squatting, accompanied by a crunch, most likely speaks of developing arthritis. The initial stage of arthritis is characterized by transient pains, especially after loads on the joint.

Pain in the sitting can be associated with fashion, this applies to the fair sex, who experiment with walking on heels of unthinkable height. Shoes with heels above 6 centimeters are considered traumatic from an orthopedic point of view and can provoke persistent pain in the knee joint, below the knee.

A metabolic disorder that leads to a weakness of the muscular, tendon-ligamentous apparatus is also one of the causes of squatting pains.

If the pain under the knee during squats is caused by simple overload or incorrect exercise, the symptom is easily and quickly eliminated.

Persistent pain, not associated with a pathological etiology, can be removed with the help of cold compresses, fresh cabbage leaves, warm, relaxing baths. Also exercises in prone position are effective - "scissors"( cross flaps) and "bicycle".In uncomplicated cases, when the disease causing pain is in the initial stage, enough physiotherapy procedures, the use of ointments, gels. Running forms of the disease - arthritis, bursitis, trauma, require a long-term comprehensive treatment.

Pain under the knee with extension

Pain sensation in the knee joint, below it is most often associated with meniscus damage, gonarthrosis and other disorders of the knee structure. In addition, that extension becomes painful and difficult, the knee swells, with a meniscus clearly visible accumulation of exudate.

The extension pain is also typical for damage to the ligamentous apparatus, especially when the cruciate ligament is stretched. PKS - anterior cruciate ligament injury is typical for those people who are engaged in sports exercises, train a lot. A sharp stop during a fast, vigorous movement, excessive rotation provokes pain when extending. The posterior ligament( ZKS) can also be damaged, but it is much stronger and more elastic, so it rarely ruptures or sprains. Her injuries can be caused by a fall, accident, a strong high-energy impact.

The main signs of damage to the PKC( anterior cruciate ligament) - a characteristic click, puffiness, pain in the extension of the leg, instability of the knee joint. If the rupture occurs instantaneously, painful shock, vomiting, and even loss of consciousness are possible.

Arthritis in the stage of exacerbation, bursitis can also be factors that cause the pain symptom in the extensor movements. Differential diagnosis in such cases is accurate enough, additional methods of knee joint research only help to clarify the nature, stage of the disease and give direction for effective therapy.

Aching under the knee at the back

Aching under the knee at the back, clearly localized in the popliteal fossa is a symptom of Becker's cyst. It is a benign tumor, a neoplasm that fetters the movement of the foot, provokes non-intensive pains, and in the initial stage proceeds without clinical manifestations.

The cyst is almost invisible in the first months, it can be detected randomly by palpation in the forward position of the foot. If the leg is bent, the tumor as if "falls through" in the popliteal fossa and is not noticeable. Skin over the cyst is not hyperemic, there is no swelling in the joint, in principle, the leg looks healthy, only the transient aching pain under the knee from behind can be the first signal of the disease.

The reason for the formation of a cyst is a meniscus injury or arthritis in the first stage, rarely synovitis. The pain becomes more noticeable if the cyst grows and grows in size, squeezing the nerve endings and disrupting the normal blood supply to the joint and legs as a whole.

If Becker's cyst does not begin to be treated timely, it can lead to serious, severe complications - varicose veins, thrombosis or rupture of the cyst walls. The rupture of the capsule is accompanied by sharp pain and hyperthermia.

In addition to cysts, aching pain behind the knee joint is often provoked by bruises, hematomas, traumatic origin.

Sharp pain under the knee at the back

Severe pain under the knee is diagnosed in the rear for serious injuries, injuries - fractures, tears, dislocations.

In traumatological practice, there is a concept - a triad of damage to the knee joint. This is a complete rupture of the anterior cruciate ligament, a complete detachment of the collateral medial ligament and a trauma to the meniscus.

This pathological complex is typical for professional athletes engaged in active, traumatic sports - football, hockey, baseball, fighting sports.

In the syndrome of the triad, there is a sharp pain under the knee at the back, a pain symptom in the entire joint, as well as a typical sign of the "front drawer", displacement of the axis of rotation, deformation of the leg, especially with the extension test.

For the triad, the effusion is not characteristic, it is compensated by a complete rupture of the medial capsule, as a result of which blood flows from the joint cavity. Such complex injuries require immediate hospitalization, often surgical intervention.

In addition, severe pain under the knee at the back can be associated with a rupture of the Becker cyst capsule, a condition that is not common in practice. As a rule, the neoplasm begins to heal at the stage of increase in size, but in a neglected state, the accumulated exudate can break through the cyst wall and cause severe pain in the back of the knee joint.

Pain under the knee laterally

The lateral location of pain in the knee joint is most often diagnosed in athletes with ligaments and tendons exposed to intense stress.

Pain under the knee from the side is accompanied by difficulties in extension of the leg, pulling sensations during long walking and rarely transformed into an acute pain symptom. In addition to athletes, such pain affects office staff, forced by duty to be in a static position, which also affects the knee joints. Also complaining of aching lateral pain in the knee area are taxi drivers, public transport drivers, in short, those who sit at the wheel in the same pose for a long time. This is a typical factor provoking the characteristic pains of lateral localization, it is called a static overstrain.

As a result of statics, muscles, body vessels do not receive proper blood supply, with chronic static postures, especially in a sitting position, thrombophlebitis often develops, and a pain symptom under the knee from behind is a secondary manifestation of the underlying disease.

The reason that a person feels pain under the knee laterally may be osteochondrosis, bruising or temporary muscle strain. Very rarely, such symptoms provoke varicose veins due to their anatomical location in other areas.

Severe pain under the knee at the back

If the knee is hurting in the lower part of the back, this is a signal of severe damage to the ligament, tendon, less often a rupture of the Becker cyst or septic bursitis.

Acute pain symptom, which can be localized at the site of the injury, but then spread laterally and behind the knee, is characteristic of the extension and rupture of the PKC - the anterior cruciate ligament. Trauma PKS, even partial immediately accompanied by a strong swelling, all knee swelling, there is a strong pain under the knee in front and behind. However, the posterior localization of pain is more typical for rupture or distension of the posterior sacral ligament, traumas of this kind are manifested in the form of severe edema in the popliteal fossa, instability of the patella and a strong pain symptom.

Large sized Bekker cyst with purulent exudate is also one of the reasons that causes acute, intense pain under the knee from behind. The cyst may be festered due to developing arthritis, concomitant skin lesions or as a result of constant mechanical compression during exercise - sports, professional activity. The severe pain of any localization requires medical attention and timely treatment.

Pain and swelling under the knee

Puffiness at the bottom of the knee can be associated with a vascular, venous factor, with an inflammatory infectious process in the acute stage, with an inadequate rehabilitation period after treatment, surgery and excessive knee stress. Typical swelling, pain and swelling under the knee, around the joint with a meniscus damage.

Fracture of the patella, dislocation, sprain or ligament rupture, especially PKC - anterior cruciate ligament, Becker's cyst - this is an incomplete list of possible pain-provoking factors.

Popliteal fossa is considered quite vulnerable and vulnerable, skin in this zone is not protected, so any violation of the structure of the knee joint, accompanied by swelling, can lead to swelling behind the joint. Pain and pressure sensation, the swelling in the popliteal cavity appears quickly and requires examination, differential diagnosis.

As a first aid, leg immobilization, knee bandage with elastic material can help. Rubbing, cold lotions are not effective and at times even harmful, especially if the swelling is associated with venous stasis.

You can remove the pain symptom by taking a non-steroidal anti-inflammatory drug, and then you should contact a traumatologist, an osteopath, a rheumatologist, a phlebologist. If the pain is associated with a trauma, a knee or gypsum will be imposed on the knee, physiotherapeutic procedures will be prescribed. Phlebologist, having determined varicose veins or thrombophlebitis, will advise methods and methods, unloading or activating blood circulation, will appoint venotonics.

Rheumatoid arthritis is treated long and complex, as it is a systemic disease. In any case, the swelling under the knee is a signal about a violation of trophism of tissues, vascular conduction, it needs not just to be stopped, but also to treat the root cause of the symptom.

Pain in the vein under the knee

The legs are equipped with two types of venous system - there are deep and superficial veins. Pain in the vein under the knee is associated with the enlargement or blockage of the vena saphena parva, a vein that extends from the outer zone of the ankle to the knee joint.

The pain of vascular etiology is uncharacteristic for the knee joint, but pain in the veins under the knee is a frequent complaint, especially from women. Infringement of a blood flow in a leg or foot, in the field of a knee is more often connected with varices, a thrombophlebitis having own etiology. As a rule, vascular pathologies "start" in the pubertal period, when the adolescent organism begins to grow rapidly, and the vessels do not have time to develop as quickly as the bone system. Pain in the vein under the knee is seldom unilateral, and both popliteal veins suffer more often. But sometimes, with a constant load on the supporting leg, it suffers more, for example, the right one. Differentiating pain in vena saphena parva - vein under the knee and other types of pain is quite easy:

1. Pain in the vein is not acute, intense as with rheumatism, arthritis, bursitis or knee injuries.
2. Pain in the vein under the knee rarely disturbs the motor activity of a person and does not provoke a decrease in the mobility of the joint itself.

Venous pain accompanied by a characteristic sensation of tired legs, often cramps, numbness.

Treatment of the initial stage of varicose dilatation is carried out on an outpatient basis, often with the help of compression linen, bandaging with elastic materials and the intake of venotonics. If the pain in the vein under the knee is caused by a protracted process, the veins are enlarged by 4 or more millimeters, sclerosis or minifleboectomy is indicated.

Pain in ligaments under the knee

Bundles are a specific fibrous tissue that is designed to connect bone structures, muscle tissue to each other.

In the knee are the main four ligaments providing the union and functionality of the thigh and tibia:

1. PKS is an anterior cruciate ligament that controls forward movements, rotation.
2. ZKS - posterior cruciate ligament, providing a rear rotation and stable position of the joint.
3. ISS is the medial( middle) collateral inner ligament.
4. BCS - lateral collateral ligament( external ligament).

Pain in the ligaments under the knee is most often due to diseases, injuries to those ligaments that are located behind the knee joint. Most often provokes such pains stretching ZKS - posterior ligament, although such traumas are very rare, because it is quite strong. In order to injure the ZKS, a very large force is needed, for example, a sharp blow to the front of the lower leg during accidents or contact sports. The so-called bumper injury is the most common cause, which results in severe pain in the ligaments under the knee from behind. If the ZKS is injured, the pain is formed in front of the knee.

In addition, the pain symptom in the ligaments is caused by stretching, which can be accompanied by joint stiffness, swelling. The most dangerous in terms of consequences and predictions - the extension of cruciate ligaments of all kinds, especially painful damage to PKC.Injuries to the anterior cruciate ligament are poorly treated and long-term rehabilitation, in addition, stretching PKC is often accompanied by a rupture and pain shock.

Standard actions in such cases - cold to the place of stretching, taking analgesic, bandaging with elastic materials and referring to a traumatologist for differential diagnosis.

Pain under the knee of a child

About 20% of all complaints of pain in the knee area occur in pediatric traumatology. As a rule, pain under the knee in a child is associated with vascular disorders. Especially in this sense, complaints made by adolescents are characteristic.

In the pubertal period, the first system of the bone system develops, the vascular system does not keep up with its intensive growth, which provokes periodic pain in the zone of large joints. The knee of the child suffers from insufficient blood supply, fortunately this condition is considered transient with age.

However, there are pathologies such as varicose veins, thrombophlebitis, which can "start" in childhood, adolescence and accompany a person all his life, periodically causing pain in the knee joint.

Vascular pains under the knee are not accompanied by deformation of the joint itself, rarely lead to swelling or restriction of movements with the foot. The pain depends on the weather conditions, the presence of concomitant diseases, for example, acute respiratory infections, acute respiratory viral infections, temperature( heat or cold), physical activity, and exercise.

Knees cease to hurt( twist) at rest, at rest, after massage or rubbing.

Also, the pain under the knee in a child caused by venous insufficiency is well removed with drugs that dilate the vessels. More specific treatment, as a rule, is not required.

A more serious cause that causes pain under the knee in a child is rheumatism or spondyloarthritis. These are systemic diseases that are symptomatically manifested in the form of joint pains, swelling, and occasionally increase in body temperature. Pathological changes in bone tissue are seen on X-rays, serum analysis shows a high level of C-response and ESR.

Treatment is prescribed by a rheumatologist, orthopedist, and less often by a therapist. Also, such a child needs constant dispensary control, a special diet and regular intake of certain anti-inflammatory drugs.

Diagnosis of pain under the knee

Diagnostic measures of pain symptoms in the joints, including the knee, are quite standard. Traumatology, orthopedics, phlebology, osteopathy are those directions in medicine that have a good clinical base, including historical one. Diagnosis of pain under the knee is of a differential nature and consists of such actions:

1. Initial visual inspection.
2. Collection of anamnesis, including hereditary, professional.
3. The character of pain, its localization and interaction with other clinical manifestations is being clarified.
4. Testing is carried out - flexion, extension.
5. Obligatory is the X-ray.
6. The joint ultrasound is assigned( duplex).
7. An important diagnostic step is angiography( leg veins).
8. MRI can be prescribed, CT - computer methods of examination of bone tissue.
9. Assigns UAC( a general blood test), a biochemical blood test.
10. Joint articular puncture may be required.

Diagnosis of pain under the knee is directly related to the nature of the injury, joint damage and is carried out in a complex, often in a stationary environment, where it is easier and faster.

Treatment of pain under the knee

Treatment of a pain symptom in the knee depends on the severity of knee injury. If the pain is intense, strong, the first therapeutic measure is pain relief, immobilization of the knee and delivery of the patient to a medical institution.

In all other cases, which are not defined as acute conditions, the treatment of pain under the knee assumes the following stages:

1. The inflammation and swelling of the joint is removed. Cold compresses are shown, gentle bandaging or reliable fixation of the joint depending on the type of damage, non-steroidal anti-inflammatory drugs are prescribed - Ibuprom, Ibuprofen, Diclofenac. Perhaps the appointment of antibiotics in the case of determining the cause as an infection.
2. Obligatory are physiotherapeutic procedures for strengthening the muscles and restoring stability of the knee joint.
3. It shows the performance of therapeutic physical training, which supports a certain group of muscles in tone, for the prevention of atrophy.
4. A rehabilitation complex is being developed, which includes the implementation of special exercises.

If the injury is severe, treatment for pain under the knee can be performed surgically. The method of surgical intervention depends on such factors:

1. Type and severity of injury.
2. The number of traumatic injuries( combined trauma, comminuted fractures and so on).
3. Assessment of the risk of repeated knee disease( meniscus injury, bursitis).
4. Professional risks associated with possible withdrawal from the sport, profession.
5. Readiness of the patient in the sense of concomitant pathologies, chronic diseases and so on.

Operations can be as follows:

1. Arthroscopy is a gentle operation with the help of small, low-injury incisions. This type of surgery is effective at breaking the meniscus, restoring ligament ruptures.
2. Endoprosthetics - used after unsuccessful conservative treatment. Replaced part of the knee, rarely - the joint completely( with osteonecrosis).

In addition, the modern treatment of pain under the knee, in the joint itself, offers non-traumatic, effective methods:

1. Introduction of glucosamine, chondroitin sulfate for the restoration of cartilaginous tissue.
2. Bioprostheses - a sheet of lining, insteps, which help reduce the burden on the knee joint and reduce pain in flatfoot, gout.
3. Adrenosteroids, which are injected directly into the joint, and are designed to prevent arthritic pain.

Almost all diseases of the knee joint in the initial stage have a favorable prognosis, which provides timely, comprehensive treatment.

Prevention of pain under the knee

Prevention of diseases of the knee requires compliance with certain rules and recommendations. Adhering to the advice, you can avoid complications and pain symptoms.

Prevention of pain under the knee requires a reasonable distribution of the load on the joint, even with professional sports. It is known that statistics on the number of injuries of the knee joint are directly related to many kinds of sports competitions. More than 45% of the pain symptoms in the knee are due to damage as a result of training or competition. In addition, those who engage in sports, shown a special diet, containing products that strengthen the ligaments and cartilaginous tissue.

It is also important to monitor the body mass index, the extra weight load on the knee joints leads to their deformation, destruction and pain. If knee treatment has already passed, the prevention of pain under the knee should include rehabilitation measures - joint development, knee support with the help of elastic bandaging, the use of special medicines, strengthening the vessels, ligaments, tendons and bone tissue.

Recommendations for the prevention of pain in the popliteal area:

1. If a person is engaged in a traumatic sport, the knee should be protected with a special knee, a cruciform bandage, a wedge.
2. If human activity is associated with monotonous movements of the legs, which can destroy the structural elements of the knee, you should introduce a regime of regular workouts, breaks in work.
3. If the knee is damaged as a result of a bruise, it is necessary to immobilize the joint and the entire leg, to limit the overall motor activity. Sometimes enough 2-3 days for the knee to recover and not hurt.
4. For the prevention of pain under the knee, in the knee should be avoided hypothermia of the joints.
5. If a person's activity is related to sitting for more than 4-6 hours, the correct posture and position of the legs is important. Constantly bent knees, cross legs, leg to foot - these are the most harmful positions for the knee joint. It is necessary to find time to periodically unbend and straighten the leg( legs).

For the prevention of pain in the knee joint, it is necessary to strengthen the muscles of the thigh( quadriceps) - lunges, squats, exercise "bicycle" will help to maintain the muscle system in a tone and remove excessive load from the knees.

Source: http: //ilive.com.ua/health/ bol-pod-kolenom_106178i15963.html