PAIN IN KNEE JOINTS AND HOW TO TREAT IT
In this article, the orthopedic doctor at the VITAMED MEDICAL clinic, Akhmedov Bekhzod Rakhmadovich, answers patients’ frequently asked questions:
“Dear colleagues, patients!
I would like to discuss the topic with you: “Pain in the knee joints and how to treat it.”
Knee pain is one of the common complaints among the population and is most often associated with wear and tear on the joints during daily activities such as walking, bending and standing for long periods of time. Regardless of the reason, i.e. Due to aging or injury, knee pain is an unpleasant sensation or even debilitating in some cases. Below are answers to questions patients often ask during consultations.
Question (Q): What causes knee pain?
Answer (A): The most common causes of knee pain are related to aging, injury, or repetitive microtrauma to the knee. Common knee problems include sprains and tears, meniscus tears, tendonitis and arthritis.
Q: What should you know about knees before you start treating them?
A: You need to understand the anatomy, or better yet, the functional anatomy of the knee joints in order to understand the cause of pain, which in turn will facilitate treatment. The knee joint includes bones such as the femur, tibia, patella - the bones that form the knee and patellofemoral joint. The joint also includes a joint capsule and ligamentous apparatus (external and internal lateral, anterior and posterior cruciate ligaments) - they limit the excursion of the limb and fix the range of movements. Inside the joint there is synovial fluid, which reduces friction between the articular cartilages. There, inside the joint, there are the outer and inner menisci - they are responsible for shock absorption of the joint. Muscles, tendons and the patellar ligament help distribute the load correctly by contracting, i.e. deceleration and, as a result, distribution of the load over the entire articular surface.
Q: Are there risk factors for knee disease and what are they?
A: Yes. As with most diseases, they exist. Risk factors include:
• aging;
• female gender;
• hereditary factor (predisposition);
• history of trauma;
• weakness of the connecting muscles;
• increased bone density;
• incorrect (O - or X-shaped deformities) axis of the lower limb;
• proprioception;
• overweight;
• traumatic physical activity.
Q: What is joint degeneration?
A: Joint degeneration is accompanied by thickening and sclerosis of the subchondral bone plate through the growth of osteophytes at the edges of the articular surface, stretching of the joint capsule, aggravated by moderate synovitis and weakness of the muscles connecting the joint.
Q: How is the presence of knee joint disease determined?
A: Diagnosis of disease states involves clinical examination and usually, the use of one or more diagnostic procedures such as X-rays, MRI, CT scans and arthroscopy.
Q: My knees hurt, but x-rays didn’t show anything.
A: Most anatomical structures are not visualized radiographically, so radiographic manifestations have a low correlation with pain intensity.
Q: What is the cause of knee pain?
A: Looking ahead, I will say that the cartilage itself does not have nerve endings. Abrasion of cartilage does not cause pain. Therefore, pain likely arises from innervated structures. Based on comparative MRI studies of patients with and without pain, it has been revealed that the cause of pain may be the following: synovium, ligaments, joint capsule, muscles, subchondral bone. Inflammation of the synovial membrane, the presence of effusion in the joint leads to stretching of the capsule from and excess fluid, which increases nociceptive (pain) stimulation. Bone marrow edema is a sign of the presence of cracks and scars, which are a consequence of injuries. The presence of osteophytes also affects the occurrence of pain - as they grow, blood vessels and nerve fibers grow into osteophytes from the base of the bone, structures outside the joint - such as the periarticular bursae, and the iliotibial band is also a common cause of pain in osteoarthritis.
Q: What methods are used to treat knee joints?
A: Both non-surgical and surgical methods are used to treat painful knee conditions, depending on the type and severity of the condition.
Non-drug treatment: it is recommended to do aerobic or isometric exercises, swimming, lose excess weight (if obese). Physiotherapy and taping are also recommendedknees, use of orthopedic insoles, warming ointments, walking aids (cane, crutches, etc.).
Drug treatment includes: analgesics, non-steroidal anti-inflammatory drugs, sometimes narcotic painkillers, intra-articular corticosteroid injections, hyaluronic acid injections, PRP therapy (plasmolifting), stem cell treatment; Genetic therapy can also be classified as drug therapy.
Therapeutic measures also include applications of cold and/or heat, lifestyle changes, electrical stimulation of muscles, wearing a splint/splint, and knee pads.
Surgical treatment of knee joints includes arthroscopy, articular cartilage grafting, surgical removal of pathologically changed synovium (synovectomy), proximal tibial osteotomy, total or partial knee arthroplasty.
Diagnosis of knee pain requires examination by a specialist, medical history and further clinical and laboratory examinations.
Q: What are the possible complications of knee pain?
A: In the absence of timely treatment, complications may appear in the form of:
• worsening inflammatory and degenerative processes in the joint itself;
• transition of the degree of traumatization of the ligamentous apparatus to a more severe form;
• transition of mild arthrosis to a more severe form;
• complete rupture of a previously existing partial ligament rupture.
In the presence of secondary and other somatic diseases, complications are possible that threaten the patient’s life.
Q: How can I prevent pain in my knee joints?
A: To prevent knee pain, you need to lead a healthy lifestyle that excludes both overload of the joints and complete adynamia.
People with risk factors should be careful and try to strengthen the ligamentous apparatus of the joint, which will reduce the load on the joint itself. Try to give your leg “rest” in time.
In severe forms of arthrosis (grade 3), consult a specialist and, if indicated, perform surgical treatment of the knee joint without self-medicating or leaving the disease to chance, which can, in principle, aggravate the patient’s condition and lead to the above-mentioned complications.
At the VITAMED MEDICAL clinic you can get specialist advice and undergo the following examinations: X-ray, MRI, computed tomography, and also undergo a course of physiotherapy prescribed by an orthopedic doctor.
Thank you for your attention! Be healthy!
You can always ask any questions you are interested in by sending a request by email or by contacting us by phone:
info@vitamed.uz
(+998 71) 129-81-81
(+998 71) 129-82-82
Additional information:
www.vitamed.uz
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Ambulance – 1063, (+998 71) 129-00-03
Be healthy and take care of your loved ones!