Trying to avoid pain, the patient begins to move less, resulting in hypodynamia.

As you know, prolonged immobility in the joints leads to diseases of the musculoskeletal system, the treatment of which requires regular medication and is not always successful.

Why does knee pain occur?

The knee, hip and ankle joints are among the most complex in structure. The knee connects the femur and tibia, with the help of menisci, tendons and ligaments. Since the knee joints are located on the lower extremities, they experience the load of the weight of the entire human body.

If the knee joints are in a satisfactory condition, moderate loads on them are not only harmless, but also useful, and besides, they do not cause pain. For effective treatment of pain in the knee joint, it is necessary to know exactly the causes that provoked this condition.

The complexity of diagnosing pathology lies in the fact that there are many diseases of the knee joint. Therefore, a complete examination of the knee joint is required to clarify the diagnosis. In each individual case, an individual approach is necessary, since the symptoms of various joint diseases are very similar.

Only a comprehensive examination can guarantee the correct definition of the disease and the appointment of adequate treatment.

Diagnostic methods

For the correct diagnosis of the disease and identification of the causes that led to it, the doctor directs the patient to undergo a comprehensive examination. Treatment can be prescribed only after confirmation of the diagnosis.

Modern diagnostic measures include the following procedures:

1. x-ray examination;
2. computed tomography of the knee joint, thanks to which doctors have the opportunity to thoroughly examine human organs;
3. magnetic resonance imaging (MRI);
4. Arthroscopy of the knee joint - this procedure is akin to surgery, but when it is performed, minimal traumatization occurs. The method is carried out using an arthroscope, with which the doctor can examine the articular cavity from the inside;
5. general blood analysis;
6. a biochemical blood test is an additional research method for suspected joint diseases;
7. rheumatic tests.

A person must be aware that a neglected disease is much more difficult to treat than its primary form. Often, with complications, conservative therapeutic measures do not bring the desired result, and the patient needs surgery.

Most people trust the effectiveness of modern pharmaceuticals, which are widely advertised on television and on the Internet. Many medicines are really capable of providing recovery, however, it must be remembered that the reaction to certain medicines is individual for each person, so only a doctor can prescribe them.

Therefore, suspecting a disease of the joints, a person should not go to the pharmacy, but to see a doctor. Self-medication can not only delay the healing process, but also complicate the course of the pathology.

It is likely that self-medication can lead to temporary relief, but this does not mean that the disease has completely receded. In the future, the patient is likely to face arthritis, contracture and loss of motor function of the knee joint.

When a tendon or meniscus is torn, only surgery can save the patient from pain.

Functional testing of the anterior cruciate ligament

• the patient lies on his back;
• the limb is 30 bent at the knee joint;
• the doctor holds the patient's thigh with one hand, and moves the lower leg forward with the other;
• knee flexors and quadriceps should be completely relaxed.

Evaluation: If there is movement of the lower leg relative to the thigh, then the anterior cruciate ligament is damaged. In this case, the end point of the displacement should not be clear and have a hard stop. If the stopping point is clear, this is evidence of the stability of the anterior cruciate ligament.

A tight stop at 3 mm displacement indicates absolute stability of the anterior cruciate ligament. A displacement of 5 mm or more confirms only the relative stability of the anterior cruciate ligament, a condition typical of sprains.

Suspicion of damage to the anterior cruciate ligament occurs when the end point of the displacement is completely absent or weakly expressed. If the range of motion of the drawer is greater than 5 mm, congenital laxity of the knee ligaments is suspected. To exclude such a pathology, a comparison with another knee joint should be made.

Non-contact Lachman test - if it is positive, dysfunction of the anterior cruciate ligament is confirmed. Test Method:

• the patient lies on his back and with both hands holds the thigh (near the knee joint) of the injured leg, bent at the knee.
• the patient should try to raise the lower leg above the table, while bending the leg at the knee should be maintained;
• when the patient performs this test, the doctor observes the tuberosity of the tibia.

With a healthy ligament, no change in the contour of the tuberosity is observed. Perhaps a slight displacement of the tuberosity forward. If there is an acute injury to the ligamentous apparatus, in which the medial collateral and anterior cruciate ligaments are damaged, there is a significant displacement of the tibial tuberosity forward (articular subluxation).

This test allows the doctor to exclude a complex limb injury in a non-contact way.

Functional testing of the posterior cruciate ligament

Posterior Lachman test (drawer test at 90 knee flexion). This test is performed with flexion and approximate extension of the knee joint. Its performance is similar to the front drawer test, but in this case, the posterior displacement in the position of internal, external and neutral rotation is evaluated.

Grade. Maximum posterior displacement when the knee joint is close to extension indicates isolated posteromedial instability. Minimal posterior drawer and maximal posterolateral rotation are observed at 90 knee flexion.

If there is an isolated rupture of the posterior cruciate ligament, maximum posterior displacement occurs during flexion. Posterolateral displacement is not observed in any of these positions.

With combined damage to the posterolateral structures and the posterior cruciate ligament, in any degree of flexion, a lateral opening of the joint space and an increase in posterior displacement are observed.

Houston test to determine recurvation (excessive extension) of the knee joint and external rotation.

• the patient lies on his back, both of his quadriceps muscles of the lower extremities are relaxed;
• the doctor alternately lifts each leg by the foot.

If posterolateral instability is present, this action can lead to recurvation of the knee joint in varus position with parallel external rotation of the tibia.

To clearly demonstrate recurvation and external rotation of the knee joint, the test should be performed alternately on both limbs. This is done as follows: the leg from a state of slight flexion at the knee is transferred to a position of full extension. The doctor places one hand on the posterior surface of the knee joint to allow palpation of the posterior sagging and external rotation of the proximal tibia.

Meniscus testing

Grinding test (determination of Apley distraction and compression):

1. the patient lies on his stomach, the test leg is bent at the knee at an angle of 90;
2. the doctor fixes the patient's thigh with his knee;
3. in this position, the doctor rotates the limb with alternate use of axial compression and distraction of the leg.

If the patient experiences pain during rotation, this indicates a ligament injury (positive distraction test). Pain on compression is indicative of a meniscal injury (positive torsion test).

With a meniscus cyst or discoid meniscus, a characteristic click may occur. Pain during internal rotation is typical of damage to the lateral capsule or lateral meniscus.

Pain during external rotation confirms damage to the ligaments, medial capsule, or medial meniscus.

If the posterior horns of the outer menisci are damaged and the ligaments of the capsule are stretched, this symptom does not appear.

Fouche Sign (McMurray Test)

• the patient lies on his back, the injured leg is maximally bent at the hip and knee joint;
• with one hand, the doctor grabs the knee joint, and with the other hand, the foot;
• first, in the position of extreme external, then internal rotation, the doctor performs passive extension of the patient's knee joint up to 90

1. If the patient has pain during extension in the state of external rotation and abduction of the leg, it is evidence of damage to the internal meniscus.
2. An injury to the external meniscus is indicated by pain during internal rotation.
3. A click in the position of maximum flexion is characteristic of a rupture of the posterior horn, in which the torn piece is infringed.
4. The crepitus that occurs on 90 flexion is typical of a medial meniscus injury.

Glide test performed to diagnose patellar instability.

• the patient is in the supine position;
• the doctor stands on the side opposite to the diseased joint;
• with the first and second fingers of the hand, the doctor grasps the proximal part of the patella, and with the other hand, its distal part;
• then, with the first fingers, the doctor tries to move the patella outward above the femoral condyle, at the same time, with the second fingers, he supports the kneecap - this is how the lateral test is performed;
• when performing a medial test, the doctor tries to move the kneecap in the opposite direction with the second fingers.

If there is a suspicion of excessive lateral displacement of the patella, stability can be achieved with this test. In this case, the test should be performed with a contracted quadriceps muscle. The patient should raise the straightened leg above the table, while the doctor evaluates the movement of the patella.

The lateral and medial slip tests allow physicians to assess the degree of tension in the lateral and medial retinaculum. For comparison, such testing is carried out simultaneously on both knees. The doctor, without changing the position of the hands, can assess the degree of anterior displacement of the patella.

If the state of the knee joint is normal, the patellas move symmetrically without a characteristic crunch and a tendency to dislocation. An increase in lateral or medial displacement indicates weakness of the ligamentous apparatus of the knee joint, congenital subluxation or dislocation of the patella.

Crepitus or crunch during movement of the patella indicates the presence of chondropathy or retropatellar osteoarthritis. The clinician can extend this test without changing hand position by moving the patella distally. Decreased distal mobility indicates high standing of the patella or pathological shortening of the rectus femoris.

How to check the knee joint

In case of damage to the knee joint, the mechanism and circumstances of the injury are specified.

First of all, the nature of the complaints is clarified - pain, lameness, instability (instability) of the joint, crunching, clicks, local changes in skin color and temperature, joint shape, the appearance of joint edema or effusion, movement restrictions (contracture or ankylosis), and much more.

On examination, attention is paid to the configuration of the knee joint, the axis of the lower limb, the condition of soft tissues, especially the muscles of the thigh and lower leg. The support ability of the limb, the nature of gait disturbance are determined.

Palpation specifies the localization of pain, the presence of effusion in the joint (fluctuation, or a symptom of balloting the patella).

Normally, the range of motion in the knee joint is °, in most cases it can be increased passively due to hyperextension (by 15 °) and flexion (by 20 °).

The rotation of the leg relative to the thigh in the position of flexion of the knee joint up to 120° is equal to°.

To assess the state of the capsular-ligamentous apparatus of the joint, a number of diagnostic techniques are used:

For specification of character of pathology To. use a number of instrumental research methods:

Biomechanical (for example, podography) and electrophysiological research methods are used to determine the nature of motor disorders.

The most common methods of instrumental research To. are MRI, X-ray.

Indications for MRI examination of the knee joints:

• chronic arthritis;
• knee pain of unknown cause;
• household, sports, knee injuries;
• bone tumors;
• cartilage damage;
• ruptures of the ligaments of the knee joint and joint capsule;
• compression, infringement of the tendons and nerves of the knee joint.

Radiography

X-ray To. carried out usually in frontal and lateral projections.

For comparison, a direct x-ray of both knee joints is taken simultaneously on one film.

• In the lateral projection (different phases of its flexion), they allow assessing the function of the knee joint.
• With maximum extension of the lower leg, it is possible to determine the ratio of the axes of the thigh and lower leg. The angle formed by them, open anteriorly and exceeding the physiological limits, indicates hyperextension of the knee joint.
• Axial X-ray of the knee joint (with maximally flexed, rarely semi-flexed knee) makes it possible to more accurately study the patella.

Due to the fact that the patella is formed by the fusion of several ossification nuclei, in children it consists of several shadows, and in adults, if the nuclei do not completely merge, structural variants are observed in the form of a double, triple and multiple patella.

In some cases (for example, with effusion in the joint), a diagnostic puncture (medical manipulation) is performed, and the joint fluid is subjected to laboratory testing (bacteriological, cytological, immunological, biochemical, etc.).

If you suspect a tumor process in K. s. perform a needle biopsy. In all cases of difficulty in diagnosis, arthroscopy is recommended. If the information obtained is not enough, then arthrotomy is indicated to clarify the diagnosis.

The choice of the most informative research method and further treatment should be prescribed by your doctor.

Registration for MRI diagnostics and treatment of the knee joint

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Evaluation of Patients with Knee Pain (Part I)

Family doctors often encounter patients who suffer from knee pain. An accurate diagnosis requires knowledge of the anatomy of knee pain, the types of pain associated with knee injuries, the characteristics of the most common causes of knee pain, as well as specific physical examination skills. The history should include a description of the pain the patient is suffering from, the mechanics of the symptoms (blockage, expulsion, sparing), joint effusion (time, number of recurrences), and mechanisms of injury.

The physical examination should include a thorough examination of the knee, palpation for tender points, recording of effusion, examination of range of motion, examination of ligaments for damage and weakness, examination of the meniscus. An x-ray should be performed in patients with isolated pain in the knee and head of the fibula, inability to bear the load and flexion of the joint up to 90 degrees in people over 55 years of age.

Knee pain accounts for about a third of all musculoskeletal pathology that occurs at a primary care physician's appointment. This complaint is prevalent mainly in physically active patients, among whom 54 percent of athletes experience some degree of knee pain each year. Knee pain can cause serious disability, limiting the ability to work and carry out daily activities.

The knee is a complex structure, the examination of which is a challenge for the family doctor (see figure).

The differential diagnosis of knee pain is broad, but can be narrowed down considerably by a detailed history, focused physical examination, and, if necessary, the selective use of appropriate imaging and laboratory tests. In Part One of this two-part article, which presents a systematic approach to examining the knee, Part II3 discusses the differential diagnosis of knee pain.

The patient's description of the nature of the pain is helpful in making a differential diagnosis. It is important to clarify the characteristics of the pain, including its onset (rapid or gradual), location (anterior, medial, lateral, or posterior knee), duration, severity, and characteristics (e.g., dull, acute, penetrating). Aggravation or vice versa dissimulation should also be excluded. In the event that knee pain is caused by an acute injury, the doctor needs to know whether the patient is able to continue activities and bear the load after the injury or if he is forced to stop his activities immediately.

The patient should be questioned for mechanical symptoms such as locking, deflection or sparing of the knee. Complaints of "locking up" may indicate a torn meniscus. A feeling of deflection at the time of injury may indicate damage to the ligaments, possibly a complete rupture of the ligaments (third degree ligament rupture). Deviation sensations can be associated with some degree of instability and are indicative of some degree of knee instability and torn ligaments.

The timing and amount of joint effusion is an important clue to diagnosis. A rapid onset (within two hours) of a large amount of tense effusion is indicative of an anterior cruciate ligament tear and a tibial plateau fracture followed by hemarthrosis. If there is a slower onset (24 to 36 hours) a small to moderate amount of effusion is characteristic of a meniscus injury and sprain. Recurrent knee effusion after physical activity is associated with a meniscal injury.

Data on the phenomena of "locking" indicate a rupture of the meniscus, while the sensation of extension during the injury indicates damage to the ligamentous apparatus.

The patient should be questioned about the specific details of the injury. It is very important whether the patient has sustained a prolonged direct impact on the knee, whether the leg was in a state of support at the time of the injury, whether the patient slowed down or suddenly stopped at that moment, whether he landed after a jump, whether there was a moment of twisting at the time of the injury, or hyperextension occurred.

A direct blow to the knee area can cause serious injury. Anterior force applied to the proximal tibia with flexed knees (eg, being hit by a dashboard in a car accident) can damage the posterior cruciate ligament. The medial collateral ligament is usually injured as a result of direct lateral impact on the knee (for example, when rolling in football); this impact creates a valgus load on the area of ​​the knee joint and leads to rupture of the medial collateral ligament. Conversely, a medial impact that creates a varus load can cause damage to the medial collateral ligament.

The figure shows the angle of the quadriceps (Q angle). Non-contact injuries are also an important cause of damage to the knee area. A quick stop and a sharp cut or turn creates a severe braking force that can cause an ACL tear.

Hyperextension can damage the anterior or posterior cruciate ligament. Unexpected twisting and turning movements can damage the meniscus. The simultaneous combination of various influences can cause damage to several structures.

A history of trauma or surgery to the knee is very important. The patient should be asked about previous attempts to treat knee pain, including medication, braces, and physical therapy. The doctor should ask about the presence of gout, pseudogout, rheumatoid arthritis, and degenerative joint disease.

INSPECTION AND PALPATION

The clinician should begin the study by comparing the diseased and healthy knee, examining the knee for erythema, edema, contusion, and dislocation. Musculature should be bilaterally symmetrical. This is especially true of the "vastus medialis obliquus" of the quadriceps, which should be examined for signs of atrophy.

The knee should then be palpated and checked for pain, fever, and effusion. There should be sharp tenderness in the area of ​​the knee, tibial tubercle, patellar tendon, quadriceps tendon, anteriolateral and anteromedial articular line, medial and lateral line of the joint. Movement of the knee joint in a short arc helps to identify the lines of the joint. Range of motion can be explored by extending and flexing the knee as far as possible (normal range of motion: zero degrees extension; degrees flexion).

KNEE AND HIP EXAMINATION

Examination of the effusion should be performed with the patient in the supine position with the injured knee extended. In order to determine the presence of an effusion, the suprapatellar bursa must be exposed.

Knee-femoral movements are examined by observing uniform movements during the contraction of the patient's quadriceps. During palpation of the patella, crepitus may be detected.

The angle of the quadriceps (Q is the angle) is determined by drawing a line spina iliaca fnterior superior through the center of the patella and a second line from the center of the patella through the tibial tuberosity (Figure 2). A Q angle greater than 15 degrees is a predisposing factor for patella subluxation (eg, if the Q angle increases, forcible contraction of the quadriceps may cause lateral subluxation of the patella).

Then a patellar apprehension test is performed. The fingers are placed on the medial part of the patella, the doctor tries to sublux the patella laterally. In the event that this test causes pain or tenderness in the patient, subluxation of the patella may be the cause of the patient's complaints. While the patella is displaced in the medial and lateral direction, the upper and lower parts of the patella are palpated.

Anterior cruciate ligament. For the test (symptom of an anterior drawer test), the patient assumes a supine position with the injured knee bent 90 degrees. The doctor fixes the patient's leg in a position of slight external rotation (sitting down on the leg) and then places the thumb on the tibial tuberosity and fingers on the posterior surface of the lower leg. While the patient keeps the muscles relaxed, the doctor presses anteriorly and examines the anterior displacement of the tibia.

The Lachman test is another way to check the integrity of the anterior cruciate ligament. This test is done with the patient supine and the injured knee bent up to 30 degrees. The clinician stabilizes the distal femur with one hand, grasping the proximal tibia with the other hand, and then attempts to sublux the tibia anteriorly. The absence of a distinct endpoint is a positive Lachman test.

Posterior cruciate ligament. For this posterior drawer test, the patient is in a supine position with the legs bent at a 90-degree angle. Standing to the side of the table on which the examination is performed, the doctor observes the posterior displacement of the tibia (posterior displacement symptom - posterior sag sign). Then the doctor shifts the patient's leg to a neutral position (sitting on his leg), the thumbs are located on the tuberosity of the tibia and the fingers on the back of the thigh. Then the doctor makes a push in the rear direction and observes the displacement of the tibia posteriorly.

Varus and valgus stress tests. These movements should be done with the knee not bent and with the knee in 30 degree flexion.

Valgus stress - the test is performed on the patient's slightly abducted leg. The doctor places one hand on the lateral part of the knee joint and the other hand on the medial part of the distal tibia. Then the valgus impact is applied to the knee in zero position (full extension) and at 30 degrees of flexion.

With the knee in zero position (i.e., in full extension), the posterior cruciate ligament and articulation of the femoral condyle with the tibial plateau should stabilize the knee; with the knee in 30-degree flexion, the application of valgus stress makes it possible to feel the weakness or integrity of the medial collateral ligament.

Lateral collateral ligaments (Lateral Collateral Ligament). To perform a varus stress test, the doctor places one hand on the medial part of the patient's knee and the other hand on the lateral part of the distal tibia (tibia). Varus stress is then applied to the knee, first in full extension (i.e., zero degrees), then the knee is flexed to 30 degrees. complete rupture (third degree rupture) of the ligament.

Patients with meniscal injuries usually show tenderness along the articular line. The McMurray test is performed on the patient in the supine position 9. The test is described in the literature in various ways, but the author adheres to the following technique.

McMurray medial meniscus test. (Top) The test is performed with the patient lying down with the knee bent at 90 degrees. To examine the medial meniscus, the examiner grasps the patient's heel with one hand, holding the lower leg in external rotation, with the thumb on the lateral articular line and the fingers on the medal articular line (Middle). The examiner flexes the patient's knee bringing the posterior horn of the meniscus against the medial femoral condyle. (Bottom) During knee extension, varus stress occurs.

The patient grabs the patient's heel with one hand and the knee with the other hand. The patient's thumb is on the lateral articular line, and the fingers are on the medial articular line. The doctor then flexes the patient's knee as much as possible. To test the lateral meniscus, the tibia is rotated inward and the knee extended from maximum flexion to approximately 900 degrees; additional compression on the lateral meniscus can be applied using a valgus stress across the knee while the knee is in an extended position.

To test the medial meniscus, the tibia is rotated outward and the knee is extended from maximum flexion to approximately 90 degrees; additional compression on the medial meniscus can be produced by applying varus stress through the knee joint while the knee is extended. A positive test produces a thud or click that causes pain in the recoverable portion of the range of motion.

Since most patients with knee pain have soft tissue injuries, a plain radiograph is not indicated. The Ottawa knee rules provide a useful guide to determining indications for a knee x-ray.

In the event that radiographs are required, three projections are usually sufficient: the anterior-posterior projection, the lateral projection, and the Merchant projection (patellofemoral joint). Adolescent patients who complain of chronic joint pain and recurrent knee effusions require marked and tunnel projection (anterior-posterior projection of the flexed knee). This view allows for x-ray transparency of the femoral condyles (more often the medial femoral condyle), which is a sign of dissecting osteochondritis "osteochondritis dissecans."

The radiograph should be carefully examined for evidence of a fracture, especially involving the patella, tibial plateau, tibial columns, proximal fibula, and femoral condyle. If osteoarthritis is suspected, radiographs should be taken in a standing position under weight bearing.

The presence of fever, hypersensitivity, painful effusion, and severe pain, in combination with mild impairment of mobility in the knee joint, can be observed in septic arthritis and acute inflammatory arthropathy. In addition to a complete blood cell count and determination of the erythrocyte sedimentation rate (ESR), arthrocentesis should be performed. The joint fluid should be sent to a laboratory for cell count and differential glucose, protein, bacteriological and sensitivity testing and polarized light microscopy to detect crystals .

Due to strain, a painful and swollen knee may present an unclear clinical picture. Arthrocentesis may be required to differentiate between a normal effusion due to hemarthrosis and a occult osteochondrosis fracture.4 A normal articular effusion contains a clear, straw-colored transudate in a knee injury and chronic meniscal injury.

Hemarthrosis can be caused by a tear in the anterior cruciate ligament, a fracture, and a sudden tear in the outer part of the meniscus. Osteochondrosis fracture causes hemarthrosis, in which fat globules are found in the aspirate. Rheumatoid arthritis can also affect the knee joint. Therefore, individual patients may need to study ESR and rheumatoid factor.

How to check the knee joint

The knee joint is considered large. It has a complex structure. Pain in the knee joint may indicate a malfunction in the body or be the result of a banal overload.

Causes and symptoms of knee pain

There can be quite a few reasons. Pain can be localized in different areas of the knee and be completely different in nature. In order to conduct proper therapy, you should accurately understand the symptoms and understand which doctor you need. Knee pain is a sign of a chronic illness.

The presence of chronic diseases in the bone tissue is a frequent provocateur of pain in the knee joint.

Arthrosis

Arthrosis is localized in both knee joints.

This condition is provoked by the following factors:

• changes in the knees provoked by age;
• disorders in the bones and cartilage of the knee;
• the presence of a tumor in the knee.

The disease proceeds in a latent form. Pain in the knee joint disturb occasionally. Over time, symptoms such as:

• crunch in the knee joint;
• morning stiffness;
• inability to move the leg.

The pain is disturbing when walking up the stairs and when getting up from a chair. Ultimately, a gradual deformity occurs in the joint. At rest, the pain does not make itself felt. Therefore, patients sleep peacefully at night.

Arthritis

Arthritis is characterized by swelling, pain, as the inflammatory process in the knee joint passes. The most common form of this disease is osteoarthritis. It is provoked by the friction of the joints against each other when walking. The main factor in the development of the disease is a decrease in the amount of intra-articular fluid.

Provoke the development of osteoarthritis and frequent injuries, as well as excessive load on the knees.

In addition to pain, the patient notes swelling of the knee, the inability to move the leg, which is inherent in the late stage of the disease. Symptoms do not appear immediately. Sometimes the disease develops over many years.

Rheumatoid arthritis usually occurs when there is an imbalance in the immune system. But scientists have not yet identified the exact cause. With this disease, the joints of the hands also hurt. In the acute form of the disease, the pain is so severe that the patient cannot even be touched.

Pain in the knee joint: symptoms, causes, diagnosis

Gout

Gout is caused by high levels of uric acid in the body. In this condition, the knees become red and hot. Touching them causes pain.

Without proper therapy, this condition lasts up to a month. Timely treatment stops this disease at the earliest stages.

Knee pain during exercise

Pain in the knee joint can be provoked by physical activity. They are inherent in any age category.

Dislocation

Dislocations are the lot of professional athletes and dancers. This injury causes swelling and deformity of the knee.

• intense pain;
• the impossibility of any movement of the leg.

A dislocation is successfully treated, but in its complicated form, damage to the ligaments is noted, and surgical intervention cannot be avoided.

stretching

Stretching can also cause pain.

The most common triggers are:

• blow to the knee area;
• incorrect rotation of the leg (more common in athletes);
• fall on the knee.

When stretched, the knee swells, walking becomes impossible due to sharp pain. After some time, hemorrhages may appear.

meniscus injury

Sometimes the meniscus can be damaged by just an unsuccessful squat or twist. There is swelling, the movement of the patient is limited. Urgent referral to a specialist is recommended, as this injury is considered complex.

vascular pain

Pain in the vessels is provoked by insufficient blood flow to the knee. This disease accounts for one tenth of all painful manifestations in the knees. The mobility of the joints in this case does not suffer in any way. Edema is also not noted.

Knee pain occurs when:

• colds;
• sudden change in weather;
• physical activity;
• hypothermia.

This condition is often diagnosed in adolescence with non-simultaneous development of bone tissue and blood vessels. This condition passes by the age of 20.

Becker's cyst

With this disease, the ligaments in the fossa under the knee become inflamed. In this area, a noticeable seal is formed - a cyst, which can be seen visually only when the knee is extended.

Such a disease is provoked:

• meniscus injury;
• joint injury;
• the presence of osteoarthritis;
• cartilage injury.

Initially, Becker's cyst does not appear. But as it progresses, the pain increases. Patients report tingling and numbness in the foot. There is also difficulty in bending the toes in the injured leg.

Examination for knee pain

The doctor should carefully listen to the patient's complaints and conduct a thorough examination of the knee. The specialist may deem it necessary to conduct additional examinations.

Perhaps you will need to:

• take an x-ray;
• donate blood for a general analysis;
• perform a bone biopsy
• undergo an ultrasound procedure;
• do an MRI.

Treatment of knee pain

It is necessary to clearly establish the cause of the painful phenomena. After that, effective therapy can be prescribed. Each specific disease requires an individual approach.

• Apply hot compresses or ointments with a warming effect.
• Put on a brace or tie an elastic bandage around your knee.
• Take anti-inflammatory drugs.
• Do stretching exercises.

Comprehensive diagnosis of arthrosis of the knee joint

Early diagnosis of arthrosis of the knee joint is one of the factors affecting the prevention of the development of the disease and the improvement of the patient's well-being. Research allows you to determine the causes of the development of pathology, as well as to choose the best course of therapy. Since in the early stages the disease does not have a pronounced clinical picture, the diagnosis is made due to the appointment of an MRI, ultrasound and X-ray of the injured knee.

MRI of the knee joint with arthrosis

This method has no analogues in terms of the information content of the survey results. The uniqueness of MRI diagnostics lies in the fact that after the study it is possible to recognize the disease in the early stages. Examination of arthrosis of the knee joint on a magnetic resonance imaging scanner allows you to establish microdamages at the cellular level, which are undoubted signs of the development of pathology. What can be seen thanks to the diagnostic procedure on an MRI?

• Any damage and degenerative changes.

• Suspicion of the development of pathology during the examination of the patient.

Ultrasound of arthrosis of the knee joint

Unlike tomography, the ultrasound method does not provide such an accurate and clear picture of the changes and is effective after the clinical manifestations of the pathology have become noticeable. But provided that the ultrasound study is carried out by a competent specialist, you can get fairly reliable results. Diagnosis of arthrosis of the knee joint by ultrasound helps to identify:

1. Thinning of cartilage. One of the most obvious clinical manifestations of the disease.

X-ray of the knee joints with arthrosis

Modern methods of diagnosing arthrosis of the knee joint may include several different diagnostic procedures, but radiography continues to be one of the most important functions in accurately determining the disease and its development. With a snapshot, you can see the following:

• The inability to repeat the diagnosis and follow the general trends in the development of pathology.

When is it necessary to see a doctor?

Patients over 50 years of age, as well as those who have recently suffered a serious knee injury, are at risk and should be attentive to any disturbing manifestations. Knee crunching, fatigue with light exertion, incomplete squeezing and unclenching of the knee may be an indication to see a doctor. In most cases, the diagnosis of arthrosis of the knee joint on x-ray will be prescribed, if the clinical manifestations of the disease have already begun, deformations of the bone tissue will be noticeable. After receiving the results, a course of therapy will be prescribed or additional examinations will be recommended.

What is knee osteoarthritis and how is it treated?

Osteoarthritis of the knee is so common that it has a separate name - gonarthrosis. Another name for this disease is deforming osteoarthritis.

Osteoarthritis of the knee joint worries 20% of the population, its ICD-10 code is M17. Half of knee pathologies are due to arthrosis. This is a disease in which the tissue of cartilage and the articular surface is reborn - their disintegration occurs. The joint is poorly supplied with nutrients and oxygen, its function deteriorates, and inflammation occurs. It becomes inactive and hurts, the patient's quality of life decreases. Complications of arthrosis lead to a wheelchair.

Let's figure out what arthrosis of the knee joint is and how to treat it. How can the disease be prevented and how dangerous is it.

Causes and classification

The causes of arthrosis of the knee joint are different - mechanical damage, hereditary predisposition, metabolic disorders.

The occurrence of the disease is associated with excessive load on the knees. This is a professional injury in many sports. People with a high degree of obesity, over 60 years old, almost always have arthrosis of one degree or another due to constant microtrauma. Osteoarthritis refers to occupational diseases in those areas where a person has to stand or lift weights for a long time. The disease can begin after suffering rheumatoid arthritis.

The most common cause of knee osteoarthritis is trauma. The second most common is dysplasia in childhood. Inflammation due to autoimmune pathologies is the third source of arthrosis. Usually there are several reasons, one complements the other.

Types of arthrosis of the knee joint are divided depending on the causes into primary and secondary. With an unknown etiology, primary arthrosis is diagnosed, if the cause is clarified - secondary.

Development mechanism

Cartilage is nourished by a constant change in osmotic pressure. When the joint is loaded, the viscosity of the intra-articular fluid decreases, and its amount increases. In a calm state, the intra-articular fluid becomes viscous, the amount decreases. Normally, these processes alternate. The cartilaginous plate, acting as a pump, pushes fluid out of the joint when loaded, and sucks it in when relaxed. This is how the joints are nourished. The pathological process manifests itself if the joint is subjected to destructive influences:

• If the load is high and the joint does not have time to recover, nutrition is disturbed. The cartilage becomes thin, cracks and ulcers appear on it;
• The structure of collagen fibers is broken, they absorb worse. Cartilage and patella soften, become inelastic, perform their functions worse;
• Bone growths appear in the joint. The shell of the articular bag is irritated and inflamed;
• Since a person begins to take care of the knee, move little, less intra-articular fluid is produced. The cartilage surface becomes dry and rough;
• The knee receives even less nutrition, atrophies, its destruction accelerates.

There are signs of arthrosis of the knee joint: it becomes inactive, pain occurs. The pain is especially severe in the morning and after prolonged immobility.

Stages of arthrosis

There are three degrees of arthrosis:

• Initial stage. The tissue has not yet been destroyed. So far, only the synovial membrane is deteriorating. The composition of the intraarticular fluid changed. The knee ceases to withstand the usual load;
• Articular cartilage and menisci begin to break down. Osteophytes grow in the bones - bone formations. There is inflammation and pain;
• Difficult stage. The supporting platform of the knee joint is deformed, the axis of the leg changes. The ligaments are shortened, the articular bag becomes rigid. The joint is pathologically mobile, but it is impossible to completely bend or straighten it. Inflammation and pain are pronounced.

At the very beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is severely restricted. Due to the change in the axis of motion, the places of attachment of the muscles change. Muscles are deformed - they contract or stretch, they can no longer contract normally. The nutrition of all leg tissues suffers.

Symptoms

Symptoms of arthrosis of the knee joint at the beginning of the disease do not manifest themselves in any way and do not force the patient to consult a doctor. The patient notices fatigue and pain, but does not attach serious importance to them.

The classic sign of knee arthrosis is stiffness and stiffness in the joint, a pulling feeling in the popliteal region, and pain after exertion. It is difficult to move in the morning or after a long period of immobility. Relief comes after the patient kneads the knee, massages it, and walks around.

After a while, the intensity and duration of the pain increases. A crunch appears in the joint, it completely stops bending and unbending. A person begins to limp when walking - with this complaint, most patients come to the doctor. Treatment of arthrosis of the knee joint usually begins only in the second stage.

If nothing is done, movement becomes possible only with outside help. When the patient lies, the knee hurts less, but often the pain bothers at night.

At the second and third stages, the knee joint is deformed - the contours of the bones are sharply defined, the lower leg is curved. If you put your hand on your knee, a crunch is heard during flexion and extension. When moving the patella, it also crunches. Fluid collects in the cavity, the joint is edematous, the tissues swell.

With the development of the disease, all symptoms become more pronounced.

Irina Alexandrovna Zaitseva

Pain in the knees. How to restore joint mobility

Bursitis, arthritis, arthrosis - all these diagnoses are associated with old age. But, unfortunately, things are different. Today, even young people are increasingly paying attention to the crunch in the joints and discomfort in the knees after a long walk, driving a car or exercising on an exercise bike. The knee joints are most susceptible to damage, because together with the hip and ankle joints they hold the weight of our body.

Pathologies of the joints may not make themselves felt for a long time. Symptoms usually appear when there is an already established disease that requires treatment.

It is important to remember that any injuries and excessive stress on the legs cause inflammation of the joints (arthritis) or joint bag (bursitis). If you do not carry out the correct treatment, then over time there is an increase in bone tissue in the joint (arthrosis). These diseases are most difficult for the elderly, as bones become more fragile with age, and the likelihood of damage increases.

It should be noted that women are more susceptible to pathologies than men. The fact is that female ligaments are weaker, and the loads on them are quite high. Shoes with heels, too active exercise in the gym, a sedentary lifestyle, injuries - all this sooner or later leads to diseases of the knee joints.

Everyone knows that the disease is easier to prevent than to cure. Prevention of joint pathologies is a healthy lifestyle, proper nutrition, wearing comfortable shoes and regular, but moderate exercise.

By adhering to these simple rules, you can significantly reduce the risk of developing the disease, as well as improve the condition of the joints with an existing pathology. In addition, it is important to know the signs of the most common diseases of the knee joints in order to immediately pay attention to them and not delay a visit to the doctor.

About how the knee joints are arranged and function, about possible pathologies and methods of their treatment will be discussed in this book. It also contains helpful tips on how to restore joint mobility without medication.

The structure and function of the knee joint

A joint is a place where bones meet. Between them is cartilaginous tissue, or meniscus, which is necessary so that the joints do not wear out in these places, and the movements are smooth. In order for the bones to hold and perform their functions, there is an articular bag, which consists of ligaments that envelop the joint and hold it in one place.

The knee joint, which provides flexion, extension and small turns to the sides, belongs to the hinge type of the synovial joint. Movement in it occurs between the joints of the bones, which include the patella, tibia and femur.

In the process of flexion and extension of the joint, movement occurs between the flattened upper part of the tibia and the heads of the femur. The condyles of the latter are distinguished by a small height, they can be easily felt as the bone structures of the lateral and inner sides of the knee joint.

Like other synovial joints, the knee joint is surrounded by a synovial membrane, from which a lubricating substance is secreted. It provides a smooth glide of cartilage, enveloping the rubbing surfaces of the bones.

In the case of arthrosis, the surfaces of the joints may not be smooth enough, which is accompanied by painful sensations during loads on the legs. However, even smooth knee joints are not strong enough and stable.

The stability of the knee joint is determined by the surrounding ligaments, which fix the bones in the desired position during flexion and extension of the knee. Knee joints, unlike stable hip joints, do not have the deep "capacity" necessary for the bones to "sit" securely in them. That is why they are quite fragile and vulnerable.

The ligaments attached to the bones and forming the knee joint bear a heavy load - preventing one bone from slipping off another.

The upper, middle and lateral surfaces of the tibia have two flattened surfaces connected to the femur. They are called tibial plateaus, and each of them corresponds to one of the two femoral condyles. There is a narrow intercondylar space between the tibial plateaus.

The knee joint is formed from two tubular bones - the femur (top) and the tibia (bottom). In addition, in front of the joint is a round bone - the patella, or patella. Two spherical elevations located at the bottom of the femur are called the femoral condyles.

The patella slides over the patellofemoral depression formed by the femoral condyles. The ends of the bones at the joints are covered by articular cartilage, which is usually 5–6 mm thick. It is a shiny white fabric with a smooth surface. Articular cartilage reduces the friction force in the joint during movement. In the knee joint, it is present at the ends of the femur and tibia, as well as on the posterior surface of the patella.

They are located on the sides of the knee joint, prevent the femur and tibia from sliding in and out and are called the tibial and peroneal collateral ligaments. This name is associated with the leg bone to which they are attached.

When the knee is flexed, the collateral ligaments are stretched, and when the knee is extended, they are weakened. The fibula (the thinnest bone located on the lateral side of the lower leg) is not part of the structure of the knee joint, but plays an important role, as it fixes the peroneal collateral ligament that surrounds it and attaches to the thigh.

The peroneal collateral ligament tears extremely rarely, since the main load falls on the inside of the knee joint. However, when the inside of the knee is overstressed, the tibia or femur can move to the side, often resulting in a rupture.

The tibial collateral ligament is located on the inside and runs along the knee between the thigh and the tibia. It is attached to the middle meniscus, so if it is damaged, the last and middle collateral ligament is torn.

Injuries resulting in damage to the tibial collateral ligaments are usually the same as those resulting in an anterior cruciate ligament tear. They are often seen in football players when the femur is displaced to the middle as a result of a blow to the side of the knee.

In the event that the tibial collateral ligaments are not torn, but only stretched, the femoral or tibial joints of these ligaments soften, which causes the development of a tumor in the inside of the knee.

These knee ligaments can be compared to a rope. They connect the femur and tibia and are located between the lateral and internal condyles of the femur and the tibial plateaus. The name of these ligaments justifies itself: intersecting, they form the letter "X".

The anterior cruciate ligament is attached to the anterior part of the tibia, and the posterior cruciate ligament is attached to the posterior side of the tibia of the knee joint. When the knee is bent, the anterior cruciate ligament is weakened, and when straightened, it is stretched. The stability of the knee when shifting forward and backward is determined by the condition of the cruciate ligaments, especially if the knee joint is tense.

Anterior cruciate ligament

This link is the weakest of the two intersecting links. It is about 38 mm long and 10 mm wide. It consists of many collagen bundles. Collagen is the main structural protein in most connective tissues, including ligaments and tendons.

The beginning of the anterior cruciate ligament is the anterior part of the intercondylar space of the tibia. It is behind the middle meniscus. The anterior cruciate ligament runs upward, forward and slightly to the side and holds together the dorsal and medial sides of the lateral condyles of the femur.

When the knee joint is flexed, there is a gap on both sides of the condyles of the femur and tibia. It is at this point that the knee is most susceptible to injury. The reason for the formation of this space is that when the knee is flexed, the anterior cruciate ligament is not stretched. Its main function is to protect the tibia from forward movement (relative to the femur).

This ligament also prevents excessive extension of the knee joint. When it is flexed to 90°, the tibia cannot move backward because it is held in place by the anterior cruciate ligament (assuming it is in a normal, healthy state).

Posterior cruciate ligament

From the back of the intercondylar space of the tibia, it goes above and in front of the middle part of the anterior cruciate ligament and is attached to the front of the middle condyle of the thigh.

When the surgeon opens the knee joint during surgery, this ligament is the first thing he sees. During knee flexion, its tension is observed. One of the functions of the posterior cruciate ligament is to prevent the tibia from moving backward relative to the femur. Due to the joint fluid and cartilage, when the knee is flexed, friction on the surface of the joint is negligible.

The posterior cruciate ligament is more vertical in knee extension and more horizontal in flexion. It prevents excessive flexion of the joint.

With a bent knee, it is the main stabilizer of the femur. This applies when the knee is bent under resistance (for example, deep leg presses while lying down, squatting, and walking down stairs).

The posterior cruciate ligament is most vulnerable to injury when the knee is bent. For example, it may be damaged in a traffic accident when another vehicle crashes into the car from behind.

The extensor muscles are located on the front of the thigh. As a result of their contraction, the leg is straightened at the knee joint, so that we can walk. The main muscle of this group is the quadriceps muscle.

The patella, which is located in the thickness of the tendon, is an additional support and allows you to change the direction of action and increases the force of the quadriceps muscle applied during the extension of the lower leg.

The calf flexors are located on the back of the thigh near the knee. Their contraction, respectively, is accompanied by flexion of the leg at the joint.

The main nerve in the knee is the popliteal nerve, which is located at the back of the knee joint. It is a component of the sciatic nerve, passes in the lower leg and foot and provides sensitivity and movement of these areas. The popliteal nerve lies just above the knee joint and divides into the tibial and peroneal nerves. The first is located on the posterior surface of the lower leg, and the second passes around the head of the fibula and goes along the anterior and outer-lateral surfaces of the lower leg.

The blood vessels are located on the back of the knee joint near the popliteal nerve. The popliteal vein and artery provide blood circulation in the lower leg and foot. The popliteal artery carries blood to the foot, and the vein back to the heart.

What does joint pain mean?

Causes of knee pain

The most common causes of knee pain are injuries from impact, bending the knee, twisting it hard, or falling on it. Unpleasant sensations can result from stretching the tendon that supports this part of the body and helps it perform its functions.

Other possible causes include a broken knee, a torn meniscus, a displaced patella, and a dislocated joint. In all these cases, immediate surgical intervention is required.

Often, pain in the knee joint occurs with increased loads on the knee or prolonged pressure on it. It can appear after a long ride on a bicycle (exercise bike), jogging, jumping, climbing stairs. The fact is that repeated loads on the joint can cause inflammation, as well as lead to thickening of its ligaments and the formation of "folds" in them.

At the same time, pain in the knee joint can occur for no apparent reason. There are a number of diseases in which there is a high probability of unpleasant and even painful sensations in this area.

For example, with osteoarthritis, discomfort appears in the morning and then gradually decreases. Stiffness and swelling in the knee area are observed in pathologies such as gout, lupus, and rheumatoid arthritis. In adolescent boys, swelling of the knee joints is often associated with Osgood-Schlatter disease. The same symptom is noted with a popliteal Baker's cyst.

Problems with the knee joints can be symptoms of a disease in another organ, such as a nerve or hip. Pain and limited mobility are often caused by an infection in the bone, joint, or skin.

Types of knee pain

Pain when walking

Pain in the knee joints when walking is not uncommon. Many people experience minor discomfort from time to time. Ideally, the habitual movements of our body should not cause discomfort, however, the appearance of symptoms is not surprising if the joints are under increased stress or an injury has occurred. The latter does not only happen to athletes. It is possible to damage the knee joint by doing ordinary activities, such as cleaning.

So, in what cases does knee pain occur when walking?

Most often, pain indicates inflammation of various structures of the knee (tendons, cartilage, periarticular bags, etc.). However, it is often accompanied by a decrease in joint mobility (stiffness of movement) and difficulty in bending the knee. The described symptoms may also be accompanied by redness in the joint area, swelling and fever in this place. These signs indicate arthritis of the knee joint.

As noted above, injuries are the most common cause of pain in the knee joints. Discomfort can increase within minutes, hours, and sometimes even days after the injury. If at the same time nerves or blood vessels were squeezed, a person may feel numbness and tingling in the knee or lower leg. In addition, there is blanching or blueness of the skin.

Acute knee injuries include:

Sprains, dislocations and other injuries of the tendons and ligaments that connect and support the kneecap;

Ruptures of the menisci (elastic cartilage discs of the knee joints);

Fracture of the patella, lower thigh, upper tibia, or fibula;

Displacement of the patella, which is most often observed in girls during adolescence;

Dislocation of the knee joint is a rare but serious injury that requires immediate evaluation and treatment.

Other causes of pain in the knee joint are damage due to overload (inflammation of the joint capsule and tendon, the formation of folds or thickening of the ligaments of the joint, irritation of fibrous tissue, etc.) and osteochondritis dissecans (a disease in which a small area of ​​cartilage is separated from the adjacent bone and shifted into joint cavity).

Pain when squatting

People who squat with a barbell during training often complain of knee pain. The causes of discomfort can be associated with both joint disease and improper exercise technique. One of the pathologies that cause pain during such exercises is gonarthrosis. With this disease, the cartilage of the knee joint wears out prematurely.

Other causes of knee discomfort can be a viral infection, poor diet, lack of physical activity, or overuse of the joint.

If you feel pain in your knee after doing 2-3 squats, immediately stop the exercise. If it does not go away within a few hours, you should consult a doctor who will prescribe an examination. Even if you have been playing sports for many years, you cannot ignore the pain and hope that it will go away on its own.

Pain when bending

In most cases, pain in the knee when flexing indicates Osgut-Schlatter disease, which is an osteochondropathy of the tibia (in the area of ​​\u200b\u200battaching the patella). As noted above, this pathology is most often observed in boys in adolescence. The cause of its development may be damage to the knee joint, but often it appears without visible prerequisites.

Patients complain of discomfort, which increases when descending stairs, walking and bending the leg at the knee. The disease lasts up to 3 weeks and ends with a complete recovery, but in some cases it becomes chronic.

Another common cause of pain when bending the knee is inflammation of the joint capsules, or bursitis. In this case, discomfort is accompanied by swelling in the joint area and limited movement.

Arthrosis of the knee joint is indicated by crunching and pain when moving, squatting and bending the leg at the knee. At the initial stage, the discomfort disappears after a good warm-up, but as the disease progresses, the pain increases and appears more often. As a result, it becomes permanent, and the patient cannot move normally and even simply bend the leg at the knee.

In some cases, limited movement and pain during flexion are due to pathology of the cartilage of the patella. At the same time, discomfort is localized in the front of the knee when walking down the stairs and sitting for a long time. In addition, patients complain of cracking when bending and unbending the knee.

Sciatica (inflammation of the sciatic nerve) also often causes discomfort when bending the knee. And sometimes the pain appears as a result of infringement of the subcutaneous branches of the nerves due to wearing narrow boots.

The crunch in the knees is very serious!

As a rule, we do not notice any sounds when the joints move, which indicates the smoothness of the hyaline cartilage, which is located in the joint cavity, and the presence of a sufficient amount of synovial fluid, which serves as a lubricant. If you notice a crunch in the joints when walking, bending the leg at the knee, doing exercises and other habitual actions, this signal is that something is not right with the joint.

In the event that the crunch is not accompanied by swelling, pain and stiffness of movements, there are few reasons for concern, but it is still worth visiting a doctor. In some people, a crunch in the joints at the beginning of the movement is the norm, but such cases are rare. This is usually due to the presence of gas bubbles in the synovial fluid. When the joint capsule is stretched, they burst, as a result of which we can hear a sound similar to a crunch.

However, cracking is often the first sign of such a serious disease as osteoarthritis. It is characterized by a slow flow. As osteoarthritis develops, the articular cartilage is destroyed and the articular ends of the bones are deformed. Due to this, the friction force in the joint increases during movement, and then a crunch occurs.

The danger of this pathology lies in the fact that it does not give any symptoms for a long time. The effectiveness of treatment depends on the stage at which the disease was diagnosed. If the destructive processes in the joint are minimal, then the prognosis is favorable. That is why, even if the crunch is not accompanied by painful sensations, it is necessary to undergo an examination to exclude osteoarthritis.

For a long time it was believed that the development of this disease contributes to the use of nightshade vegetables and large amounts of salt. However, statistics have refuted this opinion.

It should be noted that the prevention of this disease is to control the amount of food consumed. The greater the weight, the higher the load on the articular-ligamentous apparatus and the risk of developing osteoarthritis.

Physiotherapy is of great importance in the treatment of this disease. In the case of the correct selection of a set of exercises, patients achieve improved blood circulation in the tissues of the joint, which speeds up the process of cartilage regeneration.

For the treatment of this pathology, special medications (chondroprotectors) are prescribed. The composition of the preparations of this group includes glucosamine, hyaluronic acid and chondroitin sulfate. However, they can be taken only after consulting an arthrologist or orthopedist.

Diseases, injuries of the knee joint and pain associated with them

Diseases of the knee joint, diagnosis and treatment

Arthrosis of the knee joint (gonarthrosis)

This pathology is most often found in women with overweight and varicose veins of the legs. As a rule, arthrosis affects both knees, but it also happens that pain appears in only one of them for a long time.

The first sign of gonarthrosis is a slight pain when walking, descending and climbing stairs. It can also occur if a person had to stand for a long time. In the case of synovitis (swelling of the knee), the outflow of blood is disturbed, pains appear in the calf area, usually aggravated at night.

As gonarthrosis develops, the joint becomes deformed, and discomfort increases, it becomes difficult to bend the leg normally, as there is acute pain and a crunch in the joint. At stage III of the disease, it is no longer possible to completely straighten the leg. In this regard, those who suffer from this form of arthrosis walk on slightly bent legs. Quite often, X- and O-shaped curvature of the lower extremities develop.

At an advanced stage, the disease can be diagnosed even by the appearance of the joints, but it is already impossible to restore them. Treatment should be started as early as possible, when the first signs appear. Gonarthrosis is often accompanied by other lesions of the knee joint, as a result of which one disease is superimposed on another, which makes it difficult to make a correct diagnosis.

Most often, this disease is combined with meniscopathy of the knee joints, the characteristic features of which are tears and infringement of the menisci. Often, meniscopathy is one of the factors in the development of arthrosis, more about it will be discussed in the section "Injuries of the knee joint, diagnosis and treatment."

Treatment

Non-steroidal anti-inflammatory drugs

Diclofenac, indomethacin, ibuprofen, piroxicam, flexen, etc.

Therapy is aimed at relieving inflammation and swelling in the joint area. By themselves, drugs cannot cure arthrosis, but they can significantly reduce pain and stiffness of movements during an exacerbation. After that, you can proceed to therapeutic exercises, massage and physiotherapy.

Important: drugs of this group should not be used for a long time due to possible side effects.

The active ingredients of these drugs are glucosamine and chondroitin sulfate, which contribute to the restoration of cartilage tissue. Chondroprotectors eliminate the symptoms of gonarthrosis and take part in the biosynthesis of connective tissue, preventing degenerative processes in the cartilage.

It should be noted that drugs of this group are ineffective at stage III of arthrosis, when the cartilage is almost completely destroyed. In other words, they are not able to eliminate bone deformities and build up new cartilage tissue.

At stages I and II, chondroprotectors act slowly, so improvements are noticeable only after long-term treatment. To obtain tangible results, 2-3 courses are required, which usually takes from 6 months to 1 year.

Xanthinol nicotinate, nikospan, pentoxifylline.

In most cases, gonarthrosis is accompanied by stagnation of blood in the joint area, which leads to "bursting" pain at night. To eliminate this symptom, vasodilators are prescribed, which relieve spasm of small vessels of the lower extremities and restore blood supply to the joint.

The preparations of this group have a pronounced positive effect in combination with chondroprotectors, since the nutrients of the latter penetrate into the joint in greater quantities and are more actively absorbed into the tissues.

Intra-articular injections of corticosteroid hormones (diprospan, flosteron, kenalog, etc.) are used to relieve inflammation in the joint, which is expressed in swelling and swelling of the knee. With severe pain, this method brings quick relief, however, such injections can be done no more than 1 time in 2 weeks. It is also important to remember that the effect of the first injection will be more noticeable than subsequent ones. If she did not give the desired result, then it is unlikely to appear after repeated use of the drug.

Hormonal drugs have side effects, therefore, in order to avoid their manifestation, it is not recommended to inject corticosteroids into one joint more than 3 times. This method of treatment is not prescribed for patients with severe bone deformity and curvature of the legs, that is, in all those cases where the pain is not associated with inflammation, but with anatomical changes in the joint.

Intra-articular injections of chondroprotectors and enzymes are contraindicated in edema. They produce a pronounced effect in the initial stages of gonarthrosis, not accompanied by synovitis, and partially restore cartilage tissue. The disadvantages of this method of treatment are the need for a course of treatment (from 5 to 10 injections) and minor trauma to the tissues of the joint during the procedure.

Intra-articular injections of hyaluronic acid (ostenil, fermatron, etc.) are a relatively new and very effective way to treat gonarthrosis. This substance serves as a lubricant for the joint, as it is close to it in its composition. Once injected into the affected joint, it reduces surface friction and increases knee mobility.

Hyaluronic acid injections are effective in I and II stages of gonarthrosis. At stage III, the drug can alleviate the patient's condition, but only for a while. Treatment is carried out in a course (3-4 injections in each affected joint) and is repeated once a year.

Ointments and compresses

In complex treatment, it is also possible to use local remedies, the action of which is aimed at improving blood circulation in the joint and eliminating pain. For these purposes, dimexide is often used - a liquid with anti-inflammatory properties. However, this drug should be used with caution, as it often causes allergic reactions. Before use, a sensitivity test is performed: a few drops of the product are applied to the skin, after which the reaction to it is checked. If redness or burning occurs, Dimexide is not recommended.

A positive result is given by medical bile and bischofite. It should be noted that they also require a preliminary sensitivity test. In case of good tolerance, a course of treatment of 15 compresses every other day is prescribed.

As for ointments ("Fastum-gel", "Dolgit", "Voltarengel", etc.), they have a less pronounced effect.

It includes laser therapy, cryotherapy (cold treatment), electrophoresis and massage. The action of these procedures is aimed at improving the condition of tissues and blood supply to the joint, as well as at relieving inflammation. Contraindications to their implementation are hypertension, diseases of the cardiovascular system and infectious lesions of the joints.

Traction (joint traction)

Traction of the knee is carried out by manual therapy methods or using a traction apparatus. The goals of traction are to separate the bones and increase the distance between them to reduce the load on the joint.

The complexity of this method lies in the fact that it is necessary to affect four adjoining bones. There are three joints in the knee joint, and it is necessary to act on the weakest of them, which requires jewelry accuracy.

Even if the traction is done by an experienced specialist, a positive result can be achieved only in 80% of cases. This method is recommended to be combined with physiotherapy and medication.

In case of arthrosis of the III and IV degrees, an operation is prescribed for a complete or partial replacement of the joint. After it, the person becomes able-bodied again. However, such an operation requires a long recovery period, so doctors try to either avoid the operation or delay it as much as possible.

Arthritis of the knee

This is an inflammatory process that can be primary or secondary. In the first case, the infection enters the joint cavity from the environment (for example, as a result of an injury), and in the second case, it enters the joint cavity from another organ with blood and lymph flow.

Depending on the causes of the disease, arthritis can be:

Specific (caused by pathogens of syphilis, gonorrhea or tuberculosis);

Nonspecific (purulent or rheumatoid arthritis);

Infectious-allergic (developing against the background of infectious diseases: tuberculosis, brucellosis and viral infections);

Aseptic (rheumatoid arthritis, Bechterew's disease).

The most common is rheumatoid arthritis (drives) of the knee joint. Its course can be both acute and chronic. A sign of the acute form is the accumulation of exudate in the joint cavity, which can be serous, fibrous or purulent. The latter depends on the cause and stage of the disease.

Patients complain of redness, severe pain and swelling in the area of ​​the affected joint. In addition, limited movement and a half-bent position of the leg are noted. The latter allows you to reduce pain, so patients use it unconsciously.

Purulent lesion of the knee joint is characterized by an acute onset, a sharp increase in body temperature, general intoxication and chills. In addition, swelling of the joint is noted. Purulent inflammation of the articular bag is dangerous because it often leads to its perforation and the ingress of pus into the tissues of the thigh and lower leg, followed by the formation of phlegmon. It is also possible for the infection to enter the bloodstream.

In the chronic course of arthritis of the knee joint, the patient complains of pain, swelling and impaired motor functions. It should be noted that the listed symptoms are less pronounced than in the acute form.

The cause of chronic persecution can be an acute inflammatory process with a weakened immune system and improper (or insufficient) treatment. The disease can immediately take a long (sluggish) course. The result of a chronic form of arthritis is persistent ankylosis of the knee joint. This is a disease that is characterized by a complete lack of movement and pain in the knee and muscle atrophy.

If at least one of the signs of arthritis appears, you should consult a doctor. After the examination, he may order an x-ray of the knee joint. Puncture and arthroscopy are also used to diagnose this pathology. These procedures make it possible to collect exudate in order to conduct a bacteriological analysis. This determines the type of pathogen and its sensitivity to antibiotics, which allows you to prescribe the correct treatment.

In addition, when puncturing the knee joint, drugs can be injected into the focus.

Treatment

Treatment of acute persecution is carried out in a hospital. With the help of a plaster cast, joint mobility is limited, and antibiotics and drugs are prescribed to increase immunity. In addition, physiotherapy and blood transfusions may be indicated.

With purulent drive, an operation is prescribed to open and drain the articular bag.

Knee joint injuries, diagnosis and treatment

Rupture of the anterior cruciate ligament

The anterior cruciate ligament of the knee joint is injured much more often than others. Injuries are mainly associated with sports training.

On impact to the side of the leg (when the foot is planted on the ground), the anterior cruciate ligament is torn along with the tibial collateral ligament.

Rupture of the anterior cruciate ligament is possible with a significant stretching of the knee joint. The cause of damage can also be a sharp push during certain strength exercises (for example, when bending over with a barbell on the shoulders).

Athletes check the degree of stability and condition of the anterior cruciate ligament using the "drawer" method. Its essence is as follows. The subject assumes a sitting position on a chair with knees bent at a right angle and relaxed. The trainer places both hands on the back of the upper calf (just below the knee joint) and gently pulls the shin forward. In this case, the athlete should not strain the knee. When the tibia moves forward (relative to the femur), we can talk about a rupture of the anterior cruciate ligament.

So, what is the danger of such a knee injury? In most cases, this damage leads to joint instability. Although sometimes due to the strength of the muscles and other ligaments, it retains relative stability.

The injury is diagnosed without opening the knee and other drastic measures using magnetic resonance imaging. However, due to the rather high cost of this procedure, many insurance companies resort to the method of knee arthroscopy. This procedure involves making 2-3 holes around the knee joint. A special device is placed in one of them so that you can check the joint for damage, and if necessary, repair them.

Treatment

If the damage is minor, then the ligaments are treated arthroscopically. This is what the rest of the holes around the knee are made for.

In the absence of timely treatment of rupture of the anterior cruciate ligament, arthritis of the knee joint develops. In the case of severe instability of the latter, an operation is indicated to reconstruct the damaged ligament. Within a few months after it, a person can return to their previous lifestyle and play sports.

Rupture of the posterior cruciate ligament

A characteristic sign of a ruptured posterior cruciate ligament is knee instability. This can be verified with a test used to diagnose an anterior cruciate ligament tear. The difference is that you need to put your hands on the anterior surface of the tibia just below the knee joint and put pressure on it. A posterior displacement of the tibia (relative to the femur) indicates damage to the posterior cruciate ligament.

In some cases, such a test is not suitable for checking for a severe tear in the ligament, and then other methods are used (for example, magnetic resonance imaging).

Treatment

Timely treatment of the injury is of great importance, since an advanced form can lead to chronic arthritis of the patella and femur.

In the past, doctors did not recommend surgery unless the patient was over 60 years of age and had little physical activity. With small gaps, the operation was not performed, hoping for a favorable outcome.

Today, the view on this issue has been revised, because in order to maintain the health of the joints, a person must move as much as possible. Surgical repair of a damaged ligament is recommended for young people and athletes, as well as in cases where a severe tear begins at the anterior border of the tibia and ends at the posterior femoral condyles.

With regard to the removal of this ligament, this leads to instability of the joint in the posterior and lateral directions, as well as the need to wear a knee brace when playing sports, outdoor games, running and cycling.

Not too long ago, surgeons tried to save part of a torn ligament by using the curvature of the bone to attach the damaged segment to it. This is a very difficult job that requires precision and experience from the doctor. Nevertheless, such operations give good results.

In some cases, the knee needs to be immobilized for some time after surgery. This promotes better ligament recovery, but is detrimental to the muscles that surround the knee. In the stretched position of the joint, stretching of the quadriceps is reduced, which causes loss of muscle mass and atrophy.

With a successful operation, the joint will work well and not cause pain. However, it is important to remember that an injured knee will always be prone to injury and take care of it. In addition, gentle muscle strengthening is recommended to improve joint stability.

This disease is most susceptible to people of different age groups and especially professional athletes. At a young age, the pathology manifests itself in an acute form. As a result of an awkward movement, step or jump, the meniscus is damaged, manifested by acute pain.

Pain is associated with blockade of the knee. Between the articular surfaces, a meniscus or a broken piece of cartilage is pinched. First, a click is heard, and then a sharp pain occurs, which forces the victim to pay attention to the injury. After a few minutes, the foot adjusts to the pinch and the discomfort is reduced. However, if you do not see a doctor in time and do not take the necessary measures, the pain will reappear and will be accompanied by swelling of the injured knee. The latter is a protective reaction of the body, which tries to dilute the articular surfaces by increased production of intra-articular fluid and increased pressure in the joint.

With a running course, the injury becomes chronic. The pain in the knee either increases or decreases (depending on the load, weather conditions, etc.), and a slight swelling also periodically appears.

In older people, as a rule, chronic meniscopathy is observed. Infringements occur more often, but do not give such sharp symptoms as in the acute course of the disease. In addition, in most cases, meniscopathy in the elderly does not cause arthrosis, but, on the contrary, appears as a result of age-related changes in the joint.

Treatment

With a timely reposition (putting the meniscus in place using manual techniques), there is a high probability that the injury will pass without consequences. However, in most cases, it is not treated with manual methods, but with physiotherapy and drugs.

As a result, only a decrease in swelling and pain is observed, and the infringement of the meniscus becomes chronic. This means that the articular surfaces of the knee are not "fitted" to each other properly, which leads first to a redistribution of the load on the joint, and then to arthrosis. In some cases (if the infringement of the same meniscus is repeated many times), with meniscopathy, an operation is performed, the purpose of which is to remove the damaged meniscus. But usually this disease is treated with therapeutic methods. Despite the fact that as a result of the operation, the tissue and functions of the damaged joint are quickly restored, the absence of the meniscus leads to osteoarthritis of the knee over time.

In addition, the absence of menisci, which stabilize the joint during movement, is accompanied by an increase in the load on some structures of the joint, which causes cartilage destruction.

The most common cause of this injury is a fall on a bent knee. Sometimes this is due to a direct blow to the patella or pulling the tendon too hard. In the latter case, the lower part of the patella is torn off.

Mostly horizontal fractures are noted. The quadriceps tendon attaches to the top of the patella. She pulls him up, so a gap is formed between the bone fragments - this is a fracture with a displacement.

When the lower edge of the patella is torn off, the fracture line runs in its lowest part (that is, in the place where there is no cartilage). If there was a blow of considerable force and at high speed, then there is a high probability of a multi-comminuted fracture, which can be with or without displacement of fragments.

In the case of a vertical fracture, its line runs from top to bottom. As a rule, there is no displacement, since the pull of the muscle is directed along the fracture line. However, in clinical practice, there have been rare cases of displacement in such fractures. They occur with dysplasia of the condyles of the femur and displacement of the patella to the side.

There are also osteochondral fractures, in which part of the articular surface is torn off.

A fracture of the patella can be suspected when the following signs appear:

Sharp pain, aggravated by trying to lean on the injured leg or stretch it;

Edema. Since the fracture of the patella is intra-articular, its line runs along the sliding articular surfaces. Like other fractures, it causes bleeding, and since the fracture line is in contact with the joint cavity, it fills with blood and swells. This condition is called hemarthrosis and is characterized by a feeling of fullness and limited movement;

Difficulties in straightening the leg or raising it in a straightened state (this symptom is not always observed and depends on the nature of the fracture);

Deformity of the patella, which can be felt (retraction).

Some time after the fracture, a bruise appears on the skin - a consequence of soaking the tissues with blood. It gradually descends to the level of the foot. This is a normal process with a fracture of the patella, which should not be alarming.

Alarming symptoms are a rapid increase in bruise size, impaired sensitivity and increased swelling.

First aid for a fracture of the patella is to apply ice and immobilize the limb in a straightened position. After that, you need to contact a specialist.

For an accurate diagnosis, radiography is used, which is performed in frontal and lateral projections. With a vertical fracture, an axial projection is also made. In some cases, computed tomography and magnetic resonance imaging are additionally performed.

Treatment

Treatment depends on the nature of the fracture and displacement of fragments. Distinguish between stable and unstable fractures. With stable fractures, there is no displacement (these include vertical ones). Unstable fractures are characterized by displacement, or a predisposition to it. The nature of the fracture can only be determined by a specialist.

The patella slides with its back surface along the condyles of the femur, so it is important that this surface remains flat and nothing interferes with movement. Otherwise, the irregularities of the patella can lead to the development of post-traumatic arthrosis (the cartilage will be erased, and the joint will start to hurt).

Stable fractures without displacement are treated conservatively. The leg is immobilized in a straightened position with the help of a cast for 1–1.5 months. During this time, control radiographs are taken. After the cast is removed, the joint is developed to restore range of motion and muscle strength.

If the fragments are displaced by more than 3 mm and there are steps on the joint surface of more than 2 mm, an operation is performed, the goals of which are to match the fragments, restore the joint surface and fix the patella (osteosynthesis).

If a significant displacement has occurred as a result of a fracture, then the fragments may not grow together, since their surfaces do not touch each other. Surgery is necessary because the patella may not heal at all if the displacement is not corrected. In this case, the patient will not be able to bend and unbend the leg at the knee, or arthrosis of the patella-femoral joint will develop. It should also be noted that conservative treatment involves long-term immobilization of the joint, which is subsequently quite difficult to develop. The operation allows to achieve reliable fixation of fragments and to start using the injured leg earlier.

The choice of method for fixing the patella depends on the type of fracture. Optimal for a transverse fracture is the use of a special medical cerclage (wire) and knitting needles. This operation was named after its inventor - Weber.

In some cases, fragments can be well fastened with screws or screws and wire. A multifragmented fracture requires the use of the latter option. If there is a detachment of the lower edge of the patella, and the fracture line does not pass along the articular surface, then a small fragment is simply removed, after which the patellar ligament is sutured. This operation is called a patellectomy. After the operation, a plaster is applied to the injured limb for the period determined by the doctor.

Unfortunately, even with the correct comparison of fragments, arthrosis can develop, which will periodically cause pain in the anterior part of the joint.

Excess weight is the enemy of the knee joint

Cars, elevators, TV remote controls and other home appliances have reduced the need to move to a minimum. A direct consequence of this is a significant reduction in energy costs and obesity.

It is not difficult to guess about the direct dependence of joint diseases on excess weight. Among people suffering from deforming arthrosis, most of them have obesity of one degree or another. The fact is that in an obese person, the load on the joints of the lower extremities and spine, as well as on the ligamentous apparatus, increases significantly.

An example is a simple calculation. The menisci serve as a support for the condyles of the femur in the knee joint, the area of ​​\u200b\u200beach of which is 14.5 cm 2. If a person's weight does not exceed 70 kg, then the load per 1 cm 2 of his menisci will be no more than 4.5 kg. However, the impact on the supporting surface of the joints increases in proportion to the increase in weight. With a body weight of 100 kg, the pressure increases by 7 kg, and with 120 kg - by 8 kg, etc.

The more stress placed on a joint every day, the faster it wears out. It can be compared to a bearing, which is also designed for a certain external influence.

In addition, obesity adversely affects the lymph and blood circulation, which causes congestion in the tissues of the joint, which do not receive the necessary nutrients. In addition, overweight people are more likely to develop flat feet.

Metabolic disorders can be attributed to both causes and consequences of obesity. It causes many non-inflammatory diseases of the lower extremities and spine. It should be noted that the latter are much more common than inflammatory ones. Many of them are related to degenerative-dystrophic changes. The most common pathologies of this type are deforming arthrosis, osteochondrosis and spondylosis.

With these diseases, the pathological process affects the intervertebral discs and cartilage that covers the articular ends of the bones. The cartilage softens, cracks appear in it, and in some areas it collapses. In this case, the articular ends converge, and during movement, the friction between them increases. As a defensive reaction, the body tries to redistribute the load and smooth out defects in the cartilage in every possible way, which leads to the growth of bone tissue along the edges of the articular surfaces and the formation of spikes. The latter injure adjacent ligaments and the articular bag. The most severe lesion is characteristic of the knee, hip and ankle joints.

In the initial stages, the disease almost does not manifest itself. Fatigue and a slight crunch in the affected joints may appear. After some time, pain occurs at the beginning of the movement (after a state of rest), long walking, exercising in the gym, cycling, etc. A progressive pathology is indicated by pain that increases at the beginning of the movement, then decreases, and increases again in the evening . Quite often, this does not allow a person to sleep normally.

With constantly increasing pain, the muscles reflexively contract, which increases the load on the articular surfaces of the bones and cartilage, which is gradually destroyed. Patients note a feeling of stiffness and tightness in the joints, difficulty in flexion, extension and walking. These symptoms together not only cause a person constant discomfort, but also force him to change his usual way of life. As a rule, patients stop playing sports and try to avoid physical activity altogether, which leads to even greater weight gain.

In most cases, doctors prescribe to such patients many drugs to relieve inflammation and reduce pain, as well as physical therapy, but many of them forget that all of these measures will not give the desired result until the weight is reduced.

Of great importance is the revision of the diet, the introduction of foods containing calcium into the diet, the restriction of chocolate, sugar, confectionery, etc. Be sure to eat vegetables and fruits that are rich in nutrients and give a feeling of satiety. Another very important condition is the reduction of food portions by at least half.

Relieve knee pain with traditional methods

Why rest is important during an exacerbation of joint pain

The inflamed joint must be rested, otherwise the risk of damage to the membrane covering its surface increases. The inflammatory process can spread to the bone and cause its deformation. Joints can be bent and twisted, which leads to a violation of their function.

But how to limit the load on a sore joint if you need to go to work and do everyday things? With severe inflammation, it is necessary, if possible, to observe bed rest and reduce movements to a minimum. If you can walk and the pain is not strong, you should pay attention to what movements and body positions cause discomfort and, if possible, abandon them.

In specialized stores, you can buy devices that facilitate various types of stress on the joints and strengthen the muscles around them. If your work is associated with heavy physical labor, heavy lifting or prolonged stay in a forced position, then it must be changed. A special regimen is necessary in the early stages of arthritis to ensure the prevention of joint deformity.

When inflammation develops, it is necessary to monitor your movements so that the joint does not experience repetitive pressure, leading to arthritis. During the period of remission, it is also necessary to provide the joints with a sparing regimen and avoid overloading. Moderate physical activity is recommended, especially therapeutic exercises.

Painkillers for the knee

In the treatment of inflammation of the knee joint, painkillers are necessarily used, the purpose of which is to relieve pain. These are non-steroidal anti-inflammatory analgesics and other similar drugs.

Doctors most often individually prescribe drugs that slow down the activity of an enzyme that forms foci of inflammation. Their use not only helps to get rid of pain, but also effectively reduces the activity of the inflammatory syndrome.

What not to do with knee pain

In diseases of the knee joint, there are certain limitations that must be remembered by everyone who has ever experienced pain in it.

You can not supercool, especially during an exacerbation. In this regard, summer is quite dangerous. Prolonged stay in a pond with cool water, the use of a fan and air conditioning - all this can provoke an exacerbation of the disease of the knee joint.

When playing sports, make sure that the level of physical activity is sufficient, but not excessive. The diseased joint must be spared. If you experience discomfort in this area, you must immediately stop exercising and ensure peace of the joint. Do not exercise if it is red and swollen. From the complexes of therapeutic exercises, choose only those that were designed specifically to improve the condition of diseased knee joints.

Do not overeat, give up foods rich in "empty" carbohydrates and contribute to obesity. Eat food rich in ballast substances - it normalizes the functioning of the intestines and has a positive effect on metabolic processes in the body. Remember: the diet should be balanced and contain enough calcium.

How to restore joint mobility without pills

Nutrition for joint health

As noted above, a balanced diet is one of the important conditions for maintaining joint health. This is very important both for existing diseases and in terms of their prevention. What does it mean to diet? Special (in this case, therapeutic and preventive) nutrition involves a variety of diets, restriction (or complete exclusion) of some products and the obligatory use of others.

When planning your menu, take care to reduce the amount of animal fats. They must be replaced with fatty marine fish rich in omega-3 acids (sardine, mackerel, tuna, pink salmon, salmon, etc.). The results of numerous studies have shown that these acids reduce the activity of enzymes that destroy cartilage, as well as reduce inflammation. With age, the joints become more fragile, so you need to eat more fish and seafood. It is very important that fish do not include omega-6 acids, as they increase inflammation in the body.

People suffering from joint diseases are advised to drink 800 ml of milk (medium fat, not skim) and eat 2 oranges or tangerines a day. Citrus fruits contain a lot of ascorbic acid, which prevents pathological changes in the joints.

Very useful freshly squeezed fruit and vegetable juices, as well as salads from raw fruits and vegetables. It is advisable to fill the latter with vegetable oil, lemon juice or low-fat unsweetened yogurt without dyes. Of the fruits for the joints, the most useful are apricots, apples, raspberries, chokeberries, plums, etc. In the cold season, they can be partially replaced with dried fruits.

Instead of chocolate and tea buns, it is better to eat honey, which enhances the production of synovial fluid. It is very important to drink enough water, because without it, the cartilage linings crack. For the health of the joints, you need to consume it at least 2.5 liters per day. In addition, green tea, birch sap and herbal infusions are recommended. Black tea and alcoholic drinks are harmful to the joints, so it is better to refuse them.

In order for the joints to be in good condition, they need foods high in calcium: cheese, cottage cheese and lentils.

Physical activity - how not to harm the knee

In people involved in sports, the first pain in the joint usually makes itself felt during training. A feeling of infringement and discomfort can also appear in a healthy leg, because an additional load is placed on it, because when walking and exercising, a person spares the diseased limb.

Is it possible to play sports with joint diseases? It is possible and even necessary, but very moderately and only after consulting a doctor. Prohibited and permitted loads depend on the nature of the pathology and the stage of its development.

You can improve the condition of the affected joints with the help of therapeutic exercises. Specially selected exercises have a beneficial effect on the nutrition of the tissues of the joint and strengthen the muscles of the thigh and lower leg, preventing their atrophy.

At the initial stage of arthrosis, you can perform various exercises for the legs, with the exception of power, squats and options performed on your knees. Remember: exercising from time to time, you will only harm an already weak joint. If the loads are rare, then the joint that is not prepared for them will react with increased pain and inflammation. Therefore, an important condition for achieving a positive result is the regularity of classes. Plan your time and choose 20-30 minutes that you can spend daily on classes.

Gymnastics to improve joint mobility

In addition to the general strengthening complex of physical therapy exercises, you can perform special exercises for the knee joints. With limited mobility, atrophy of the thigh muscles and pain (both when walking and at rest), do not proceed with exercise 5 and those options in which you need to stand. Gymnastics is performed at a slow pace. The number of repetitions during the first 2 weeks is 4–5. With good health, this number can be gradually increased to 10. If you cannot do all the exercises, choose a few of them.

Many people place a small pillow under their knee when pain occurs, but this is wrong. Also, you should not rest with your leg bent at the knee, because a long stay in this position causes a flexion contracture, which is difficult to correct. Rest in the supine position with your legs straight out to the sides. The muscles should be relaxed.

Take a sitting position on the bed, lower your legs down. Alternately bend and unbend your knees.

Take a sitting position on the bed, lower your legs down. Using your hands, pull your knee towards your stomach, and then straighten your leg. Repeat with the other leg.

Take a sitting position on the bed, lower your legs down. Straighten your legs and pull your feet towards you.

Take a sitting position on the couch, straighten your right leg, lower your left leg down.

Perform a half turn to the right, placing your hands on the knee of your right leg.

While inhaling, make three springy tilts, slightly pressing on the knee joint. Then repeat with the other leg.

Take a sitting position on the bed, straighten your legs. Leaning on your hands, tighten the muscles of the thighs, and then relax them. During the exercise, the popliteal fossae should be pressed against the surface of the bed.

Take a position lying on your back, stretch your arms along the body. Then lift them up, take them back and stretch, stretching your feet towards you. Relax and then repeat the exercise.

Take a position lying on your back, bend your legs at the knees. Straighten your right leg, lifting it up, and then slowly lower it. Repeat the exercise with the other leg.

Take a supine position, straighten your legs. Take one leg out to the side and then return to the starting position. Repeat with the other leg.

Take a position lying on your back, stretch your arms along the body. Raise your legs up and perform movements, as when riding a bicycle.

Take a standing position, rest your hands on the back of the chair. Take one leg to the side, then the other.

Take a standing position sideways to a chair, with one hand lean on its back. Perform leg swings forward and backward. Repeat the exercise with the other leg.

Self-massage of the knee joint

Self-massage should be performed after therapeutic exercises and before going to bed. If you practice 1 time per day, then the duration of the procedure should be 15 minutes, and if 2-3 times, then 10 minutes will be enough. When performing massage techniques, be careful: do not exert strong pressure on the joint and do not twist it. If discomfort occurs, immediately stop the procedure and let the sore leg rest. You need to massage both limbs, even if only one of them bothers you.

Rub the lateral surfaces of the joints with back and forth movements.

Massage the left knee with the right hand, the right knee with the left. The number of repetitions is 5–7.

Place your right hand on your right leg just above the knee and stroke in different directions. Do the same with the other leg. The number of repetitions is 8.

Press the palms and tubercles of the thumbs firmly against the side surfaces of the knee joint and move them back and forth. Then the same with the other leg. The number of repetitions is 5.

Place your thumbs lightly on the top of your knee. With the pads of the remaining fingers, perform circular movements along the lateral surfaces of the joint. The number of repetitions is 10.

Perform stroking with the palm of the outer side, first the right and then the left knee joint. The number of repetitions is 6.

Bend your right leg at the knee joint, turning it outward. Use both hands to stroke the inside of the joint. Do the same with the other leg.

Clench the fingers of both hands into a fist and lightly rub the joint of the right leg with the protrusions of the phalanges. Do the same with the other leg. The number of repetitions is 6–7.

Lay your hands on top of each other, clasp your fingers and use the base of your palm and the tubercle of your thumb to move from the knee joint to the hip joint. Do the same with the other leg. The number of repetitions is 6–7.

Stretch your right leg on the bed, and lower your left leg down. Turn your body slightly to the right and relax your thigh muscles. Place the hands of both hands across the massaged muscles. The distance between it should be 8 cm. With your fingers, grab the muscles tightly and pull them up. Movements should be smooth. Do the same with the other leg. The number of repetitions is 6–8.

Relax the muscles of the thigh of the right leg, grab them with the thumb and little finger of the right hand and perform oscillatory movements in the transverse direction (relative to the axis of the thigh). Do the same with the other leg. The number of repetitions is 6–8.

Place the hands of both hands on the muscles of the left leg just above the knee and perform tapping with the edge of the palms. The movements should not be intense, and the muscles should not be tense. Do the same with the other leg. The number of repetitions is 6–8.

Take a sitting position on a chair, take your right leg to the side and, slightly bending at the knee, put it on your toe. With the base of the palm of your right hand, stroke from the popliteal fossa to the buttock. Straighten your toes, tightly grasp the massaged muscles and make rotational movements. Do the same with the other leg. The number of repetitions is 6–8.

With atrophy of the muscles of the anterior surface of the thigh, it is necessary to massage the points located along the nerve trunks.

The first is located on the outer surface of the thigh just above the patella, the second is on the outer surface of the thigh just below the patella. Perform rotational movements in the area of ​​\u200b\u200bthese points with the pads of the thumb, index and middle fingers folded together. The number of repetitions is 6–8.

Sand is an effective means of prevention and treatment of inflammatory diseases of the joints. It is used for both general and local treatments. The convenience of this method of heat treatment lies in the fact that it can be practiced, for example, while relaxing on a sandy beach. To achieve the desired effect, the sand must be warm enough.

To use this method at home, collect enough sand, sift through a fine sieve, rinse and dry thoroughly. Use only clean river or sea sand, which does not contain gravel and clay impurities. In most cases, it is applied to the affected joint, that is, it is used topically. To do this, it must be heated in the oven to a temperature of 50–60 ° C, then poured into a bag made of natural fabric, tied and applied for a while to the sore joint.

In summer, in hot weather, you can take general and local sand baths. To do this, you need to lie down on the heated sand (its layer should be at least 10 cm), and then fill up the body up to the chin (or only the limb with the affected joint). Important: the area of ​​the heart must be free of sand. With local exposure, the temperature of the sand may be higher, and the duration of the procedure longer.

The time of taking one sand bath is 20–30 minutes, and the course of treatment is 15–20 procedures. After each session, you need to take a warm shower.

Sand treatment is contraindicated in diseases and injuries of the skin, acute inflammatory diseases, active tuberculosis, heart pathologies, anemia, bleeding tendencies, tumors and exhaustion.

Clay has an anti-inflammatory effect, restores damaged tissues and helps relieve pain. Due to these properties, it is often used in diseases of the joints.

Clay is no less effective than anti-inflammatory ointments. However, it, unlike them, has no side effects, does not cause allergic reactions and promotes wound healing.

Clay wrap to relieve swelling

Dissolve 20 g of honey and 20 ml of lemon juice in water, fill it with clay and mix until a homogeneous mass is formed. Apply the resulting product in a thick layer on gauze, wrap around the diseased joint and cover with a woolen or flannel cloth for 1-2 hours. Wash off the residue with warm water. The course of treatment - 10 procedures.

Clay compress to relieve swelling and redness

Dilute 30 g of clay with water to the consistency of a viscous slurry, apply it to the sore joint and wrap it with plastic wrap. After 30-40 minutes, wash off the remnants of the product with warm water. The course of treatment - 10 procedures.

Clay compress with a decoction of herbs to relieve pain and inflammation

Combine 5 g of oregano herb, 5 g of rosemary herb and 5 g of crushed rosemary hop cones, pour 300 ml of water, bring to a boil and keep on low heat for 10 minutes, then cool and strain. Combine the broth with clay diluted in water and mix well. Moisten gauze folded in several layers in the resulting product, apply to the affected joint, wrap with plastic wrap and woolen cloth and leave for 1 hour. The course of treatment is 10–15 procedures.

Clay compress with honey and aloe for pain relief

Dilute the clay with water to a liquid consistency, add a little honey and aloe juice and mix thoroughly. Moisten a gauze bandage in the resulting product, apply it on the sore joint, wrap it with plastic wrap, woolen cloth and leave for 30–40 minutes. The course of treatment is 10–20 procedures.

Clay bath for pain relief

Dilute the raw clay with warm water and add some lemon juice. Place the foot in the resulting mixture so that it covers the sore joint for 30 minutes. The course of treatment is 10–20 procedures.

Clay bath with herbal infusion to relieve inflammation and pain

Combine dried rosemary herb, oregano and calendula and birch buds in equal proportions, fill with water and infuse for 30 minutes, and then strain. In the resulting product, dilute the clay and make a bath for the knee joint. The course of treatment - 10 procedures.

Clay bath with herbal decoction to relieve pain, redness and inflammation

Combine St. John's wort, chamomile, hemlock and burdock root (taken in equal proportions), cover with water, bring to a boil and keep on low heat for 10-15 minutes, then strain and cool. Dilute the clay with the decoction and make a bath for the diseased joint. The course of treatment is 10–15 procedures.

Clay lotions to relieve swelling

Dilute the clay with water to a liquid consistency, add a few drops of lemon juice, apply on gauze folded in several layers and apply to the affected joint for 25-30 minutes, and then rinse with warm water. The course of treatment is 4–5 procedures.

Clay application to relieve pain and inflammation

Dilute the clay with water to a thick consistency, add a little ground table salt and mix. Apply the resulting mass in a thick layer on the injured joint, wrap with a cotton cloth and leave for 20 minutes, then rinse with warm water. The course of treatment - 10 procedures.

Rubbing with clay water to relieve pain

Dilute the clay with water to a liquid consistency, add a little lemon juice and mix well.

In the resulting liquid, moisten a cotton swab and rub it on the sore joint. The course of treatment is 10–15 procedures.

Rubbing clay with garlic to relieve inflammation

Dilute the clay with water to a semi-liquid consistency, add a small amount of garlic, passed through a garlic press, and mix thoroughly. Dip a cotton swab into the resulting slurry and rub it on the sore joint. The course of treatment is 10–12 procedures.

Rubbing with clay water and mint to relieve redness and pain

Dilute the clay with boiling water to a liquid consistency, add finely chopped mint and a little honey melted in a water bath and mix thoroughly. Soak a cotton swab in the resulting liquid and rub the sore joint.

The course of treatment - 10 procedures.

Ice is an ambulance for a sore joint

If you are concerned about joint pain that appeared immediately after an injury or for other reasons, use the effect of cold.

The sooner you apply ice to the pain site, the better. For this purpose, you can use both ready-made ice and frozen vegetables, meat, etc. The duration of the procedure is 20 minutes.

Ice should be wrapped in a towel. Apply it 4-5 times a day until the swelling subsides. After that, the sore spot will need to be warmed in accordance with the recommendations of the attending physician.

Compresses for the knee joint

A compress is a bandage applied to a sore spot in order to relieve inflammation, pain and redness. To achieve the best effect, the place of the compress should be wrapped with a woolen or flannel cloth. The used dressing should be discarded and wrapped around the joint. In the intervals between procedures, it is recommended to rub fir oil into the affected area, which reduces pain.

hot steam compress

Fold a linen or waffle towel 2-3 times, soak it in boiling water, wring it out slightly and place it between two pieces of flannel fabric on a sore joint. To enhance the action of the compress, you can place a heating pad with warm water on top. The course of treatment is 10–14 days.

Compress with fresh coltsfoot leaves

Wrap the diseased joint with fresh coltsfoot leaves, wrap a woolen cloth on top and leave overnight. The course of treatment is 10–12 days.

Compress with radish

Grate the radish on a fine grater. Put the resulting slurry in an even layer on gauze, wrap around the diseased joint and cover with a flannel cloth. Leave the compress overnight. The course of treatment is 5–7 days.

Turnip compress

Boil the turnip and mash with a spoon. Put the resulting mass on a towel and wrap around the affected joint, cover with a flannel or woolen cloth on top. Leave the compress on for 2 hours and then rinse with warm water. The course of treatment is 1-2 weeks.

Compress with infusion of wormwood

Pour 20 g of wormwood with 250 ml of boiling water and insist for 30 minutes, then strain, moisten gauze folded in several layers in the resulting product, wrap it around the diseased joint, cover with a cloth on top and leave for 30 minutes. The course of treatment is 2-3 weeks.

Compress with steamed linden flowers

Hold the linden flowers over the steam for 20–25 minutes, then lay them evenly on a napkin and wrap around the sore joint. Cover the compress with a flannel or woolen cloth and leave for 1-2 hours, then rinse with warm water. The course of treatment is 3 weeks.

Compress with a decoction of birch leaves

Pour fresh birch leaves with water, bring to a boil and keep on low heat for 20 minutes, then drain the water. Put the leaves in an even layer on a gauze bandage, wrap it around the diseased joint and cover with a flannel cloth.

Leave the compress for 6-8 hours. The course of treatment is 1-2 weeks.

Compress with apple puree

Grate apples on a coarse grater. Put the resulting mass in an even layer on gauze folded in several layers and wrap around the affected joint, and cover with a woolen cloth on top. Leave the compress for 6 hours. The course of treatment is 21-30 days.

Compress with infusion of hop cones

Grind a few hop cones, pour 300 ml of boiling water and leave for 1 hour in a thermos. Then strain, moisten a gauze bandage in the resulting product, wrap it around the diseased joint, cover with a warm natural cloth on top and leave for 1-2 hours. The course of treatment is 1-2 weeks.

Compress with vodka, honey and aloe juice

Combine 50 ml of vodka, 100 g of honey and 150 ml of aloe juice and infuse for 3 days. Soak a gauze bandage in the resulting product, wrap it around the affected joint and leave for 20 minutes. The course of treatment is 3-4 days.

Compress with wood lice herb

Rinse the woodlice grass, steam it, put it on the sore joint and wrap it with plastic wrap and flannel cloth. Leave the compress overnight. The course of treatment is 1-2 weeks.

Compress with honey, mustard and vegetable oil

Combine 20 g of honey, 10 g of dry mustard and 20 ml of vegetable oil and heat over low heat. Put the resulting mass on double-folded gauze, wrap it around the diseased joint, cover with plastic wrap and flannel cloth. Leave the compress for 1.5 hours. The course of treatment is 1 week.

Compress with alder leaves

Soak alder leaves in hot water, put on a sore joint and wrap with a towel. Leave the compress for 2 hours. The course of treatment is 2-3 weeks.

Compress with chamomile flowers and black elderberry

Steam the chamomile and elderberry flowers, place in a gauze bag, tightly attach it to the sore joint and fix it with a flannel cloth. Leave the compress for 1 hour. The course of treatment is 10–14 days.

Compress with sweet clover grass

Grind the sweet clover grass, pour over with boiling water and put it in a colander. As soon as the water drains, lay the resulting mass in an even layer on a towel and wrap the affected joint with it. Leave the compress for 2 hours. The course of treatment is 1-2 weeks.

Baths for the knee joint

With exacerbations of diseases of the joints, baths will help relieve inflammation and reduce pain.

Bath with vegetable oil and garlic

In 1 liter of hot water, add 50 g of minced garlic, mix well and dip your feet in it for 15 minutes. After that, wipe your feet dry and lubricate the sore joints with vegetable oil. The course of treatment is 2 weeks.

Bath with spruce cones

Add 200 g of spruce cones to 1 liter of boiling water and infuse in a thermos for 1 hour. Add the resulting product to a container of hot water and make a foot bath. The duration of the procedure is 30 minutes. The course of treatment is 2-3 weeks.

Bath with oak and willow bark

Pour 50 g of oak bark and 50 g of willow bark with boiling water and insist for 30 minutes, then strain, add to a container of hot water and dip your feet into it for 25-30 minutes. The course of treatment is 10–15 days.

Bay leaf bath

Pour 50 g of chopped bay leaf with 40 ml of vegetable oil and keep in a water bath for 30 minutes.

Strain the resulting mass, add to hot water and dip your feet into it for 25 minutes. The course of treatment is 2 weeks.

Bath with beetroot juice

Add 200 ml of beetroot juice to 1 liter of water and pour into the bath. The duration of the procedure is 20 minutes. After that, wipe your feet dry and lubricate with softening cream. The course of treatment is 3 weeks.

Bath with lilac flowers

Combine 120 ml of vegetable oil with 50 g of crushed lilac flowers and heat in a water bath. Strain the resulting mass, add to the bath and keep the leg with the affected joint in it for 25 minutes. The course of treatment is 2 weeks.

Bath with chamomile flowers

Pour 30 g of chamomile flowers, pour 1 liter of boiling water and leave for 30 minutes. Strain the resulting remedy, let it cool slightly and lower the leg with the sore joint into it. The duration of the procedure is 10–15 minutes. The course of treatment is 2-3 weeks.

Bath with cherry flowers

Combine 50 g of fresh bird cherry flowers and 120 ml of vegetable oil and keep in a water bath for 25 minutes. Strain the resulting mass and pour into the bath. Place the foot with the diseased joint in it for 20-30 minutes, and then wipe it dry and lubricate it with a cream to relieve inflammation. The course of treatment is 1-2 weeks.

Tray with sweet clover grass, hops and St. John's wort

Crush 25 g of sweet clover herb, 30 g of hop herb and 15 g of St. John's wort, pour 1 liter of boiling water and insist for 30 minutes, then strain and pour into the bath. The duration of the procedure is 30 minutes. The course of treatment is 21 days.

Bath with parsley and wild garlic

Combine 30 g wild garlic and 20 g parsley, pour 1 liter of water and leave for 20 minutes, then strain and add to the bath. Place the affected leg in it for 20 minutes. The course of treatment is 20 days.

Bath with white cabbage

Pour 50 g of white cabbage leaves into 1 liter of hot water and infuse for 1 hour, then take them out and add the resulting liquid to the bath. The duration of the procedure is 25–30 minutes. The course of treatment is 14–20 days.

How to relieve joint pain folk remedies

There are many traditional medicine recipes for the treatment of joints. They can be used in combination with traditional methods or on their own. However, before being treated with such means, it is desirable to cleanse the body.

Bay leaf medicine to relieve inflammation and pain

Pour 20-25 bay leaves with 500 ml of boiling water and keep on fire for 5 minutes, then leave for 3-4 hours. Strain the resulting product and take in small portions throughout the day. The course of treatment is 3 days.

Rye grain medicine to relieve inflammation and swelling

Pour 250 g of rye grains into 2 liters of water, bring to a boil and keep on low heat for 30 minutes, and then strain. In the resulting broth, add 10 g of chopped barberry root, 30 g of honey and 500 ml of vodka, put in a dark place for 1.5–2 weeks. Take the finished product 60-100 ml 20 minutes before meals. The course of treatment is 2-3 weeks.

Horseradish remedy for pain and inflammation

Pour 1 kg of chopped horseradish into 4 liters of water, bring to a boil and keep on low heat for 5 minutes. Strain the resulting broth, cool, add 500 g of honey and store in the refrigerator. Take the finished product 200 ml per day for 1-2 months. Treat 1 time per year.

horseradish juice medicine for pain relief

Squeeze the juice from 350 g of horseradish and take a small amount throughout the day. The course of treatment is 1-2 weeks.

Cottage cheese medicine with calcium chloride to strengthen joints

Heat 500 ml of milk, add 40–50 g of 10% calcium chloride. Once the milk has curdled, remove the container from the heat. Cool the resulting mass, put it in a colander, cover with gauze and leave overnight. Take 200 g 1 time per day for 2 months.

Medicine from chestnuts for relieving inflammation and pain

Combine 500 ml of vodka and 300 g of finely chopped chestnuts and infuse for 2 weeks. Rub the sore joints with the resulting remedy at night. The course of treatment is 4–6 months.

Rice remedy for inflammation

Pour 50 g of rice with 250 ml of cold water and leave for 24 hours. Boil the resulting mass and eat in the morning without salt and bread. Normal food can be consumed after 2-3 hours. The course of treatment is 1-2 weeks.

Dandelion flower remedy for inflammation

Pour 20 g of dried dandelion flowers with 300 ml of boiling water and infuse for 1 hour, then strain and refrigerate. The resulting remedy, take 100-150 ml 2-3 times a day. The course of treatment is 2 weeks.

Thyme and Linden Blossom Medicine for Relieving Inflammation and Pain

Combine 10 g of thyme and 20 g of lime blossom, pour 350 ml of boiling water and insist for 30 minutes, and then strain. The resulting remedy, take 200 ml 2-3 times a day. The course of treatment is 1-2 weeks.

Nettle remedy for inflammation

Pour 10 g of dried nettle with 250 ml of boiling water and infuse for 30 minutes, then strain and take 80-100 ml 2 times a day. The course of treatment is 1-2 weeks.

Medicine from green tea and birch bark to relieve inflammation and pain

Combine 5 g of green tea and 5 g of crushed birch bark, pour 200 ml of boiling water and infuse for 15 minutes, then strain and drink in one go. The course of treatment is 3-4 months.

Onion medicine to relieve inflammation

Grind or pass through a meat grinder 200 g of onion and apply the resulting mass to the sore joint for 20 minutes 2-3 times a day. The course of treatment is 2 months.

Elecampane root medicine to relieve pain and inflammation

Pour 20 g of crushed elecampane roots with 180 ml of vodka and infuse for 12 days in a dark glass container. Use the finished product for rubbing. The course of treatment is 2–3 months.

Medicine from celandine to relieve inflammation

Mash 50 g of chopped celandine, put in a dark glass container, pour 1 liter of olive oil and leave for 2 weeks in a dark place. Strain the resulting remedy and use it for self-massage of the diseased joint.

Medicine from chalk and kefir to strengthen joints

Grind 100 g of chalk, combine with 200 ml of kefir and mix thoroughly. Put the resulting mass on a gauze bandage and apply to the sore joint for 30 minutes. The course of treatment is 6 months.

Medicine from white cabbage and vegetable oil to improve the condition of the joints

Combine 100 g of finely chopped white cabbage and 30 ml of vegetable oil and mix thoroughly. The resulting remedy, take 50 g 3-4 times a day. The course of treatment is 2-3 weeks.

A medicine made from white cabbage, honey and lard to relieve inflammation and improve the condition of the joints

Finely chop 100 g of white cabbage, combine with 50 g of liquid honey and 50 g of lard and mix thoroughly. Store the resulting product in the refrigerator and take 50 g 2 times a day. The course of treatment is 1 month.

Medicine from white cabbage and plums to improve the condition of the joints

Peel 200 g of plums, knead well with a spoon, combine with 100 g of finely chopped white cabbage and mix thoroughly.

The resulting remedy, take 50 g 2-3 times a day. The course of treatment is 2-3 weeks.

Broccoli and Sunflower Seed Medicine to Improve Joint Health

Chop 200 g of broccoli, add 100 g of sunflower seeds, 100 g of liquid honey and mix thoroughly. The resulting remedy, take 50 g 1-2 times a day. The course of treatment is 1 month.

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Many people know what pain in the knee joint is - this phenomenon is rather unpleasant and reduces the quality of life of a person, since pain causes limitation of mobility.

Trying to avoid pain, the patient begins to move less, resulting in hypodynamia.

As you know, prolonged immobility in the joints leads to diseases of the musculoskeletal system, the treatment of which requires regular medication and is not always successful.

The knee, hip and ankle joints are among the most complex in structure. The knee connects the femur and tibia, with the help of menisci, tendons and ligaments. Since the knee joints are located on the lower extremities, they experience the load of the weight of the entire human body.

If the knee joints are in a satisfactory condition, moderate loads on them are not only harmless, but also useful, and besides, they do not cause pain. For effective treatment of pain in the knee joint, it is necessary to know exactly the causes that provoked this condition.

The complexity of diagnosing pathology lies in the fact that there are many diseases of the knee joint. Therefore, a complete examination of the knee joint is required to clarify the diagnosis. In each individual case, an individual approach is necessary, since the symptoms of various joint diseases are very similar.

Only a comprehensive examination can guarantee the correct definition of the disease and the appointment of adequate treatment.

Diagnostic methods

For the correct diagnosis of the disease and identification of the causes that led to it, the doctor directs the patient to undergo a comprehensive examination. Treatment can be prescribed only after confirmation of the diagnosis.

Modern diagnostic measures include the following procedures:

1. x-ray examination;
2. computed tomography of the knee joint, thanks to which doctors have the opportunity to thoroughly examine human organs;
3. magnetic resonance imaging (MRI);
4. - This procedure is akin to surgery, but when it is performed, minimal trauma occurs. The method is carried out using an arthroscope, with which the doctor can examine the articular cavity from the inside;
5. general blood analysis;
6. a biochemical blood test is an additional research method for suspected joint diseases;
7. rheumatic tests.

A person must be aware that a neglected disease is much more difficult to treat than its primary form. Often, with complications, conservative therapeutic measures do not bring the desired result, and the patient needs surgery.

Most people trust the effectiveness of modern pharmaceuticals, which are widely advertised on television and on the Internet. Many medicines are really capable of providing recovery, however, it must be remembered that the reaction to certain medicines is individual for each person, so only a doctor can prescribe them.

Therefore, suspecting a disease of the joints, a person should not go to the pharmacy, but to see a doctor. Self-medication can not only delay the healing process, but also complicate the course of the pathology.

It is likely that self-medication can lead to temporary relief, but this does not mean that the disease has completely receded. In the future, the patient is likely to face arthritis, contracture and loss of motor function of the knee joint.

When a tendon or meniscus is torn, only surgery can save the patient from pain.

Test one:

• the patient lies on his back;
• the limb is 30 bent at the knee joint;
• the doctor holds the patient's thigh with one hand, and moves the lower leg forward with the other;
• knee flexors and quadriceps should be completely relaxed.

Evaluation: If there is movement of the lower leg relative to the thigh, then the anterior cruciate ligament is damaged. In this case, the end point of the displacement should not be clear and have a hard stop. If the stopping point is clear, this is evidence of the stability of the anterior cruciate ligament.

A tight stop at 3 mm displacement indicates absolute stability of the anterior cruciate ligament. A displacement of 5 mm or more confirms only the relative stability of the anterior cruciate ligament, a condition typical of sprains.

Suspicion of damage to the anterior cruciate ligament occurs when the end point of the displacement is completely absent or weakly expressed. If the range of motion of the drawer is greater than 5 mm, congenital laxity of the knee ligaments is suspected. To exclude such a pathology, a comparison with another knee joint should be made.

Non-contact Lachman test - if it is positive, dysfunction of the anterior cruciate ligament is confirmed. Test Method:

• the patient lies on his back and with both hands holds the thigh (near the knee joint) of the injured leg, bent at the knee.
• the patient should try to raise the lower leg above the table, while bending the leg at the knee should be maintained;
• when the patient performs this test, the doctor observes the tuberosity of the tibia.

With a healthy ligament, no change in the contour of the tuberosity is observed. Perhaps a slight displacement of the tuberosity forward. If there is an acute injury to the ligamentous apparatus, in which the medial collateral and anterior cruciate ligaments are damaged, there is a significant displacement of the tibial tuberosity forward (articular subluxation).

This test allows the doctor to exclude a complex limb injury in a non-contact way.

Functional testing of the posterior cruciate ligament

Posterior Lachman test (drawer test at 90 knee flexion). This test is performed with flexion and approximate extension of the knee joint. Its performance is similar to the front drawer test, but in this case, the posterior displacement in the position of internal, external and neutral rotation is evaluated.

Grade. Maximum posterior displacement when the knee joint is close to extension indicates isolated posteromedial instability. Minimal posterior drawer and maximal posterolateral rotation are observed at 90 knee flexion.

If there is an isolated rupture of the posterior cruciate ligament, maximum posterior displacement occurs during flexion. Posterolateral displacement is not observed in any of these positions.

With combined damage to the posterolateral structures and the posterior cruciate ligament, in any degree of flexion, a lateral opening of the joint space and an increase in posterior displacement are observed.

Houston test to determine recurvation (excessive extension) of the knee joint and external rotation.

Methodology:

• the patient lies on his back, both of his quadriceps muscles of the lower extremities are relaxed;
• the doctor alternately lifts each leg by the foot.

If posterolateral instability is present, this action can lead to recurvation of the knee joint in varus position with parallel external rotation of the tibia.

To clearly demonstrate recurvation and external rotation of the knee joint, the test should be performed alternately on both limbs. This is done as follows: the leg from a state of slight flexion at the knee is transferred to a position of full extension. The doctor places one hand on the posterior surface of the knee joint to allow palpation of the posterior sagging and external rotation of the proximal tibia.

Meniscus testing

Grinding test (determination of Apley distraction and compression):

1. the patient lies on his stomach, the test leg is bent at the knee at an angle of 90;
2. the doctor fixes the patient's thigh with his knee;
3. in this position, the doctor rotates the limb with alternate use of axial compression and distraction of the leg.

If the patient experiences pain during rotation, this indicates a ligament injury (positive distraction test). Pain on compression is indicative of a meniscal injury (positive torsion test).

With a meniscus cyst or discoid meniscus, a characteristic click may occur. Pain during internal rotation is typical of damage to the lateral capsule or lateral meniscus.

Pain during external rotation confirms damage to the ligaments, medial capsule, or medial meniscus.

If the posterior horns of the outer menisci are damaged and the ligaments of the capsule are stretched, this symptom does not appear.

Fouche Sign (McMurray Test)

Methodology:

• the patient lies on his back, the injured leg is maximally bent at the hip and knee joint;
• with one hand, the doctor grabs the knee joint, and with the other hand, the foot;
• first, in the position of extreme external, then internal rotation, the doctor performs passive extension of the patient's knee joint up to 90

Assessment of the situation:

1. If the patient has pain during extension in the state of external rotation and abduction of the leg, it is evidence of damage to the internal meniscus.
2. An injury to the external meniscus is indicated by pain during internal rotation.
3. A click in the position of maximum flexion is characteristic of a rupture of the posterior horn, in which the torn piece is infringed.
4. The crepitus that occurs on 90 flexion is typical of a medial meniscus injury.

Glide test performed to diagnose patellar instability.

Methodology:

• the patient is in the supine position;
• the doctor stands on the side opposite to the diseased joint;
• with the first and second fingers of the hand, the doctor grasps the proximal part of the patella, and with the other hand, its distal part;
• then, with the first fingers, the doctor tries to move the patella outward above the femoral condyle, at the same time, with the second fingers, he supports the kneecap - this is how the lateral test is performed;
• when performing a medial test, the doctor tries to move the kneecap in the opposite direction with the second fingers.

If there is a suspicion of excessive lateral displacement of the patella, stability can be achieved with this test. In this case, the test should be performed with a contracted quadriceps muscle. The patient should raise the straightened leg above the table, while the doctor evaluates the movement of the patella.

Arthrosis is increasingly common in people of a fairly young age (20-25 years). In the increased development of the disease, experts blame poor ecology and not quite the right lifestyle.

Introduction

A large number of people do not at all attach importance to the primary symptoms that directly indicate the onset of arthrosis, and do not even think about visiting a doctor. This is a big omission, because such a disease without treatment can lead to disability and even disability.

But often the reason is not laziness, but a simple lack of information about which doctor treats joints. Joints are treated by specialists of several categories: in each specific situation of the development of the disease, a doctor is required to treat specific pathologies.

Symptoms that indicate the need to see a doctor

Immediate medical attention requires the presence of certain symptoms:

1. Discomfort in the articulation area, gradually turning into constant, fairly severe pain.
2. Sensation of sharp attacks of pain, with the inability to move the affected parts of the body.
3. Swelling and redness of the skin, crunching in the joints of the legs, arms or fingers.
4. Shape change.

Causes of pain:

• inflammatory processes in the body;
• infection through open wounds near the joint;
• trauma;
• metabolic disease.

Which specialist treats joints

Joint diseases have two types of development:

1. Degenerative-dystrophic - the active nutrition of cartilage tissue is disrupted.
2. Inflammatory - serious inflammatory processes develop, including synovial membranes, cartilage, ligamentous apparatus.

It is by the etiology and mechanism of the lesion that they determine which doctor should be consulted.

Rheumatologist

This is a doctor of a therapeutic profile, works exclusively with the initial stages of diseases against the background of viral infections. If you find a slight soreness of the joints, increased fatigue due to stress, you should consult a rheumatologist. The specialist will prescribe all the necessary studies after he finds out the causes of pain in the joints of the arms and legs:

• x-ray;
• rheumatic tests.

It is important to determine the presence or absence of viruses in the body. After carrying out all diagnostic measures, the doctor will make an accurate diagnosis, give recommendations for further treatment. Treatment by a rheumatologist is only conservative, with the use of intra-articular injections, physiotherapy, massage or exercise therapy. In more complicated stages of the disease, he will refer you to the right specialist.

Orthopedist-traumatologist

When treatment with conservative methods does not bring results, the disease takes on a more complex form, then you need to contact an orthopedic traumatologist. The doctor is engaged in surgical methods for restoring the functions of the joints. The main symptoms for contacting this specialist:

1. Complete or partial destruction of the joint.
2. Deformation, up to a complete loss of motor ability.
3. Pain is present all the time, even at night.

An orthopedic traumatologist performs several types of surgical intervention:

1. Organ-preserving operations (joint resection, arthroplasty, arthrodesis) - this type of intervention helps to eliminate pain, restore natural functions, while preserving as much of the patient's own tissue as possible.
2. Endoprosthetics - this type of operation is performed in the most severe forms of arthrosis, with complete destruction of the joint. There is a complete replacement of the joint with a prosthesis to ensure full motor activity.

Most often, prosthetics are performed on the knee and hip joints. The goal is to restore the normal course of life, to avoid disability.

Neurologist

Naturally, few people go with joint pain for a consultation with a neurologist, but the role of this specialist is quite large in the treatment of pain, including pain in the joints of the arms, legs and fingers. There is a possibility of neurological causes of the development of the disease - this is a pinched nerve by the spine or an inflammatory process of the nerve ending. It is with such lesions that a neuropathologist will help fight.

Endocrinologist

A doctor of this profile can help with arthritis associated with metabolic disorders: many diseases appear against the background of stress and malnutrition. Due to impaired metabolism, there is an active layering of salts on the joints, which quickly lose elasticity and are at risk of impaired functionality. An endocrinologist will help restore metabolic processes in the body, prevent the development of arthritis.

Which doctor treats osteochondrosis

To determine which doctor treats the joints of the spine, you need to know some features.

Osteochondrosis is a pathological change in the spine. The development of the disease has two factors:

Joint treatment More >>

1. Changes in the bone and cartilage tissues of the vertebrae.
2. Inflammation and pinching of the roots of the spine.

Therefore, the treatment of the disease is carried out by doctors of two specialties:

1. Orthopedist - prescribes treatment to restore the elasticity of the intervertebral discs, treats osteoporosis of bone tissues;
2. Neurologist - deals with the treatment of osteochondrosis, the cause of which is the infringement of the spinal roots. Determines the exact location of the development of the disease.

When spinal lesions require surgical interventions, this task falls on the shoulders of neurosurgeons.

Some diseases of the joints and which doctor treats them

Some diseases of the joints, their types, symptoms, which doctor treats:

1. Bursitis is an inflammation of the articular sac with subsequent accumulation of fluid. Accompanied by severe pain, swelling, redness of the inflamed area. The most common is bursitis of the knee and elbow joints. With bursitis, you need to contact a rheumatologist or orthopedist.
2. Baker's cyst of the knee joint - a watery formation; the cyst is localized only under the kneecap. The disease was discovered by Dr. W. Baker, named after him. Baker's cyst is accompanied by pain in the knee area, swelling. The pathology is treated by a traumatologist and an orthopedist. In some cases, therapists and rheumatologists can diagnose this disease.
3. Synovitis is an inflammation process localized inside the synovium of the knee or elbow. It manifests itself in the form of severe swelling, rarely painful. Synovitis often affects the elbow and knee joints. Basically, a person is referred to a surgeon, sometimes the victim immediately goes to an appointment with a traumatologist.
4. Gonarthrosis of the knee joints is a complete decomposition of the cartilage tissue of the joints of a non-inflammatory nature. Gonarthrosis is accompanied by pain in the knee when walking. The patient can be referred to an orthopedic traumatologist, a rheumatologist, and in milder cases of arthrosis, even to a general practitioner.

At the slightest suspicion of the presence of these diseases, immediately consult a doctor!

About 80% of orthopedic trauma patients are interested in how to check their posture or correct a curvature of the back. This problem is relevant due to the fact that if the proportions of the body are violated due to deformations of the spinal column, all internal organs are displaced. To acquire good health, let us consider in detail the factors that influence the formation of a straight back.

Anatomical features of a flat back

There are certain body standards that affect the formation of posture. There are many, but the main ones are:

1. Growth.

Normal human growth is a relative concept. In short people, weakness of the muscular-ligamentous structures is very often observed, so the body is considered weaker. Tall people are exposed to traumatic injuries, as the features of the social sphere are more adapted to average weight and age indicators.

Body weight affects the functioning of organs. The musculoskeletal system has certain reserve capabilities, like the heart muscle. As a result, obesity becomes a provoking factor in reducing the motor and strength qualities of the muscular corset. Excess fat layer contributes to the accumulation of heat in the body. Against this background, there are violations of the blood supply and delivery of nutrients to the spinal column.

In people with low body weight, the load on the skeletal system is facilitated by the activation of fast motor muscles. Strength adaptation is poorly developed, so lifting weights contributes to a violation of posture.

1. Body proportions.

Diagnosis of changes in the proportions of the body is necessary to assess the factors leading to the curvature of the back. A large belly with normal weight and age characteristics forms an increase in lumbar lordosis (internal concavity in the lumbar spine). A strong chest prevents curvature in the thoracic region, but with weakness in the muscles of the legs, an increase in the load on the joints occurs. This shifts the center of gravity of the body. The result is a curvature of the spinal column.

Diagnosis of the causes of pathology by a doctor is based primarily on the study of these indicators.

There are other indicators that the doctor should check before developing methods for treating bad posture. The above parameters can be assessed by each person independently according to special schemes for matching age to certain anatomical characteristics of the body. We also recommend checking the length of the legs, which has a significant impact on the distribution of the load when walking.

Diagnosis of correct posture

Posture is a relative concept that reflects the location of all anatomical structures of the body in a normal standing position with toes apart (at an angle of 45 degrees) and heels brought together.

What to check for posture assessment:

• The degree of severity of the vertebral bends (kyphosis and lordosis);
• The position of the shoulder girdle and head;
• The shape of the abdomen and chest;
• The angle of the pelvis;
• The location of the lower extremities and the shape of the legs (normal, "O" or "X" shaped).

Diagnosis of the state of the spine and back is based on an assessment of the totality of the above factors at different age periods of a person's life. It is advisable to carry it out annually, since over the years there is a weakening of the muscles, the structure of the intervertebral discs is disturbed, which forms a predisposition to back curvature.

In the elderly, the diagnosis of pathology should take into account the structure of bone tissue. The rarefaction of the bone structure (loss of calcium salts) develops intensively after 50 years. Against this background, the vertebrae decrease in size, and there is a curvature of the spinal column.

How to check your posture at home

Diagnosis of curvature of the back at home is based on the following principles:

• Assessment of the state of the muscular corset;
• Determination of the severity of curvature of the spine;
• Identification of deformities in the joints of the lower extremities;
• Check for flat feet and clubfoot.

The easiest way to assess the verticality of the axis of the spinal column at home is the comparison test with the cabinet. To execute it:

• Stand with your back to the closet;
• Align the vertical plane of the body. To do this, lean against the surface of the cabinet with the back of your head, shoulder girdle, gluteal region, knee joints and heels;
• Try to pull your stomach inward as much as possible to eliminate the gap between the lower back and the closet.

In this position, the determination of posture is carried out according to the following factors:

1. The level of verticality of the body and the position of the head;
2. The relief of the neck (the symmetry of the distance from the auricles to the shoulder on both sides);
3. The uniformity of the position of the shoulders in the horizontal plane;
4. The symmetry of the localization of the blades;
5. Features of bends in the cervical and lumbar spine.

Diagnosis of correct posture is based on determining the synchronism and uniformity of the position of the above structures on both sides of the body. If there is a deviation from the norm in at least one of the indicators, it is obvious that your back is not characterized by ideality.

There are indirect signs of displacement of the vertical axis of the body:

1. Displacement of the navel from the center;
2. Asymmetry of the abdomen;
3. Deviation of the level of the location of the nipples of the breast;
4. The level of localization of the angles of the blades;
5. The location of the ilium and shoulder girdle;
6. Curvature of the waist line on both sides.

At home, you can determine the mobility of the spine. It indirectly reflects the reserve capacity of the muscular and skeletal systems to restore the vertical axis of the body. To do this, bend down to the floor and measure the distance from the tip of the third finger of the hand to the horizontal surface, which was not enough to reach the floor.

In conclusion: Posture diagnostics can be carried out at home and indirectly reflect the degree of curvature of the back. If violations are detected, you should consult a doctor for a more thorough assessment of the changes and making decisions on the tactics of treating the pathology.

How to treat osteoporosis of the bones? How to identify the symptoms?

Osteoporosis is a widespread lesion of the bones that make up the human skeleton. As a result of violations of the metabolism of minerals and proteins, the microscopic structure of the bone is rebuilt and its strength decreases. The main clinical manifestation of the pathology are fractures with minor impacts.

Among people aged 50 and over, osteoporosis affects 25% of men and 33% of women, and most are unaware of their disease.

• Causes
• Symptoms of osteoporosis of the bones
• How to treat osteoporosis of the bones
• Treatment with folk remedies
• How to test bones for osteoporosis

Timely treatment of pathology can prevent complications of osteoporosis. The diagnosis and treatment of this disease is carried out by therapists, rheumatologists, endocrinologists or specialists who have received additional training in this matter.

Causes

There are primary and secondary forms of pathology.

Primary osteoporosis

The disease develops as a result of the interaction of many factors. It has a genetic basis associated with a violation of the production of various substances involved in the construction of bone tissue.

These can be sex hormones, parathyroid hormone, vitamin D, growth factors, cytokines, and others.

• In women, the main cause of the pathology is a decrease in bone mass after menopause or as a result of estrogen deficiency during removal of the ovaries. In the first 5 years of this condition, the likelihood of a fracture of the spine and radius increases, but not the femoral head. Hip injury occurs in older patients.
• The basis of bone tissue is calcium compounds. To assimilate this trace element from food, vitamin D is needed. With its hypovitaminosis, calcium absorption decreases, and the body begins to use reserves from bone tissue by activating the synthesis of parathyroid hormone. As a result, the bones become less strong and dense, and the processes of their resorption (destruction) are activated. The resorptive effect of parathyroid hormone on the body of a woman after menopause is especially pronounced. A direct relationship has been proven between vitamin D deficiency and the incidence of femoral neck fracture in this group of patients.
• Bone density is largely dependent on heredity. So, genes control the production of vitamin D, leptin, collagen, estrogen receptors. All these substances are involved in the synthesis and breakdown of bone tissue. If a person at a young age has managed to accumulate a sufficient mass of bone tissue, then even with age, his bones will not become so fragile as to undergo fractures. In the event that bone density is initially reduced, it is very difficult to avoid the development of osteoporosis in old age. Conditions under which hypovitaminosis D develops in Caucasians:
• age over 65 years;
• excess weight;
• cold climate, long winters.

Factors that increase the likelihood of osteoporosis:

• bright skin;
• age over 65 years;
• female;
• previous fractures due to minor trauma;
• hereditary predisposition to osteoporosis, cases of fracture of the femoral neck in the family, a tendency to falls;
• prolonged immobility or low physical activity;
• taking systemic glucocorticoids (prednisolone tablets) for 3 months or more;
• hypogonadism;
• smoking and excessive alcohol consumption;
• hypovitaminosis D and lack of calcium in the diet;
• impaired renal function, accompanied by a decrease in creatinine clearance or glomerular filtration;
• body weight less than 57 kg or body mass index less than 20 kg/m2.

Patients with one or more of these factors should be regularly screened for early diagnosis of osteoporosis.

Secondary osteoporosis

Many diseases are accompanied by metabolic disorders or intestinal pathology. As a result, normal hormonal levels and the absorption of nutrients necessary to maintain bone density suffer.

Affected system	Diseases associated with osteoporosis
Endocrine	thyroid diseases, accompanied by increased secretion of hormones (hyperthyroidism); hyperparathyroidism due to diseases of the parathyroid glands; hypogonadism - underdevelopment of the gonads; diabetes; Itsenko-Cushing's disease or syndrome, accompanied by an excess of adrenal hormones
Connective tissue	ankylosing spondylitis; rheumatoid arthritis;
digestive	resection (removal of part) of the stomach for a tumor or ulcer; malabsorption syndrome in intestinal diseases; ulcerative colitis, Crohn's disease; celiac disease, cystic fibrosis, Gaucher disease; hepatitis and cirrhosis of the liver
Respiratory	COPD
urinary	kidney failure; tubular acidosis; Fanconi disease; hypercalciuria, hypophosphatemia
Blood	leukemia; lymphoma; thalassemia; myeloma
Genetic diseases	imperfect osteogenesis; Marfan syndrome; Ehlers-Danlos syndrome; homocystinuria; lysinuria

Osteoporosis can occur after transplantation of various organs - bone marrow, lungs, liver, kidneys or heart.

Many medicinal substances, when taken for a long time, cause a side effect such as osteoporosis. These include:

• glucocorticoids;
• heparin;
• many tranquilizers and anticonvulsants;
• antipsychotics and anesthetics;
• morphine and its derivatives.

Symptoms of osteoporosis of the bones

As a rule, the disease is diagnosed only when a fracture occurs. In the early stages, it is not accompanied by pain or swelling of the joints, impaired motor activity, and other symptoms.

In addition, even bone fractures can proceed painlessly, this applies primarily to compression injuries of the vertebral bodies. In these cases, narrowing of the intervertebral foramens, compression of the nerve roots, and the appearance of chronic pain in the back may occur several years after the injury. Repetitive vertebral fractures lead to weight loss and a specific deformity - curvature of the spine with a posterior bulge.

If the fracture is still accompanied by symptoms, then it may be pain, dysfunction of the limb, pathological limb mobility. Manifestations of pathology in men and women are the same.

Osteoporosis of the femur

This is the main cause of hip fracture, especially in the elderly. After such an injury, one in five patients die within a year from other causes; a third become disabled and only less than a third restore their former physical activity. The economic consequences of these injuries for the state are very high.

Risk factors for hip osteoporosis:

• elderly and senile age;
• hereditary predisposition;
• hypovitaminosis D;
• immobility;
• smoking;
• frequent falls, including from a small height.

Osteoporosis of the hip most commonly affects older women, although a gradual decrease in bone density in this area occurs already after 30 years and can be diagnosed using x-rays.

Osteoporosis of the tibia

The first symptoms of the disease may be aching pain and cramps in the legs. Later, a pathological fracture occurs.

The tibia is the basis of the lower leg, so when it is fractured, the patient cannot step on the leg. Pathology is accompanied by pain, swelling of the limb. Its deformation is possible. Fractures of the tibia in osteoporosis can occur with minor stress, such as an awkward fall or "tucking" the leg.

Surgical treatment of such a lesion is accompanied by technical difficulties: when using a plaster cast, immobility leads to the progression of the process, and the use of external fixation devices causes eruption of the bone tissue and instability of the pins.

Osteoporosis of the calcaneus

The body of the calcaneus takes on almost all the load during walking. If this bone becomes brittle due to osteoporosis, it may fracture. However, such damage is rare, because the calcaneus is one of the most durable.

However, osteoporosis of the heel leads to rarefaction of the bone substance. As a result of this, when running, walking, jumping or falling from a height, the separation of its processes from the bone is facilitated. In this case, there is pain, swelling of the heel and ankle joint, the inability to step on the foot. In the treatment of such a pathology, immobilization with gypsum is used in combination with active therapy of osteoporosis with the help of medications.

Osteoporosis of the bones of the foot

The first sign of the disease is pain when walking and fatigue of the feet. Pathological fractures of individual metatarsal or tarsal bones may be accompanied by increased pain, swelling and hemorrhage on the back of the foot, and the inability to step on the foot.

Sometimes there are no external symptoms of pathology. In this case, the disease can be suspected only according to the X-ray of the foot. The treatment is carried out with the help of a plaster splint.

Osteoporosis of the humerus

Most often, the pathology manifests itself in the development of a fracture in the upper third of the shoulder, where its surgical neck is located (the most common site of injury). Pathology occurs when falling on the shoulder, elbow or on the inner surface of the shoulder when the arm is moved to the side.

Osteoporosis can also affect other parts of the bone, in which case a fracture of the diaphysis or the lower third of the shoulder occurs. The disease is accompanied by pain, impossibility of movements in the limb, swelling; if the vessels are damaged, a hemorrhage appears, if the bone fragments touch the nerve bundle, numbness occurs below the injury site. If the intraarticular surfaces of the bone are damaged, blood accumulates (hemarthrosis) in the cavity of the shoulder or elbow joint.

For treatment, immobilization with gypsum is most often used.

Osteoporosis of the radius

The radius is located on the inside of the forearm. When affected by an osteoporotic process, it becomes brittle and breaks easily. Most often, a so-called fracture occurs in a typical place - slightly above the wrist. The mechanism of injury is a fall on the arm, hand. Symptoms - pain, swelling of the forearm, subcutaneous hemorrhage, violation of the shape of the limb. Movement in the hand is sharply difficult or impossible. Damage to blood vessels and nerves with the development of appropriate complications is not excluded.

Diffuse osteoporosis

Osteoporosis is a systemic disease, that is, it affects all bone structures, reducing their strength. The main cause of the pathology is a violation of calcium metabolism due to age-related hormonal changes. Diffuse osteoporosis is manifested by a change in posture, pain in the back and limbs, and a decrease in growth. With minor injuries, pathological fractures can occur, and they can be multiple. In severe osteoporosis, even ordinary stress can lead to a fracture, and it is impossible to predict the place of its occurrence.

For the treatment of this pathology, various groups of drugs are used. To prevent diffuse osteoporosis, it is worthwhile at a young age to increase the intake of calcium and vitamin D, as well as to ensure regular physical activity and stop smoking. These measures can prevent critical bone loss, which serves as the pathogenetic basis of diffuse osteoporosis.

Distal osteoporosis

With a moderate severity of the process, the marginal (distal) parts of the limbs are the first to suffer. Therefore, fractures are often localized in the following anatomical areas:

• lower third of the radius (fracture in a typical place);
• upper third of the shoulder (in the area of ​​the surgical neck);
• neck and region of the trochanters of the femur.

When such damage occurs, it is necessary not only to start treating the fracture, but also to contact a rheumatologist or endocrinologist to diagnose osteoporosis and select a rational treatment. Usually, in this case, calcium and vitamin D preparations are no longer effective enough. Systemic therapy, combined with proper nutrition and exercise, will help prevent the development of diffuse osteoporosis of the bones.

How to treat osteoporosis of the bones

Comprehensive treatment involves the use of non-drug methods, proper nutrition and medications.

Physical therapy is shown: walking and strength training; running and jumping are not recommended. In the diet, you should increase the content of foods rich in calcium. These are cheese, cabbage, sardines, milk, black bread, shrimp, sesame seeds. It is necessary to give up smoking and alcohol.

Fall prevention is important, especially in the elderly:

• selection of points;
• correction of blood pressure, prevention of hypotension;
• cane use;
• creating a safe environment - bathroom railings, non-slip mats, low-heeled shoes;
• taking calcium and vitamin D supplements.

In total, the body should receive up to 1.5 g of calcium and up to 2000 units of vitamin D per day.

In postmenopausal osteoporosis, nitrogen-containing bisphosphonates are prescribed: alendronate, zoledronic acid, ibandronate. There are different schemes for their administration and routes of administration - from the daily intake of tablets to the annual infusion of the medicinal solution. Only a doctor prescribes them.

Zoledronic acid is also indicated in men and women after a fracture of the femoral neck caused by osteoporosis to prevent new injuries.

With the ineffectiveness of these drugs, as well as after a fracture of the vertebral bodies or the femoral neck, teriparatide is prescribed.

In case of intolerance or ineffectiveness of the listed drugs, strontium ranelate is prescribed. However, it is often contraindicated in the elderly if they have concomitant coronary artery disease, hypertension, and cerebral artery disease.

Treatment is carried out for several years, only 1 drug is used in combination with calcium and vitamin D. After 1-3 years from the start of therapy, its effectiveness is evaluated using axial DXA densitometry. When the patient fulfills all the doctor's recommendations, osteoporosis therapy with drugs is usually effective, and bone mass increases or remains at the same level.

Treatment with folk remedies

Folk recipes for osteoporosis include foods and plants rich in calcium and vitamin D:

• infusion of parsley and dill: finely chopped greens are poured with the same amount of hot water and infused for 3 hours, the infusion should be taken in a glass during the day;
• onion broth: two large onions with a peel are crushed and fried, then boiled for 10 minutes in a liter of water; after cooling and straining, it is necessary to take a glass of decoction per day;
• tea from dandelion leaves: pour a spoonful of chopped greens with a glass of boiling water, make an infusion and drink throughout the day;
• eggshell: it is cleaned from the inner film, washed and dried, then boiled for 3 minutes and dried again, and only then crushed; take it with lemon juice, a quarter teaspoon every morning.

These and other means can be used only in addition to the main treatment.

How to test bones for osteoporosis

If this pathology is suspected, the doctor prescribes tests:

• general blood analysis;
• the level of calcium, phosphorus, vitamin D, in men - testosterone in the blood;
• alkaline phosphatase (an indicator of bone tissue destruction);
• creatinine clearance to assess kidney function.

The main method for diagnosing pathology is DXA densitometry. Moreover, it should be central (axial) when the bone tissue of the vertebrae or the femoral neck is examined. In the absence of such equipment, distal densitometry in the region of the lower third of the forearm is allowed.

Groups of patients who need to perform densitometry:

• all women over 65 and men over 70;
• people of any age who have risk factors for osteoporosis;
• patients with fractures caused by a weak damaging effect;
• patients who are likely to have secondary osteoporosis or low bone mass, including as a result of taking medications;
• all patients before starting treatment for osteoporosis and after 1 to 3 years of therapy.

X-rays of the spine are needed for back pain if it is associated with any of the following conditions:

• pain first appeared over the age of 50;
• osteoporosis has already been diagnosed using densitometry;
• the appearance of pain after a fall or injury;
• the patient's age is more than 55 years;
• taking glucocorticoid hormones.

In addition, such a diagnosis should be carried out with a decrease in growth by 2 or more cm in recent years, or by 4 cm compared to growth at 25 years. A pronounced hump (kyphosis) of the thoracic region is also an indication for radiography. This study is necessary for the diagnosis of fractures of the vertebral bodies.

Another way to diagnose osteoporosis is to calculate the risk of fracture in the next 10 years using a special FRAX scale. The doctor can assume a disease even without densitometry data, and, if necessary, prescribe treatment for this disease. The main goal of such therapy is the prevention of fractures, which often disable the patient.

Osteoporosis of the bones is a slowly but steadily developing chronic disease. With age, bone strength decreases in all people, but there are groups of patients with an increased risk of fractures - the main manifestations of osteoporosis. Therefore, at a young age, it is important to accumulate sufficient bone density through a balanced diet and physical activity. In the future, if you suspect osteoporosis, you should consult a doctor and undergo densitometry and other necessary studies. If a disease is diagnosed, long-term drug therapy is prescribed. Remedial gymnastics and prevention of falls are also necessary. Under these conditions, the risk of osteoporosis to health is significantly reduced. In the case of fractures, their treatment is carried out mainly in a conservative way.

Useful articles:

Each of us periodically faces pain in the bones and joints. Not all of these problems are dangerous. But, it is best to protect yourself and see a specialist.

After all, such problems can lead to serious consequences.

Causes of pain in the joints

Pain in the bones and joints can signal various problems. The specialist must find out the nature of the problem and find the connection (if any) between this problem and the damage to the muscles and nerves.

Arthritis can be the cause of pain and discomfort in the joints. This disease is characterized by inflammatory processes. Metabolic disorders in the body can lead to arthrosis. Also, the pains described are affected by diseases of the tissues surrounding the joint due to infection, allergies, and blood diseases.

Sports overload

If the joints and legs hurt after exertion, then this is most likely due to overtraining. Such pains are especially intense when making movements with parts in which pain is localized. Most often, the bones of the lower extremities suffer from overtraining. After all, it is they who are subjected to especially heavy loads. But, and the pain in the legs with overtraining passes quickly enough. To do this, it is enough to increase the rest time or treat the muscles with a warming ointment. But, if the pain after exertion does not go away for a long time, then you need to go for a consultation with a doctor. A therapist can help you deal with this problem.

Systemic blood diseases

Pain in the bones and joints can be the result of damage to the bone marrow due to blood diseases. Pain can signal multiple myeloma, acute leukemia and chronic myeloid leukemia.

With multiple myeloma, discomfort is localized in the ribs, bones of the pelvis and spine. They can have a pronounced painful character. The disease affects the bones to such an extent that they become brittle. This can lead to compression fractures of the spine.

In acute leukemia, the pain manifests itself in different parts of the body. A person suffering from this disease may have enlarged lymph nodes and spleen. The patient complains of weakness and a slight increase in body temperature.

If the joints and bones hurt, and infectious diseases often appear, this indicates chronic myeloid leukemia. Indirect signs of this disease are an enlarged spleen (visible to the naked eye) and excessive sweating.

Infectious and inflammatory diseases

Also, pain in the bones can be caused by diseases of an infectious and inflammatory nature. One of the most common diseases of this variety is osteomyelitis. This disease is accompanied by inflammation of the bone marrow, accompanied by the release of pus and bone damage. Pain in osteomyelitis is very strong and acute. In addition, the patient has a high temperature. Toxins penetrate the bloodstream, which affect the rest of the body and internal organs. Which leads to even bigger problems. Often with this disease, the affected arm or leg cannot fully perform its functions.

The virus that causes this disease enters the bloodstream and spreads throughout the body and affects various tissues. After the body copes with the virus, the pain disappears.

Pain due to diseases of metabolic disorders and hormonal diseases

Why do all joints and bones hurt? It is very difficult to answer. One of the reasons for this pathology is improper metabolism. If, as a result of a metabolic disorder, there is a lack of calcium or another substance important for bone tissue, then this can also manifest itself as a pain syndrome. The described vitamin problem is negatively affected by the lack of vitamins D and B1. From their lack, the knee or other joint may suffer.

Also, the appearance of problems with bones can be affected by an excess production of digestive and thyroid hormones by the body, as well as the adrenal cortex. The formation of bone tissue decreases with prolonged immobility of the patient and the intake of certain hormonal drugs. Problems in the bones with such problems are manifested slightly.

Diabetes

Such a formidable disease as diabetes can also cause bone pain. Most often they are localized in the legs. It is still unknown what can lead to such consequences. Modern medicine believes that the appearance of such pain is due to blockage of blood vessels, which is why there is a violation of tissue nutrition. Bone pain due to diabetes can be of a different nature.

The endocrine system has a direct impact on the entire body as a whole. An excess or deficiency of one or another hormone can affect the development of pathological processes in the bones and joints. In addition, diabetes mellitus can provoke the development of arthrosis.

Tumor processes of bones

If joints and bones hurt throughout the body, then this may indicate oncology. According to statistics, bone tumors are very rare. Only 0.2-1% of the total number of all diseases of this nature. But, such damage to the bone tissue is extremely dangerous and often leads to fatal consequences. These diseases include:

• Hodgkin's lymphoma. This disease is characterized by disorders in the lymphatic system. Bone lesions in lymphogranulomatosis occurs in 20% of cases. Most often, this pathology affects the spine and ribs. With such a lesion, the pains are very strong with a radiating character.
• Fibrosarcoma and histiocytoma. Oncological diseases such as fibrosarcoma and histiocytoma are also accompanied by bone pain. At first they are not very strong, but gradually their intensity increases. This is due to the increase in the affected area. Over time, the bone cannot cope with even a slight load and is destroyed, characterized by a general malaise of the body, constant weakness, an increase in temperature and a decrease in body weight.

This procedure, in turn, can lead to joint pain. This is due to the general intoxication of the body. You can eliminate such pain with the help of special medications.

Tuberculosis of the bones

Another disease that can be accompanied by pain throughout the body is bone tuberculosis. This disease is associated with the negative effect of Koch's wand. This microbacterium infects bones containing spongy substance. In severe cases, the disease can lead to destruction of bones and joints, as well as paralysis of the limbs. Pain symptoms in bone tuberculosis begin with discomfort in the places of their localization. Over time, they can develop into severe pain.

The patient becomes lethargic, and in small pains begin to be localized at the site of the lesion. Depending on it, the disease can affect the spine, knee, hip, shoulder, wrist and elbow joints. Tuberculosis of the ankle joint and tubular bone is also isolated.

This disease is manifested by increasing pain.

Intermittent fever

This disease, which is also called malarial fever, is accompanied by pain in the middle of the spine and intense thirst. A common symptom of this ailment is fever. Moreover, a high temperature can quickly change to a normal temperature.

This disease develops when infected with malaria, brucellosis and relapsing fever.

Warts and papillomas

Non-inflammatory benign skin lesions can also cause bone pain. Warts, which are formed due to damage to the body by the papillomavirus, become causes of pain only if they form on the soles of the feet.

Warts can appear anywhere on the body. Most often, such neoplasms reach a diameter of several millimeters. But, there are also those whose size can reach several centimeters. You can get rid of warts with the help of a beautician.

The papilloma virus, which causes warts, is transmitted through contact with a carrier or through the use of shared objects. Very often you can pick up this virus in public pools, baths and saunas.

In which case immediately see a doctor?

In this article, we answered the question of why the bones and joints of the whole body hurt. Most often, this discomfort passes quickly. But, if the pain does not go away for more than a day, then this is a good reason that it is time to go to the doctor.

Be sure to watch the following video

Therefore, taking painkillers and forgetting about it is not the best way out. Especially if the pain periodically appears in the same place. Listen to your body. Self-medication is not worth it. Get checked out by a specialist. In this way, the risk of developing dangerous diseases can be reduced.

Coxarthrosis of the hip joint: symptoms and treatment

In medical reference books, coxarthrosis of the hip joint is described as a degenerative-dystrophic violation of the integrity of the articular structures due to their injuries and diseases. Cartilage gradually loses its cushioning function over the years. It can no longer fully provide the necessary friction between the bones that form the femoral joint.

• Causes of coxarthrosis of the hip joint
• Symptoms of the disease and the degree of coxarthrosis of the hip joint
• Diagnosis of the disease
• • Conservative treatments
  • Surgery

As a result, the surface layer of the bone is covered with osteophytes, which constrain mobility and accelerate the destruction of the joint. Bilateral lesion of the hip joint of a progressive nature is possible.

According to statistics, elderly people are most often affected, but causeless episodes of disease detection also occur in young people. Timely diagnosis of the early stage of coxarthrosis of the hip joint allows us to limit ourselves to conservative methods of treatment. With advanced coxarthrosis, it is difficult to avoid surgical intervention due to the fact that this is the only way to return the joint to its function. Of all the known types of arthrosis, hip coxarthrosis is the most common. Increased load on the hip joint, together with congenital pathological joint dysplasia, causes the wide spread of this disease.

Causes of coxarthrosis of the hip joint

The factors that provoke coxarthrosis are very diverse, but more often they interact in a complex, thereby complicating the pathological process. The most common causes of coxarthrosis can be identified:

Symptoms of the disease and the degree of coxarthrosis of the hip joint

At different stages of the development of coxarthrosis, it is impossible to distinguish significant differences in the symptomatic picture. By certain symptoms, you can understand when you need to take emergency measures to restore health to your joint. It often happens that the patient seeks help from a traumatologist or orthopedist in the last stages of the pathology, when the possibility of reversing the process is close to zero. Therefore, it is important to know the general symptoms of coxarthrosis:

There are three degrees of coxarthrosis of the hip joint:

Diagnosis of the disease

The main methods for diagnosing coxarthrosis of the hip joint:

• Radiography. It reveals the presence of bone growths, a decrease in the gap between the joints. Allows you to detect seals under the cartilage in the bone tissue and cartilage ossification.
• Magnetic resonance imaging. It aims to identify the pathology of bone structures.
• CT scan. Provides an opportunity to study in detail changes in soft tissues.

Treatment of coxarthrosis of the hip joint

Conservative treatments

The treatment course is prescribed by the doctor in accordance with the current stage of the disease. For the treatment of coxarthrosis of the hip joint of the first and second degree, conservative therapy is used.

To alleviate pain syndromes in the treatment of coxarthrosis, anti-inflammatory nonsteroidal drugs, such as diclofenac or ketorol, are prescribed. They provide partial removal of puffiness and are effective in stopping painful sensations. In turn, it is worth noting that prolonged use of this group of drugs for the treatment of coxarthrosis of the hip joint will entail undesirable side effects. One of them is the body's inability to return the former regenerative function of cartilage tissue.

If there is an urgent need to take anti-inflammatory drugs for a long period, then you should pay attention to movalis. Despite the impressive list of side effects, nevertheless, he has established himself as the most sparing drug from this group of tablets.

Good blood circulation and, accordingly, the restoration of cartilage is provided by vasodilators (trental, cynoresin). The main role of these drugs in the complex treatment of coxarthrosis is the relaxation of the smooth muscles of small vessels, increasing their throughput for good blood microcirculation. Relieving muscle spasms, vasodilators help fight, including debilitating night pains.

Muscle relaxants (mirdokal, sirdalut) will be indispensable helpers in eliminating spasms of the femoral and calf muscles, while at the same time providing improved blood supply, resulting in subsiding joint pain. With coxarthrosis, a course or one-time intake of drugs of this group should be carried out strictly according to the prescription of the attending physician. Influencing the central nervous system of a person, muscle relaxants provoke dizziness and a change in consciousness, so they should be used in treatment with extreme caution.

The most effective and useful drugs in the treatment of coxarthrosis of the hip joint are chondoprotectors (glucasamine, teraflex). They significantly reduce the rate of joint-destroying processes, actively stimulating intracellular regeneration, which is so necessary for cartilage tissue. The use of chondroprotectors on a regular basis allows you to stop the disease and prevent it from turning into a more complex form. These drugs are contraindicated in pregnant and lactating women.

Intramuscular injections with hormonal drugs (hydrocortisone, kenagol) have proven themselves in the treatment of coxarthrosis, in combination with inflammatory processes of other diseases of the tendons and muscles. The maximum benefit from this type of treatment is possible only in the absence of inflammation in the tendon of the femur. A course of hormone therapy is carried out once every two weeks, three injections per day.

The skin plus muscle and fat layers create a barrier to the penetration of therapeutic components of gels and ointments into the damaged joint. Such local therapeutic agents, along with compresses, do not bring the desired result in the treatment of coxarthrosis. However, it is worth paying tribute to the warming effect of some ointments. Due to intensive rubbing of painful areas, local blood circulation is activated and muscle spasm is relieved.

Physiotherapy (UHF, magnetotherapy, laser therapy, electrophoresis, cryotherapy, inductothermy) is not the main method of treatment, but rather is of an auxiliary nature. Possessing medicinal properties similar to those of local therapy, physiotherapy is prescribed in the early stages of coxarthrosis.

Massage is absolutely safe and welcome at all stages of the disease. It is also designed to improve blood circulation, remove swelling and muscle spasms. At the first stage of coxarthrosis, the patient is sent to a massage room only after a drug course that restores cartilage tissue. Before the first sessions, it is necessary to reduce the load on the diseased joint, move less and rest more. After surgery, as soon as the stitches are removed, massage is indispensable for speedy rehabilitation and recovery.

Traumatologists pay special attention to gymnastics in the treatment of coxarthrosis of the hip joint. The positive therapeutic effect of the exercises of the therapeutic gymnast is based on the strengthening of the periarticular muscles. The main thing is that the lesson should be held under the supervision of a good specialist, since there are some exercises that, if performed incorrectly, can harm the patient. The specificity of exercises for training the hip joint allows you to simultaneously work out the gluteal and femoral muscles, which, in turn, leads to the correct fixation of the cartilage. A set of stretching exercises helps a kind of stretching of the joint capsule, due to this, the length of the legs is leveled.

Surgery

Surgery is the only treatment for coxarthrosis in the last stages of the disease. Before the operation, the patient undergoes a number of preparatory procedures: examination by a therapist, testing. The surgeon is considering the option of replacing the destroyed joint with a modern endoprosthesis. If it is necessary to replace the femoral head and the bifid cavity, a bipolar endoprosthesis is implanted in the patient, if only the femoral head needs to be replaced, then a unipolar endoprosthesis is dispensed with. The operated person is under local anesthesia all this time and does not feel anything.

The sutures are removed after about two weeks, and before that, the patient is prescribed antibiotics to rule out purulent-inflammatory reactions.

The percentage of successful operations today is quite high and more than 90% of people have a complete recovery of the damaged limb. After twenty years of service life of the prosthesis, it is replaced by a new operation.

Inflammation of the joint of the big toe: what diseases cause it and how to treat them?

With inflammation of the joint on the leg, as a rule, the ability to move is reduced, the joint swells or swells, and pain appears in it, not only when walking and at rest. These are common symptoms for a wide variety of diseases.

Why does inflammation occur in the joint of the big toe? In this article, you will learn about the possible reasons why your big toe hurts and what to do in this case.

Causes of inflammation

Inflammation of the joint on the first toe can occur with a number of diseases. Basically, these are various diseases of the joints: arthritis (gout, rheumatoid arthritis, arthritis of the thumb), osteoarthritis, bursitis.

Arthritis

Common symptoms for all arthritis are:

• joint pain that gets worse over time
• the joint area swells;
• the skin over the joint becomes hot and reddish.

The presence of these symptoms indicates that it is necessary to urgently consult a doctor, otherwise the neglected inflammation will lead to irreversible changes and an operation will be needed to restore the mobility of the articular joint.

In the acute course, the pain is severe and frequent, in the chronic - periodic. Chronic arthritis is especially dangerous because of the unexpressed symptoms, while long-term low-intensity inflammation causes not only joint deformity, it can even collapse.

Of the many types of arthritis, rheumatoid arthritis, infectious arthritis, reactive arthritis, and gout are the most common. Each of them proceeds in its own way and is treated in different ways.

Rheumatoid arthritis

This disease is diagnosed by characteristic symptoms, as well as on the basis of x-rays and changes in tests. Rheumatoid arthritis is characterized by symmetrical joint damage in both legs.

The joints swell, redden, their mobility is limited, the person experiences pain of moderate intensity. At the same time, after physical exertion, stiffness and pain decrease.

Causes

Rheumatoid arthritis is caused by autoimmune disorders in the human body.

With them, the immune system attacks the joint tissues, perceiving them as foreign.

Often this inflammation develops a couple of weeks after suffering an acute respiratory disease or tonsillitis.

Treatment

When the very first signs appear, it is urgent to contact a rheumatologist. There is no cure for this disease, but it is possible to significantly reduce the signs of inflammation with medication or with a synovectomy (surgical treatment). This will help stop the progression of arthritis in time and improve well-being.

Basic antirheumatic drugs (azathioprine, levamisole, cyclosporine, mesalazine, dixycycline and many others) and biological agents (embrel, kineret, humira, remicade, orencia) are prescribed.

Gout

This disease is called the disease of meat eaters due to the fact that it occurs as a result of the deposition in the joints of a substance that is formed during the exchange of purines. They are especially abundant in meat. Most often, gout affects middle-aged men.

The symptoms are sudden and very sharp, tearing, burning or throbbing pain in the joint. Especially the pain intensifies at night, and weakens in the morning. The joint becomes purplish red and swells. Attacks last for 3-4 days up to six times a year and are provoked by excessive consumption of fatty foods and meat, alcohol intake.

Often, advanced gout is accompanied by the deposition of urates in the kidneys, which leads to pyelonephritis and urolithiasis.

Treatment of gout

Treatment primarily requires a meat-restricted diet and drugs that normalize purine metabolism. To relieve pain, ibuprofen, voltaren, nimulide, movalis, as well as another group of drugs - colchicine, a special short-acting drug, are used.

Attention! Specific medications should be prescribed only by a doctor. Self-medication is unacceptable and dangerous.

infectious arthritis

With such inflammation, constant pain during movement worries. After a night's rest, there is a feeling of stiffness, the joint swells, the skin becomes hot and red. In this case, the body temperature can rise significantly.

This type of arthritis is caused by an infection. She could get directly into the joint of the fingers or with blood flow from other organs. Therefore, in addition to local symptoms, general signs of the disease of the body also appear:

• increase in body temperature,
• chills,
• headache,
• general weakness.

Treatment of arthritis caused by infection

Treatment for infectious arthritis depends on the underlying cause. With this inflammation, it is important to find and treat the underlying infection.

Therefore, antibiotics are necessarily prescribed either with a broad spectrum of action, or according to the results of the tests: penicillins (oxacillin, ampicillin).

Non-steroidal anti-inflammatory drugs are also prescribed: paracetamol, diclofenac, ibuprofen.

Osteoarthritis

This disease is characterized by dull pain, which usually bothers during the day. It is aggravated after prolonged standing and during physical exertion. After rest and in the morning it noticeably decreases. In the joints, a crunch and clicking may appear periodically. The finger deviates to the side, loses mobility and deforms. Often, a deformed joint is additionally injured by uncomfortable shoes.

To clarify the diagnosis, the doctor prescribes x-rays and a blood test to check the uric acid content.

Treatment

If the disease is started to be treated on time, then orthopedic shoes, massages, mud therapy, swimming, and physiotherapy can be dispensed with. Pain is relieved by local anesthetic injections. Corticosteroids are used to reduce inflammation.

Bursitis

Why else can a condition occur when the big toe hurts? Another possible cause is bursitis. This is an inflammation of the metatarsophalangeal joint of the thumb, which occurs as a result of injuries and microtraumas (uncomfortable shoes), as well as the spread of inflammation from surrounding tissues.

At first, it is characterized by the appearance on the outside of the thumb of a painless tumor-like formation - “bones” or “bumps”. The joint is bent, moving away from the other fingers.

Only after a few months does pain appear along the plantar surface of the foot and in the area of ​​​​the inflamed joint. Painful corns form on the sole.

Causes

The cause of bursitis is a violation of pronation, and a large mobility of the metatarsal bone. And them, the metatarsophalangeal joint of the big toe experiences excess pressure at the moment when the foot is pushed off the ground. The tendons of the thumb are constantly in a stretched state, and this causes the thumb to arch outward.

Bursitis treatment

The joint is easier to cure at those stages when it is curved as little as possible. Therefore, it is necessary to consult a doctor as soon as possible, without expecting pain. To correct a small deformity of the thumb, orthopedic shoes are actively used, which change the direction of action of mechanical forces.

If there are already pains in the finger, then anti-inflammatory drugs and interstitial injections are used to relieve them. In a severe stage, an operation is necessary.

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In most cases, a person suffering from joint diseases cannot indicate the exact time and cause of the onset of symptoms of the disease. For quite a long time, the disease, even in the presence of changes in the tissues of the joint and radiographic signs, is asymptomatic. Therefore, it is advisable to focus on those methods by which you can recognize the disease.

First- this is a survey, in the language of the Aesculapius, the collection of anamnesis. The main symptom in diseases of the joints of the upper and lower extremities is pain. The joint, along with mechanical functions, performs the function of a receptor field, that is, it contains receptors that perceive and transmit “distress signals” to our brain.

Therefore, joint pain has a reflex nature, which means that joint pain should be considered not only on the basis of the biomechanical features of the musculoskeletal system, but also from the standpoint of the reflex nature of pain.

Pain receptors are located in the fibrous and synovial layers of the capsule, their irritation can be caused by a functional overload of the joint or a reaction of the synovial membrane to inflammation, trauma.

The nature of the pain syndrome- one of the differential diagnostic signs - helps to distinguish one disease from another. For rheumatoid arthritis or an inflammatory process in the joint, the "inflammatory" nature of pain is characteristic - it occurs or increases at rest, at night, subsides with movements in the joint.

Osteoarthritis is characterized by "mechanical pain", that is, it occurs or increases during the load on the joint and subsides at rest. Pain usually appears after some time (minutes or hours) after the load, and continues for several hours or days even after the end of the load.

The diagnostic value of the study of synovial fluid is significantly increased by determining the total protein in it, immunological parameters (rheumatoid factor, compliment, beta-2-microglobulin).

With the simultaneous study of immunological and some other parameters (free radical oxidation activity, fatty acid spectrum of lipids) in the blood flowing to the limb (arterial) and flowing from it (venous) blood, additional information can be obtained about the activity and severity of the pathological process in the joint.