Have you ever had knee pain? It can be extremely uncomfortable when you suddenly become limp or unable to go down stairs without pain in your knees. Osteoarthritis is not life-threatening, but it significantly degrades the quality of the joint.
What is a hydrocele?
Knee joint(osteoarthritis, osteoarthritis, osteoarthritis). Gonarthrosis is a dry joint disease of the knee joint (it has nothing to do with gonorrhea). In advanced cases, nothing but surgery helps. You need it? Then don't let yourself fall into that state.
Causes of dry knee disease.Distinguish primary and secondary osteoarthritis. If the cause of the disease is not known, then such joint disease is called primary, it is inherited through the maternal line. If a grandmother has osteoarthritis of her knee, her daughter and granddaughter can get it when they are young.
Secondary fibrosis develops due to injury, birth defects of the knee joint, physical overload (sports, occupation), and endocrine disorders.
Risk factors are overweight, female gender, old age. Cartilage is very sensitive to the decline of female sex hormones, when menopause, all joints begin to "crack". As a result, overweight older women suffer from more frequent and severe degenerative knee osteoarthritis.
Knee surgery.The knee joint is made up of the femur, tibia, and kneecap. The joint surfaces of bones are covered with a layer of cartilage. The additional cartilage cushions between bones are called cartilage and are the cushions. The knee joint has the largest synovial sac, forming large nodules and bursae.
The joint cavity is filled with synovial fluid, which nourishes the cartilage and joints. Synovial fluid contains hyaluronic acid, which is necessary for the smooth slide of joint surfaces. Ligaments, muscles, and tendons guide and restrict movement in the joint.
General description.With osteoarthritis of the knee, cartilage destruction occurs. There are three stages of knee arthritis. In the early stages, the nutrition of the articular cartilage and meniscus is interrupted. Cartilage loses elasticity and cracks. Abnormal friction occurs between bones. Joint overload accompanied by inflammation and knee pain.
In the second stage, the destruction of the joint cartilage and the meniscus begins. The bone responds to the load by outgrowth - osteoporosis ("spikes"). The amount of intra-joint fluid decreases, the joint cavity narrows. As a result, knee pain has occurred with normal movement, walking.
In the third stage, a pronounced bone deformity of the knee joint with a marked restriction of natural movements is revealed.
Symptoms of dry joint disease of the knee joint.The main symptoms of joint disease are pain, limited mobility and deformity of the knee joint. The knee arthritis takes place for a long time, the symptoms increase slowly and cannot be reversed. If the pain in the knee comes on suddenly, suddenly, for the first time it is most likely not a joint disease.
Osteoarthritis begins gradually with discomfort or mild pain in the knee when active overload, long walking, walking down stairs, standing up from a squatting position. When you rest, the pain will quickly go away.
During the second stage, knee pain is already present with normal exertion. Volume of active movement in the knee joint is reduced. The shape of the joint changes due to bone deformity and abnormal fluid accumulation in the joint.
During the third stage, pain becomes chronic, occurring not only with exercise but also during rest. Nocturnal pain disturbs sleep. It is difficult for the knee to lie in bed without pain. Swollen joints indicate more inflammation. The mobility of the knee joint is minimized.
The joint is significantly deformed, the leg becomes an O or X-shape. In severe cases, there is a complete destruction of the ankle (immobility).
With hemorrhage of the knee, there are 4 types of pain:
- Mechanical pain type that arises under the influence of physical activity during the day and decreases gradually during night rest. These knee pain is associated with reduced shock absorption of cartilage and bone structures. As a rule, knee pain is localized in the anterior and inner area of the knee joint and the upper part of the lower leg.
- Nocturnal pain is associated with stagnation of venous blood, increased pressure in the joints and inflammation.
- "Onset" pain appears after a period of rest and disappears 15-20 minutes after joint movement. These knee pain are caused by the friction of the joint surfaces, on which the broken cartilage fragments are deposited.
- Persistent knee pain is caused by muscle spasms, as well as the development of bursitis.
Complications of osteoarthritis of the knee.Bursitis is an inflammation of the synovial membrane that coats the joint cavity from within. Signs of inflammation: swelling, fever, redness, pain, joint dysfunction.
Normally, the knee joint contains 3-5 ml of joint fluid. With diseases of the joints, an increase in the production of inflammatory fluid occurs. The amount of overflow (pathology) can be up to 30-70 and even more than 100 ml. The knee joint fluid first fills in the cavity in the inner side of the kneecap (medial furrow). With an increase in volume, the upper volume fills, with a large swelling above the kneecap ("saddle").
Baker cyst occurs with a significant increase in fluid volume in the joint. A round, elastic bulge forms in the skin of the face. This is not a tumor, it is not a cancer and it does not require surgery. Baker's cyst can cause discomfort, pressure, and knee pain while moving. The diameter of the tumor is from 2 to 6 cm, with an even larger size, the tumor may compress the nearby perineal nerve with the development of weakness and numbness in the foot.
Diagnosis of osteoarthritis of the knee.Laboratory tests are not useful to diagnose, but are used to rule out other conditions that accompany knee pain. With arthritis, the CBC values do not change in inflammation, leukocytes and ESR within normal ranges. The rheumatoid tests were all negative. Uric acid concentrations are within the normal range.
X-rays show changes in bones in the joints, rule out the traumatic causes of joint pain. In our country, people use the X-ray method to classify joint diseases according to each stage.
Stage 1 - presence of marginal growth with a slight narrowing of joint space;
Stage 2 - more obvious narrowing of the joint space, the appearance of sub-cartilage sclerosis;
Stage 3 - a pronounced narrowing of the joint space, flatness of the joint surface, the development of a cyst;
MRI of the knee is indicated in the early stages of the disease, when radiologic changes are not observed but the patient presents with typical knee pain. With the help of MRI, you can assess the condition of cartilage, meniscus, ligaments, tendons. Ultrasound of the knee joint helps visualize soft tissues (meniscus, muscles, ligaments), and assess the volume of the effusion
Arthroscopy is the most accurate diagnostic method of knee effusion today. A special probe is inserted into the joint cavity and the doctor assesses the extent of cartilage destruction under a microscope.
Treatment of the knee jointpresents a difficult task. In each case, you must choose a separate treatment plan.
When you start saying trivial things during counseling sessions, the patient will be surprised from the very first moment. Is this what we came to do? Give a magic shot so my knee never hurts again. We have to explain that there is no single cure for dry joints. To recover, you need to exercise, lose weight, subscribe to the pool. And one wants to lie down on a couch, develop a "beer belly", grasp the problem with a variety of drugs and be healthy. But alas !!! In this case, medicine is powerless.
Pain relievers do not cure illnesses, they only relieve pain. Anti-inflammatory drugs are prescribed only during the period of exacerbation of pain in the knee joint. Some nonsteroidal drugs, by way of pain relief, contribute to cartilage destruction. Healing ointments do not heal knee pain, but they do help relieve knee pain. In the case of edema, redness and swelling of the joints, warm ointment and compression bandages are contraindicated; it is better to use topical remedies with nonsteroidal anti-inflammatory drugs.
Chondroprotectors are pain-free, expensive and need to be used for a long time. I consider them "dummies" and practically do not appoint them. Currently, avocado and soybean extracts are available in pharmacies, however I have not yet used this drug in clinical practice nor have my own opinion on its effectiveness.
For the treatment and prevention of osteoarthritis of the knee, physical therapy exercises should be performed in accordance with sitting or lying position. Squatting and dancing are prohibited. Cycling, swimming or water exercise, or skiing are all helpful. And the exploitation of domestic labor often leads to increased knee pain. With osteoarthritis of the knee, you should not run, walk quickly up the slope, lift weights.
Diet treatment for knee osteoarthritis.The knee joints carry a load in terms of their own weight. So overweight people need to lose at least 3-5 kg. And some patients need to lose more than a dozen kilograms. If not, there will be no effective treatment. It is not necessary to "sit" on any type of diet that is harmful to the body.
You need to change your eating behavior for the rest of your life, just "stop loving" all the harmful products (sweets, carbohydrates, beer, . . . ). Eating right should become a habit. To lose weight, you need to eat the right foods every 3 hours.
To reduce inflammation in the joints, homeopathic remedies recommend foods that alkalize the blood and fluid in the joints. To do this, it is necessary to limit meat intake and increase the amount of vegetables and fruits in the diet.
It is believed that hot dogs, sausages, bacon, fast foods enhance inflammation in the joints. Instead of pharmaceutical chondroprotectors, I recommend properly cooked meat with jelly.
Orthopedics reduce stress on the knee joint. If you have pain in the knee joints, you must remove the kneecap. In advanced cases, walking with a stick is indicated. When shortening your legs, you should use a heel sole. Recently, it is fashionable to use kinesio tape. These are adhesive tapes made of natural cotton that are glued around the affected knee, which does not limit its ability to move but help relieve joint pain and reduce muscle spasms.
I consider interstitial electrical stimulation to be the most effective treatment for joint pain. Combined with hirudotherapy and drug acupuncture, VTES gives very good results. I will give a case from reality.
A 54-year-old man with stage II right knee osteoarthritis asked me for help. The knee pain has bothered him for 6 years. Over the years, he has undergone many courses of drug therapy, physical therapy, blockade with corticosteroids and repeated courses in a rehabilitation center. But the patient's condition only got worse. He came to me for advice on whether to agree to a joint replacement surgery or to try something else cautiously. I did not have to recover for long, he immediately agreed to the treatment I suggested.
The first session, I gave him 6 leeches to help treat swelling and pain at night. The knee has become easier and more free to move. The man felt a little relieved. We then performed three procedures of interstitial electrical stimulation and almost completely ended pain syndrome.
Thereafter, success is strengthened by the introduction of homeopathic preparations with anti-inflammatory and chondroprotective effects into acupuncture points. After 3 weeks from the start of treatment, the patient threw away the stick and began to walk freely, without limping. It has been 3 years since then. The knee pains have not returned. Once a year, we conduct a VTES session for preventive purposes.
Intra-joint hormone injections are very effective in emergencies to relieve severe pain, swelling, and inflammation. Indicated is an effusion, not blockade with corticosteroids in "dry joints"! They temporarily relieve pain, but such injections do not cure joint disease on their own, and even more cartilage after their destruction. They must be performed by a specially trained doctor who understands the indications, contraindications, drugs, how to use them. In total, no more than 3 blocks are required per match.
After eliminating swelling and inflammation, hyaluronic acid preparations, called pseudo-liquid, are injected into the joint. They act on joints as a natural lubricant, improving the slippage of the bone's surface and restoring the shock-absorbing functions of cartilage. But hyaluronic acid preparations are very expensive and they last only 6-8 months. There is no benefit in using hyaluronic acid preparations for complete loss of joint space and in patients over 65 years of age.
Treatment with folk remedies.You can use tincture or clove decoction, apply with radish, horseradish or ginger, bath turpentine.
Arthroscopy should only be performed in cases where the knee joint has a serious dysfunction, as it will need to be replaced after 10-15 years. Is it healthy and healthy every 10-15 years for surgery under general anesthesia and rehabilitation thereafter??? So don't agree to a surgery yet! Take care of your joints!