Pain under the knee

Pain under the knee can be caused by many reasons, since the knee joint is considered complex and the largest joint in the human body and is subject to stress almost every day, and sometimes injuries, inflammation, and damage.

Symptoms - pain under the knee, pain in the knee joint make up almost 30% of all complaints associated with musculoskeletal diseases and are most often found in people leading an active lifestyle, involved in sports, including professional sports.

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Causes of pain under the knee

Pain in the knee is caused by changes, damage to cartilage, periarticular bag, tendons, muscles, vascular system and is associated with various provoking factors, which may include the following:

• Traumatic injuries as a result of intense physical activity, failure to follow warm-up rules before active, long-term training.
• Injuries caused by a bruise, blow, accident, fall.
• Inflammatory process in the joint – osteoarthritis, gout, rheumatoid arthritis.
• An inflammatory process in the periarticular bursa is bursitis.
• Baker's cyst (popliteal growth) caused by arthritis.
• Rheumatoid arthritis, systemic lupus erythematosus.
• Infectious process in the joint (psoriasis, sexually transmitted diseases).
• Patellar dislocation.
• Meniscus damage.
• Tendinitis (inflammation of the tendons).
• Tendinosis (ruptured tendons).
• Schlatter's disease.
• Sprain, ligament rupture.
• Patellar fracture.
• Chondramation of the patella (kneecap) is a deformation and softening of the articular cartilage.
• Bone tumor.
• Excess body weight as a factor provoking damage to the patellofemoral joint.
• Osteochondrosis of the lumbosacral spine.
• Diseases of the hip joint.
• Cyclist's knee syndrome is a syndrome of the iliotibial band.
• Varicose veins.

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

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Pain in the leg below the knee

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

Tendons are textus connectivus or connective tissue of striated muscles, responsible for the compatibility and attachment of bone and muscle tissue. Tendons are very strong, but are not capable of strong stretching, which determines their sensitivity to inflammation, injury, stretching and rupture. In addition, pain in the leg below the knee can be associated with a serious condition - a torn meniscus, a fractured patella, a dislocation or an inflammatory process in the periosteum (shin splint).

Diseases of the knee joint tendons are typical problems for professional athletes; in rheumatological practice, there are even definitions that describe the highly specific symptoms and etiology of pain in the knee area:

1. STIT – runner's syndrome or iliotibial band friction syndrome.
2. Patellar tendinitis – “jumper’s knee” (less commonly basketball player’s knee).
3. Chronic tenosynovitis - "swimmer's knee".

In addition, pain in the leg below the knee is often associated with varicose veins, which manifests itself as pulsation, heaviness, pulling sensations that increase with a static body position - standing, sitting.

How does pain under the knee manifest itself?

Signs and symptoms of pain under the knee need to be differentiated for a more accurate diagnosis.

Types and nature of pain symptoms below the knee joint:

• Aching, nagging pain, which most likely signals a developing inflammatory process in the joint - arthrosis, arthritis of rheumatoid etiology.
• Severe, sharp pain, characteristic of traumatic injury, ligament or tendon rupture, as well as fracture.
• Acute pain below the knee may be a sign of meniscus damage or be referred pain from radicular syndrome (lumbar radiculopathy).

In addition to the pain symptom, knee joint diseases are accompanied by a decrease in functional mobility, stiffness, when extension and flexion of the leg are very difficult. Symptoms of pain under the knee together with other clinical manifestations - redness of the skin, swelling, hematomas, atypical position or appearance of the knee are important diagnostic indicators that help the doctor accurately determine the root cause and prescribe adequate treatment. There are certain conditions that cannot be treated independently, as they can lead to serious complications and loss of motor function.

Signs and symptoms requiring medical attention:

• If the pain below the knee is not intense, but does not go away within 3-5 days.
• If the pain increases during the day and is accompanied by an increase in body temperature and general malaise.
• If the pain symptom below the knee joint does not allow one to step on the leg, it immobilizes the person.
• When pain is accompanied by severe swelling of the joint.
• The pain symptom is acute and intolerable, the knee is deformed, and the leg takes on an uncharacteristic appearance.
• If severe pain occurs when going down or up.

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Pain under the knee when bending

Pain in the joint itself, pain under the knee when bending is associated with the fact that the muscles of the knee joint work in two directions - concentric and eccentric. Flexion is an eccentric contraction of the muscular apparatus. The pain symptom can be caused by poor preparation, insufficient warm-up, warm-up before training, when sudden movements are made. Less often, the cause of pain during eccentricity (flexion) is prolonged static tension of muscles, ligaments and tendons (stagnation). In addition, when subjected to stress, the patella compresses the inflamed articular surface, which complicates the normal sliding of the structural parts of the knee and provokes a pain symptom. As a rule, in such cases, pain under the knee when bending is associated with gonarthrosis - an inflammatory process of the knee. The painful sensations are dull and constant, if they are not diagnosed and treated in time, knee arthrosis can lead to serious deformation of the joint structure, damage to the cartilage tissue and a condition in which it is difficult, and sometimes impossible, to straighten the legs completely. A typical gait of "half-bent" legs appears, characteristic of gonarthrosis in an advanced stage.

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Pain under the knee in front

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

• Weakness of the medial head (caput mediale) of the extensor, which causes pressure on the lateral parts of the patella and disrupts its movement. If atony of the head and mechanical pressure become chronic, softening and deformation develops - chondromalacia of the patella.
• Instability of the patella, its displacement as a result of constant rotation of the tibia. Most often, this disorder is associated with sports.
• Tendinitis, which manifests itself as pain in the knee, pain under the knee in front. The pain symptom can be aggravated by physical activity, climbing or descending stairs.

Pain under the knee from behind

The causes that provoke pain under the knee from behind are well studied in the clinical sense and, as a rule, are caused by damage to the meniscus or stretching, rupture of the ligaments. In addition, the pain symptom localized behind the knee indicates a neoplasm - Baker's cyst. The cyst is formed in the inflamed tendon-ligament apparatus of the knee, in the popliteal fossa due to a long-term, chronic inflammatory process in the mucous bag - arthrosis. Exudate accumulates there, which, collecting, protrudes inward. This not only interferes with normal movement, but also causes transient, tingling pain at first, then numbness. In the deepening of the knee joint, a formation is clearly palpated, painful to the touch. Baker's cyst is diagnosed using X-rays and the introduction of a contrast agent into the soft tissues. In the initial stage, pain under the knee from behind is treated with conservative methods; in severe, advanced cases, puncture is required, during which exudate is pumped out of the cavity, and a corticosteroid drug is injected inside. Surgical intervention is also possible when the cyst grows to large sizes and contains pus. In addition, after the relief of the pain symptom, basic treatment of the inflammatory process in the joint itself and the body as a whole is necessary.

Aching pain under the knee

Nagging pain under the knee is associated with arthritis or degenerative processes in the meniscus. The area of the inner part of the knee is considered to be the projection of the medialis (medial), internal meniscus, as well as the internal collateral ligament. A characteristic symptom of damage to the medial meniscus is nagging pain under the knee when descending from an elevation or stairs. As a rule, X-ray examinations at the initial stage of the process do not show cartilage degeneration, therefore, with persistent, prolonged pain, arthroscopy is prescribed, which helps to accurately establish and confirm the deformation of the internal meniscus - the cartilaginous pad of the joint. Nagging pain under the knee can also be caused by osteochondrosis of the lumbar spine or a more banal cause - flat feet. Also, pulling painful sensations at the bottom of the knee joint are characteristic of venous congestion - varicose veins, which develop in office workers who are forced to sit for more than 7-8 hours in the same position, such symptoms are typical for drivers who spend most of their time behind the wheel. In these situations, regular warm-ups, preventive massages and examinations are indicated.

Arthritis, which causes a nagging pain under the knee, is most often found in older people, since this process is associated with age-related changes in bone and muscle tissue.

Pain under the knee when walking

A common cause of persistent pain under the knee is progressive gonarthrosis. This is especially true for people over 40-45 years old, for whom, according to statistics, it is the deforming lesion of the knee joint that provokes pain under the knee when walking in 30%. The symptom can develop in one knee or be felt in both legs.

The onset of the disease is asymptomatic, a person feels almost no discomfort, only transient aching pains can signal the development of arthrosis, but, as a rule, they are “written off” to overwork, tired legs. The cause of gonarthrosis is intra-articular progressive deformation of cartilage and bone tissue associated with age-related changes, including hormonal ones. The signs accompanying pain are:

• Periodic crunching in the knee joint when walking or squatting.
• Slight limitation of mobility of the knee(s).
• The knee begins to hurt not only when walking long distances, but also when getting out of bed or a chair.
• The area below the knee hurts a lot when lifting weights from a squatting position.
• Pain under the knee when walking is accompanied by painful sensations when climbing elevated areas, stairs, and also when descending.
• The pain begins to take on a constant, aching character and subsides only when lying down, at rest.
• In the acute stage of gonarthrosis, pain can manifest itself at night as sharp and severe.

Differentiation of pain below the knee when walking is quite simple:

• Vascular changes do not provoke an increase in pain over time, with age.
• Pain associated with overwork goes away with rest and does not recur.

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Severe pain under the knee

Severe pain under the knee can be caused by many reasons, but most often they relate to injuries, tears, fractures.

If the knee joint is seriously injured as a result of a bruise, blow or fall, it is the severe pain under the knee, in the joint itself, in the surrounding tissues that serves as the first signal requiring immediate medical attention. After a severe pain symptom, swelling develops, and there may be hematomas.

Also, the following diseases can be a factor that provokes severe pain below the knee:

• A purulent infectious process in the joint, which in addition to pain causes hyperthermia of the body, fever, and general intoxication of the body.
• Bursitis in the acute stage, which is accompanied by severe pain when squatting, moving up or down stairs, often during long walks.
• Osteoarthritis, which manifests itself as severe pain under the knee in the morning or before bed. During the day, the pain symptom usually subsides, but the knee is swollen, may hurt when palpated, and has limited mobility.
• Rheumatoid arthritis, which is considered an autoimmune disease, affects not only the knees, but also other joints of the human body. In addition to severe, unbearable pain, rheumatoid arthritis causes hyperemia of the skin around the knee, deformation of the knee.
• Dislocation of the patella – complete or incomplete, associated with a professional factor (sports, dancing, ballet). Severe pain under the knee, above the joint, almost complete immobilization, deformation of the joint, swelling – these are characteristic signs of traumatic damage to the patella.
• Sprain or complete rupture of ligaments due to a fall, blow to the area below the knee. In addition, a ligament rupture can be caused by a sharp turn of the leg due to a strong blow to the knee (most often - collisions in sports).
• Damage, rupture of the meniscus, which is accompanied not only by severe pain, but also by hemorrhage (hemarthrosis), swelling of the joint. Balloting (loss of stability) of the kneecap is associated with the fact that exudate and blood accumulate in the cavity of the joint capsule.

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Pain under the kneecap

The kneecap is the patella, as rheumatologists, osteopaths, and surgeons call it. The patella is a structural part of the knee system, which is held in place by the Musculus quadriceps femoris - the tendons of the quadriceps femoris. The patella is responsible for the normal sliding of the tendon-ligament apparatus.

If the cartilaginous layer of the patella is damaged, chondropathy develops, smooth and painless sliding, joint movement is impaired, pain under the kneecap increases. Signs of chondropathy may include the following clinical manifestations:

• Pain under the patella, in the joint itself during intense physical activity.
• The characteristic sound of "friction" under the cup.
• Painful sensation upon palpation in the area under the kneecap.
• Joint swelling, accumulation of exudate.
• Decreased muscle tone, atrophy.

In addition, pain under the kneecap can be caused by instability of the patella with complete or incomplete subluxation. The causes that cause pathological tilt or subluxation of the patella can be the following:

• Overstretching or tearing of the lateral ligament that supports the kneecap.
• Atrophy of the lateral ligament.
• Atrophy of the Musculus vastus medialis - the internal (medial) broad muscle of the thigh.
• Anatomically incorrect structure, shape of legs.
• Valgus shape of the legs (X-shape).
• Dysplasia of the hip joint, femoral condyles.
• Displacement (luxation) or too high position of the kneecap (patella) - patella alta.
• Anatomical pathology of the lower leg, flat feet - rotation of the lower leg ("raking" the feet inward when walking).

In addition to the fact that tilt, subluxation causes pain under the kneecap, a person can feel a spreading pain symptom under the patella or in the entire joint, hear a crunch or click. But the most characteristic sign of subluxation is a feeling of instability, mobility of the patella.

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Aching pain under the knee from behind

The pulling nature of pain in the area under the knee joint may be associated with osteochondrosis of the lumbosacral spine. Pinching of the nerve roots provokes an irradiating symptom, which is felt as aching, pulling pain under the knee from behind along the location of the nerve endings.

Also, pain associated with the back area under the knee can be caused by varicose veins, vascular pathology. These diseases require differential diagnostics using angiography, ultrasound of the vessels and X-ray of the knee joint, lumbosacral area.

A nagging pain under the knee from behind is a characteristic sign of a developing Baker's cyst, which at the initial stage is asymptomatic, only occasionally manifesting itself as nagging, periodic pain. As the formation grows, pressure is placed on nearby nerve endings, this is accompanied by painful sensations behind the knee joint, numbness and a tingling sensation in the feet. Knee movements become limited, it is especially difficult to bend the leg. A large cyst is visible to the naked eye, it is painful to palpation and often causes swelling of the entire joint.

Aching pain under the knee

The aching nature of the pain may be associated with an inflammatory process in the periosteum of the knee joint. Aching pain under the knee, constant, lasting for hours, spreading to the hip area causes a lot of discomfort to the patient, and may also be accompanied by limited mobility of the leg during extension. Inflammation of the periosteum requires accurate diagnosis and timely treatment, as it can lead to complications up to complete immobility of the legs.

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

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

Pain under the left knee

Most often, the knee joints hurt at the same time - both the right and left.

However, pain under the left knee is a fairly common occurrence in the following diseases:

• An irradiating symptom, characteristic of radicular syndrome in lumbago, radiculopathy, osteochondrosis of the lumbosacral spine. Lumbago can signal itself with shooting pain in the knee area, without manifesting itself in the main place of the pinched intervertebral disc.
• A vascular symptom that indicates venous congestion, arterial occlusion. Pain under the left knee may increase with physical exertion - walking long distances. Painful sensations are aggravated by bending the leg when going up - up the stairs, when raising the leg when stepping over an obstacle. A characteristic feature of the pain symptom is that it subsides at rest or when the movement stops, due to which the clinical syndrome of this disease is called "window dressing disease": you walk and it hurts, you stop to look at the window - there is no pain. It is for varicose veins and vascular pathologies of the lower extremities that one-sided pains are characteristic, such as pain under the left knee.

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Pain under the right knee

One-sided pain under the knee is most likely associated with vascular pathologies or the formation of a popliteal cyst.

Baker's cyst is a neoplasm that has an inflammatory, less often traumatic, infectious etiology. The cyst is formed on the back of the knee joint, if it is formed in the right leg, pain under the right knee is an inevitable symptom, which is not manifested at first, but increases as the cyst grows. A noticeable compaction develops in the popliteal fossa, the skin is not hyperemic, easily shifts over the formation, is not fused with it. The cyst is noticeable with a straight leg, an unbent knee, if the knee joint is bent, the cyst seems to fall inward and is not visible. Baker's cyst can be provoked by trauma, mild meniscus damage, synovitis, osteoarthritis, rheumatoid arthritis. Pain under the right knee associated with a small cyst, as a rule, does not cause severe discomfort, only a feeling of pressure. There are slight difficulties with movements, but they do not limit the mobility of the knee. A large cyst causes a feeling of tingling, numbness, cold, which indicates a clear violation of blood circulation in the tissues of the leg. Thrombosis and thrombophlebitis can be called a possible complication of a developing cyst.

Pain under the right knee is also provoked by arthrosis in the initial stage, which can "start" with one leg, but then spreads to both joints. Excess weight, varicose veins, which can be an independent cause of pain in the knee joint of one leg, will complicate the condition with arthrosis. Varicose veins are characterized by aching, pulling pains that can increase with load. Usually, varicose veins develop more intensively in the supporting leg, which bears the main load when walking, doing exercises. At rest, in a horizontal position with legs (legs) raised up, the pain subsides, it also goes away if a person "walks around", that is, consciously activates blood circulation.

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Sharp pain under the knee

Sharp pain under the knee is a symptom that requires not only medical consultation, examination, diagnosis, but also immediate assistance.

Among the causes that provoke sharp, severe pain in the knee, under the knee, the most dangerous are the following injuries, traumas and diseases:

• Traumatic injury to the cartilage - meniscus. You can damage or tear the meniscus not only when doing professional sports, but also at home with a sharp, unsuccessful turn, jump (landing), and even bending or squatting. Violation of the meniscus structure manifests itself as sharp pain, immobilizing the entire knee, especially its extension function. The knee joint quickly swells, hurts even when touched. Meniscus injury should be treated as quickly as possible, since in advanced cases it leads to complete immobilization of the leg. As first aid, cold on the joint, taking an analgesic drug (non-steroidal anti-inflammatory drug) and immediate medical attention are indicated. As a rule, an X-ray of the knee is prescribed, which shows the condition of the bone tissue, not the cartilage. The condition of the meniscus is checked using ultrasound. Treatment measures depend on the severity of the injury. If sharp pain under the knee is accompanied by extensive swelling and hyperemia of the skin, a dislocation is possible, it is reduced. A meniscus rupture may require surgical intervention, during which parts of the cartilage are reconstructed and sutured. After the first stage of treatment, therapeutic exercises, physiotherapy, and adherence to a regime of gentle physical activity on the knee are indicated.
• Sharp pain under the knee is also typical for ligament ruptures, which can be caused by a fall on the knee joint, a blow to the joint, or a turn in some sports (hockey, football). Signs of knee ligament ruptures can include sharp, acute pain, swelling of the joint, soreness when bending or unbending, clicking or crunching when moving. If the ligament is completely torn, a hematoma gradually develops at the site of injury. As first aid, you can apply ice, cold, take a painkiller and immobilize the knee at a right angle. A cold compress is designed to relieve swelling, prevent intra-articular hemorrhage, a tight bandage helps reduce pain. A visit to the doctor, diagnosis of the injury and treatment are mandatory. It is believed that the most dangerous rupture is a violation of the integrity of the anterior cruciate ligament, which is restored and heals extremely slowly and with difficulty.

Sharp pain under the knee

Any acute pain is a signal that the disease is acute, the inflammation is developing rapidly, or the injury requires urgent medical care. Acute pain under the knee is no exception, which is provoked by the following factors:

Knee joint fracture. The patella is most often injured as a result of a fall from a height or on a bent knee. In traumatology, horizontal fractures of the patella are most often diagnosed, which manifest as acute pain under the knee, in the area of the knee itself. A horizontal fracture is accompanied by displacement of fragments and is treated only with fixation (plastering). Complex fractures may require surgery, complications can lead to endoprosthetics. Also, a fracture can be accompanied by a tear of the patella, when the line of injury passes below and provokes severe pain precisely under the knee. A comminuted fracture of the patella is diagnosed less often, it is provoked by a blow of great force, requiring high speed, application energy. A vertical fracture is located from top to bottom, it does not lead to displacement. The rarest type of patellar fracture is an osteochondral type of injury caused by an already developing process of deformation and degeneration of bone tissue in arthritis, osteoarthritis. Symptoms of a fracture are typical:

• Sharp, acute pain under the knee.
• Swelling that develops rapidly.
• Internal bleeding into the joint capsule, into the cavity – hemarthrosis.
• Immobilization of the leg.
• Deformation of the joint (inward movement of fragments).
• Hematoma, penetration of blood into the subcutaneous tissue. The bruise extends down the leg, all the way to the foot.
• Loss of sensation in the knee and leg as a whole is possible.

First aid for a fracture is to call a doctor, apply cold to the injury site, immobilize the knee and leg. The prognosis for patella fractures is usually favorable, provided that timely medical care is provided.

Synovitis of the knee is an inflammation of the inner part of the joint and the accumulation of exudate in the cavity. Sharp, acute pain under the knee, fever, immobility of the leg require immediate treatment; in advanced stages, synovitis can provoke deformation of bone and cartilage tissue, the development of arthrosis.

Professional injuries of those who are familiar with sports, ballet, dancing - dislocation, subluxation, partial dislocation of the kneecap (patella). Symptoms that demonstrate dislocation - sharp pain under the knee, in the joint, difficulty moving, pain in the leg when stepping. The knee swells greatly, deforms. As first aid, cold compresses, fixation of the knee with a splint from the buttock to the ankle, taking a painkiller are indicated. Self-reduction of dislocation is unacceptable, as this can provoke a rupture of the ligaments and further surgical intervention. Only a traumatologist, orthopedist, surgeon can reposition a damaged patella after examination, diagnosis of damage. Treatment for dislocation, subluxation involve relief of acute pain, fixation of the joint for a month or more. Even massage, physiotherapy procedures are prescribed.

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

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Pain under knee when squatting

Pain in the knee, pain under the knee when squatting is caused by excessive stress on the joint, which may already be inflamed or injured.

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

• Illiterate performance of strength exercises, failure to observe technique. For example, there are training options during which the knees should be parallel to the foot, looking forward. An acute angle when squatting, spreading the knees can provoke additional stress on the joint and cause painful sensations.
• Acute, severe pain when squatting indicates traumatic injury - a rupture or, at a minimum, a sprain of the ligaments. If the pain does not go away after straightening, you need to apply a cold compress to the knee and seek medical help, undergo diagnostics.
• Constant pain under the knee when squatting signals a possible disease - Schlatter's disease. Especially if the pain symptom accompanies going down the stairs, from the threshold. Schlatter's disease has been little studied and is most often diagnosed in young people.
• Pain under the knee when squatting, accompanied by a crunch, most likely indicates developing arthritis. The initial stage of arthritis is characterized by transient pain, especially after stress on the joint.
• Pain in squatting can be related to fashion, this concerns the fair sex who experiment with walking on heels of unimaginable height. Shoes equipped with heels higher than 6 centimeters are considered traumatic from an orthopedic point of view and can provoke persistent pain in the knee joint, below the knee.
• Metabolic disorders that lead to weakness of the muscular, tendon-ligament apparatus are also one of the causes of pain when squatting.

If the pain under the knee when squatting is caused by simple overload or incorrect exercise performance, the symptom is eliminated quite simply and quickly. Persistent pain not associated with pathological etiology can be relieved with cold compresses, compresses from fresh cabbage leaves, warm, relaxing baths. Also effective are exercises in a lying position - "scissors" (cross swings) and "bicycle". In uncomplicated cases, when the disease causing pain is in the initial stage, physiotherapy procedures, the use of ointments, gels are sufficient. Advanced forms of the disease - arthritis, bursitis, injuries, require long-term complex treatment.

Pain under the knee when straightening

Pain in the knee joint, below it is most often associated with damage to the meniscus, gonarthrosis and other disorders of the knee structure. In addition to the fact that extension becomes painful and difficult, the knee swells, with a clearly visible meniscus accumulation of exudate. Also typical is pain during extension for damage to the ligamentous apparatus, especially with a sprained cruciate ligament. ACL - anterior cruciate ligament injury is typical for those people who are engaged in sports exercises, train a lot. A sharp stop during a fast, energetic movement, excessive rotation provokes pain during extension. The posterior ligament (PCL) can also be damaged, but it is much stronger and more elastic, so it is less likely to be torn or stretched. Its injuries can be caused by a fall, an accident, a strong high-energy blow. The main signs of ACL (anterior cruciate ligament) damage are a characteristic click, swelling, pain when straightening the leg, instability of the knee joint. If the rupture occurs instantly, pain shock, vomiting, and even loss of consciousness are possible.

Arthritis in the acute stage, bursitis can also be factors causing pain symptoms during extension movements. Differential diagnostics in such cases is quite accurate, additional methods of examining the knee joint only help to clarify the nature, stage of the disease and give direction for effective therapy.

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Aching pain behind the knee

Aching pain under the knee from behind, clearly localized in the popliteal fossa is a symptom of Baker's cyst. This is a benign tumor, a neoplasm that restricts the movement of the leg, provokes mild pain, and in the initial stage proceeds without clinical manifestations. The cyst is almost invisible in the first months, it can be detected accidentally by palpation in a straight leg position. If the leg is bent, the tumor seems to "fall" into the popliteal fossa and is not noticeable. The skin above the cyst is not hyperemic, there is no swelling in the joint, in principle, the leg looks healthy, only transient aching pain under the knee from behind can be the first signal of the disease. The cause of the cyst is considered to be a meniscus injury or arthritis in the first stage, less often - synovitis. The pain becomes more noticeable if the cyst grows and increases in size, squeezing the nerve endings and disrupting the normal blood supply to the joint and the leg as a whole. If Baker's cyst is not treated in a timely manner, it can lead to serious, severe complications - varicose veins, thrombosis or rupture of the cyst walls. Rupture of the capsule of the formation is accompanied by sharp pain and hyperthermia.

In addition to cysts, aching pain behind the knee joint is often caused by bruises, hematomas, and traumatic origins.

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Sharp pain under the knee from behind

Sharp pain under the knee from behind is diagnosed with serious injuries, damages - fractures, ruptures, displacements.

In traumatology practice, there is a concept called a triad of knee joint injury. This is a complete rupture of the anterior cruciate ligament, a complete rupture of the medial collateral ligament, and a meniscus injury. This pathological complex is typical for professional athletes involved in active, traumatic sports - football, hockey, baseball, combat sports. With the triad syndrome, there is a sharp pain under the knee from behind, a pain symptom in the entire joint, as well as a typical sign of "anterior drawer", displacement of the axis of rotation, deformation of the leg, especially during the extension test. The triad is not characterized by the manifestation of effusion, it is compensated by a complete rupture of the medial capsule, as a result of which blood flows out of the joint cavity. Such complex injuries require immediate hospitalization, often surgical intervention.

In addition, sharp pain under the knee from behind may be associated with a rupture of the capsule of the Baker's cyst, a condition that is not often encountered in practice. As a rule, the neoplasm begins to be treated at the stage of increasing in size, but in an advanced state, the accumulated exudate can break through the cyst wall and cause severe pain in the back of the knee joint.

Pain under the knee on the side

Lateral localization of pain in the knee joint is most often diagnosed in athletes, whose ligaments and tendons are subject to intense stress. Pain under the knee on the side is accompanied by difficulty in straightening the leg, pulling sensations during long walks and rarely transforms into an acute pain symptom. In addition to athletes, office workers who are forced to be in a static position due to their job, which also affects the knee joints, suffer from similar pain. Taxi drivers, public transport drivers, in a word, those who sit behind the wheel for a long time in the same position, also complain of aching lateral pain in the knee area. This is a typical factor that provokes characteristic pain of lateral localization, it is called static overstrain. As a result of statics, the muscles and vessels of the body do not receive the proper blood supply, with chronic static positions, especially in a sitting position, thrombophlebitis often develops, and the pain symptom under the knee from behind is a secondary manifestation of the underlying disease.

The reason why a person feels pain under the knee on the side may be osteochondrosis, bruise or temporary muscle strain. Very rarely, such symptoms are provoked by varicose veins due to their anatomical location in other areas.

Severe pain under the knee from behind

If the knee hurts in the lower part at the back, this is a sign of serious damage to the ligament, tendon, less often a rupture of the Baker's cyst or septic bursitis.

Acute pain that can be localized at the site of injury, but then spread to the side and behind the knee, is typical for stretching and ruptures of the ACL - the anterior cruciate ligament. An ACL injury, even partial, is immediately accompanied by severe swelling, the entire knee swells, severe pain appears under the knee in front and behind. However, posterior localization of pain is more typical for a rupture or stretch of the posterior cruciate ligament, injuries of this kind are manifested in the form of severe swelling in the popliteal fossa, instability of the patella and severe pain.

A large Baker's cyst with purulent exudate is also one of the causes of acute, intense pain under the knee from behind. The cyst may become purulent due to arthritis, associated skin damage, or as a result of constant mechanical compression during physical activity - sports, professional activities. Severe pain of any localization requires medical care and timely treatment.

Pain and swelling under the knee

Swelling at the bottom of the knee may be associated with a vascular, venous factor, with an inflammatory infectious process in the acute stage, with an insufficient rehabilitation period after treatment, surgery and excessive load on the knee. Swelling, pain and swelling under the knee, around the joint with damage to the meniscus are also typical. Fracture of the patella, dislocation, stretching or rupture of the ligaments, especially the ACL - anterior cruciate ligament, Baker's cyst - this is an incomplete list of possible factors that provoke pain. The popliteal fossa is considered quite vulnerable and vulnerable, the skin in this area is not protected, so any violation of the structure of the knee joint, accompanied by swelling, can lead to swelling behind the joint. Pain and a feeling of pressure, swelling in the popliteal fossa manifest quickly and require examination, differential diagnosis. Immobilization of the leg, bandaging the knee with elastic material can help as first aid. Rubbing, cold compresses are not effective and sometimes even harmful, especially if the swelling is associated with venous congestion. You can relieve the pain symptom by taking a non-steroidal anti-inflammatory drug, and then you should contact a traumatologist, osteopath, rheumatologist, phlebologist. If the pain is associated with an injury, a splint or plaster will be applied to the knee, physiotherapy procedures will be prescribed. A phlebologist, having determined varicose veins or thrombophlebitis, will advise methods and ways to relieve or activate blood circulation, prescribe venotonics. Rheumatoid arthritis is treated for a long time and in a complex manner, since it is a systemic disease. In any case, swelling under the knee is a signal of a violation of tissue trophism, vascular conductivity, it must not only be stopped, but also the underlying cause of the symptom must be treated.

Pain in the vein under the knee

The legs are supplied with two types of venous system – there are deep and superficial veins. Pain in the vein under the knee is associated with the expansion or blockage of the vena saphena parva – the vein that runs from the outer ankle to the knee joint.

Pain of vascular etiology is not typical for the knee joint, but pain in the vein under the knee is a fairly common complaint, especially from women. Impaired blood flow in the leg, in the knee area is most often associated with varicose veins, thrombophlebitis, which have their own etiology. As a rule, vascular pathologies "start" in puberty, when the adolescent body begins to grow rapidly, and the vessels do not have time to develop as quickly as the skeletal system. Pain in the vein under the knee is rarely one-sided, more often both popliteal veins hurt. But sometimes, with constant stress on the supporting leg, it suffers more, for example, the right one. It is quite easy to differentiate pain in the vena saphena parva - the vein under the knee and other types of pain:

• Pain in the vein is not sharp and intense, as with rheumatism, arthritis, bursitis or knee injuries.
• Pain in the vein under the knee rarely interferes with a person’s motor activity and does not provoke a decrease in the mobility of the joint itself.
• provokes a decrease in the mobility of the joint itself.
• Venous pain is accompanied by a characteristic feeling of tired legs, often cramps, and numbness.

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

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Pain in the ligaments under the knee

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

There are four main ligaments in the knee that provide union and functionality of the femur and tibia:

• ACL – anterior cruciate ligament, which controls forward movements, rotation.
• PCL – posterior cruciate ligament, which provides posterior rotation and stability of the joint.
• MCL – medial (middle) collateral ligament.
• LCL – lateral collateral ligament (external ligament).

Pain in the ligaments behind the knee is most often caused by diseases, injuries of the ligaments that are behind the knee joint. Most often, such pain is provoked by a sprain of the PCL - the posterior ligament, although such injuries are very rare, since it is quite strong. To injure the PCL, a blow of great force is needed, for example, a sharp blow to the front of the shin during accidents or contact sports. The so-called bumper injury is the most common cause, as a result of which severe pain in the ligaments behind the knee develops. If the PCL is injured, the pain is formed in front of the knee.

In addition, the pain symptom in the ligaments is caused by stretching, which can be accompanied by joint stiffness and swelling. The most dangerous in terms of consequences and prognosis are stretching of the cruciate ligaments of all types, especially painful is damage to the ACL. Injuries to the anterior cruciate ligaments are difficult to treat and take a long time to rehabilitate, in addition, stretching of the ACL is often accompanied by a rupture and pain shock.

Standard actions in such cases are cold on the site of the sprain, taking an analgesic, bandaging with elastic materials and contacting a traumatologist for differential diagnosis.

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Pain under the knee in a child

About 20% of all complaints about knee pain are reported to pediatric traumatology. As a rule, pain under the knee in a child is associated with vascular disorders. Complaints made by adolescents are especially characteristic in this regard. During puberty, the skeletal system develops first, and the vascular system does not keep up with its intensive growth, which provokes periodic pain in the area of large joints. The child's knee suffers from insufficient blood supply, fortunately, this condition is considered transient with age. However, there are pathologies such as varicose veins, thrombophlebitis, which can "start" in childhood, adolescence and accompany a person throughout life, periodically causing pain in the knee joint.

Vascular pain under the knee is not accompanied by deformation of the joint itself, rarely leads to swelling or limitation of movement of the leg. The pain depends on weather conditions, the presence of concomitant diseases, such as acute respiratory infections, acute respiratory viral infections, on the temperature regime (heat or cold), on physical activity, load. The knees stop hurting (twisting) at rest, during rest, after massage or rubbing. Also, pain under the knee in a child caused by venous insufficiency is well relieved by drugs that dilate blood vessels. More specific treatment, as a rule, is not required.

A more serious cause that provokes pain under the knee in a child is rheumatism or spondyloarthritis. These are systemic diseases that manifest symptomatically in the form of joint pain, swelling, and occasionally an increase in temperature.

Bodies. Pathological changes in bone tissue are visible on X-rays, blood serum analysis shows a high level of C-reaction and ESR. Treatment is prescribed by a rheumatologist, orthopedist, less often - a therapist. Such a child also requires constant dispensary monitoring, a special diet and regular intake of certain anti-inflammatory drugs.

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Diagnosis of pain under the knee

Diagnostic measures for pain symptoms in joints, including the knee, are quite standard. Traumatology, orthopedics, phlebology, osteopathy are the areas of medicine that have a good clinical base, including historical. Diagnostics of pain under the knee is differential in nature and consists of the following actions:

• Initial visual inspection.
• Collection of anamnesis, including hereditary and professional.
• The nature of the pain, its localization and interaction with other clinical manifestations are clarified.
• Testing is carried out - flexion, extension.
• An x-ray is mandatory.
• An ultrasound examination of the joint (duplex) is prescribed.
• An important diagnostic step is angiography (leg veins).
• MRI and CT scans may be prescribed – computer methods for examining bone tissue.
• A complete blood count (CBC) and biochemical blood test are prescribed.
• A puncture of the joint cavity may be required.

Diagnosis of pain under the knee is directly related to the nature of the injury, damage to the joint and is carried out in a comprehensive manner, often in a hospital setting, where it is easier and faster to do this.

Treatment for pain under the knee

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

In all other cases that are not defined as acute conditions, treatment of pain under the knee involves the following steps:

1. Inflammation and swelling of the joint are relieved. Cold compresses, gentle bandaging or reliable fixation of the joint are indicated depending on the type of injury, non-steroidal anti-inflammatory drugs are prescribed - Ibuprom, Ibuprofen, Diclofenac. Antibiotics may be prescribed if the cause is determined to be an infection.
2. Physiotherapy procedures to strengthen the muscles and restore stability to the knee joint are mandatory.
3. It is recommended to perform therapeutic physical training that maintains certain muscle groups in tone to prevent atrophy.
4. A rehabilitation complex is being developed that includes the performance of special exercises.

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

• The type and severity of injury.
• Number of traumatic injuries (combined trauma, comminuted fractures, etc.).
• Assessment of the risk of recurrent knee disease (meniscus injury, bursitis).
• Professional risks associated with possible departure from sports, profession.
• Patient readiness in terms of concomitant pathologies, chronic diseases, and so on.
• Operations can be as follows:
• Arthroscopy is a gentle operation using small, low-trauma incisions. This type of operation is effective in case of meniscus rupture, restoration of ligament ruptures.
• Endoprosthetics – used after unsuccessful conservative treatment. Part of the knee is replaced, less often – the entire joint (in case of osteonecrosis).

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

• Introduction of glucosamine, chondroitin sulfate to restore cartilage tissue.
• Bioprostheses are sheet linings, insoles, which help reduce the load on the knee joint and reduce pain in flat feet and gout.
• Adrenosteroids, which are injected directly into the joint, are intended to prevent arthritic pain.
• Almost all knee joint diseases in the initial stage have a favorable prognosis, which ensures timely, comprehensive treatment.

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Prevention of pain under the knee

Prevention of knee joint diseases requires compliance with certain rules and recommendations. By following the advice, you can avoid complications and painful symptoms.

Prevention of pain under the knee involves reasonable distribution of the load on the joint even during professional sports. It is known that statistics on the number of knee joint injuries are directly related to many types of sports competitions. More than 45% of pain symptoms in the knee are caused by damage as a result of training or competitions. In addition, those who play sports are recommended a special diet containing products that strengthen ligaments and cartilage tissue. It is also important to monitor the body mass index, excess weight load on the knee joints leads to their deformation, destruction and pain. If knee treatment has already been completed, prevention of pain under the knee should include rehabilitation measures - joint development, knee support with elastic bandaging, taking special medications that strengthen blood vessels, ligaments, tendons and bone tissue.

Recommendations that include prevention of pain under the knee:

• If a person is involved in a traumatic sport, the knee should be protected with a special knee pad, cruciform bandage, or wedge heel.
• If a person’s activity is associated with monotonous leg movements that can destroy the structural elements of the knee, a regime of regular warm-ups and breaks in work should be introduced.
• If the knee is injured as a result of a bruise, the joint and the entire leg should be immobilized, and general motor activity should be limited. Sometimes 2-3 days are enough for the knee to recover and not hurt.
• To prevent pain under the knee, in the knee itself, you should avoid overcooling the joints.
• If a person's activity involves sitting for more than 4-6 hours, the correct posture and position of the legs are important. Constantly bent knees, crossing legs, leg over leg - these are the most harmful positions for the knee joint. It is necessary to find time to periodically straighten and unbend the leg (legs).

To prevent knee pain, you need to strengthen your thigh muscles (quadriceps) - lunges, squats, and the "bicycle" exercise will help keep your muscles toned and relieve excess stress from your knees.

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