The knee is one of the most overloaded and vulnerable joints, and as a result, often causing pain and trouble. There are ways to soothe your knee discomfort.
The kneeis the largest and most complexjointof the human body. The apparently simple movement of the knee consists not only of flexion and extension, but also small rotational movements and sliding movement of the articular surfaces of the thigh in relation to the tibia and displacement of the patella. In addition to movement, an important function of the knee is also to support the weight of the body. No wonder that such a precise mechanism, in constant use, is relatively easy to damage.
The surfaces of the bones forming the joint are covered with cartilage tissue - hard and elastic - which protects the bones from friction and ensures smooth movement in the joint. However, with age, cartilage ages (its fibrous structure loosens) and also wears down. This process progresses faster, the more the joints are stressed, e.g. as a result of excess weight or anatomical defects of the legs (so-called valgus, varus, flatfoot knees).
The cartilage is also destructively affected by any knee injuries, and many of these are common in our lives - bruises, sprains. Each such trauma increases the risk of degenerative changes. Cartilage tissue does not have regenerative abilities. The body tries to repair its damage, but the restorative process only leads to the formation of scar tissue and bone growths (the so-called osteophytes).
Degeneration affects people of all ages
Changesdegenerative knee jointsusually begin between the ages of 40 and 60. But also young people have "sick" knees - often due to heavy overload while practicing certain sports. A bad running technique (standing on the inner part of the foot) has a detrimental effect on the articular cartilage, especially in shoes that do not absorb shocks. The knees are most stressed when running on a slope, especially from top to bottom. Effect? Cartilage nourishes mainly from synovial fluid: when it is relieved, it sucks it up like a sponge, and when it is loaded, it is squeezed out. Therefore, large and frequent overloading causes the cartilage to be "malnourished", its structure changes - it softens, deforms, and breaks. This process is calledchondromalacia or fluffiness, because the diseased cartilage turns from smooth and shiny to dull, with a texture reminiscent of worn plush.
ImportantThe surgeon has the last word
With large changes in the joint (and poor results of conservative treatment), it may be necessary to surgically smooth the surface of the joints. Removal of the superficial layer of damaged cartilage allows for better nourishment of its deeper layers. The condition of the cartilage improves, the pain subsides. The procedure is performed arthroscopically - micro tools and a camera are inserted through small incisions on both sides of the knee, which shows the operation field. The procedure is performed under local or lumbar anesthesia. You can go home a few hours after it. Unfortunately, the effects of this method are not permanent. The final solution is endoprosthesis implantation.
Ultrasound and X-ray of the knee
Pain and crackling in the knee when bending and walking sharply (especially going down the stairs) indicate that something is wrong with the joint.
To find degenerative changes, usually an orthopedic examination and ultrasound of the knee or X-ray (in two planes) are enough. On their basis, however, it is sometimes difficult to assess whether the changes in the joint are the result of the degenerative process itself, or whether this process overlaps with the pre-existing inflammatory changes or changes of a different nature. In such cases, the doctor may also order computed tomography or magnetic resonance imaging. And if there is exudate in the joint, it is also helpful to test the fluid that is removed from the joint with a syringe.
Keep your knees fit
The process of cartilage degradation will not stop by itself, on the contrary - it will progress faster and faster. Why? Because instinctively, avoiding painful movements and positions, the legs are placed a bit differently, which in turn leads to even greater overloading of the joint and the formation of painful muscle contractures. Unfortunately, there is no way or medicine to reverse the process of cartilage destruction, but it can be stopped, or at least slowed down.
- Treatment without medication
Sick joints must be relieved, because it eliminates the most important cause of the disease. So if you are overweight - lose it. Avoid lifting heavy loads, kneeling position, bending your knees sharply, strenuous runs, swinging your legs, and weight-bearing exercises. But to keep your joints fit, you need exercise. It is especially about strengthening the quadriceps muscles (thighs) that keep the knee joints in the correct position. Isometric exercises can be very useful at the beginning, as they help you quickly improve the mechanics of your knees. Works wellstationary bicycle - set the saddle high, at the beginning set the lowest load and pedal calmly.
Your doctor may also advise you to use your walking stick while walking - at least until your knees improve.
- Physical therapy
Well-chosen treatments relieve pain and chronic inflammation, have a relaxing effect on the muscles. There is no one golden mean that would work in every case. One patient is helped by the use of the so-called deep heat, e.g. paraffin compresses or heating with high-frequency electromagnetic fields. Otherwise, treatments in the cryochamber or therapy with a low-frequency pulsed magnetic field may turn out to be more effective. And in yet another - the therapeutic use of ultrasound waves or irradiation with biostimulation laser rays. However, it is always important to take a series of treatments - do not stop the therapy as soon as you feel better.
- Pharmacological treatments
In case of minor ailments, it may be sufficient to rub (4-5 times a day) analgesic and anti-inflammatory preparations into the sick joint. Good results are achieved by physical therapy (e.g. ultrasounds) with the use of anti-inflammatory gels. Oral relieving and anti-inflammatory drugs - especially paracetamol, dicofenac, and ibuprofen - are more helpful in the fight against stronger joint pain. Unfortunately, they have a negative effect on the digestive system, especially the stomach. The safest in this respect is paracetamol; only when it turns out to be ineffective, you can use other medications.
With significant joint inflammation - pain, redness, swelling, increased knee heat - more aggressive treatment is used. Sometimes it is very effective to rinse the affected joint with a physiological sodium chloride solution. Injection of an anti-inflammatory drug from the group of glucocorticosteroids into the joint has a stronger effect - if there is effusion in the joint, the doctor first extracts the accumulated fluid, which immediately brings relief. However, such therapy should not be carried out more often than 3-4 times a year, so as not to intensify the process of cartilage destruction.
High hopes are associated with hyaluronic acid. It's a kind of lubricant - a very sticky substance that is produced by the synovium and allows smooth movement in the joint (without friction). Natural hyaluronic acid is destroyed during the inflammatory process. It is replaced by synthetic acid introduced into the joint with a syringe. It is administered once a year in a series of 3-5 injections, at weekly intervals.
Supportingly, the doctor may also recommend homeopathic and homeostatic measures, as well as taking the preparationimproving the structure of articular cartilage (e.g. avocado and soybean extract, glucosamine sulphate, shark cartilage extract).
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