Knee pain – causes, diagnostics and treatment

Knee pain is a common symptom that affects people of all ages. It occurs as a result of an injury (to a ligament, meniscus, etc.) or as a consequence of degenerative diseases, arthritis, gout or infection.

Most common causes of knee pain without visible injuries:

Gonarthrosis (knee osteoarthritis) is the most common cause of knee pain in elderly patients. Gonarthrosis is a condition of the knee accompanied by worn cartilage and damage to other knee structures (menisci, ligaments, etc.). Gonarthrosis accompanies the natural ageing process, but can be significantly accelerated when there is a genetic predisposition, obesity or overuse of the joint, especially if combined with injuries.

Symptoms of gonarthrosis:

• Pain, swelling and stiffness
• Clicking in the knee joint
• Knee weakness and instability
• Inability to bend the knee

Risk factors for the development of gonarthrosis

• Obesity increases the load on the knee joint, which accelerates cartilage degradation
• Physical inactivity represents a risk factor because only strong muscles stabilise the knee joint and thereby prevent its damage. That is why regular exercise is important both in the prevention and treatment of knee osteoarthritis. Excessive physical activity also represents a risk factor, mostly in professional athletes. Joint damage in athletes occurs due to excessive and prolonged joint loading and the resulting cartilage wear.
• Genetic predisposition If your parents had gonarthrosis, there is a higher risk that you will also develop it, so it is important to reduce risk factors.
• Previous knee injuries also increase the risk of developing gonarthrosis

Treatment of gonarthrosis

To establish a diagnosis and adequate therapy, you need to consult your doctor. If the pain lasts for more than a few weeks, a physiatrist consultation helps to determine the therapy and exercise plan. While waiting for your appointment, avoid standing for long periods and straining the knee, and to reduce pain you can use topical anti-rheumatic preparations and paracetamol tablets as needed. Long-term therapy for degenerative diseases involves changing habits.

1. The most important measure is weight loss and exercise.  Strengthening the muscles leads to the stabilisation of the knee joint, slows down further damage and reduces pain, while weight loss reduces the strain on the knee. You can view recommended knee exercises on our YouTube channel Knee exercises and you can read detailed instructions by clicking this link.
2. Knee supplements
   Today, the most commonly used knee supplements are glucosamine, chondroitin, hydrolysed collagen and various plant extracts.

Glucosamine preparations have a long tradition and the greatest body of evidence for efficacy. The largest number of clinical studies has been carried out for a specific type of glucosamine – crystalline glucosamine sulphate (which is registered as a medicine in some countries) – which has been shown to reduce pain, increase mobility, slow down the progression of osteoarthritis, and can reduce the risk of the disease in people who are at high risk. You can read all about glucosamine sulphate in our article here.Chondroitin has less clinical evidence behind it, but its action is essentially similar to that of glucosamine. Preparations collagen of different origins (bovine, fish, porcine) are somewhat effective in reducing pain and increasing joint mobility. Hydrolysed collagen fragments show particular effectiveness, as they are absorbed significantly better, and for some patented preparations there are good clinical studies which have shown that these fragments affect the symptoms of the disease and even slow down the progression of the disease.

Injections for the treatment of gonarthrosis

Rheumatoid arthritis

Rheumatoid arthritis is the most common form of joint inflammation. It is an autoimmune disease that can affect any joint, including the joints between the auditory ossicles. Involvement of the knee joint in rheumatoid arthritis is very common, and it is not uncommon for a patient to have both gonarthrosis and rheumatoid arthritis at the same time. The treatment of a knee affected by arthritis almost always involves adjusting the therapy the patient is taking for the arthritis, as well as knee aspiration—that is, withdrawing fluid from the knee and administering certain medications. When the knee is affected by arthritis, it should be treated as early as possible, because any delay in intervention can lead to permanent damage to the knee joint and significant impairment of function. Read all the details about rheumatoid arthritis in our article here.

Gout

Inflammation of the knee joint due to giga it usually occurs in patients who have already had gout attacks in their feet. In gout, the knee suddenly swells, becomes very red, warm to the touch and extremely painful. Rarely, patients also have a slightly elevated temperature. An acute attack of knee pain usually lasts for a few days, and rapid relief of symptoms can be achieved by joint aspiration and administering medication directly into the knee. Read all about gout in our article here.

Bursitis

There are several bursae in the knee. These are fluid-filled sacs located between bone and tendons and ligaments, and they serve to reduce friction during movement. In the knee, the so-called pes anserine bursa and prepatellar bursa are the most commonly inflamed. In cases of bursitis, there is usually local swelling and redness at the site of the bursa, accompanied by quite severe pain. Treatment is carried out by applying cold compresses, anti-rheumatic ointments and administering medication directly into the bursa under ultrasound guidance, which quickly leads to the alleviation of symptoms.

How can you ease the pain while waiting for an appointment?

If you have severe pain, without consulting a doctor you can use paracetamol-based preparations, and in consultation with a doctor or pharmacist you can also use certain medicines from the anti-rheumatic group. In most cases of acute knee pain, especially if it is accompanied by swelling, the application of cold compresses to the knee can be of great benefit. Cold compresses can be applied several times during the day. Applying various anti-rheumatic ointments also reduces pain and increases mobility. Of course, it is important to rest the joint for a few days.

To see what an examination looks like and how to book an appointment, please visit the page Rheumatologist appointment.

What must I not do when I have knee pain?

Many patients with knee pain often keep the knee slightly bent and usually place rolled-up towels or other items under the knee while lying down to keep it in a semi-bent position. Although this temporarily relieves pain, in these situations the knee can become stiff in this slightly bent position, which later makes walking difficult in the long term and usually has to be resolved surgically.