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Если болит колено при ходьбе

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17 августа 2019

Часто человек замечает, что болит колено при ходьбе или физических нагрузках. Такое явление не редкость и беспокоит в разном возрасте. Сильная боль может проявляться выше, ниже, сбоку или непосредственно в коленном суставе. Спровоцировать отклонение способны травмы, механические повреждения и многие суставные заболевания.

Частые причины из-за которых болят колени при ходьбе

Ушибы и иные травмы

Резкая и острая боль в колене во время ходьбы бывает вызвана повреждениями различной сложности и локализации. Частыми источниками болевого синдрома при ходьбе становятся:

  • Ушибы. Боль проявляется в зависимости от тяжести повреждения. Такая травма является наиболее распространенной и легкой. Помимо болевого приступа, при ушибе возникает отек, подкожное кровоизлияние.
  • Разрыв и повреждение мениска. Травмирование является следствием резкого движения ногой вбок, когда ступня зафиксирована на полу. Преимущественно такая травма, вызывающая впоследствии боль в колене, возникает у спортсменов. Болезненность отличается острым характером, человек не в состоянии полностью разогнуть ногу.
  • Разрыв или растяжение связочного аппарата. Как правило, травма колена происходит при падении с высоты, автомобильной аварии, профессиональных занятиях спортом. Пострадавшего беспокоят неприятные ощущения при ходьбе, коленка отекает и краснеет.
  • Вывих. Считается редким травмированием, что вызывает сильную боль не только во время ходьбы, но и при наступлении на ногу. Участок вокруг коленного сустава сильно опухает.
  • Переломы внутри подвижного сочленения. Проявляются, как правило, в зрелом возрасте. При нарушении возникает отечность, болезненность в области травмы, которая усиливается со временем и не позволяет человеку нормально ходить.
  • Повреждение целостности хрящевой ткани. Является следствием вывиха, сильного удара или перелома.

Нередко проявляется комбинированная травма, которая требует особого терапевтического подхода. Поэтому при выраженной боли в коленном суставе при ходьбе необходимо обращаться к доктору.

Заболевания

Боль в колене при ходьбе нередко беспокоит на фоне развития суставных или иных патологий. Распространенными нарушениями, приводящими к болезненности в суставах, являются:

  • Артроз. При отклонении отмечаются дистрофические изменения в подвижном коленном сочленении. Пациенту становится больно в коленной чашечке после длительной ходьбы или нагрузки. Беспокоит ощущение жжения и припухлость.
  • Тендинит. Воспалительная реакция проявляется в связочном аппарате колена, что связано с проникновением инфекции или растяжением. Болевой синдром может возникнуть в левом или правом сочленении и беспокоить в любой области коленки.
  • Подколенная киста или Бейкера. Характеризуется отеком, припухлостью задней части сустава, жжением в коленке. Боль чаще беспокоит при наклоне или разгибании конечности.
  • Остеохондрит рассекающего типа. Болезненность тянущего характера, проявляющаяся сзади колена во время ходьбы. Запущенная форма недуга провоцирует деформацию подвижного коленного сочленения.
  • Артрит инфекционной формы, остеомиелит либо бурсит септического течения. Такие нарушения часто становятся источником боли при ходьбе. Болезненность чувствуется в мускулатуре и возникает жгучее ощущение в колене.
  • Заболевания позвоночного столба. При некоторых болезнях могут проявляться спазмы, отдающие в коленный сустав при передвижениях.

Вернуться к оглавлению

Что делать и как оказать первую помощь?

При выраженном болевом синдроме во время ходьбы необходимо знать какие меры предпринять для облегчения состояния. Важно как можно скорее обратиться в медицинское учреждение. Если это в ближайшее время невозможно, то требуется оказывать первую помощь самостоятельно, выполняя такие действия:

  • Снижают нагрузку на поврежденное подвижное сочленение. Рекомендуется 1—2 часа лечь и полежать.
  • Для устранения отечности прикладывают холодный компресс к больному колену.
  • Если боль вызвана легкой травмой, то можно воспользоваться эластичным бинтом, который наматывают на поврежденную нижнюю конечность.
  • Для улучшения циркуляции кровяной жидкости выполняют легкие массажные движения в месте поражения.

Вернуться к оглавлению

Диагностика

Поскольку многие причины могут повлиять на возникновение боли в колене при ходьбе, то при появлении патологического симптома требуется обратиться к доктору. В основном консультируются у травматолога, ортопеда, ревматолога, остеопата. Специалист осматривает больную область ноги и собирает детальный анамнез. Подтвердить диагноз возможно такими инструментальными методами:

  • рентгенография;
  • компьютерная и магнитно-резонансная томография;
  • артроскопия;
  • обследование ультразвуком.

Категорически запрещено самостоятельно назначать лечение, не выяснив причин болей в колене при ходьбе. Неосторожными и неправильными действиями можно спровоцировать осложнения, вследствие которых человек вообще не сможет наступать на ногу.

Чем лечить?

Консервативное лечение

Если после долгой прогулки сильно болят суставы ног в области колена, то необходимо обратиться к доктору и провести необходимую терапию. Консервативное лечение включает корректировку питания и прием лекарственных препаратов. Требуется делать легкую гимнастику, которая разрабатывает левое или правое поврежденное коленное сочленение. В таблице представлены медикаменты, устраняющие боль в колене при ходьбе:

Лечение народными средствами

Болезненные ощущения, возникающие в колене при ходьбе, возможно купировать, используя природные компоненты. Эффективные рецепты:

  • Картофельное соцветие. На 1 ст. л. сырья используется 400—500 мл кипятка. Лекарство запаривают в термосе и настаивают 14 дней. После употребляют перорально перед приемом пищи.
  • Сало свинины. Небольшой кусок продукта прибинтовывают к поврежденной области перед отходом ко сну.
  • Капустный лист. Овощ используют в качестве компресса, фиксируя листок на больном колене. Можно также использовать сок капусты для растирок.
  • Зверобой. На основе растения готовят домашнюю мазь, добавляя соцветие донника и хмельные шишки.
  • Редька и мед. Из овоща готовят кашицу и добавляют в нее пчелиный продукт. Используется смесь в качестве компресса.
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Перед использованием любого нетрадиционного лекарственного средства необходимо проконсультироваться с доктором. Хотя природные компоненты редко вызывают побочные реакции, при неправильном их применении боли в коленном сочленении при ходьбе могут усилиться. Для лучшего эффекта народные средства рекомендуется использовать совместно с препаратами традиционной терапии.

Боль в колене во время ходьбы может появляться ненадолго и проходить без следа, а иногда коленный сустав постоянно болит при движении. Если в первом случае болевой синдром вызван кратковременным защемлением нервного корешка или сосудистым спазмом, то постоянная боль в коленке указывает на развитие патологии. Рассмотрим основные причины боли в колене при ходьбе, и в каких случаях необходимо посещение врача.

1. Артрит

Заболевание сопровождается деструктивными процессами в хрящевой ткани и истончением коленного хряща.

Провоцирующие факторы

Причин для развития заболевания много. Это могут быть:

  • большие нагрузки (поднятие тяжестей, интенсивные тренировки);
  • травмы коленного сустава;
  • избыточный вес;
  • перенесенные ранее острые воспаления коленей;
  • возрастное нарушение обменных процессов.

Клиническая картина болезни нарастает постепенно и человек нередко игнорирует начальные проявления патологии.

Симптомы

Первым признаком болезни является ощущение боли в колене при движении. Появление другой симптоматики зависит от того, насколько разрушен хрящ:

  • I – колено болит умеренно при длительной ходьбе, после больших нагрузок появляется отечность. Изменений в суставной структуре нет.
  • II – возникает боль и хруст при небольших физических усилиях. Человек жалуется на скованность, а при рентгенографии выявляются признаки нарушений строения сустава.
  • III – коленный сустав болит постоянно, а ходьба для коленей становится тяжелым испытанием. Внешне они выглядят отекшими и деформированными.

При артрите боль имеет ноющий характер, а интенсивность зависит от выраженности патологического процесса.

Лечение

Пока деформация выражена умеренно, применяют консервативную терапию, для уменьшения деструктивного процесса в хрящах и снижения боли. Пациенту назначают:

  • анальгетики;
  • препараты, стимулирующие регенерацию хряща (хондропротекторы);
  • средства для уменьшения боли и воспаления (НПВП).

Дополнительно назначают лечение мазями, имеющими в составе обезболивающие и противовоспалительные компоненты.

В тяжелых случаях, когда хрящевая прокладка сильно истончена, показано оперативное лечение с заменой поврежденных тканей на искусственный сустав. Перед эндопротезированием проводят оценку состояния пациента: у пожилых или при серьезных заболеваниях (сердечно-сосудистые, эндокринные) эндопластику не делают из-за риска отторжения имплантата и возможных послеоперационных осложнений. Таким пациентам проводят медикаментозную терапию, а для снижения нагрузки, при ходьбе советуют пользоваться тростью, костылями или другими вспомогательными средствами.

Какого доктора посетить

При болях в коленке, которые усиливаются при ходьбе, даже если деформации еще нет, а отечность появляется только после физических усилий, следует посетить ортопеда.

2. Травмы мениска

Другое название патологии – менископатия. При неудачном падении или подвывихе колена изменяется положение мениска в суставе.

Причины

  • частые ушибы (занятия спортом);
  • слабость менисковых сухожилий.

Дополнительным фактором, повышающим риск травматизма, служит избыточный вес и болезни опорно-двигательного аппарата.

Симптомы

В чашечке колена появляется острая пульсирующая боль, пострадавший не в состоянии наступать на поврежденную ногу.

Кроме боли появляются:

  • выраженная отечность;
  • затруднение при сгибании;
  • похрустывание в суставе во время движения.

Предположить повреждение мениска можно, если коленка стала болеть внезапно после падения или подворота ноги. Такое состояние требует экстренной помощи.

Если пострадавший не обратился за медицинской помощью, то колено постепенно начинает болеть меньше и процесс переходит в хроническую форму. При этом появляется нарушение чувствительности, чувство скованности при ходьбе, усиление боли при незначительных ушибах или резких движениях. Походка такого человека становится неровной из-за нарушения сгибательной функции коленки . Нередко при этом суставы начинают сильнее болеть «на смену погоды».

Лечение

Как будет лечиться больной при менископатии, зависит от характера возникших нарушений.

Консервативное

Под наркозом придают смесившемуся мениску анатомическое положение и накладывают гипсовый бандаж для обеспечения полной неподвижности и предотвращения повторного смещения.

Для облегчения состояния и ускорение заживления, пациентам назначают:

  • обезболивающие;
  • нестероидные противовоспалительные средства;
  • лекарства, стимулирующие восстановление поврежденных хрящей и связок.

После того, как происходит заживление тканей, гипсовую повязку снимают и разрабатывают коленку с помощью лечебной физкультуры.

Хирургическое

В зависимости от характера повреждений, больному проводят:

  • удаление мениска и установку протеза;
  • ушивание растянутых сухожилий.

После операции накладывается гипс и проводится консервативное лечение с последующим восстановлением подвижности конечности.

Какой врач лечит

По поводу повреждения мениска следует обратиться к травматологу.

3. Воспаление околосуставной сумки

Капсула, содержащая синовиальную жидкость, при воспалении приводит к тому, что коленка начинает болеть при ходьбе.

Причины

Воспалительный процесс возникает по разным причинам:

  • посттравматические осложнения;
  • глубокие раны;
  • последствия перенесенных ранее воспалений коленного хряща;
  • аутоиммунные заболевания;
  • ранее перенесенные операции на колене.

Воспалительный процесс может протекать остро или хронически.

Острая форма

Воспалительный процесс причиняет острую боль в колене на прогулке или при нагрузке, которая незначительно уменьшается в состоянии покоя. При этом появляются внешние признаки воспаления:

При остром процессе колено может болеть настолько сильно, что больной не может наступать на ногу.

Хроническая форма

Воспаление будет вызывать незначительные симптомы:

  • умеренную боль во время ходьбы;
  • небольшую отечность.

Часто хронический процесс сопровождается не тем, что во время ходьбы колено болит, а умеренным дискомфортом в суставе при движении. Коварство слабо выраженной в том, что человек не считает заболевание чем-то серьезным и откладывает визит к врачу, усугубляя течение патологического процесса.

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Способы лечения

Терапия зависит от причины воспалительного процесса. Пациентам назначают:

  • гормональные препараты;
  • антибиотики (если причина – инфекционный возбудитель);
  • лекарства нестероидной противовоспалительной группы;
  • анальгетики.

Медикаменты принимают в таблетках или инъекциях, а при сильном воспалении назначают внутрисуставное введение гормонов или антибиотиков.

В случае, когда колено сильно болит и обезболивающие средства не помогают, чем лечить резкую боль в колене индивидуально решает врач, обычно для облегчения боли проводят блокаду с Лидокаином или Новокаином.

При болях в колене ходьбу запрещают, рекомендуя пациенту постельный режим. Для ограничения подвижностиделают фиксирующий бандаж.

Кто лечит воспаление суставной сумки

Если при опоре на колено оно болит и имеются признаки воспаления (гиперемия, отечность), то нужно обратиться к ортопеду или хирургу.

Еще 4 причины

Воспаление и травмы – частые факторы, вызывающие такую боль. Но есть и менее распространенные причины:

  • 1. Патологии в развитии скелета . Нарушение строения позвоночника (кифоз, лордоз) приводят к повышению нагрузки при ходьбе. Болеть будет ниже колена с той стороны, куда искривлен позвоночник (выше нагрузка). Боль усиливается при подъеме по ступенькам.
  • 2. Патологическое отложение солей . Отложение уратов (солей мочевой кислоты) начинается с мелких суставов стоп и постепенно в патологический процесс вовлекаются голени и коленки. Появляется при ходьбе и сгибании сильная боль в колене.
  • 3. Врожденные патологии сухожилий и мышц . При этом колено сильно болит не из-за патологического процесса в суставной структуре, а из-за неправильного строения мускулатуры или связок. При врожденной патологии болеть при движении колени начинают в детском возрасте.
  • 4. Ущемление нервных отростков . Корешок защемляется костными или хрящевыми отростками.

«Что делать с болью в колене при ходьбе?» Ответ один – посетить врача и пройти курс лечения.

Как определить источник болей

Лечение болезненности колена при ходьбе проводится после выявления причины развития заболевания. Болеть коленка при ходьбе может из-за изменений в тканях сустава, воспаления суставной сумки или из-за других патологий. Определить, какого врача нужно посетить в первую очередь, поможет примерная самодиагностика:

  • Симметричность . При ходьбе боль в обоих коленях возникает при хронических заболеваниях (артроз, подагра). При воспалениях или травмах чаще болеть будет одна коленка.
  • Интенсивность . Сильная боль бывает при повреждениях колена или при болезнях, сопровождающихся суставной деформацией, а также при ущемлениях нерва.
  • Характер . Остро болеть будет при воспалении или травмы, а для деструктивных изменений хряща характерна тупая ноющая боль.
  • Связь с повреждением или травмой . Когда после ушиба или подвывиха ноги начало болеть колено — это указывает на менископатию и нужно обратиться к травматологу, а если видимой связи нет, то посетить ортопеда или артролога.
  • Длительность . Если стало больно ходить давно, то это хронический процесс, связанный с изменением суставной структуры, а если болит остро – воспаление или защемление нерва.

Не всегда болит колено именно из-за патологического процесса в суставе, нередко боль вызывают другие факторы. Не стоит откладывать посещение доктора . Боль всегда указывает на наличие патологии и без лечения могут развиться необратимые изменения, мешающие полноценно передвигаться.

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Боль в колене при ходьбе свидетельствует о развитии в нем дегенеративного процесса. Колено является самых сложным суставом в организме, поэтому длительные физические нагрузки, нарушение питания и вредные привычки способствуют развитию процессов, разрушающих кости и хрящи. Появление дискомфорта — это показание для немедленного лечения органов опорно-двигательной системы.

Причины дискомфортных ощущений

Наиболее распространенная причина появления болевых ощущений в коленном суставе — его повреждение. Острые травмы возникают в результате падения, удара, аномальных движений (скручивания, изгибания). Болевые приступы, отек, гематома, скованность и невозможность движений появляются как сразу после травмы, так и в течение нескольких часов и даже дней после нее.

Наличие повреждения облегчает диагностику болей. Пациент может точно зафиксировать момент повреждения колена, механизм травмы: болевые ощущения в колене появились после удара, ушиба, ранения, неудачного движения. Часто в это время человек ощущает острую боль в области ноги.

Причинами болей бывают:

  • вывихи сустава;
  • растяжение сухожилий и связок;
  • травмы связок, которые поддерживают чашечку;
  • разрыв мениска — эластичного диска;
  • разрыв связок;
  • перелом чашечки;
  • вывих чашечки;
  • смещение суставной сумки.

Причинами дискомфорта являются длительные физические перегрузки. Они бывают при повторяющихся движениях, давлении на колено. Воспалению, раздражению и дискомфорту способствуют:

Возможные заболевания

Неприятные ощущения и боль в коленном суставе вызываются следующими патологиями.

  1. Остеоартрит. Это заболевание, при котором постепенно разрушается костная и хрящевая ткани. Она приводит к сильным болям, которые обостряются в утреннее время и стихают к вечеру. Остеоартрит развивается чаще всего на месте полученных ранее травм.
  2. Подагра и системная волчанка способствуют скованности колена, ограничению движений и дискомфортным ощущениям.
  3. Синдром Осгуда-Шлаттера способствует появлению боли и скованности в колене.
  4. При подколенной или кисте Бейкера происходит развитие отека задней стороны коленного сустава. Такое колено может болеть долго.
  5. При инфекционном артрите и остеомиелите почти всегда возможно развитие внезапных неприятных проявлений.
  6. Боль может появляться в результате защемления нервов или заболеваний бедра.
  7. При рассекающем остеохондрите возможна боль в области колена и затруднение подвижности.
  8. Неприятные периодические ощущения, вплоть до болезненных, появляются из-за онкологического процесса. Интенсивность болевых симптомов варьируется в зависимости от степени его запущенности.
  9. Ноющая боль появляется в результате коксартроза (дегенеративного процесса в тазобедренном соединении концов костей) и перелома шейки бедра. В таких случаях дискомфорт носит отраженный характер. Точно такие же процессы происходят и при дегенеративных процессах в пояснично-крестцовом отделе.
  10. Поражение внутрисуставного хряща надколенного сустава характеризуется долгими неприятными ощущениями с внутренней стороны, разной степени интенсивности.
  11. Лигаментит — воспалительное поражение связок сопровождается колющими болевыми проявлениями в состоянии покоя и движений.
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Примерно половина всех пациентов с болью в колене обращается к врачу по причине развития артроза сустава или гонартроза. Чаще всего это заболевание поражает людей после 40 лет. У человека поражается одно или оба колена, из-за чего нарушаются процессы сгибания и разгибания.

Патология развивается постепенно, на протяжении нескольких лет. Боли в колене сначала проявляются слабо и только после длительных и интенсивных нагрузок. В дальнейшем пациент начинает чувствовать дискомфорт после незначительных движений, а затем — в покое. Особенно тяжело таким больным приходится во время подъема или спуска с лестницы.

Достаточно часто повреждается мениск (внутренний и наружный хрящевые образования в форме полумесяца). Оно встречается у пациентов разного возраста. В этом случае поражается только 1 сустав. Разрыв хряща диагностируется у человека после неудачного движения, длительной ходьбы, при катании и др. При повреждении у человека мениска всегда чувствуется острая боль и скованность движений.

Рекомендованные методы лечения

При длительных болях в колене нельзя откладывать терапию. Прежде всего нужно выяснить и устранить причину появления неприятных проявлений. Для лечения бывает недостаточно одного только местного воздействия на пораженный сустав. Врач назначает таким пациентам препараты для приема внутрь с целью укрепления пораженного хряща и профилактики дегенеративных нарушений.

Комплекс традиционных терапевтических мер направлен на:

  • анестезию;
  • устранение причины боли;
  • восстановление нормальной структуры коленного сустава и его функционирования.

По мере устранения провоцирующих факторов будет уменьшаться, а в дальнейшем и полностью проходить боль. Пациентам практически всегда назначаются хондропротекторы, противовоспалительные, общеукрепляющие и иммуностимулирующие препараты.

Снятие болей невозможно без лечения лишнего веса. Пациентам, страдающим ожирением, назначается диета с пониженным количеством углеводов. Рекомендуются умеренные занятия спортом, ЛФК — только в период ремиссии. Задача лечебных упражнений — укрепление связок, мышц, недопущение дегенеративных процессов в суставе.

Благоприятный эффект оказывают радоновые ванны и грязелечение. 1 курс физиотерапии позволяет надолго отстрочить наступление остеоартроза.

Для лечения могут использовать такие народные средства:

  1. Солевой компресс. Для его приготовления нужно растворить в стакане воды 1 ст. л. соли и 2 капли спиртовой настойки йода. Смочить этим составом марлю и приложить ее к больному колену на полчаса. Делать необходимо такую процедуру ежедневно на протяжении 10 дней.
  2. Хорошо согревает колено компресс из сала. Небольшую пластинку продукта приложить к колену и укутать тканью. Держать такой компресс не менее 10 часов. Срок лечения — 1 неделя.
  3. Собрать в литровую банку в равных пропорциях цветки сирени, одуванчика и каштана. Залить ее водкой и настоять 2 недели в прохладном и темном месте. Смочить настойкой марлю и обмотать ею колено на ночь (сустав нужно дополнительно укутать теплой тканью). Чаще всего за 3 процедуры удается снять даже самые сильные боли.
  4. Измельчить шляпки мухомора, заполнить ими бутылку из коричневого стекла наполовину. Залить смесь водкой доверху и настоять в темном месте в течение месяца. Рекомендуется растирать колено утром и вечером на протяжении месяца.
  5. 4 ст. л. картофельных цветков залить стаканом спирта и настоять в холодильнике в течение 10 дней. Втирать полученное лекарство надо в кожу 3 раза в день в течение 3 недель.

Способы обезболивания

Для снятия болевых ощущений в колене применяются такие медикаментозные препараты:

  1. Индометацин. Это средство не только устраняет резкую боль, еще способствует восстановлению пораженного хряща коленного сустава. Применяется в виде таблеток.
  2. Мелоксикам используют в виде таблеток, мази или инъекций. Назначение Мелоксикама оправдано при болях в подвижных соединениях костей. Препарат понижает интенсивность выработки простагландинов, что способствует прекращению воспалительного процесса и болей, сильно ограничивающих движение.
  3. Диклофенак или Ортофен показан в период обострения. Способствует снижению интенсивности болей и снятию воспаления в области колена.
  4. Нурофен быстро снимает острый процесс, и уже через четверть часа пациент отмечает существенное снижение интенсивности болевых ощущений.
  5. Препарат Найз снимает дегенеративные процессы в суставе, уменьшает риск развития обездвиженности.
  6. Парацетамол снижает выработку простагландинов и интенсивность воспаления.

Если указанные препараты не приносят облегчения, прибегают к внутрисуставным инъекциям анестетиков. Наиболее быстро действует Кетонал. Существенно меньшее количество побочных эффектов имеет Новокаин или Лидокаин. Инъекции внутрь сустава делают только в условиях лечебного учреждения.

Если пациент попытается самостоятельно лечить колено, это принесет большой вред, потому что 1 неумелое действие может полностью разрушить колено.

Профилактика

Предупреждение появления боли в колене состоит в соблюдении правильного режима физической активности. И недостаток движений, и излишние нагрузки в одинаковой степени способствуют появлению неприятных проявлений.

При занятиях спортом, которые повышают вероятность травм (катание на роликах или коньках, футбол, скейтборд и др.) следует носить специальные наколенники. Они позволят смягчить удары и не допустить травмы. При хронических заболеваниях коленного сустава, особенно прогрессирующем остеоартрозе, необходимо отдавать предпочтение плаванию.

Перед занятиями физкультурой, активными видами спорта нужно обязательно разминать колено для его разогрева и активизации кровообращения. Следует избегать переохлаждений, сквозняков, которые способствуют усилению воспалительных процессов в колене.

После достижения 40-летнего возраста необходимо тщательно следить за диетой и заниматься физическими упражнениями. Для регуляции массы тела нужно выбирать рацион, в котором преобладают растительные продукты, богатые клетчаткой. Они помогут вывести из организма свободные радикалы и другие токсины.

После хирургического лечения важно соблюдать все рекомендации по реабилитации коленного сустава. Они помогут не допустить рецидива болезни. Непременным условием сохранения здорового состояния является лечебная гимнастика.

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