Joint pain, or arthralgia, appears in a number of diseases, and so far its mechanism is not completely clear. Articular elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritation. During movement, joint receptors are irritated, signals from them enter the brain and the person feels pain. During inflammation, the receptors become more sensitive to any irritation, as cells of the immune system release substances that are pain transmitters.
Typically, joint pain is not accompanied by swelling of the surrounding soft tissues, contour deformities or redness. When palpating the joints, the pain is moderate. In some cases, there are no visible signs of inflammation on the x-ray. There are also no complaints about a marked decrease in the mobility of large joints.
Arthralgia often accompanies rheumatic diseases. In this case, the joints ache and hurt when the weather changes. Severe discomfort in the knee and hip joints is more common. In the morning, the patient is unable to get up immediately and walk at a pace due to stiffness and pain in the joints.
If the pain in the joints is paroxysmal, appears suddenly, becomes stronger within a day, lasts for several days and hurts only one joint, then we can assume the presence of arthritis due to gout. Uric acid crystals accumulate in joint tissue and irritate the tissue, causing pain.
If arthralgia occurs in large joints (knees, hips), increases slowly, becomes stronger during physical work and is combined with stiffness in the morning, then degenerative-dystrophic changes can be diagnosed - osteoarthritis.
Causes
Joint pain has various causes. One of the most common causes of arthralgia is acute infection. Painful joint pain can appear before the first signs of the disease or in the early stages. Often, during an infectious process, it breaks joints throughout the body. At the same time, the amplitude of movements in them does not change.
Severe post-infectious arthralgia occurs during urogenital and intestinal infections.
Nodes suffer from secondary syphilis, endocarditis, tuberculosis. If there are foci of chronic infection in the body, for example, in the kidneys, bile ducts, pelvic organs, parasitic diseases, then the joints also hurt.
Common causes of joint pain are:
- Thyroid diseases.
- Poisoning with salts of heavy metals.
- Physical injuries.
- Long-term use of certain medicines.
I am worried about joint pain due to various diseases. They are divided into 2 large groups:
- Arthritis is an inflammatory joint disease caused by infection, autoimmune processes, endocrine gland dysfunction and metabolism.
- Arthrosis is a disease associated with the destruction of articular cartilage and articular surfaces of bones. Over time, the cartilage becomes rough, loses elasticity and cracks.
The division of joint diseases into arthritis and arthrosis is conditional. Without treatment, arthritis eventually turns into arthrosis, as inflammatory processes disrupt cartilage metabolism. They do not receive proper nutrition and quickly become thinner and gradually collapse.
With arthrosis, initially associated with physical overload of the joint, inflammation develops over time. It is caused by the accumulation of fragments of cartilage and bone tissue in the joint cavity and causing inflammatory reactions.
The risk group for the development of this pathology includes:
- Women during menopause.
- Elderly people with pronounced age-related changes in the body.
- Obese patients.
- Patients with a history of joint trauma.
- Athletes.
- People with certain professions. For example, the knee joint often suffers in those who spend many hours on their feet (teachers, surgeons, hairdressers, etc. ). Pain in the joints of the hand is a common symptom in musicians, cashiers and loaders who perform monotonous movements with their hands.
The types
There are different classifications of joint pain. According to the location of arthralgia, they are distinguished:
- Mono Arthralgia (1 painful joint).
- Oligo Arthralgia (affecting 2-5 joints).
- Polyarthralgia (pain in more than 5 joints).
Depending on the location of the joints, arthralgia is divided into general and localized.
The nature of arthralgia is:
- Sharp and dull.
- Transient and permanent.
- Weak, moderate and intense.
The characteristics and conditions for the appearance of arthralgia depend on the diagnosis. The most common signs of joint pain are:
- Starting
. Arthralgia occurs when walking at first, then goes away as you move. It is accompanied by friction of the articular surfaces of the bones, which are covered with destroyed cartilage tissue. After a few steps, this mass accumulates in the inversions of the articular capsule and the arthralgia disappears. - Pain
. They appear after physical work of the joints and go away with rest. - night
. They confirm severe joint damage and are caused by overload, blood pressure in the bone tissue under the cartilage. After a night's sleep, a feeling of stiffness appears in the joints, and as you move, the discomfort goes away. - Permanent
. It occurs when there is inflammation in the joint capsule. - Unexpected (joint blockage). Caused by compression of a piece of bone or cartilage stuck between two articular surfaces.
- Migrating
. First one joint hurts, then the pain moves to the other. - REFLECT
. They are felt not in the affected joint, but in a nearby one. For example, if you have hip joint disease, your knee hurts.
Diagnosing
If you have arthralgia, you should not self-medicate. If you have joint pain, be sure to consult your doctor to determine the diagnosis. After the main examination, he will refer you for a consultation to an orthopedic traumatologist or rheumatologist. If a previously damaged joint becomes ill, then consultation with a surgeon is indicated.
When visiting a doctor, it is important to talk about the following points:
- When pain occurs.
- From which the pain is reduced and soothed.
- How often do painful attacks occur?
- Arthralgia appeared for the first time or existed previously.
- Is there any hyperemia, swelling or deformity of the joint.
- Have you had stress, acute respiratory illness or heavy physical activity in the last few days?
This information will help the specialist make a conclusion about the condition of the patient's joints and make a diagnosis.
After determining the nature of joint pain, the doctor will prescribe an examination and give a recommendation for:
- General analysis of blood and urine.
- Blood chemistry.
- Immunodiagnostics.
- X-ray, CT, MRI, ultrasound of joints.
- If necessary, biopsy of the damaged tissue.
X-ray of joints. This method allows you to examine the joint in two projections and it is possible to perform radiopaque arthrography.
Using MRI and CT, you can evaluate in detail the condition of osteochondral structures and soft tissues.
Ultrasound of joints. It helps to identify the effusion in the joint cavity, the erosion of the articular surfaces of the bones, the changes in the synovial membrane and the assessment of the width of the joint spaces.
Invasive examination methods. If indicated, joint puncture and synovial biopsy are performed. In difficult cases, arthroscopy is performed (examination of the joint cavity from the inside).
Laboratory tests help identify signs of inflammation and rheumatic pathology. In the peripheral blood, the sedimentation rate of erythrocytes, the level of C-reactive protein, uric acid, antinuclear antibodies, rheumatoid factor and ACCP are determined. Synovial fluid is subjected to microbiological and cytological analyses.
Treatment
For joint pain, treatment should be comprehensive. Tactics include reducing the mechanical load on the joint, eliminating inflammation and preventing the progression of the underlying disease. This is the only way to slow cartilage degeneration, preserve joint mobility and improve the quality of life of a patient with arthralgia.
To reduce joint pain it is recommended:
- Painkillers and anti-inflammatories.
- Physiotherapy (shock wave therapy, ozone therapy, myostimulation, phonophoresis).
- Therapeutic exercises.
- Massage.
- Acupuncture.
- Orthopedic or surgical correction.
Conservative therapy is carried out with non-steroidal anti-inflammatory drugs, they relieve pain and have an anti-inflammatory effect. Chondroprotectors slow down the development of osteoarthritis. These drugs reduce inflammation and prevent further degeneration of the cartilage in the joint. They include cartilage components - chondroitin, glucosamine. Chondroprotectors promote restoration processes in cartilage tissue.
To eliminate skeletal muscle spasms, muscle relaxants are prescribed.
If arthritis is accompanied by infection, then antibiotics are indicated.
For the good functioning of joints and recovery processes, complexes of vitamins and mineral elements are also prescribed. Vitamins A, C, E, group B and the mineral elements calcium and selenium are particularly important.
In case of severe inflammation and lack of treatment effect, glucocorticosteroids are prescribed according to the scheme.
Drug treatment is supplemented with ointments that warm, relieve pain and have an anti-inflammatory effect.
If the arthralgia is very severe, then nerve endings are blocked. To do this, they use powerful drugs that will allow you to forget about joint pain for a long time.
To reduce arthralgia, the joints are protected from overload. Standing for a long time, lifting and carrying heavy objects puts pressure on the joints that far exceeds the permissible load and contributes to cartilage damage.
To prevent arthralgia, follow these rules:
- Normalize your body weight.
- Wear comfortable shoes with low heels; if you have flat feet, use orthopedic insoles.
- Avoid psycho-emotional and physical overload.
- While you are at work, change your body position more often, take five minutes to move and relieve muscle tension.
- To maintain physical activity, choose moderate exercises. Alternating mobility with periods of rest.
- Do regular exercises that relieve stress on your joints. For example, you can bend and straighten your legs while sitting or lying for 20-30 minutes and perform the "bicycle" exercise. After that, rest for 7-10 minutes to improve blood circulation. These exercises help strengthen the cartilage in the joints of the legs.
In severe cases, surgical treatment is necessary. Through small incisions, the doctor will remove the necrotic tissue from the joint cavity. If fluid has accumulated in the joints, a biopsy is performed.
To reduce the load and increase the mobility of the diseased joint, a periarticular osteotomy is performed. The bones that form the joint are sawn so that they grow together at a certain angle.
In severe cases, joint replacement is performed.
Preventing
To avoid joint diseases, follow these recommendations:
- If you are obese, normalize your body weight.
- Drink at least 1. 5-1. 7 liters of water per day.
- Avoid hypothermia.
- Lead an active lifestyle.
- Avoid excessive use of alcohol and tobacco.
- Night sleep should last at least 8 hours.
- Walk outside as often as possible.
- Try to change your body position more often.
Briefing
According to statistics, arthralgia of the upper and lower extremities occurs in half of people over 40 years old. In patients over 70 years of age, joint diseases are observed in 90% of cases. If a joint hurts suddenly, consult a doctor immediately to find out the causes and prescribe treatment. Take care of your joints and load them with useful activity. Only physical exercise can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.