Joint pain or arthralgia appears in a number of diseases and its mechanism has not yet been fully understood. Joint 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 a person experiences pain. During inflammation, the receptors become more sensitive to any irritation, as cells of the immune system release substances that are conductors of pain.
Joint pain is usually 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 obvious signs of inflammation on the X-ray. There are also no complaints about a pronounced decrease in the mobility of large joints.
Arthralgia often accompanies rheumatic diseases. In this case, the joints hurt and hurt when the weather changes. More often, severe discomfort is observed in the knee and hip joints. In the morning, the patient cannot immediately get up and walk at a pace due to stiffness and pain in the joints.
If the pain in the joints is paroxysmal, appears unexpectedly, becomes stronger in 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 the joint tissues and irritate the tissues, causing pain.
If arthralgia appears in large joints (knees, hips), grows slowly, becomes stronger during physical work and is combined with stiffness in the morning, then degenerative-dystrophic changes can be diagnosed - osteoarthritis.
reasons
Joint pain has various causes. One of the most common causes of arthralgia is an acute infection. Joint pain can appear before the first signs of the disease or in the early stages. Often, during an infectious process, it destroys joints throughout the body. At the same time, the amplitude of movements in them does not change.
Post-infectious severe arthralgia occurs with urogenital and intestinal infections.
Joints 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:
- Diseases of the thyroid gland.
- Poisoning with salts of heavy metals.
- Physical injuries.
- Long-term use of certain drugs.
I am worried about joint pain due to various diseases. They are divided into 2 large groups:
- Arthritis is an inflammatory disease of the joints that is caused by infection, autoimmune processes, endocrine gland dysfunction, and metabolism.
- Arthritis is a disease associated with the destruction of articular cartilage and the underlying articular surfaces of bones. Over time, cartilage thickens, 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 adequate nutrition and quickly thin and gradually shrink.
In 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 the triggering of 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 among musicians, cashiers and loaders who perform monotonous movements with their hands.
Kinds
There are different classifications of joint pain. According to the localization of arthralgia, the following are distinguished:
- Monoarthralgia (1 joint hurts).
- Oligoarthralgia (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 blunt.
- Transient and permanent.
- Weak, moderate and intense.
The characteristics and conditions for the occurrence of arthralgia depend on the diagnosis. The most common signs of joint pain are:
- Launch
. Arthralgia occurs when walking at first, then disappears as you move. It is associated with friction of the articular surfaces of the bones, which are covered with destroyed cartilage tissue. After a few steps, this mass accumulates in the folds of the joint capsule and the arthralgia disappears. - Pain
. They appear after physical work on the joints and disappear when resting. - night
. They confirm severe damage to the joint and are caused by congestion, pressure of blood on 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 disappears. - Always
. Occurs with inflammation of the joint capsule. - Sudden (joint block). It is caused by the pinching of a piece of bone or cartilage stuck between two joint surfaces.
- Migrating
. First one joint hurts, then the pain moves to the other. - Reflected
. They are felt not in the affected joint, but in the nearby one. For example, if you have hip disease, your knee hurts.
Diagnosis
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 basic examination, he will refer you for a consultation to an orthopedic traumatologist or a rheumatologist. If a previously damaged joint becomes ill, then a 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 decreases and subsides.
- How often do painful attacks occur?
- Arthralgia is new or pre-existing.
- Is there hyperemia, swelling or deformation of the joint.
- Have you had stress, acute respiratory illness or heavy physical exertion in recent days?
This information will help the specialist draw a conclusion about the condition of the patient's joints and make a diagnosis.
After determining the nature of the pain in the joints, the doctor will prescribe an examination and give a referral for:
- General analysis of blood and urine.
- Blood chemistry.
- Immunodiagnosis.
- X-ray, CT, MRI, ultrasound of the joints.
- If necessary, biopsy of damaged tissue.
X-ray of the joints. This method allows you to examine the joint in two projections and it is possible to perform a radiopaque arthrography.
With the help of MRI and CT, you can evaluate in detail the condition of osteochondral structures and soft tissues.
Ultrasound of the joints. It helps identify effusion in the joint cavity, erosion of the articular surfaces of the bones, changes in the synovial membrane and assessment of the width of the joint spaces.
Invasive research methods. If indicated, joint puncture and synovial biopsy are performed. In difficult cases, arthroscopy (examination of the joint cavity from the inside) is performed.
Laboratory tests help identify signs of inflammation and rheumatic pathology. The erythrocyte sedimentation rate, C-reactive protein level, uric acid, antinuclear antibodies, rheumatoid factor and ACCP were determined in the peripheral blood. The synovial fluid is subjected to microbiological and cytological analysis.
Treatment
In case of joint pain, the 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 pain in the joints, the following is prescribed:
- Pain relievers and anti-inflammatory agents.
- Physiotherapy (shock wave therapy, ozone therapy, myostimulation, phonophoresis).
- Remedial gymnastics.
- 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 arthrosis. These drugs reduce inflammation and prevent further degeneration of the cartilage in the joints. They include cartilage components - chondroitin, glucosamine. Chondroprotectors promote recovery processes in cartilage tissue.
Muscle relaxants are prescribed to relieve skeletal muscle spasms.
If the arthritis is associated with an infection, then antibiotics are indicated.
Complexes of vitamins and mineral elements are also prescribed for good joint function and recovery processes. Vitamins A, C, E, group B and the mineral elements calcium and selenium are especially 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 a nerve ending block is performed. 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. Prolonged standing, lifting and carrying heavy objects puts pressure on the joints that significantly exceeds the permissible load and contributes to cartilage damage.
To prevent arthralgia, follow these rules:
- Normalize your body weight.
- Wear comfortable shoes with a low heel, 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 exercise. Alternate mobility with periods of rest.
- Do regular exercises that relieve stress on the joints. For example, you can bend and straighten your legs while sitting or lying down for 20-30 minutes and perform the "bicycle" exercise. Then rest for 7-10 minutes to improve blood circulation. These exercises help strengthen the cartilage in the joints ofthe 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 joint, a puncture is performed.
To reduce the load and increase the mobility of the diseased joint, a periarticular osteotomy is performed. The bones that make up the joint are cut so that they can then grow together at a certain angle.
In severe cases, joint replacement is performed.
Prevention
To avoid joint diseases, follow the following recommendations:
- If you suffer from obesity, 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 outdoors as often as possible.
- Try to change your body position more often.
Summary
According to statistics, arthralgia of the upper and lower limbs occurs in half of people over 40 years of age. In patients over 70 years of age, joint diseases are observed in 90% of cases. If any joint suddenly becomes ill, immediately consult a doctor to find out the causes and prescribe treatment. Take care of your joints and load them with useful activity. Only exercise can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.