Joint pain, or arthralgia, appears in several diseases and until now the mechanism is not completely clear. Articular elements (ligaments, cartilage, capsule, bone) 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, because the cells of the immune system release substances that become conductors of pain.
Usually, joint pain is not accompanied by swelling of the surrounding soft tissues, contour defects, or redness. When palpating the joint, the pain is moderate. In some cases, there are no obvious signs of inflammation on x-rays. There are also no complaints about a significant decrease in the mobility of large joints.
Arthralgia often accompanies rheumatic diseases. In this case, the joints ache and ache when the weather changes. Severe discomfort in the knee and hip joints is more common. In the morning, the patient could not immediately get up and walk quickly because of the 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 only one joint pain, then we can assume the presence of arthritis due to gout. Uric acid crystals accumulate in the joint tissue and irritate the tissue, 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.
Cause
Joint pain has many causes. One of the most common causes of arthralgia is acute infection. Pain in the joints may appear before the initial signs of the disease or at an early stage. Often, during the infectious process, it breaks joints throughout the body. At the same time, the amplitude of movement in it does not change.
Severe post-infectious arthralgia appears during urogenital and intestinal infections.
Joints suffer from secondary syphilis, endocarditis, tuberculosis. If there is a focus 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 disease.
- Poisoning with heavy metal salts.
- Physical injury.
- Long-term use of certain medications.
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.
- Arthritis is a disease associated with the destruction of articular cartilage and the underlying articular surface of the bone. Over time, 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, because the inflammatory process disrupts the metabolism in the cartilage. They do not receive enough nutrition and quickly become thinner and gradually collapse.
With arthrosis, initially associated with physical load on the joint, inflammation develops over time. It is caused by the accumulation of cartilage fragments and bone tissue in the articular cavity and triggers an inflammatory reaction.
Risk groups for the development of this pathology include:
- Women during menopause.
- Elderly people with significant age-related changes in the body.
- Obese patients.
- Patients with a history of joint trauma.
- Athlete.
- People with certain professions. For example, knee joints often suffer in those who spend many hours on their feet (teachers, surgeons, hairdressers, etc. ). Pain in the joints of the hands is a common symptom among musicians, cashiers, and loaders who perform monotonous movements with their hands.
Type
There are different classifications for joint pain. According to the location of arthralgia, they are distinguished:
- Mono Arthralgia (pain in 1 joint).
- Oligo Arthralgia (affects 2-5 joints).
- Polyarthralgia (pain in more than 5 joints).
Depending on the location of the joint, arthralgia is divided into general and localized.
The characteristics of arthralgia are:
- Sharp and dull.
- Temporary and permanent.
- Weak, medium and intense.
The characteristics and conditions for the occurrence of arthralgia depend on the diagnosis. The most common symptoms of joint pain are:
- Begin
. Arthralgia occurs when walking at first, then disappears when you move. It is associated with friction of the articular surface of the bone, which is covered with destroyed cartilage tissue. After several steps, this mass accumulates in the inversion of the articular capsule and the arthralgia disappears. - heartache
. They appear after physical work of the joints and disappear with rest. - night
. They confirmed severe damage to the joints and due to congestion, blood pressure on the bone tissue under the cartilage. After a night's sleep, a feeling of stiffness in the joints appears, and when you move, the discomfort disappears. - Stay
. Occurs when there is inflammation in the joint capsule. - Suddenly (joint restraints). Caused by the pinching of a piece of bone or cartilage stuck between two articular surfaces.
- Migrate
. First one joint hurts, then the pain moves to another. - Mirrored
. They are not felt in the affected joint, but in nearby joints. For example, if you have hip joint disease, your knees hurt.
Diagnostics
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 to consult an orthopedic-traumatologist or a rheumatologist. If the previously injured joint becomes painful, then a consultation with a surgeon is indicated.
When visiting the doctor, it is important to discuss the following:
- When pain appears.
- From where the pain lessens and subsides.
- How often do painful attacks occur?
- Arthralgia appeared for the first time or existed before.
- Is there hyperemia, swelling or joint deformation.
- Have you had any stress, acute respiratory illness, or strenuous physical activity lately?
This information will help the specialist draw conclusions about the condition of the patient's joints and make a diagnosis.
After determining the nature of the joint pain, the doctor will prescribe an examination and give a referral for:
- General blood and urine analysis.
- Blood chemistry.
- Immunodiagnostics.
- X-ray, CT, MRI, joint ultrasound.
- If necessary, biopsy the damaged tissue.
X-ray of the joint. 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 assess in detail the state of the osteochondral structure and soft tissue.
Joint ultrasound. Helps identify effusion in the joint cavity, erosion of the articular surface of the bone, changes in the synovial membrane, and assess the width of the joint space.
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 peripheral blood, erythrocyte sedimentation rate, C-reactive protein level, uric acid, antinuclear antibody, rheumatoid factor, and ACCP were determined. Synovial fluid is subjected to microbiological and cytological analysis.
Treatment
For joint pain, treatment should be comprehensive. Tactics include reducing the mechanical load on the joint, eliminating inflammation, and preventing the development of the underlying disease. This is the only way to slow cartilage degeneration, maintain joint mobility and improve the quality of life of patients with arthralgia.
To reduce joint pain, the following is prescribed:
- Painkillers and anti-inflammatory drugs.
- Physiotherapy (shock wave therapy, ozone therapy, myostimulation, phonophoresis).
- Therapeutic exercise.
- 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 the progression of osteoarthritis. These drugs reduce inflammation and prevent further degeneration of the cartilage in the joints. They include cartilage components - chondroitin, glucosamine. Chondroprotectors promote the recovery process in cartilage tissue.
To eliminate skeletal muscle spasms, muscle relaxants are prescribed.
If arthritis is associated with infection, then antibiotics are indicated.
For good joint function and the recovery process, a complex of vitamins and mineral elements is also prescribed. Vitamins A, C, E, group B and the mineral elements calcium and selenium are very important.
In case of severe inflammation and no 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 strong drugs that will allow you to forget about joint pain for a long time.
To reduce arthralgia, the joint is protected from overload. Prolonged standing, lifting and carrying heavy objects put pressure on the joints that greatly exceed the permissible load and contribute to cartilage damage.
To avoid arthralgia, follow these rules:
- Normalize your weight.
- Wear comfortable shoes with low heels; if you have flat feet, use orthopedic insoles.
- Avoid psycho-emotional and physical stress.
- While at work, change your body position more often, take five minutes to move and relieve muscle tension.
- To maintain physical activity, choose moderate exercise. Mobility alternates with periods of rest.
- Do regular exercise that relieves stress on your joints. For example, you can bend and straighten your legs while sitting or lying down for 20-30 minutes, and do "cycling" exercises. After this, rest for 7-10 minutes to improve blood circulation. This exercise helps strengthen the cartilage in the leg joints.
In severe cases, surgical treatment is required. Through a small incision, 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, periarticular osteotomy is performed. The bones that make up the joint are sawed down so that they then grow together with a certain slope.
In severe cases, joint replacement is performed.
Prevention
To prevent arthritis, follow these recommendations:
- If you are fat, normalize your weight.
- Drink at least 1. 5-1. 7 liters of water a day.
- Avoid hypothermia.
- Live 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.
Summary
According to statistics, arthralgia in the upper and lower extremities occurs in half of people over the age of 40. In patients over 70 years of age, joint disease is observed in 90% of cases. If the joint suddenly hurts, see a doctor immediately to find out the cause and prescribe treatment. Take care of your joints and load them with useful activities. Only physical exercise can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.