Joint pain

Joint pain, or arthralgia, appears in several diseases and until now its mechanism is not completely clear. Joint elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritations. During movement, joint receptors are irritated, signals from them enter the brain and the person feels pain. During inflammation, receptors become more sensitive to any irritation, as immune system cells release pain-conducting substances.

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 obvious signs of inflammation on x-rays. 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 ache and ache when the weather changes. Severe discomfort in the knee and hip joints is most common. In the morning, the patient is unable to get up immediately and walk at a fast pace due to stiffness and pain in the joints.

If joint pain is paroxysmal, appears unexpectedly, becomes stronger within a day, lasts for several days, and only one joint hurts, we can assume the presence of arthritis due to gout. Uric acid crystals accumulate in 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.

Causes

Joint pain has several causes. One of the most common causes of arthralgia is acute infection. Joint pain may appear before the first signs of the disease or in the early stages. Often, during an infectious process, joints throughout the body rupture. At the same time, the amplitude of movements in them does not change.

Severe post-infectious arthralgia appears during 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, the joints also hurt.

Common causes of joint pain are:

• Thyroid diseases.
• Poisoning with heavy metal salts.
• Physical injuries.
• Prolonged use of certain medications.

I am worried about joint pain due to various illnesses. They are divided into 2 large groups:

• Arthritis is an inflammatory disease of the joints caused by infection, autoimmune processes, dysfunction of the endocrine glands and metabolism.
• Osteoarthritis is a disease associated with the destruction of articular cartilage and the underlying 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 adequate nutrition and quickly become thinner and gradually faint.

In osteoarthritis, initially associated with physical overload on 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 developing 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 tends to 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 porters who perform monotonous movements with their hands.

Types

There are different classifications of joint pain. According to the location of arthralgia, the following are distinguished:

• Mono Arthralgia (1 joint hurts).
• Oligo Arthralgia (affecting 2 to 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:

1. Sharp and dull.
2. Transitory and permanent.
3. 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:

• Getting started.Arthralgia initially occurs when walking and then disappears as you move. It is associated with friction of the articular surfaces of bones, which are covered with destroyed cartilaginous tissue. After a few steps, this mass accumulates in the inversions of the joint capsule and the arthralgia disappears.
• Sore.They appear after physical work on the joints and disappear with rest.
• Night.They confirm serious damage to the joint and are caused by congestion, blood pressure in the bone tissue under the cartilage. After a night's sleep, a feeling of stiffness in the joints appears and, as you move, the discomfort goes away.
• Permanent.It occurs when there is inflammation in the joint capsule.
• Sudden (joint blockage). Caused by compression of a piece of bone or cartilage trapped between two joint surfaces.
• Migrating.First one joint hurts, then the pain passes to the other.
• Reflected.They are not felt in the affected joint, but in a nearby joint. For example, if you have a hip joint disease, your knee hurts.

Diagnosis

If you have arthralgia, you should not self-medicate. If you have joint pain, see your doctor to determine the diagnosis. After the main examination, he will send you for consultation with an orthopedist-traumatologist or rheumatologist. If a previously injured joint becomes ill, a consultation with a surgeon is indicated.

When visiting a doctor, it is important to discuss the following points:

• When the pain appears.
• From which the pain subsides and subsides.
• How often do painful attacks occur?
• Arthralgia appeared for the first time or existed before.
• There is hyperemia, swelling or deformation of the joint.
• Have you had any stress, acute respiratory illnesses or intense physical activity in the last few days?

This information will help the specialist to draw 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 refer you to:

• General analysis of blood and urine.
• Blood chemistry.
• Immunodiagnosis.
• X-ray, computed tomography, magnetic resonance imaging, ultrasound of the joints.
• If necessary, biopsy the damaged tissue.

X-ray of the joints. This method allows you to examine the joint in two projections, making it possible to perform radiopaque arthrography.

Using MRI and CT, you can assess the condition of osteochondral structures and soft tissues in detail.

Ultrasound of the joints. It helps to identify effusions in the joint cavity, erosion of the articular surfaces of bones, changes in the synovial membrane and assess 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 peripheral blood, the erythrocyte sedimentation rate, the level of C-reactive protein, uric acid, antinuclear antibodies, rheumatoid factor and ACCP are determined. The synovial fluid is subjected to microbiological and cytological analysis.

Treatment

For joint pain, treatment must be comprehensive. Tactics include reducing the mechanical load on the joint, eliminating inflammation and preventing the progression of the underlying disease. Only in this way is it possible to delay cartilage degeneration, maintain joint mobility and improve the quality of life of a patient with arthralgia.

To reduce joint pain, the following is prescribed:

• Analgesics and anti-inflammatories.
• Physiotherapy (shock wave therapy, ozone therapy, myostimulation, phonophoresis).
• Therapeutic exercise.
• Massage.
• Acupuncture.
• Orthopedic or surgical correction.

Conservative therapy is carried out using non-steroidal anti-inflammatory drugs, which relieve pain and have an anti-inflammatory effect. Chondroprotectors slow the development of osteoarthritis. These medications reduce inflammation and prevent degeneration of cartilage in joints. They include cartilage components - chondroitin, glucosamine. Chondroprotectors promote restoration processes in cartilaginous tissue.

To eliminate spasms of skeletal muscles, muscle relaxants are prescribed.

If arthritis is associated with infection, antibiotics are indicated.

For good joint function 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 especially important.

In case of severe inflammation and no effect from treatment, glucocorticosteroids are prescribed according to the scheme.

Drug treatment is complemented with ointments that warm, relieve pain and have an anti-inflammatory effect.

If the arthralgia is very severe, a block of the nerve endings is performed. To do this, they use potent medications that will allow you to forget about joint pain for a long time.

To reduce arthralgia, joints are protected from overload. Prolonged standing, lifting and carrying heavy objects puts pressure on joints that far exceeds the allowable load and contributes to cartilage damage.

To prevent arthralgia, follow these rules:

• Normalize your body weight.
• Wear comfortable, low-heeled shoes; If you have flat feet, use orthopedic insoles.
• Avoid psycho-emotional and physical overload.
• During work, change your body position more often, take five minutes to move around and relieve muscle tension.
• To maintain physical activity, opt for moderate exercise. Mobility alternated with periods of rest.
• Do exercises regularly that relieve stress on your joints. For example, you can bend and stretch your legs while sitting or lying down for 20 to 30 minutes and perform the "bicycle" exercise. After that, rest for 7 to 10 minutes to improve blood circulation. These exercises help strengthen the cartilage in your leg joints.

In severe cases, surgical treatment is necessary. Through small incisions, the doctor will remove necrotic tissue from the joint cavity. If fluid accumulates 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 form the joint are sawn so that they grow together at a certain angle.

In severe cases, joint replacement is performed.

Prevention

To avoid joint diseases, follow these recommendations:

1. If you are obese, normalize your body weight.
2. Drink at least 1. 5-1. 7 liters of water per day.
3. Avoid hypothermia.
4. Lead an active lifestyle.
5. Avoid excessive use of alcohol and tobacco.
6. Night sleep should last at least 8 hours.
7. Walk outdoors whenever possible.
8. Try changing your body position more often.

Summary

According to statistics, arthralgia of the upper and lower extremities occurs in half of people over 40 years of age. In patients over 70 years old, joint diseases are observed in 90% of cases. If a joint suddenly hurts, immediately consult a doctor to find out the causes and prescribe treatment. Take care of your joints and load them with useful activities. Only physical exercise can maintain joint mobility, even if the cartilage is damaged and movement causes discomfort.