Joint pain

Joint pain, or arthralgia, appears in a number of diseases and until now 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, the 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 conductors of pain.

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 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 ache when the weather changes. Severe discomfort in the knee and hip joints is more common. In the morning, the patient is unable to immediately get up and walk at a pace due to stiffness and pain in the joints.

If pain in the joints is paroxysmal, appears unexpectedly, becomes stronger within a day, lasts for several days, and only one joint aches, 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.

Causes

Joint pain has various causes. One of the most common causes of arthralgia is acute infection. Aching pain in the joints may 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.

Post-infectious severe 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, then the joints also ache.

Common causes of joint pain are:

• Thyroid diseases.
• Poisoning with salts of heavy metals.
• Physical injuries.
• Long-term use of certain medications.

I am worried about pain in the joints 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, dysfunction of the endocrine glands and metabolism.
• Arthrosis is a disease associated with the destruction of articular cartilage and the underlying articular surfaces of the bones. 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, since inflammatory processes disrupt the metabolism in cartilage. They do not receive adequate 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 articular 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 location of arthralgia, they are distinguished:

• Mono Arthralgia (1 joint hurts).
• 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:

1. Sharp and dull.
2. Transient and permanent.
3. Weak, moderate and intense.

Features and conditions for the occurrence 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 associated with friction of the articular surfaces of 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.
• Aching.They appear after physical work of the joints and go away with rest.
• Night.They confirm severe damage to the joint and are caused by congestion, blood pressing on 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.Occurs when there is inflammation in the joint capsule.
• Sudden (joint blockade). Caused by pinching of a piece of bone or cartilage stuck between two articular surfaces.
• Migrating.First one joint hurts, then the pain moves to the other.
• Reflected.They are felt not in the joint that is affected, but in a nearby one. For example, if you have a hip joint disease, your knee hurts.

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 for a consultation to an orthopedist-traumatologist or rheumatologist. If a previously injured 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 appears.
• From which the pain decreases and subsides.
• How often do painful attacks occur?
• Arthralgia appeared for the first time or existed before.
• Is there any hyperemia, swelling or deformation of the joint.
• Have you had any stress, acute respiratory diseases, or heavy physical activity in recent 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 referral for:

• General blood and urine analysis.
• Blood chemistry.
• Immunodiagnostics.
• X-ray, CT, MRI, ultrasound of joints.
• If necessary, biopsy of 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. Helps to identify effusion 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. 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 progression of the underlying disease. This is the only way to slow down cartilage degeneration, maintain joint mobility and improve the quality of life of a patient 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 down the development of osteoarthritis. These drugs reduce inflammation and prevent further degeneration of cartilage in the joints. They include cartilage components - chondroitin, glucosamine. Chondroprotectors promote restoration processes in cartilage tissue.

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

If arthritis is associated with infection, then 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 of treatment, 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 block of nerve endings is performed. To do this, they use potent drugs 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 places pressure on joints that greatly 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 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 exercises regularly that relieve stress on your joints. For example, you can bend and straighten your legs while sitting or lying down for 20-30 minutes, and perform the "bicycle" exercise. After this, 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 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 forming the joint are sawed down so that they then grow together with a certain slope.

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 as often as possible.
8. Try to change 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 of age, 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 activity. Only physical exercise can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.