Joint pain

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 react to inflammatory processes and mechanical irritation.During the movement, the receptors of the joints are irritated, the 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 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.Also, there are no complaints about a marked decrease in the mobility of the 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 cannot immediately get up and walk at a pace due to stiffness and pain in the joints.

If joint pains are paroxysmal, appear unexpectedly, become stronger within a day, last for several days, and only one joint hurts, then the presence of arthritis due to gout can be assumed.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 acute infection.Pain in the joints can appear before the first signs of the disease or in the early stages.Often, during an infectious process, it breaks the joints throughout the body.At the same time, the amplitude of movements in them does not change.

Post-infectious severe arthralgia occurs 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 hurt.

Common causes of joint pain are:

• Diseases of the thyroid gland.
• Poisoning by salts of heavy metals.
• Bodily 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, dysfunction of endocrine glands and metabolism.
• Arthritis is a disease associated with the destruction of joint cartilage and the basic joint surfaces of bones.Over time, cartilage becomes rough, loses elasticity and cracks.

The division of common diseases into arthritis and arthrosis is conditional.Without treatment, arthritis eventually turns into arthrosis, because the inflammatory processes disrupt the metabolism in the cartilage.They do not receive adequate nutrition and quickly become weaker 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 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.).Wrist pain is a common symptom among musicians, cashiers and loaders who perform monotonous hand movements.

Species

There are different classifications of joint pain.According to the location of arthralgia, they differ:

• Mono Arthralgia (1 joint hurts).
• Oligo arthralgia (affects 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.

The characteristics and conditions for the occurrence of arthralgia depend on the diagnosis.The most common signs of joint pain are:

• Starting.Arthralgia initially occurs when walking, 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 several steps, this mass accumulates in inversions of the articular capsule and the arthralgia disappears.
• Sick.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 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.
• Permanent.It occurs when there is inflammation in the joint capsule.
• Sudden (common block).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 joint that is affected, but in the nearby one.For example, if you have 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 to a consultation with an orthopedic traumatologist or a rheumatologist.If a previously injured 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.
• As a result, the pain decreases and subsides.
• How often do painful attacks occur?
• Arthralgia appeared for the first time or existed before.
• Is there hyperemia, swelling or deformation of the joint.
• Have you had stress, acute respiratory illnesses or heavy physical activity 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 instructions for:

• General analysis of blood and urine.
• Biochemical blood test.
• Immunodiagnostics.
• X-rays, CT, MRI, ultrasound of the joints.
• If necessary, biopsy of damaged tissue.

X-rays of the 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 assess the condition of osteochondral structures and soft tissues in detail.

Ultrasound of the joints.It helps to identify effusion in the joint cavity, erosion of the articular surfaces of the bones, changes in the synovial membrane and to estimate the width of the joint spaces.

Invasive examination methods.If indicated, joint puncture and synovial biopsy are performed.In severe cases, arthroscopy (examination of the joint cavity from the inside) is performed.

Laboratory tests help identify signs of inflammation and rheumatic pathology.In peripheral blood, erythrocyte sedimentation rate, C-reactive protein level, 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 cartilage degeneration, maintain joint mobility and improve the quality of life of the patient with arthralgia.

To reduce pain in the joints, 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 the cartilage in the joints.These include cartilage components - chondroitin, glucosamine.Chondroprotectors promote restoration processes in cartilage tissue.

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

If the arthritis is associated with an infection, then antibiotics are indicated.

Complexes of vitamins and mineral elements are also prescribed for good joint functioning and recovery processes.Vitamins A, C, E, group B and the mineral elements calcium and selenium are particularly 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 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, joints are protected from overload.Prolonged standing, lifting and carrying heavy objects puts pressure on the joints that greatly exceeds the permissible load and contributes to cartilage damage.

To prevent arthralgia, follow these rules:

• Normalize 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 release muscle tension.
• To maintain physical activity, choose moderate exercise.Alternative mobility with rest periods.
• 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 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 the fluid has accumulated in the joint, a puncture is performed.

To reduce the load and increase the mobility of the affected joint, a periarticular osteotomy is performed.The bones that form 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 these recommendations:

1. If you are obese, normalize your 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 limbs occurs in half of people over 40 years old.In patients older than 70 years, joint diseases are observed in 90% of cases.If the joint suddenly hurts, immediately consult a doctor to find out the reasons and prescribe treatment.Take care of your joints and load them with useful activity.Only physical exercises can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.