Joint pain, or arthralgia, occurs 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 tissue, 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.Serious 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 pain in the joints is paroxysmal, appears unexpectedly, becomes stronger within a day, lasts for several days, and only one joint hurts, then we can assume the presence of gout due to gout.Uric acid crystals accumulate in the joint tissues and irritate the tissues, causing pain.
If arthralgia occurs 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 different causes.One of the most common causes of arthralgia is acute infection.Pain in the joints can occur before the first signs of the disease or in the early stages.Often, during an infectious process, that joint breaks 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.
Joint suffers 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 damage.
- Long-term use of certain medicines.
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 caused by infection, autoimmune processes, dysfunction of the endocrine glands and metabolism.
- Osteoarthritis is a disease associated with the destruction of joint cartilage and the underlying joint 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 osteoarthritis, as inflammatory processes disrupt the metabolism of cartilage.They do not receive sufficient nutrition and quickly become thinner and gradually collapse.
With osteoarthritis, which is 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:
- Menopausal women.
- Elderly with pronounced age-related changes in the body.
- Obese patients.
- Patients with a history of joint trauma.
- Athletes.
- People with certain occupations.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.
Species
There are different classifications of joint pain.According to the location of arthralgia, they are distinguished between:
- 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 the arthralgia is:
- Sharp and boring.
- Transient and permanent.
- 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 first occurs when you walk and then disappears when you move.It is associated with friction of the articular surfaces of bones, which are covered by destroyed cartilage tissue.After a few steps, this mass accumulates in the inversions of the joint capsule, and the arthralgia disappears.
- Pain.They appear after physical work in the joints and go away with rest.
- Night.They confirm serious damage to the joint and are caused by overload, blood pressing on the bone tissue under the cartilage.After a night's sleep, a feeling of stiffness occurs in the joints, and as you move, the discomfort disappears.
- 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 not felt in the affected joint, but in a 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 rheumatologist.If a previously injured joint becomes diseased, consultation with a surgeon is indicated.
When visiting a doctor, it is important to talk about the following points:
- When the pain appears.
- From which the pain recedes and recedes.
- How often do painful attacks occur?
- Arthralgia appeared for the first time or existed before.
- Is there hyperaemia, swelling or deformation of the joint.
- Have you had stress, acute respiratory illnesses or hard physical activity in recent days?
This information helps the specialist to draw conclusions 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 to:
- General blood and urine analysis.
- Biochemical blood test.
- Immunodiagnosis.
- 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 radiographic arthrography.
With the help of MRI and CT, you can evaluate in detail the condition of osteochondral structures and soft tissues.
Ultrasound of joints.Helps 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 (examination of the joint cavity from the inside) is performed.
Laboratory tests help identify signs of inflammation and gout 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
In case of joint pain, the 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 a patient with arthralgia.
To reduce joint pain, the following are prescribed:
- Analgesic 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, antibiotics are indicated.
For good joint function and recovery processes, complexes of vitamins and mineral elements are also prescribed.The vitamins A, C, E, group B and the mineral elements calcium and selenium are particularly important.
In case of severe inflammation and no effect of the treatment, glucocorticosteroids are prescribed according to the schedule.
Drug treatment is supplemented with ointments that warm, relieve pain and have an anti-inflammatory effect.
If the arthralgia is very severe, a block of nerve endings is performed.To do this, they use potent substances that 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 far 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 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 do the "bicycle" exercise.Then 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 that form the joint are sawed down 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:
- If you are overweight, 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 must last at least 8 hours.
- Go outdoors 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 40 years of age.In patients over 70, joint diseases are observed in 90% of cases.If a joint suddenly hurts, you should immediately consult a doctor to find out the causes and prescribe treatment.Take care of your joints and fill them with useful activity.Only physical exercise can keep your joints moving, even if the cartilage is damaged and movement causes discomfort.