Joint pain

Joint pain, or arthralgia, occurs in a number of diseases and so far its mechanism is not fully understood.Joint elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritation.During movement, the joint receptors become irritated, signals from them enter the brain and the person feels pain.During inflammation, the receptors become more sensitive to possible irritation, because cells of the immune system release substances that are pain conductors.

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, no obvious signs of inflammation are visible on the X-ray.There are also no complaints about a pronounced decrease in the mobility of large joints.

Arthralgia is often associated with 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 cannot immediately get up and walk at a pace due to stiffness and pain in the joints.

If the pain in the joints is paroxysmal, appears unexpectedly, becomes stronger within a day, lasts for several days and hurts only one joint, 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 occurs in large joints (knees, hips), grows slowly, becomes stronger during physical work and is accompanied by stiffness in the morning, then degenerative-dystrophic changes can be diagnosed - arthrosis.

Reasons

Joint pain has various causes.One of the most common causes of arthralgia is an acute infection.Painful pain in the joints may occur before the first signs of the disease or at its early stages.Often it breaks joints throughout the body during an infectious process.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 include:

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

I worry about pain in the joints due to various diseases.They are divided into 2 major 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 the bones.Over time, cartilage becomes rough, loses its elasticity and tears.

The division of joint diseases into arthritis and arthrosis is conditional.Without treatment, arthritis eventually turns into osteoarthritis, because inflammatory processes disrupt the metabolism in the cartilage.They do not receive adequate nutrition and quickly become thinner and gradually succumb.

In osteoarthritis, 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 causing 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 from people who spend many hours on their feet (teachers, surgeons, hairdressers, etc.).Pain in the hand joints is a common symptom among musicians, cashiers and loaders who perform monotonous movements with their hands.

Species

There are different classifications of joint pain.Depending on the location of arthralgia, they are distinguished:

• Monoarthralgia (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 boring.
2. Transient and permanent.
3. Weak, moderate and intense.

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

• Start.Arthralgia first occurs while walking and then disappears 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 joint capsule and the joint pain disappears.
• Painful.They appear after physical work of the joints and disappear with rest.
• Night.They confirm serious damage to the joint and are caused by congestion, where blood presses on the bone tissue beneath the cartilage.After a night's sleep, a feeling of stiffness appears in the joints, and as you move, the discomfort disappears.
• Permanent.Occurs when there is inflammation in the joint capsule.
• Suddenly (joint blockage).Caused by pinching of a piece of bone or cartilage stuck between two joint surfaces.
• Migrate.First one joint hurts, then the pain moves to the other.
• Reflected.They are not felt in the affected joint, but in a nearby joint.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, see your doctor for diagnosis.After the main examination, he will refer you for a consultation to an orthopedist-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 pain appears.
• The pain of which waxes and wanes.
• How common are painful attacks?
• Arthralgia appeared for the first time or existed before.
• Is there hyperemia, swelling or deformity of the joint?
• Have you suffered from stress, acute respiratory illness 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 the joint pain, the doctor will prescribe an examination and give a referral for:

• General blood and urine analysis.
• Biochemical blood test.
• 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 allows you to perform radiopaque arthrography.

With the help of MRI and CT, you can evaluate the condition of osteochondral structures and soft tissues in detail.

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 research methods.If indicated, joint punctures 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 mechanical stress 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 a patient with arthralgia.

To reduce joint pain the following is prescribed:

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

Conservative therapy is carried out with nonsteroidal anti-inflammatory drugs, they relieve pain and have an anti-inflammatory effect.Chondroprotectors slow down the development of osteoarthritis.These medications reduce inflammation and prevent further degeneration of cartilage in the joints.They include cartilage components - chondroitin, glucosamine.Chondroprotectors promote repair processes in cartilage tissue.

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

If arthritis is accompanied by an 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 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, a block of the nerve endings is performed.To do this, they use powerful drugs that allow you to forget about joint pain for a long time.

To reduce arthralgia, joints are protected against overload.Standing for long periods of time, lifting and carrying heavy objects puts pressure on the joints that far exceeds the allowable load and contributes to cartilage damage.

Follow these rules to prevent arthralgia:

• Normalize your body weight.
• Wear comfortable shoes with low heels;If you have flat feet, use orthopedic insoles.
• Avoid psycho-emotional and physical overload.
• During work, change your posture 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 regular exercises that relieve pressure on your joints.For example, you can bend and straighten your legs while sitting or lying down for 20-30 minutes, performing the "cycling" 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.The doctor will remove necrotic tissue from the joint cavity through small incisions.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 off so that they can grow together at a certain angle.

In severe cases, joint replacement is performed.

Prevention

Follow these recommendations to prevent joint diseases:

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. Nighttime sleep should last at least 8 hours.
7. Walk outside as often as possible.
8. Try to change your posture more often.

Summary

According to statistics, arthralgia of the upper and lower extremities occurs in half of people over 40 years old.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 determine the causes and prescribe treatment.Take care of your joints and load them with useful activities.Only exercise can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.