Joint pain

Joint pain, or arthralgia, appears in several diseases, and so far its mechanism is not completely clear.Joint elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritation.During movements, joint receptors are irritated, signals from them reach the brain and a person feels pain.During inflammation, the receptors become more sensitive to any irritation, as the cells of the immune system release substances that are pain conductors.

Usually, pain in the joints is not associated with swelling of the surrounding soft tissues, contour deformations or redness.When palpating the joints, the pain is moderate.In some cases, there are no obvious signs of inflammation on an X-ray.There are also no complaints about a pronounced decrease in mobility of the 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 more common.In the morning, the patient cannot get up immediately and walk at the same pace because of stiffness and pain in the joints.

If joint pain is paroxysmal, appears unexpectedly, worsens within a day, lasts for several days, and only one joint hurts, then we can assume that arthritis is caused by gout.Uric acid crystals accumulate in the joint tissue and irritate the tissue, 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 - osteoarthritis can be diagnosed.

Reasons

Joint pain has various causes.One of the most common causes of arthralgia is an acute infection.Joint pain can appear before the first signs of the disease or in the early stages.It often breaks joints throughout the body during the infection process.At the same time, the amplitude of movements in them does not change.

Severe post-infectious arthralgia appears during genitourinary 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.

The most common causes of joint pain are:

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

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 caused by infections, autoimmune processes, endocrine gland dysfunction and metabolic disorders.
• Arthrosis is a disease associated with the destruction of the articular cartilage and the joint surfaces of the lower 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, as inflammatory processes disrupt metabolism in the 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 joint cavity and the occurrence 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 for those who spend many hours on their feet (teachers, surgeons, hairdressers, etc.).Wrist pain is a common symptom among musicians, cashiers and stackers who perform monotonous hand movements.

Species

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

• Monoarthralgia (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.

Arthralgia symptoms and conditions depend on the diagnosis.The most common symptoms of joint pain are:

• Begins.Arthralgia first occurs when walking, then changes to movement.This is due to the friction of the joint surfaces of the bones, which are covered with 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 of the joints and pass with rest.
• Night.They confirm serious damage to the joint and are caused by congestion when blood pushes the bone tissue under the cartilage.After a night's sleep, a feeling of stiffness appears in the joints, and the discomfort goes away when you move.
• Permanent.Occurs when there is inflammation in the joint capsule.
• Sudden (joint blockade).Caused by compression of a piece of bone or cartilage between two articular surfaces.
• Migration.First one joint hurts, then the pain moves to the other.
• Reflected.They are felt not in the affected joint, but in the adjacent one.For example, if you have hip 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 for a diagnosis.After the main examination, he will send for a consultation with an orthopedist-traumatologist or a rheumatologist.If a previously injured joint becomes ill, a consultation with a surgeon is indicated.

When visiting the doctor, it is important to talk about the following questions:

• When pain occurs.
• From which the pain decreases and decreases.
• How often do painful attacks occur?
• Arthralgia appeared for the first time or existed previously.
• Is there hyperemia, swelling or deformation of the joint.
• Have you had stress, acute respiratory illness or strenuous physical activity in the last few 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 joint pain, the doctor will prescribe an examination and send:

• General blood and urine analysis.
• Biochemical blood analysis.
• Immunodiagnosis.
• X-ray, CT, MRI, joint ultrasound.
• If necessary, a biopsy of the damaged tissue.

X-ray 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 osteochondral structure and soft tissue condition in detail.

Ultrasound of the joints.Helps determine effusion in the joint cavity, erosion of bone joint surfaces, changes in the synovial membrane and assess the width of joint spaces.

Invasive investigation 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 rheumatic pathology.Erythrocyte sedimentation rate, C-reactive protein, uric acid, antinuclear antibodies, rheumatoid factor and ACCP levels are determined in peripheral blood.The synovial fluid is subjected to microbiological and cytological analysis.

Treatment

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 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 performed 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 cartilage degeneration in the joints.They include cartilage components - chondroitin, glucosamine.Chondroprotectors promote regeneration processes in cartilage tissue.

Muscle relaxants are prescribed to prevent skeletal muscle spasms.

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

Vitamin and mineral complexes are also prescribed for good joint function and recovery processes.Vitamins of group A, C, E, B and mineral elements calcium and selenium are especially important.

In case of severe inflammation and without 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 strong drugs that will 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.
• When you are at work, change your body position more often, take five minutes to move and relieve muscle tension.
• Choose moderate exercise to stay physically active.Alternate mobility with periods of rest.
• Do regular exercises that relieve joint stress.For example, for 20-30 minutes sitting or lying down, you can bend and straighten your legs and do the "bicycle" exercise.Then rest for 7-10 minutes to improve blood circulation.These exercises help to strengthen the cartilage of the leg joints.

In severe cases, surgical treatment is required.Through small incisions, the doctor will remove the 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 make up 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 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 alcohol and tobacco use.
6. Night sleep should last at least 8 hours.
7. Walk outside 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 a joint hurts suddenly, consult a doctor immediately to find out the causes and prescribe treatment.Take care of your joints and load them with useful activity.Only physical exercises can maintain joint mobility, even if the cartilage is damaged and movement causes discomfort.