Joint pain or arthralgia manifests itself in a number of diseases, and its mechanism is still not fully understood. Articular elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritation. During movement, the joint receptors 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 transmit pain.
Typically, joint pain is not accompanied by swelling, contour deformations or redness of the surrounding soft tissues. Pain when palpating the joints is moderate. In some cases, there are no obvious signs of inflammation on X-ray. There are also no complaints about a noticeable decrease in the mobility of large joints.
Arthralgia is often accompanied by rheumatic diseases. At this time, when the weather changes, the joints ache and ache. Severe discomfort in the knee and hip joints is more common. In the morning, the patient cannot get up and walk quickly due to stiffness and pain in the joints.
If the pain in the joints is paroxysmal, occurs suddenly, worsens within a day, lasts for several days, and only one joint hurts, then we can assume that arthritis is 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, increases during physical work and is combined with morning stiffness, degenerative-dystrophic changes can be diagnosed - osteoarthritis.
Reasons
There are various causes of joint pain. One of the most common causes of arthralgia is an 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 destroys joints throughout the body. At the same time, the amplitude of their movements does not change.
Post-infectious severe arthralgia occurs during genitourinary and intestinal infections.
Joints suffer from secondary syphilis, endocarditis, tuberculosis. If there are centers of chronic infection in the body, for example, in the kidneys, bile ducts, pelvic organs, parasitic diseases, the joints also hurt.
Common causes of joint pain include:
- Thyroid diseases.
- Poisoning with salts of heavy metals.
- Physical injuries.
- Long-term use of certain drugs.
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 joints caused by infection, autoimmune processes, dysfunction of endocrine glands and metabolism.
- Arthritis is a disease associated with the destruction of the main articular surfaces of the articular cartilage and bones. Over time, the cartilage becomes rough, loses its elasticity and cracks.
Joint diseases are divided into arthritis and arthrosis. Without treatment, arthritis eventually turns into arthrosis, as inflammatory processes disrupt cartilage metabolism. They are not adequately nourished and quickly become thin and gradually collapse.
At the beginning, inflammation develops over time with arthrosis associated with physical loading of the joint. 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 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 hands 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 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.
Nature of arthralgia:
- Sharp and dull.
- Transient and permanent.
- Weak, medium and dense.
The characteristics and conditions of the occurrence of arthralgia depend on the diagnosis. The most common symptoms of joint pain are:
- It starts
. Arthralgia first occurs when walking, then disappears when moving. It is associated with friction of the articular surfaces of the bones covered with destroyed cartilage tissue. After a few steps, this mass collects in the inversions of the articular capsule and the arthralgia disappears. - Painful
. They appear after physical work of the joints and go away with rest. - At night
. They confirm serious damage to the joint and cause congestion, blood pressure in the bone tissue under the cartilage. After a night's sleep, there is a feeling of stiffness in the joints, and the discomfort disappears as you move. - Constantly
. It occurs when there is inflammation in the joint capsule. - Sudden (joint blockade). It is caused by compression of a piece of bone or cartilage stuck between two joint surfaces.
- Move
. First one joint hurts, then the pain moves to the other. - was reflected
. They are not felt in the affected joint, but nearby. 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 basic examination, he will send you for a consultation with an orthopedic traumatologist or a rheumatologist. If a previously damaged joint becomes ill, a consultation with a surgeon is indicated.
When contacting a doctor, it is important to talk about the following points:
- When pain appears.
- From this, the pain decreases and decreases.
- How often do painful attacks occur?
- Arthralgia appeared for the first time or was previously present.
- Is there hyperemia, swelling or deformation of the joint.
- Have you had any stress, acute respiratory illness or strenuous physical activity in recent days?
This information will help 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 refer to the following:
- General blood and urine analysis.
- Blood chemistry.
- Immunodiagnostics.
- X-ray, CT, MRI, ultrasound of joints.
- If necessary, a biopsy of the 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 assess the condition of osteochondral structures and soft tissues in detail.
Ultrasound of joints. It helps to determine the effusion in the joint cavity, erosion of the articular surfaces of the 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. Erythrocyte sedimentation rate, C-reactive protein, uric acid, antinuclear antibodies, rheumatoid factor and ACCP levels are determined in peripheral blood. Synovial fluid is subjected to microbiological and cytological analysis.
Treatment
Treatment for joint pain 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 down cartilage degeneration, maintain joint mobility and improve the quality of life of an arthralgia patient.
The following are prescribed to reduce joint pain:
- Pain relievers 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, relieves pain and has an anti-inflammatory effect. Chondroprotectors slow down the development of arthrosis. These drugs reduce inflammation and prevent further degeneration of the cartilage in the joints. They include cartilage components - chondroitin, glucosamine. Chondroprotectors promote regeneration processes in cartilage tissue.
Muscle relaxants are prescribed to relieve spasms of skeletal muscles.
Antibiotics are indicated if arthritis is associated with infection.
Complexes of vitamin and mineral elements are also prescribed for good joint function and recovery processes. Vitamins A, C, E, B group, calcium and selenium mineral elements are especially important.
In case of severe inflammation and no effect of treatment, glucocorticosteroids are prescribed according to the scheme.
Drug treatment is completed with warming, pain-relieving and anti-inflammatory ointments.
If the arthralgia is very severe, a block of nerve endings is performed. For this, they use strong drugs that will allow you to forget joint pain for a long time.
Joints are protected from overload to reduce arthralgia. 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.
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 stress.
- During work, change your body position more often, take five minutes to move and relieve muscle tension.
- Choose moderate exercise to maintain physical activity. Alternate mobility with periods of rest.
- Regularly do exercises 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 to strengthen the cartilage in the joints of the feet.
In severe cases, surgical treatment is necessary. Through small incisions, the doctor will remove necrotic tissue from the joint space. If fluid accumulates in the joint, a puncture is performed.
Periarticular osteotomy is performed to reduce the load and increase mobility of the diseased joint. The bones that make up the joint are sawn so that they grow together with a certain slope.
In severe cases, joint replacement is performed.
Prevention
Follow these tips to prevent co-morbidities:
- If you are obese, normalize your body weight.
- Drink at least 1. 5-1. 7 liters of water per day.
- Avoid hypothermia.
- Live an active lifestyle.
- Avoid excessive use of alcohol and tobacco.
- Night sleep should last at least 8 hours.
- Walk outdoors as often as possible.
- 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. Joint diseases are observed in 90% of cases in patients over 70 years old. If the joint suddenly hurts, 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 exercise can keep your joints moving, even if the cartilage is damaged and movement causes discomfort.