Joint pain

Joint pain, or arthralgia, appears in numerous diseases and until now its mechanism is not completely clear. Joint elements (ligaments, cartilage, capsules, bones) have pain receptors and respond to inflammatory processes and mechanical irritations. During movement, the receptors in the joints are irritated, their signals enter the brain, and the person feels pain. During inflammation, the receptors become more sensitive to any irritation, as the cells of the immune system release pain-conducting substances.

Joint pain is usually 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. 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. Intense 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 more intense within a day, lasts for several days, and only one joint hurts, then we can assume the presence of arthritis due to gout. Uric acid crystals accumulate in joint tissues and irritate them, 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.

Causes

Joint pain has different causes. One of the most common causes of arthralgia is acute infection. Joint pain may appear before the first signs of the disease or in the early stages. Often, during an infectious process, it damages joints throughout the body. At the same time, the amplitude of movements in them does not change.

Severe postinfectious arthralgia appears during urogenital and intestinal infections.

The 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, the joints also hurt.

Common causes of joint pain are:

• Thyroid diseases.
• Poisoning with heavy metal salts.
• Physical injuries.
• Prolonged 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 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 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 alter cartilage metabolism. They do not receive adequate nutrition and quickly lose weight and gradually collapse.

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 the triggering of inflammatory reactions.

The risk group for the development of this pathology includes:

• Women during menopause.
• Older people with pronounced age-related body changes.
• 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 hand joints is a common symptom among musicians, cashiers and porters who perform monotonous movements with their hands.

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

• Monoarthralgia (1 joint hurts).
• Oligo arthralgia (affecting 2 to 5 joints).
• Polyarthralgia (pain in more than 5 joints).

Depending on the location of the joints, arthralgias are divided into general and localized.

The nature of arthralgia is:

1. Sharp and dull.
2. Transitory and permanent.
3. Weak, moderate and intense.

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

• From.Arthralgia occurs at first when walking and then goes away as you move. It is associated with friction of the articular surfaces of bones, which are covered by destroyed cartilaginous 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 on the joints and disappear with rest.
• Evening.They confirm severe damage to the joint and are caused by congestion, the pressure of blood on the bone tissue under the cartilage. After a night of 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 (joint lock). Caused by pinching a piece of bone or cartilage trapped 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 one. For example, if you have a disease in the hip joint, your knee hurts.

Diagnosis

If you have arthralgias you should not self-medicate. If you have joint pain, be sure to see your doctor to determine the diagnosis. After the main examination, you will be referred for a consultation with a traumatologist or rheumatologist. If a previously injured joint becomes ill, consultation with a surgeon is indicated.

When visiting a doctor, it is important to discuss the following points:

• When the pain appears.
• From where the pain diminishes 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 intense physical activity in the last few days?

This information will help the specialist to draw 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 you a referral for:

• General blood and urine tests.
• Blood chemistry.
• Immunodiagnosis.
• X-ray, CT scan, MRI, ultrasound of joints.
• If necessary, biopsy of damaged tissue.

Joint x-ray. This method allows the joint to be examined in two views and radiopaque arthrography can be performed.

Using magnetic resonance imaging and computed tomography, the condition of osteochondral structures and soft tissues can be assessed in detail.

Joint ultrasound. It helps to identify effusions in the joint cavity, erosion of the articular surfaces of bones, changes in the synovial membrane and evaluate 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 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. The synovial fluid is subjected to microbiological and cytological analysis.

Treatment

For joint pain, treatment must be comprehensive. Tactics include reducing mechanical loading on the joint, eliminating inflammation, and preventing progression of the underlying disease. Only in this way can cartilage degeneration be stopped, joint mobility maintained and the quality of life of a patient with arthralgia improved.

To reduce joint pain, the following is prescribed:

• Painkillers and anti-inflammatories.
• 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 medications reduce inflammation and prevent further degeneration of joint cartilage. They 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.

For the proper functioning of the joints 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.

Pharmacological treatment is complemented by 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 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 allowable 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.
• As you work, change your body position more frequently, take five minutes to move and relieve muscle tension.
• To stay physically active, choose moderate exercise. Alternate mobility with rest periods.
• Do regular exercises that relieve stress on your joints. For example, you can bend and straighten your legs sitting or lying down for 20 to 30 minutes and perform the "bicycle" exercise. After this, 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 cut so that they then grow together with a certain slope.

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 to 1. 7 liters of water daily.
3. Avoid hypothermia.
4. Lead an active lifestyle.
5. Avoid excessive consumption of alcohol and tobacco.
6. Nighttime sleep should last at least 8 hours.
7. Walk outdoors as often as possible.
8. Try changing your body position more frequently.

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 activity. Only physical exercise can maintain joint mobility, even if the cartilage is damaged and movement causes discomfort.