Joint pain

Joint pain, or arthralgia, occurs in a number of diseases and until now its mechanism is not completely clear.The articular elements (ligaments, cartilages, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical stimuli.During the movement, the receptors of the joints are stimulated, the signals from them 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 substances that are conductors of pain.

Typically, joint pain is not accompanied by swelling of the surrounding soft tissues, contour distortions 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 sharp decrease in the mobility of 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 a pace due to stiffness and pain in the joints.

If the joint pain 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 gouty arthritis.Uric acid crystals accumulate in the joint tissues and irritate the tissues, causing pain.

If arthralgia occurs in large joints (knees, hips), develops slowly, gets stronger during physical work and is combined with stiffness in the morning, then degenerative-dystrophic changes can be diagnosed - osteoarthritis.

Reasons

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

Severe post-infection arthralgia occurs 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.

Common causes of joint pain are:

• Thyroid diseases.
• Poisoning with heavy metal salts.
• Bodily 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 joint disease caused by infection, autoimmune processes, endocrine gland dysfunction and metabolism.
• Arthritis is a disease associated with the destruction of articular cartilage and the underlying articular surfaces of bones.Over time, the cartilage becomes rough, loses its elasticity and cracks.

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

With arthropathy, initially associated with physical overloading 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 people with pronounced age-related changes in the body.
• Obese patients.
• Patients with a history of joint trauma.
• Athletes.
• People with specific occupations.For example, the knee joint often suffers in those who spend long 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.

Kind

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

• Monoarthralgia (1 joint hurts).
• Oligoarthralgia (affects 2-5 joints).
• Polyarthralgia (pain in more than 5 joints).

Depending on the location of the joints, arthralgia is divided into general and local.

The nature of arthralgia is:

1. Sharp and dull.
2. Transient and permanent.
3. Weak, medium and intense.

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

• Getting started.Arthralgia occurs when walking at first, then subsides as you move.It is associated with the friction of the articular surfaces of the bones, which are covered with damaged cartilage.After a few steps, this mass accumulates in the inversions of the joint capsule and the arthralgia disappears.
• Hurting.They appear after physical work of the joints and subside with rest.
• Night.They confirm severe damage to the joint and are caused by 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 as you move, the discomfort goes away.
• Permanent.It occurs when there is inflammation in the joint capsule.
• Sudden (joint block).It is caused by the pinching of a piece of bone or cartilage stuck between two articular surfaces.
• Migration.First one joint hurts, then the pain moves to the other.
• is reflected.They are felt not in the affected joint, but in a nearby one.For example, if you have a 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 for a consultation to an orthopedic-traumatologist or a rheumatologist.If a previously injured joint becomes ill, then consultation with a surgeon is indicated.

When you visit a doctor, it is important to talk about the following points:

• When pain occurs.
• From which the pain decreases and subsides.
• How often do painful attacks occur?
• Arthralgia appeared for the first time or existed before.
• There is hyperaemia, swelling or deformity of the joint.
• Have you had any stress, acute respiratory illness or vigorous physical activity in the last few 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 pain in the joints, the doctor will prescribe an examination and give a referral for:

• General analysis of blood and urine.
• 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 radiopaque arthrography is possible.

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

Ultrasound of joints.It helps to identify effusion in the joint cavity, erosion of the articular surfaces of the bones, changes in the synovial membrane and to estimate the width of the joint spaces.

Invasive examination methods.If indicated, a puncture of the joint and biopsy of synovial synovium is 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.The synovial fluid is subjected to microbiological and cytological analysis.

Treatment

For joint pain, treatment must 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 an arthralgia patient.

The following are prescribed to reduce joint pain:

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

Conservative treatment is carried out with non-steroidal anti-inflammatory drugs, they relieve pain and have an anti-inflammatory effect.Chondroprotectants slow the development of osteoarthritis.These drugs reduce inflammation and prevent further degeneration of the cartilage in the joints.They include cartilage components - chondroitin, glucosamine.Chondroprotectants promote repair 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.

Vitamin and mineral complexes are also prescribed for the good functioning of the joints and recovery processes.Particularly important are vitamins A, C, E, group B and the minerals calcium and selenium.

In case of severe inflammation and no 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 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 avoid 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 regular 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 do 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 required.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 affected joint, a peri-articular osteotomy is performed.The bones that form the joint are sawn so that they 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 a day.
3. Avoid hypothermia.
4. Follow an active lifestyle.
5. Avoid excessive use of alcohol and tobacco.
6. Night sleep should last at least 8 hours.
7. Walk outdoors 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 over 70 years of age, joint diseases are observed in 90% of cases.If a 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 mobile, even if the cartilage is damaged and movement causes discomfort.