Joint pain, or arthralgia, appears in a number of diseases, and its mechanism is still not fully understood.Joint elements (ligaments, cartilage, capsule, bones) have pain receptors and react to inflammatory processes and mechanical irritation.During movement, joint receptors are irritated, signals from them enter 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 transmit pain.
As a rule, joint pain is not accompanied by swelling, contour deformation or redness of the surrounding soft tissues.Pain on palpation of the joints is moderate.In some cases, x-rays show no signs of inflammation.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 is unable to get up immediately and walk briskly due to joint stiffness and pain.
If the joint pain is paroxysmal, comes on suddenly, worsens within a day, lasts for several days, and only one joint hurts, then the presence of arthritis due to gout can be assumed.Uric acid crystals accumulate in the joint tissues and irritate the tissues, causing pain.
If arthralgia occurs in large joints (knees, hips), grows slowly, is intensified during physical work and is combined with morning stiffness, then degenerative-dystrophic changes may occur - osteoarthritis.
reasons
Joint pain has different causes.One of the most common causes of arthralgia is an acute infection.Painful pain in the joints may appear at the first signs of the disease or in the early stages.Often, during the infectious process, it breaks the joints throughout the body.At the same time, the amplitude of movement in them does not change.
Severe post-infectious 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 are:
- Diseases of the thyroid gland.
- Poisoning by salts of heavy metals.
- physical injuries.
- Long-term use of certain medications.
I suffer from 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, endocrine gland dysfunction and metabolism.
- Arthrosis is a disease associated with the destruction of articular cartilage and the posterior 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 arthrosis, as inflammatory processes disrupt cartilage metabolism.They do not receive proper nutrition and quickly become thin and gradually fall apart.
In arthrosis, which is initially associated with physical overloading of the joint, inflammation develops over time.This is due to 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 is often affected by those who spend many hours on their feet (teachers, surgeons, hairdressers, etc.).Wrist pain 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 distinguish:
- Mono arthralgia (1 joint hurts).
- Oligo arthralgia (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 as follows:
- sharp and dull.
- transitory and permanent.
- Weak, moderate and intense.
Features and conditions of the occurrence of arthralgia depend on the diagnosis.The most common symptoms of joint pain are:
- starting with.Arthralgia occurs first when walking, and then disappears when moving.It is associated with the friction of the articular 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.
- it hurts.They appear after physical work of the joints and disappear during rest.
- night.They indicate severe damage to the joint and are caused by swelling, pressure of blood on the bone tissue under the cartilage.After a night's sleep, there is a feeling of stiffness in the joints and discomfort during movement disappears.
- permanent.Appears during inflammation in the joint capsule.
- Sudden (joint blockade).Caused by compression of a piece of bone or cartilage stuck between two articular surfaces.
- migration.First one joint hurts, then the pain moves to another.
- reflected.They are felt not in the affected joint, but nearby.For example, if you have hip joint disease, your knee hurts.
diagnosis
If you have arthralgia, you should not self-medicate.If you have joint pain, be sure to see your doctor for a diagnosis.After the basic examination, we will refer you to an orthopedic traumatologist or a rheumatologist.If a previously damaged joint becomes ill, then a 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 recedes and recedes.
- 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 any stress, acute respiratory illnesses or heavy physical exertion 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 joint pain, the doctor will order an examination and prescribe:
- General analysis of blood and urine.
- Biochemical blood test.
- Immunodiagnosis.
- X-ray, CT, MRI, ultrasound of joints.
- 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 a radiopaque arthrograph can be performed.
Using magnetic resonance imaging and computer tomography, you can assess the condition of osteochondral structures and soft tissues in detail.
Ultrasound of joints.It helps to identify protrusions in the joint cavity, erosion of the articular surfaces of the bones, changes in the synovial membrane and to assess the width of the joints.
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.Erythrocyte sedimentation rate, C-reactive protein level, uric acid, antinuclear antibodies, rheumatoid factor and ACCP 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 progression of the underlying disease.This is the only way to slow down cartilage degeneration, maintain joint mobility and improve the quality of life of a patient suffering from arthralgia.
The following are prescribed to reduce joint pain:
- Painkillers 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, they relieve pain and have an anti-inflammatory effect.Chondroprotectors slow down the development of osteoarthritis.These drugs reduce inflammation and prevent further degeneration of the cartilage in the joints.Among them are cartilage components - chondroitin, glucosamine.Chondroprotectors promote cartilage tissue recovery processes.
Muscle relaxants are prescribed to eliminate spasms of skeletal muscles.
If arthritis is associated with infection, then antibiotics are indicated.
Complexes of vitamins and mineral elements are also prescribed for good joint functioning and recovery processes.Vitamins A, C, E, B group and mineral elements calcium and selenium are especially important.
In case of severe inflammation and lack of treatment effect, glucocorticosteroids are prescribed according to the scheme.
Medicinal 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.For this, they use strong drugs that will allow you to forget about joint pain for a long time.
Joints are protected from overload to reduce arthralgia.Prolonged standing, lifting and carrying heavy objects puts pressure on the joints, which significantly exceeds the permissible 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.
- While at 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.
- Do regular exercises that relieve stress on the 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 legs.
In severe cases, surgical treatment is necessary.Through small incisions, the doctor removes 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, periarticular osteotomy is performed.The bones that make up the joint are cut so that they then grow together at a certain angle.
In severe cases, joint replacement is performed.
Prevention
To prevent joint diseases, follow the following recommendations:
- If you are obese, adjust your body weight.
- Drink at least 1.5-1.7 liters of water per day.
- Avoid hypothermia.
- Lead an active lifestyle.
- Avoid excessive consumption of alcohol and tobacco.
- Night sleep should last at least 8 hours.
- Go outside as often as possible.
- Try to change your body position more often.
resume
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 patients over 70 years old.If your joint hurts suddenly, see your doctor right away to find out the cause and prescribe treatment.Take care of the joints and load them with useful activity.Only physical exercise can move your joints, even if the cartilage is damaged and movement causes discomfort.