Joint pain

Joint pain or arthralgia appears in a number of diseases and until now the mechanism is not completely clear.Articular elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritation.During movement, joint receptors are irritated, signals from them enter the brain and the person feels pain.During inflammation, receptors become more sensitive to any irritation, as the cells of the immune system release substances that are pain transmitters.

Usually, joint pain is not accompanied by swelling of the surrounding soft tissue, contour deformity, or redness.When feeling the joint, the pain is moderate.In some cases, there are no obvious signs of inflammation on x-ray.There were also no complaints about decreased 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 immediately get up and walk quickly because of stiffness and pain in the joints.

If the pain in the joints is paroxysmal, appears unexpectedly, gets worse within a day, lasts several days, and only one joint is painful, then we can assume that arthritis is due to gout.Uric acid crystals accumulate in joint tissue and irritate the tissue, causing pain.

If arthralgia appears in large joints (knee, hip), grows slowly, becomes stronger during physical work, and is combined with morning stiffness, then degenerative-dystrophic changes - osteoarthritis - can be diagnosed.

Reason

There are various causes of joint pain.One of the most common causes of arthralgia is acute infection.Pain in the joints may appear before the first signs of the disease or in the early stages.Often, during the infectious process, joints throughout the body are damaged.At the same time, the amplitude of movement in it does not change.

Severe post-infectious arthralgia appears with 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 become painful.

Common causes of joint pain are:

• Thyroid disease.
• Heavy metal salt poisoning.
• Physical injury.
• 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.
• Arthrosis is a disease associated with the destruction of the articular cartilage and the articular surface of the underlying bone.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 the inflammatory process disrupts cartilage metabolism.They do not receive enough nutrition and quickly become emaciated and slowly collapse.

With arthrosis, which is initially associated with excessive physical load on the joint, inflammation develops over time.This is caused by the accumulation of fragments of cartilage and bone tissue in the articular cavity and triggers an inflammatory reaction.

The risk group for the development of this pathology includes:

• Women during menopause.
• Elderly people with age-related body changes.
• obese patients.
• Patients with a history of joint trauma.
• Athlete.
• People with certain professions.For example, knee joints often suffer in those who spend long hours on their feet (teachers, surgeons, hairdressers, etc.).Pain in the joints of the hands is a common symptom in musicians, cashiers and loaders who make monotonous movements with their hands.

Species

There are different classifications of joint pain.According to the location of the arthralgia, there are:

• Mono Arthralgia (1 joint hurts).
• Oligo Arthralgia (affects 2-5 joints).
• Polyarthralgia (pain in more than 5 joints).

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

The nature of arthralgia is:

1. Sharp and boring.
2. Temporary and permanent.
3. Weak, moderate and intense.

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

• Start.Arthralgia first occurs when walking, then disappears over time.It is associated with friction on the articular surfaces of the bones, which are covered with crushed cartilage tissue.After several steps, this mass accumulates in the inversion of the articular capsule and the arthralgia disappears.
• Sick.They appear after physical work of the joint and disappear with rest.
• Evening.They confirmed severe damage to the joint and was caused by congestion, blood pressure on the bone tissue beneath the cartilage.After a night's sleep, stiffness in the joints appears, and when you move, the discomfort goes away.
• Permanent.Occurs when inflammation occurs in the joint capsule.
• Sudden (joint blockade).Caused by a piece of bone or cartilage caught between two articular surfaces.
• Migrate.At first one joint hurts, then the pain moves to other joints.
• Reflected.They are not felt in the affected joint, but in nearby joints.For example, if you suffer from hip joint disease, your knees hurt.

Diagnostic

If you suffer from arthralgia, you should not self-medicate.If you experience joint pain, be sure to consult your doctor to determine a diagnosis.After the primary examination, he will refer you for a consultation to an orthopedic-traumatologist or rheumatologist.If previously injured joints become painful, consultation with a surgeon is indicated.

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

• When pain appears.
• From which the pain lessens and subsides.
• How often do pain attacks occur?
• Arthralgia appears for the first time or has existed before.
• Is there hyperemia, swelling or joint deformity.
• Have you experienced stress, acute respiratory illness or heavy physical activity in the last few 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 give a referral for:

• General analysis of blood and urine.
• Biochemical blood test.
• Immunodiagnostics.
• X-ray, CT, MRI, ultrasound of joints.
• If necessary, biopsy 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 evaluate in detail the condition of the osteochondral structures and soft tissues.

Joint ultrasound.Helps identify effusion in the joint cavity, erosion of the articular surfaces of bones, changes in the synovial membrane, and assess the width of the joint space.

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.In peripheral blood, erythrocyte sedimentation rate, levels of C-reactive protein, uric acid, antinuclear antibodies, rheumatoid factor, and ACCP were determined.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 development of the underlying disease.This is the only way to slow cartilage degeneration, maintain joint mobility and improve the quality of life of arthralgia patients.

To reduce joint pain, the following drugs are prescribed:

• 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, eliminating pain and having an anti-inflammatory effect.Chondroprotectors slow down the progression of osteoarthritis.This drug reduces inflammation and prevents further cartilage degeneration in the joints.It includes cartilage components - chondroitin, glucosamine.Chondroprotectors promote restoration processes in cartilage tissue.

To eliminate skeletal muscle spasm, muscle relaxants are prescribed.

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

For good joint function 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 very important.

If severe inflammation occurs and there is no effect of treatment, glucocorticosteroids are prescribed according to the scheme.

Drug treatment is complemented by ointments that warm, relieve pain, and have an anti-inflammatory effect.

If the arthralgia is very severe, a nerve ending block is performed.To do this, they use powerful drugs that allow you to forget about joint pain for a long time.

To reduce arthralgia, the joints are protected from excessive stress.Prolonged standing, lifting and carrying heavy objects exert stress on the joints that exceeds the permissible load and contribute to cartilage damage.

To prevent arthralgia, follow these rules:

• Normalize your weight.
• Wear comfortable shoes with low heels;if you have flat feet, use orthopedic insoles.
• Avoid psycho-emotional and physical overload.
• When working, change body position often, take five minutes to move and relieve muscle tension.
• To maintain physical activity, choose light exercise.Alternating mobility with rest periods.
• Do regular exercise to 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 "bike" exercise.After that, rest for 7-10 minutes to improve blood circulation.These exercises help strengthen the cartilage in the joints of the feet.

In severe cases, surgical treatment is required.Through a small incision, the doctor will remove necrotic tissue from the joint cavity.If fluid accumulates 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 joints are sawed so that they can grow together at a certain angle.

In severe cases, joint replacement is performed.

Prevention

To avoid joint disease, follow these recommendations:

1. If you are obese, normalize your 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 use of alcohol and tobacco.
6. A night's sleep should last at least 8 hours.
7. Walk outdoors as often as possible.
8. Try to change body position more often.

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 disease is observed in 90% of cases.If your joints suddenly hurt, immediately consult a doctor to find out the cause and prescribe treatment.Take care of your joints and fill them with useful activities.Only physical exercise can keep your joints moving, even if the cartilage is damaged and movement causes discomfort.