Joint pain

Joint pain, or arthralgia, appears in several diseases and so far its mechanism is not completely clear.Articular elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritation.During movement, the joint receptors are irritated, signals from them go to 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 transmitters of pain.

Joint pain is usually not accompanied by swelling in 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 significant reduction in the mobility of the large joints.

Arthralgia is often accompanied by rheumatic diseases.In this case, the joints hurt and pain when the weather changes.Serious discomfort in the knee and hip joints is more common.In the morning, the patient is unable to get up immediately and walk at a pace due to stiffness and pain in the joints.

If the pain in the joints is paroxysmal, appears unexpectedly, becomes stronger within a day, lasts for several days, and only one joint pains, then we can accept the presence of arthritis due to gout.Uric acid crystals accumulate in the joint tissues and irritate the tissues, causing pain.

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

Reasons

Joint pain has various causes.One of the most common causes of arthralgia is an acute infection.Aching pain in the joints 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 the movements in them does not change.

Severe post-infectious 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, then there is also pain in the joints.

Common causes of joint pain are:

• Thyroid diseases.
• Poisoning with salts of heavy metals.
• Physical injuries.
• Long-term use of certain medications.

I am concerned about pain in the joints due to various diseases.They are divided into 2 large groups:

• Arthritis of the joints is an inflammatory disease caused by infection, autoimmune processes, dysfunction of the endocrine glands and metabolism.
• Arthrosis 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.

There are several joint diseases in arthritis and conditional arthritis.Without treatment, arthritis eventually turns into arthritis, since inflammatory processes affect cartilage metabolism.They do not receive adequate nutrition and quickly become thinner and gradually fall.

With arthritis, initially associated with physical overload of the joint, inflammation develops over time.It is the result of the accumulation of fragments of cartilage and bone tissue in the articular cavity and causes inflammatory reactions.

The risk group for the development of this pathology includes:

• Women during menopause.
• Elderly people have pronounced age-related changes in the body.
• Obese patients.
• Patients with a history of joint trauma.
• Athletes.
• People with certain occupations.For example, the knee joint often suffers in those people who spend a lot of time on their feet (teachers, surgeons, hairdressers, etc.).Pain in the joints of the hand is a common symptom among musicians, cashiers and loaders who make monotonous movements with their hands.

A species

There are different classifications of joint pain.According to the location of the arthralgias, they are distinguished:

• Arthralgia Mona (1 joint hurt).
• Oligo Arthralgia (affecting 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 the arthralgia is:

1. Sharp and dull.
2. Transient and permanent.
3. Weak, moderate and severe.

Features and conditions for the occurrence of arthralgia depend on the diagnosis.The most common symptoms of joint pain are:

• Starting.Arthralgia occurs when you first walk, then goes away when you move.It is associated with the friction of the articular surfaces of bones, which are covered with destroyed cartilage tissue.After several stages, this mass accumulates in inversions of the articular capsule and the arthralgia disappears.
• Aching.They appear after the physical work of the joints and disappear with rest.
• Night.They confirm severe damage to the joint and lead to congestion, blood pressure on the bone tissue under the cartilage.After a night's 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 blockage).This results in a piece of bone or cartilage stuck between two articular surfaces.
• Migration.One joint hurts first, then the pain moves to the other.
• Shown.They do not feel in the affected joint, but in a nearby one.For example, if you have hip disease, your knees hurt.

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 to an orthopedist-traumatologist or a rheumatologist for a consultation.If a joint becomes painful before, it is suggested to consult a surgeon.

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

• When pain appeared.
• From which the pain decreases and subsides.
• 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 illnesses, or heavy physical activity in the last few days?

This information will help the specialist reach a conclusion 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 make a referral to:

• General analysis of blood and urine.
• Biochemical blood test.
• Immuno-agnosic.
• X-ray, CT, MRI, ultrasound of the joints.
• If necessary, biopsy damaged tissue.

X-ray of the joints.This method allows you to examine the joint in two projections, and radiopaque arthrography can be performed.

Using MRI and CT, you can assess the condition of osteochondral structures and soft tissues in detail.

Ultrasound of the joints.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 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, erythrocyte sedimentation rate, C-reactive protein level, uric acid, antinuclear antibodies, rheumatoid factor, and ACCP are determined.Synovial fluid is subjected to microbiological and cytological analysis.

Treatment

For joint pain, treatment 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 cartilage degeneration, maintain joint mobility and improve the quality of life of patients with arthralgia.

To reduce joint pain the following are prescribed:

• 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 delay the development of osteoarthritis.These drugs reduce inflammation and prevent further degeneration of cartilage in the joints.They include cartilage components - chondroitin, glucosamine.Chondroprotectors promote restoration processes in cartilage tissue.

To eliminate the spasms of the skeletal muscles, muscle relaxants are prescribed.

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

For good joint function and recovery processes, vitamin complexes and mineral elements are also prescribed.Vitamins A, C, E, group B and the mineral elements calcium and selenium are particularly important.

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 a block of nerve endings is made.To do this, they use strong 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 put pressure on joints that greatly exceed the permissible load and contribute 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.
• While working, 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 periods of rest.
• Do exercises regularly 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 "bicycle" exercise.After this, 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 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 make up the joint are saved so that they can 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 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 outside as often as possible.
8. Try to change your body position more often.

Summary

According to statistics, arthralgia of the upper and lower extremities occurs in half of people over 40 years of age.In patients over 70 years of age, joint diseases are observed in 90% of cases.If a joint hurts suddenly, consult a doctor immediately to find out the causes and prescribe treatment.Take care of your articles and load them with useful activity.Only physical exercise can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.