Articolar pains

Joint pain, or arthralgia, appears in numerous diseases and until now its mechanism is not entirely clear. Joint 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 cells of the immune system release substances that conduct pain.

Typically, joint pain is 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. Also, there are no complaints about a marked 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 at a brisk 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 several days and only one joint hurts, then we can assume the presence of arthritis due to gout. Uric acid crystals build up in joint tissues and irritate the tissues, 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 - arthrosis.

Causes

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

Severe postinfectious arthralgia appears 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, the joints also hurt.

Common causes of joint pain are:

• Thyroid diseases.
• Poisoning with heavy metal salts.
• Physical injuries.
• Long-term use of some drugs.

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 infections, autoimmune processes, dysfunction of endocrine glands and metabolism.
• Osteoarthritis is a disease associated with the destruction of the articular cartilage and underlying articular surfaces of the 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 the metabolism of cartilage. They do not receive adequate nutrition and quickly become thinner and gradually collapse.

In arthrosis, 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 in menopause.
• Older 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 often suffers in those who spend many 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.

Types

There are different classifications of joint pain. Based on the location of the arthralgia, the following are distinguished:

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

Depending on the position of the joints, arthralgia is divided into general and localized.

The nature of arthralgia is:

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

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

• Starting. Arthralgia initially appears when walking, then disappears as one moves. It is associated with friction of the articular surfaces of the bones, which are covered with destroyed cartilaginous tissue. After a few steps this mass accumulates in the inversions of the joint capsule and the arthralgia disappears.
• In pain.They appear after physical work of the joints and disappear with rest.
• Night.They confirm severe damage to the joint and are caused by congestion, by blood pressing on the bone tissue beneath 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 block). Caused by the crushing of a piece of bone or cartilage stuck between two joint surfaces.
• Migration.First one joint hurts, then the pain moves to the other.
• Reflex.They are not felt in the affected joint, but in the nearby one. For example, if you have a hip joint disease, your knee hurts.

Diagnostics

If you suffer from arthralgia, you should not self-medicate. If you suffer from 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 rheumatologist. If a previously injured joint becomes diseased, consultation with a surgeon is indicated.

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

• When the pain appears.
• From which the pain decreases and subsides.
• How often do painful attacks occur?
• Arthralgia first appeared or existed before.
• There is hyperemia, swelling or deformation of the joint.
• Have you had stress, acute respiratory illness or intense physical activity in the last few days?

This information will help the specialist 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 a referral for:

• General blood and urine analysis.
• Blood chemistry.
• Immunodiagnostics.
• X-ray, CT, MRI, ultrasound of the joints.
• If necessary, biopsy the damaged tissue.

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

Using MRI and CT it is possible to evaluate in detail the condition of the osteochondral structures and soft tissues.

Ultrasound of the joints. It helps to identify effusion 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 disease. In the 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 should be comprehensive. Tactics include reducing the mechanical load on the joint, eliminating inflammation, and preventing progression of the underlying disease. This is the only way to slow cartilage degeneration, maintain joint mobility and improve the quality of life of a patient suffering from arthralgia.

To reduce joint pain the following is 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 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. Chondroprotectors promote the restoration processes of cartilaginous tissue.

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

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

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

In case of severe inflammation and no effect of treatment, 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, a blockade 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. Standing for a long time, lifting and carrying heavy objects puts pressure on the joints that far exceeds the allowable load and contributes to damage to the cartilage.

To prevent arthralgia, follow these rules:

• Normalizes 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. Alternating mobility with rest periods.
• Regularly perform exercises that relieve stress on your joints. For example, you can bend and straighten your legs while sitting or lying for 20-30 minutes and perform the "bicycle" exercise. Afterwards, rest for 7-10 minutes to improve blood circulation. These exercises help strengthen the cartilage in the leg joints.

In more 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 sawn off so that they can then grow together at a certain slope.

In more 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. Night sleep should last at least 8 hours.
7. Walk outdoors as often as possible.
8. Try changing your body position more often.

Summary

According to statistics, arthralgia of the upper and lower extremities occurs in half of people over the age of 40. 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 activities. Only exercise can keep joints mobile, even if the cartilage is damaged and movement causes discomfort.