Joint pain

Joint pain or joint pain occurs in many diseases and its mechanism is still not fully understood.Joint elements (ligaments, cartilage, capsule, bones) have pain receptors and respond to inflammatory processes and mechanical irritation.During movement, the joint receptors are irritated, 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 conduct pain.

Joint pain is typically not accompanied by swelling of the surrounding soft tissues, contour deformity 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 is also no complaint of a pronounced decrease in the mobility of the 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 steadily due to joint stiffness and pain.

If the joint pain is rapid, appears unexpectedly, gets stronger within a day, lasts for several days, and only one joint hurts, then we can assume gouty arthritis.Uric acid crystals accumulate in the joint tissues and irritate the tissues, causing pain.

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

Reasons

Joint pain has different 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 early stages.It often breaks down joints throughout the body during an infectious process.At the same time, the amplitude of the movements in them does not change.

Severe post-infection arthralgia occurs during urogenital and intestinal infections.

The joints suffer from secondary syphilis, endocarditis, tuberculosis.If there are chronic foci of 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 include:

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

I am worried about joint pain due to various diseases.They can be divided into 2 large groups:

• Arthritis is an inflammatory disease of the joints caused by infection, autoimmune processes, endocrine glands and metabolic disorders.
• Arthrosis is a disease that is 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 arthrosis is conditional.Without treatment, arthritis eventually turns into arthrosis, as inflammatory processes disrupt cartilage metabolism.They do not receive adequate nutrition, they quickly become thin and gradually collapse.

In the case of arthrosis, which is initially associated with physical overload of the joint, inflammation develops over time.This 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 pathology includes the following:

• Women during menopause.
• Elderly people who have 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 make monotonous movements with their hands.

Species

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

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

Depending on the location of the joints, arthralgia is general and localized.

Nature of arthralgia:

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

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

• Departures.The joint pain first occurs while walking and then goes away during movement.It is accompanied by friction on the articular surfaces of the bones, which are covered by dead cartilage tissue.After a few steps, this mass accumulates in the inversions of the joint capsule, and joint pain disappears.
• Sore.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, the bone tissue under the cartilage is pressed by the blood.After a night's sleep, the feeling of joint stiffness appears, and the discomfort disappears when moving.
• Constant.It occurs when there is inflammation in the joint capsule.
• Suddenly (common blockade).It is caused by the pinching of a piece of bone or cartilage stuck between two joint surfaces.
• Migration.First one joint hurts, then the pain moves to the other.
• is reflected.They are not felt in the affected joint, but in a nearby joint.For example, if you have hip joint disease, your knees hurt.

Diagnostics

If you have joint pain, do not self-medicate.If you have joint pain, be sure to consult your doctor for a diagnosis.After the main examination, he refers to a consultation with an orthopedic traumatologist or a rheumatologist.If a previously injured joint becomes ill, a surgeon's consultation is necessary.

When you visit the doctor, it is important to discuss the following points:

• When the pain appears.
• Which makes the pain decrease and subside.
• How often do painful attacks occur?
• Arthralgia appeared for the first time or existed previously.
• Is there hyperemia, swelling or deformation in the joint.
• Have you had a stressful, acute respiratory illness or heavy physical activity in the past few days?

This information helps the specialist draw conclusions about the condition of the patient's joints and make a diagnosis.

After determining the nature of the joint pain, the doctor prescribes an examination and gives a referral:

• General blood and urine analysis.
• Biochemical blood test.
• Immunodiagnosis.
• X-ray, CT, MRI, joint ultrasound.
• If necessary, a biopsy of the damaged tissue.

X-ray of the joints.This method allows the examination of the joint in two projections, and it is possible to perform radiopaque arthrography.

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

Ultrasound of joints.It helps identify fluid accumulation in the joint cavity, erosion of the joint surfaces of bones, changes in the joint membrane, and assess the width of the joint gaps.

Invasive examination methods.If justified, 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.The erythrocyte sedimentation rate, C-reactive protein, uric acid, antinuclear antibodies, rheumatoid factor and ACCP levels are determined in the peripheral blood.The synovial fluid is subjected to microbiological and cytological analysis.

Treatment

Treatment of 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 patients with joint pain.

To reduce joint pain, the following are prescribed:

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

Conservative therapy is performed 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.These include cartilage components - chondroitin, glucosamine.Chondroprotectors promote recovery processes in the cartilage tissue.

Muscle relaxants are prescribed to eliminate spasms of skeletal muscles.

If the arthritis is accompanied by an infection, then antibiotics are indicated.

Complexes of vitamins and mineral elements are also prescribed for the good functioning of the joints and recovery processes.Vitamins A, C, E, B, as well as the minerals calcium and selenium are particularly important.

In case of severe inflammation and treatment ineffectiveness, glucocorticosteroids are prescribed according to the scheme.

The medicinal treatment is complemented by warming, pain-relieving and anti-inflammatory ointments.

If the joint pain is very severe, then a block of the nerve endings is performed.For this, they use strong drugs that allow you to forget about joint pain for a long time.

In order to reduce joint pain, the joints are protected from overload.Prolonged standing, lifting and carrying heavy objects puts pressure on the joints that greatly exceeds the allowable load and contributes to cartilage damage.

To prevent arthralgia, follow these rules:

• Normalize your body weight.
• Wear comfortable, low-heeled shoes;if you have flat feet, use orthopedic insoles.
• Avoid psycho-emotional and physical overload.
• During work, change your body position more often, take five minutes to move and relieve muscle tension.
• Choose moderate exercise to maintain physical activity.Vary mobility with rest periods.
• Do regular exercises that relieve stress on your joints.For example, sitting or lying down, you can bend and straighten your legs for 20-30 minutes and do the "bicycle" exercise.Afterwards, 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 required.Through small incisions, the doctor removes the necrotic tissue from the joint cavity.If fluid has accumulated in the joint, a puncture is performed.

In order 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 sawed off so that they can then grow together at a certain angle.

In severe cases, joint replacement is performed.

Prevention

To avoid joint diseases, follow the recommendations below:

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 alcohol and tobacco consumption.
6. Nighttime sleep should last at least 8 hours.
7. Walk outside as often as possible.
8. Try to change your position more often.

Summary

According to statistics, joint pain in the upper and lower limbs 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 activity.Only exercise can move the joints, even if the cartilage is damaged and movement causes discomfort.