Articular pain

Joint pain, or arthralgia, occurs in a number of diseases and until now, its mechanism is not entirely clear. Joint elements (ligaments, cartilage, capsule, bone) have pain receptors and respond to inflammatory processes and mechanical irritation. During movement, joint receptors are irritated, their signals enter the brain, and the person feels pain. During inflammation, the receptors become more sensitive to irritation because cells of the immune system release pain-conducting substances.

As a rule, joint pain is not accompanied by swelling of the surrounding soft tissues, contour deformations or redness. On palpation of 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 pronounced decrease in mobility of large joints.

Arthralgia often accompanies rheumatic diseases. In this case, the joints hurt 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, intensifies in one day, lasts for several days and hurts only one joint, 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), develops slowly, intensifies during physical work and is accompanied by stiffness in the morning, then degenerative-dystrophic changes can be diagnosed - osteoarthritis.

Causes

Joint pain has different causes. Acute infection is one of the most common causes of arthralgia. Aching joint pain may appear before the first signs of the disease or at an early stage. Often, during an infectious process, it breaks the joints of the whole body. At the same time, the range of movements does not change.

Severe post-infectious arthralgias appear during urogenital and intestinal infections.

The joints suffer from secondary syphilis, endocarditis and 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.
• Heavy metal salt poisoning.
• Physical injuries.
• Long-term use of certain medications.

I worry about joint pain due to various illnesses. They are divided into 2 large groups:

• Arthritis is an inflammatory joint disease caused by infection, autoimmune processes, dysfunction of the endocrine glands and metabolism.
• Osteoarthritis is a disease associated with the destruction of articular cartilage and underlying joint surfaces of bones. Over time, cartilage becomes rough, loses elasticity and cracks.

The division of joint diseases into arthritis and osteoarthritis is conditional. Without treatment, arthritis eventually turns into osteoarthritis, as inflammatory processes disrupt cartilage metabolism. They do not receive adequate nutrition, lose weight quickly and gradually collapse.

With osteoarthritis, 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 during menopause.
• Elderly people with pronounced age-related body changes.
• Obese patients.
• Patients with a history of joint trauma.
• Athletes.
• People exercising 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 hand joints is a common symptom among musicians, cashiers and loaders who perform monotonous movements with their hands.

Types

There are different classifications of joint pain. Depending on the location of the arthralgias, they are distinguished:

• Mono Arthralgia (1 joint hurts).
• Oligo Arthralgia (affecting 2 to 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:

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

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

• Departure.Arthralgia initially occurs when walking, then disappears as you move. It is associated with friction of the articular surfaces of 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.
• Painful.They appear after physical work on the joints and disappear with rest.
• Night.They confirm severe damage to the joint and are caused by congestion, pressure of blood on the bone tissue under the cartilage. After a night's sleep, a feeling of stiffness in the joints appears, and as you move, the discomfort disappears.
• Permanent.Occurs when there is inflammation in the joint capsule.
• Suddenly (common blockade). Caused by pinching a piece of bone or cartilage stuck between two joint surfaces.
• Migration.First one joint hurts, then the pain shifts to the other.
• Reflected.They are not felt in the affected joint, but in a nearby joint. For example, if you suffer from hip joint disease, your knee hurts.

Diagnostic

If you have arthralgia, you should not self-medicate. If you experience joint pain, be sure to consult your doctor to determine the diagnosis. After the main examination, he will refer you for a consultation with an orthopedist-traumatologist or a rheumatologist. If a previously injured joint becomes ill, then a consultation with a surgeon is indicated.

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

• When pain appears.
• Hence the pain diminishes and subsides.
• How often do painful attacks occur?
• The arthralgia appeared for the first time or existed previously.
• Is there hyperemia, swelling or deformity of the joint.
• Have you experienced stress, acute respiratory illness or strenuous physical activity in recent days?

This information will help the specialist to 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 order an examination and refer to:

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

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

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

Ultrasound of joints. Helps to identify effusion in the joint cavity, erosion of the articular surfaces of bones, changes in the synovial membrane and to assess the width of the joint spaces.

Invasive examination methods. If indicated, a 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, 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 must be comprehensive. Tactics include reducing mechanical load on the joint, eliminating inflammation and preventing progression of the underlying disease. It is the only way to slow down cartilage degeneration, maintain joint mobility and improve the quality of life of a patient suffering from arthralgia.

To reduce joint pain, it is prescribed:

• Analgesics and anti-inflammatories.
• Physiotherapy (shock wave therapy, ozone therapy, myostimulation, phonophoresis).
• Therapeutic exercise.
• Massage.
• Acupuncture.
• Orthopedic or surgical correction.

Conservative treatment is carried out with nonsteroidal anti-inflammatory drugs, they relieve pain and have an anti-inflammatory effect. Chondroprotectors slow the development of osteoarthritis. These medications reduce inflammation and prevent degeneration of joint cartilage. They include cartilaginous components - chondroitin, glucosamine. Chondroprotectors promote the processes of restoration of cartilage tissue.

To eliminate skeletal muscle spasms, muscle relaxants are prescribed.

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

For the proper functioning of joints 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, glucocorticoids 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 block of the nerve endings is then 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. Prolonged standing, lifting and carrying heavy objects place pressure on the joints that far 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.
• At work, change your body position more often, take five minutes to move and relieve muscle tension.
• To maintain physical activity, choose moderate exercise. Alternation of mobility with periods of rest.
• Do exercises regularly that relieve stress on your 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 strengthen the cartilage in the joints of the legs.

In severe cases, surgical treatment is necessary. Through small incisions, the doctor will remove 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, a periarticular osteotomy is performed. The bones forming the joint are sawed so that they then grow together at a certain slope.

In severe cases, arthroplasty is performed.

Prevention

To avoid joint diseases, follow these recommendations:

1. If you are obese, normalize your weight.
2. Drink at least 1. 5 to 1. 7 liters of water per day.
3. Avoid hypothermia.
4. Lead an active lifestyle.
5. Avoid excessive consumption of alcohol and tobacco.
6. Night sleep should last at least 8 hours.
7. Walk outside 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 40 years old. In patients over 70 years old, joint diseases are observed in 90% of cases. If a joint suddenly hurts, see a doctor immediately to find out the causes and prescribe treatment. Take care of your joints and load them with useful activities. Only physical exercise can keep your joints mobile, even if the cartilage is damaged and movement causes discomfort.