Joint pain

Joint pain is the most painful manifestation of diseases of the musculoskeletal system. About 30% of the world's population suffers from this pathology. Joint diseases are particularly important due to the increase in life expectancy: according to epidemiological studies, joint pathology in people over 40 years is found in 50% of cases, and after 70 years - in 90% of the population.

pain in the joints of the body

Joint pain, or arthralgia (Greek arthron - "joint" and algos - "pain") can be observed in various diseases - metabolic, rheumatic, tumor, systemic and acute infectious, endocrine and rheumatic. Therefore, it is wrong to believe, and so do most people with arthralgia and self-medication, that joint pain is necessarily caused by arthritis. It should be noted here that there are dozens of types of arthritis alone and not all of them have symptoms of pain.

Joint pain is caused by irritation of nerve endings coming from the synovial joint sac (capsule), and irritants can be toxins, salt crystals (sodium or potassium urate), allergens, products of autoimmune processes, osteophytes and other inflammatory components. In case of joint pain of any intensity, but with sufficient duration, it is obligatory to undergo a medical examination.

Types of joint pain

Joint pain is not a disease but a symptom of many infectious and non-infectious diseases. The perception of pain largely depends on the state of the nervous system. A calm, balanced person hardly reacts to mild pain. In an emotionally unstable person, the pain threshold is lowered. The pain in intensity and time is diametrically opposed and is characterized as follows:

  • tolerant - unbearable;
  • weak strong;
  • sudden - constant;
  • dull - sharp;
  • often - rarely;
  • short-term - long-term, etc.

If the constant pain bothers a person for more than 30 days, they are considered chronic. After treatment, they disappear for a while (remission stage), then reappear (exacerbation stage). The provoking factor for the return of acute pain is hypothermia, physical activity, malnutrition, excess weight, stress.

Risk factors

There are several risk factors that can lead to the disease. One of the most common is heredity. If, for example, grandmother and mother have suffered from several groups of joints at the same time, then sooner or later this problem may arise in future generations.

Gender is another risk factor. It has been found that joint diseases are several times more common in women than in men. In this case, women are more likely to get sick after menopause. This is due to the fact that before him women were "protected" by their own female sex hormones. Therefore, this problem practically does not occur in men, therefore the joints, due to the violation of the hormonal background, injure them a little less often than in women.

In men, joint pain occurs mainly due to hard physical labor. This is due to the fact that they are constantly under heavy load. Gradually, the cartilage begins to wear out, the joints themselves become inflamed and deformed at the same time.

People who often suffer from a disease such as tonsillitis may complain that their joints are starting to hurt. This is due to the fact that the bacteria that cause angina can also adversely affect the joints, especially the large ones. The causes and treatment of pain in all joints of the body are closely related.

Common symptoms of arthralgia

It seems that it is easy to determine the presence of the disease - by painful symptoms. But:

  1. The presence of pain does not always mean the presence of disease, as pain can be caused by bruising, one-time (acute) physical overload, sprain and other similar causes.
  2. If you already develop a disease, its symptoms may not be noticeable at first, as the pain, especially acute, as a rule, is already a serious manifestation of the disease.

Early signs of arthralgia, which appear even before the pain, may be:

  • stiffness of movements, more often in the morning or after prolonged sitting in one position;
  • periodic creaking and crunching in the joint.

Such bodily signals cannot be ignored; these may be the initial symptoms of a serious illness.

Causes of joint pain

The joint is an anatomically complex structure. Pain can be caused by everything that forms it: muscles, bones, ligaments, cartilage, tendons, intra-articular cavities. Such pathological conditions as inflammation, sprains, tears, metabolic processes are disturbed in the structures of the joint. The causes of arthralgia can be very diverse. For some diseases, they have not yet been precisely identified.

In summary, the following can be distinguished:

  • lack of physical activity and sedentary lifestyle;
  • too much, frequent and monotonous physical activity;
  • old injuries;
  • reduced immunity;
  • infections.

Arthralgia occurs as a result of irritation of neuroreceptors, which are located in all structures of the joint, by various factors, depending on the underlying disease. One of the causes of joint pain can be bruising of the joint and the formation of a hematoma that is not visible to the eye. By the nature of the painful sensations, the presence of one or another pathology can be assumed.

Diseases that cause joint pain

Osteoarthritis is the most common chronic disease of the joints (often the hips, knees, interphalangeal joints of the hands), which is based on degenerative-dystrophic disorders (metabolic disorders) of articular cartilage, bone tissue, synovial membranes, ligaments and ligaments. overweight, impaired metabolism, injuries, lack of vitamins C and D, occupational risks).

Reiter's disease (a separate type of reactive arthritis with a genetic predisposition) - occurs after chlamydial or intestinal infection. Manifested by reactive arthritis (mainly of the joints of the lower extremities), joint pain, characteristic extra-articular manifestations (urethritis or prostatitis, conjunctivitis or uveitis, lesions of the skin and mucous membranes - ulcerative stomatitis, erosive balanitis), damage to the cardiovascular systemarrhythmias, blockade, aortitis), fever (38, 6 - 40, 0).

Rheumatoid arthritis is a chronically progressive systemic inflammation of the connective tissue (autoimmune inflammation in the joint). The small joints of the arms and legs are affected, less often the knee and elbow joints. Symptoms - constant joint pain, joint deformity, joint swelling, joint stiffness in the morning, symmetry of joint damage, weakness, fatigue, weight loss.

Psoriatic arthritis - arthritis that develops in genetically predisposed patients with psoriasis, exacerbation of arthritis coincides with exacerbation of psoriasis. Symptoms. Joint pain (mainly the interphalangeal joints of the arms and legs are affected), purple-cyanotic skin with swelling above the joint area, asymmetry of the joint damage, lumbosacral spine pain, heel pain (thalagia), psoriatic skin plaques, nail damage(brittleness, grooving and clouding of nail plates).

Bursitis - This disease is often confused with arthritis, although bursitis does not cause inflammation of the joint, but of the joint sac. Bursitis can cause discomfort, stiffness and pain in the joints. Symptoms are associated with inflammation of the synovial membranes of the joint, usually caused by improper movement, compression or trauma. More often bursitis develops in the shoulder, knee or hip joint. A type of bursitis called "maid's knee" develops as a result of prolonged pressure on the knee joint on a hard surface.

Gout (gouty arthritis) is microcrystalline arthritis, an inherited disease based on a metabolic disorder (a dietary disorder), namely purine metabolism, which results in the deposition of urate crystals (uric acid salts) in the periarticular and joint tissues. Symptoms. Joint pain (more often in the first metatarsophalangeal joint of the foot), bright redness (redness), swelling and scaling of the skin over the joint, fever, increased local temperature in the affected joint, skin manifestations in the ears, elbow joints, feet, hands, in the form of tophi (local accumulation of urate salt crystals surrounded by granulomatous tissue), heart damage (myocarditis, endocarditis, pericarditis, coronary arteritis, aortitis, arrhythmias), kidney damage (amyloidosis, glomerulonephritis).

Drug-induced arthralgia is a temporary condition characterized by joint pain (mainly small joints) when taking certain medications in high daily doses. It is not a disease and is not classified in ICD-10 by the WHO. Groups of drugs that can cause drug arthralgia are penicillin antibiotics, barbiturates and mild hypnotics and tranquilizers (chemical-based), antihypertensive drugs, contraceptives and anti-TB drugs, proton pump inhibitors. The causes, pathogenesis, clinical manifestations and diagnosis of this condition have not been studied due to the active promotion of drugs on the pharmacological market and the lack of severity of the condition in terms of functional joint disorders and individual drug tolerance.

The same can be said for meteopathic arthralgia (joint pain that occurs in people with meteopathy who are sensitive to changes in atmospheric pressure).

Diagnosis of joint pain

The clinical blood test in most cases shows different deviations depending on the nature of the joint damage and its severity, the increase in ESR, reflecting the level of the inflammatory process, with a normal number of leukocytes, is characteristic of rheumatic diseases. The increase in the number of leukocytes in inflammatory diseases of the spine and joints may indicate the presence of an outbreak of infection in the body and others.

Immunological tests. For the early diagnosis of rheumatoid lesions, rheumatoid factor, antiglobulin antibody, is of particular importance. It is formed in the lymph nodes, spleen, synovial membrane of lymphoplasmocyte cells. For the detection of rheumatoid factor in blood serum and synovial fluid, the Vaaler-Rose test is considered positive if there is a concentration of 1: 28 or more. Rheumatoid factor is found in 75-85% of patients with rheumatoid arthritis. In the early stages and in the seronegative form of rheumatoid arthritis, an immunocytoadhesive reaction is used to isolate rheumatoid factor at the lymphocyte level.

The antistreptolysin O test (ASL-O) reflects the immunological reactivity to streptococcal infection. Increased titer of ASL-0 is observed in patients with rheumatism, infectious-allergic polyarthritis.

Leukocyte migration inhibition reaction. Usually leukocytes have the ability to migrate into the environment with the formation of conglomerates. If there is sensitization of the body to a particular antigen, then when the sensitized leukocytes encounter this antigen, the lymphocytes secrete an inhibitory factor that inhibits the migration of leukocytes. This reaction is positive in rheumatism, rheumatoid arthritis and other rheumatic diseases.

Blood on the HLA system - the possibility of early diagnosis of Bechterew's disease, the determination of HLA B-27 is of great importance. The HLA complex is located in the cell membrane and is isolated using immunological methods.

Immunoelectrophoresis - reveals immunoglobulins of classes A, G, M, which are of great importance for the development of the pathological process in rheumatoid arthritis.

Radiography is a reliable method of examining the joints. In fact, without it, the doctor cannot diagnose and make a differential diagnosis. X-ray examination allows you to determine the stage and prognosis of the disease and in the dynamics to objectively assess the effectiveness of therapy. It is necessary to compare the radiological data with the clinical picture, the duration of the disease and the age of the patient.

Tomography allows you to more accurately identify focal lesions or individual segments of the vertebrae.

Myelography is a contrast method for examining the spine, and with the help of this method it is possible to clarify the location of the pathological process, especially in cases where surgery is required.

Intraosal phlebography - to study the venous blood flow in the epidural space. This method allows you to assess the state of blood circulation in the paravertebral space and indirectly for a possible degenerative lesion.

Arthroscopy is a research method that allows you to visually see the structure of the knee joint and take a biopsy of the desired area, detect the contours, color and capillary network of the synovial membrane, cruciate ligaments, menisci and fat pad.

Discography - the introduction of a contrast agent into the intervertebral disc, followed by radiography, makes it possible to assess the condition of the intervertebral discs, the location and extent of the lesion.

Radionuclide scanning is an important objective method for early diagnosis of joint damage.

Arthrography - with the help of intra-articular injection of various contrast agents, allows you to more accurately determine the pathology in the deep joints.

How to treat joint pain

The treatment of joint pain itself is symptomatic, ie it is aimed at eliminating or reducing the pain syndrome. At the same time, it is obvious that the elimination of joint pain must inevitably be complemented by treatment of the root cause of arthralgia. But regardless of the identified cause of joint pain, and in the absence of direct contraindications, doctors most often prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), which have the ability to relieve pain, swelling, redness, fever, fever, reduce inflammation. .

Side effects of almost all NSAIDs include gastrointestinal irritation, as the drugs are acid-based, inhibit platelet aggregation (reduce blood clotting) and impaired renal blood flow (with renal failure). Otherwise, if there are no individual contraindications and there is a desire to follow all medical prescriptions, NSAIDs are quite harmless.

However, effective treatment of joint pain is not limited to NSAIDs, as after elimination of the syndrome of primary or acute pain, it makes sense to switch to non-drug or homeopathic treatment, including some types of physiotherapy (SWT, magnetic therapy, ultrasound andelectropulse therapy), exercises, gymnastics, manual therapy, swimming, etc. Also, be sure to review your diet and nutrition.

Diet for joint pain

General nutritional requirements for joint pain:

  • limiting the content of carbohydrates, especially sugar;
  • reduction (maximum) of salt;
  • partial, frequent meals (5-6 meals a day);
  • exclusion from the diet of spicy, salty foods, extractives (strong broths, fried foods), strong drinks, strong tea, coffee.

The dishes are prepared without salt, meat and fish - in boiled or lightly fried (after cooking) form; the vegetables must be well cooked.

General recommendations for nutrition in diseases of the joints:

  • Soups - mostly vegetarian, as well as cereals, dairy, fruit, lean meat or fish soups - 1-2 times a week.
  • Meat or poultry of low-fat varieties - mostly cooked or baked. It is desirable to exclude the liver, tongue, brain, chicken, beef.
  • Fish - a variety of varieties, except salted and smoked.
  • Soft-boiled eggs, omelets.
  • Vinaigrettes and salads with vegetable oil from various vegetables, vegetables in the form of garnish. Limit (exceptionally) beans, peas, beans, spinach, sorrel.
  • Fruit dishes, berries: all kinds, limited grapes.
  • Cereal dishes, dairy products are not limited.
  • Fats: vegetable oil (1/3 of the total).
  • Pastries: sugar - up to 30 g per day (4 pieces), honey, jam, jam.
  • Drinks: weak tea, coffee, vegetable, fruit, forest juices (except grape). Alcoholic beverages are excluded.
  • Spices, condiments: bay leaf, dill, parsley, cinnamon, cloves.

Therapeutic Gymnastics (LFK)

Physiotherapy is prescribed at almost every stage of any disease. If exercise causes discomfort, then pain relief with ointments, tablets or injections is prescribed (depending on the situation). Healing therapy is an exercise designed specifically to restore healthy mobility of the joints without damaging them. On the one hand, such exercises are gentle, on the other hand, they make the necessary parts of the body "wake up". Physical education is also recommended for people at risk as a preventive measure.

Acupuncture

For the most part, this is an Eastern practice, but today this method is already adopted by official medicine and is used successfully in many private and public clinics. One problem: there are not many professionals in this field who know their business well. Therefore, before treating in this way, we advise you to carefully consider the choice of a specialist. Acupuncture affects the body in a very interesting way. They are unlikely to be able to completely cure arthralgia, but after a few sessions, patients usually feel much better - all symptoms subside.

Manual therapy

Manual therapy also does not tolerate amateurism and unprofessionalism. But if you get to a person who knows his job, you can rest easy - the results will be. With the help of manual therapy you can eliminate muscle spasms in the problem area of the body. Regularity is important in its application, the procedures can be performed quite often - from 12 times a year or more. There are contraindications to manual therapy, including some types of exacerbation of arthralgia! It is inadmissible to prescribe it yourself, contact a chiropractor - he will tell you about effective treatment in your particular case and will choose the most appropriate methods.

Medical massage

Massage gives good results when combined with other therapies. In order to really work properly on the diseased joint, the masseur must have medical knowledge and experience in therapeutic (therapeutic) massage.

Surgical method

This option is used in cases where the operation is simply not enough.

  • Puncture. Or a mini-operation in which the inflammatory fluid is removed from the joint cavity with a needle.
  • Arthroscopic debridement. In this case, wide incisions are not needed - everything happens through mini holes (removal of inanimate tissue from the joint cavity) with the help of endoscopic instruments.
  • Periarticular osteotomy. Used if joint prosthetics are prohibited. The essence of the operation is to sharpen the articular bones and then merge them at different angles to improve mobility and reduce the load.
  • Endoprosthesis. A radical option for treatment with long-term recovery, in which the joint is replaced with a prosthesis.

Many methods have been invented to treat various pathologies of the joints. It is true that for the success of treatment you must first find an experienced specialist. Self-medication on this issue is absolutely unacceptable!

Prevention of joint diseases

To save your joints, you need to constantly protect them and engage in preventive work. After all, people do not agree in vain with the statement that the disease is easier to prevent than to cure. The first thing to do is to avoid hypothermia whenever possible, as this can lead to a disease such as tonsillitis. And it in turn can give complications. And in itself, hypothermia can lead to inflammation of several groups of joints at once.

Don't forget about physical activity! The load on the diseased joints, of course, should be dosed, but it would be wrong to leave them immobile. Reasonable movement stimulates the production of synovial fluid, improves blood circulation and tissue nutrition. Swimming, cycling, therapeutic exercises will help you maintain the working condition of your joints. In addition to physical education, you may be prescribed physiotherapy and rehabilitation measures, such as electrophoresis, therapeutic massage, mud baths, various body wraps and more.

Both women and men should monitor their weight carefully, as being overweight is a direct route to deforming osteoarthritis, at least of the knee and hip joints. You also need to monitor your drinking habits. It is known that the average adult should drink at least two liters of fluid a day. In this case, the synovial joint fluid is constantly updated. If there is not enough fluid, then the cartilage begins to rub, thus causing severe pain and the joints begin to deform.