Joint pain

Joint pain- These are uncomfortable, painful feelings of stretching in the joint area, the intensity sometimes reaching the level of pain. This symptom is associated with muscle pain, weakness, weakness, crepitation, and limited movement and may occur before joint pain (arthralgia). Joint pain is accompanied by damage to the musculoskeletal system, infections, diseases of the hematopoietic system and vascular pathologies. To determine the cause of the disorder, laboratory tests, ultrasound, radiography and invasive methods are used. Treatment includes treating the disease causing the pain.

Causes of joint pain

Mild or moderate joint discomfort is not always a manifestation of a pathological process. Sometimes symptoms have natural causes. A transient feeling of pain in the joints when wearing uncomfortable shoes and in people who are sensitive to the weather - when the weather changes. During puberty, pain in the shoulder and knee joints is due to insufficient blood supply due to rapid bone growth.

Significant physical activity

During intense exercise or heavy work, the common cause of this symptom is excessive tension in the musculo-ligamentary apparatus, less commonly due to microtrauma of the cartilage and synovial membrane. . A typical combination of pain in the joints and discomfort in the bones and muscles. Joint and muscle discomfort occurs immediately after physical activity or due to prolonged monotonous work with constant tension in the same muscle groups. Pain in the joints of the body occurs without fever. With large overloads, the general condition and weaknesses can be moderately violated.

This disorder can last up to several days and when physical activity is limited, the disease will gradually decrease until it disappears completely without treatment. If the aches and pains caused by playing sports or heavy work are replaced by persistent pain, swelling in the wrists, elbows, shoulders, ankles, knee joints and hips as well as limited movement. Usually, you should see your doctor.

Age-related changes in the musculoskeletal system

The cause of moderate bone and joint pain in the elderly is due to the degenerative process leading to calcium loss, bone thinning, reduced blood supply to cartilage and reduced fluid volume in the joints. Mild discomfort is just the first sign of joint damage caused by old age. Usually, periodic discomfort occurs after 45-50 years. At the age of 60-65, unpleasant pain occurs even with light exertion, accompanied by stiffness when moving, stooping, dragging gait and gradually gives way to pain.

Pregnancy

Complaints of joint pain are more likely to appear in the second half of gestation. Uncomfortable feeling when pulling and pain often occurs in the joints of the pelvis and lower limbs. It intensifies at the end of the day, after long standing or long walks. A night's rest helps alleviate the condition. Joint pain during pregnancy is due to the following causes:

• Vitamin and mineral deficiencies. The biggest role is played by calcium and vitamin D deficiency, leading to osteomalacia. Characteristics of the manifestation of symptoms are a feeling of pain not only in the joints but also in the bones, fatigue, the appearance of other signs of hypocalcemia and vitamin D deficiency - tooth decay, brittle nails, muscle weakness, painmuscle and frequent occurrence of ARVI.
• Significant weight gain. Joint discomfort is often a concern for pregnant women who gain a lot of weight or who are obese. Pain at the end of the day and finally in the middle of the day is felt in the joints of the hips, knees, ankles, the cartilage is subjected to loads many times higher than the allowable level. To alleviate this condition, women deliberately limit physical activity, which causes weight gain even faster.
• Soften cartilage and ligaments. About half of pregnant women feel discomfort in the pelvic joints due to the effects of the hormone Relaxin. In most cases, the discomfort is of a painful nature in the pubic area and hip joints. In a pathological course with the development of sympathetic arthritis, the feeling of soreness is replaced by pain, which increases when pressing on the uterus, trying to separate the legs during sexual intercourse. The appearance of pain in the pubic area is a serious reason to see an obstetrician-gynecologist.
• Carpal tunnel syndrome. A specific manifestation found in the 2nd-3rd trimester in nearly 20% of pregnant women is called tunnel syndrome. The cause of this disorder is swelling of the soft tissue of the hand and compression of the carpal tunnel of the nerves that go to the fingers. In addition to pain in the small joints of the hands, patients also complain of skin numbness, tingling and crawling sensations. The condition improves when the arm position is raised.

Fat

In overweight people, pressure on cartilage tissue increases, causing the cartilage to wear out faster. The degenerative-dystrophic process often involves the large joints of the lower limbs and the intervertebral joints. The disorder increases as obesity progresses. Discomfort in the joints first manifests itself in the form of pain without fever at the end of the day, then the cartilage is increasingly destroyed, leading to the development of joint deformities, spondylosis, and osteoarthritis accompanied by pain syndrome. limits the patient's motor activities.

Acute infection

Body and joint pain is one of the early signs (signs) of many viral acute respiratory infections. The main cause of joint discomfort is intoxication of the body due to the spread of viruses and bacteria, the accumulation of toxins and the development of the inflammatory process. Usually patients complain that the whole body aches, mild and moderate pain is noted in both joints and muscles and bones. This symptom is accompanied by weakness, fatigue, insomnia and frequent awakenings. Simultaneously with signs of general pain and discomfort, chills and hyperthermia are observed.

The most obvious pain in the joints and body is when you have the flu. Up to 50% of patients have constant pain in the legs, arms and trunk. The intensity of the pain is so high that it is difficult for a person to perform the simplest actions - get out of bed, go to another room, get a glass of water. The situation is aggravated by high temperature (fever) and severe headache. Sore throat and stuffy nose occur after a few hours or even days. Less joint discomfort occurs with parainfluenza, an adenovirus infection.

Joint pain can occur with acute infectious lesions in the digestive tract - food poisoning, salmonellosis. Joint pain of varying intensity appears suddenly several hours after eating contaminated food and is associated with a sharp increase in temperature, chills and headache. Pain is preceded by nausea, vomiting, abdominal pain, foul-smelling diarrhea with mucus and sometimes blood.

Collagenose

Joint pain is a precursor to most diseases that occur due to autoimmune inflammation of connective tissue, including joint tissue. The location, prevalence, and intensity of the discomfort are determined by the characteristics of the specific collagen disease. The general pattern is the involvement of certain joint groups in this process, a gradual increase in sensation to severe pain to the point of debilitation, observed first with movement and then withrest. Deformity of the arthritic joints is possible. The main systemic inflammatory causes of the disorder:

• Rheumatism. Symptoms of "unstable": soreness and then pain in the large joints of the arms and legs - elbows, shoulders, hips, knees, ankles. The affected areas are swollen. Joint discomfort often precedes sore throat. With treatment, changes in the joints can be reversed.
• Rheumatoid arthritis. Discomfort often appears after 40 years. Typical pain in the small joints of the hands and feet, combined with marked swelling and stiffness of movement in the morning. In the future, pain and curvature of the joint will appear.
• Systemic scleroderma. It is characterized by localized changes in pain, the presence of morning stiffness in the joints of the hands, elbows and knees. Pain is often symmetrical. The swelling is short-lived. Due to scleroderma, the mobility of joints is limited, tendon damage causes a feeling of friction when moving.

Osteoarthritis

Pain syndrome in the early stages of the disease is mild and is considered discomfort and pain in the joints of the legs and less commonly in the arms. The direct cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Usually, a feeling of convulsions or pain without fever appears in adulthood and old age. Pain may begin earlier when there are occupational hazards (vibration, heavy manual labor). Gradually, the joints become stiff, the patient feels severe pain, has difficulty walking and takes care of himself.

Metabolic disorder

The cause of metabolic disorders causing joint pain is due to insufficient supply of vitamins and minerals, rapid accumulation or excessive excretion of metabolic products. Discomfort is caused by inflammatory or dystrophic processes, has varying degrees of severity and is often a manifestation of pathological conditions such as:

• Osteoporosis. When calcium is washed out of bone tissue, the joint surface of the bone becomes fragile, the cartilage becomes thinner, accompanied by pain. The pain syndrome gradually increases from mild aches to severe joint pain, combined with bone discomfort and muscle weakness. The joints that bear the maximum load are most often affected - hips and knees; Shoulders, elbows and ankles are less affected.
• Gout. Mild pain in the big toe is a concern in the preclinical stages of the gout process. There may be uncomfortable pain in the knees, elbows, wrists and fingers. Accumulation of urine in the joint cavity leads to rapid manifestation of the disease with a change from pain to acute joint pain that does not subside within a few hours. The affected joint is hot to the touch. Red skin and limited movement.

Cancer

In acute and chronic leukemia, widespread bone and joint pain, followed by pain, often occurs even before noticeable pathological changes in general blood tests and clinical symptomsother - general malaise, night sweats, fever, loss of appetite, bleeding. The unpleasant feelings are initially painful, then continuously strong, causing the patient to become debilitated.

Hodgkin's lymphoma and lymphogranulomatous disease are characterized by a combination of joint pain with muscle discomfort, weakness, enlarged lymph nodes and other lymphadenopathy. Pain is common, usually moderate in severity. Soreness in the knee joints and thigh muscles of short duration, which intensifies at night and with exertion, transforms into increasing pain and lameness, observed in osteosarcoma. Other joints are less affected by this disease.

Joint injury

Joint pain occurs due to minor trauma, causing damage to the ligaments around the joint and bruising of the soft tissues in the joint area. More severe pain occurs when joint cartilage is damaged. This symptom is clearly related in time to a blow, a fall or an awkward movement. Usually, discomfort is felt in one affected joint, rarely spreading to neighboring areas of the body.

Chronic infectious process

A possible cause of joint pain that occurs without fever or with a mild fever is a long-term infection. In patients with chronic infectious and inflammatory diseases, joint discomfort becomes a consequence of intoxication of the body or the direct damaging effect of microorganisms on joint tissue (usually streptococci, mycoplasmas, chlamydia). The appearance or intensification of pain may indicate exacerbation of chronic tonsillitis, sinusitis, genital tract infection, adnexitis, pyelonephritis.

Distinctive features of joint pain in common chronic infections that occur with intoxication are moderate joint discomfort, gradual development, and cyclical intensification and weakening of symptoms. . In patients with hematogenous tuberculosis and osteomyelitis, the basis for the development of painful sensations is an increase in temperature to a level below the level of fever, general malaise - fatigue, weakness, attenuate. Without treatment, the patient's condition will gradually worsen.

Complications of drug treatment

Taking certain medications can be complicated by moderate soreness and pain in the small joints of the hands. The discomfort is not accompanied by redness or joint deformity. Patients may complain of muscle pain, fever, skin rash and other manifestations of drug allergy. Discomfort quickly disappears after stopping the drug that caused the discomfort, and special treatment is less likely to be needed for complications that arise. Aches and mild joint pain are caused by:

• Antibiotics: penicillin, fluoroquinolone.
• sedative: phenazepam, diazepam, lorazepam, etc. v.
• Birth control pills: combined oral contraceptives (COC).

Rare cause

• Inflammation of the respiratory system: pneumonia, bronchitis, tracheitis.
• intestinal disease: non-specific ulcerative colitis, Crohn's disease.
• Skin diseases: Psoriasis.
• Endocrine disorders: diabetes mellitus, diffuse toxic goiter, hypothyroidism, Itsenko-Cushing disease.
• Autoimmune process: Hashimoto's thyroiditis, vasculitis.
• Face damage: necrotizing fasciitis in the recovery phase.
• Congenital defects of bones and joints.

Survey

To determine the reason why there is pain in the joints and bones, it is necessary to consult a therapist or family doctor, who will conduct an initial diagnosis and prescribe examination by specialized specialists. . Taking into account the nature of the unpleasant sensation, the speed of its appearance and accompanying symptoms, the following are recommended to determine the cause of the disorder:

• Laboratory blood test. It is necessary to evaluate the white blood cell count and ESR level to rule out infection, inflammatory processes and cancer. In systemic diseases, it is important to measure total protein levels, fractions of proteins in the blood, specific acute phase proteins, markers of rheumatoid arthritis and other inflammatory diseases. Testing vitamin, electrolyte (especially calcium) and uric acid levels helps diagnose metabolic disorders.
• Check for bacteria. Bacterial culture is necessary if pain in the joints and the whole body is likely to be infectious. Urine, stool, sputum, and secretions from the genitourinary tract were collected for study. To choose an antibiotic treatment regimen, antibiotic sensitivity is determined. In doubtful cases, microscopy and culture are supplemented with serological reactions (RIF, ELISA, PCR).
• Joint ultrasound. It is often used to clearly identify painful sensations and the suspected presence of rheumatic diseases. Ultrasound of the joint allows us to examine its structure, determine the destruction of cartilage and bone, preclinical inflammatory changes and study the condition of the soft tissues around the joint. The advantages of the method are accessibility, non-invasiveness and high information content.
• X-ray technique. Changes in the width of the joint space, stiffness of soft tissues, presence of calcifications, osteophytes and erosion of the joint surface are detected during arthrography. To improve diagnostic efficiency, special techniques are used - contrast arthrography, tracheography. In the early stages of damage, computed tomography (MRI, CT joint) is considered more indicated. Bone density can be conveniently assessed by densitometry.
• Invasive examination techniques. In some cases, to determine the cause of joint pain, aspiration is performed with a biopsy of the cartilage, the inner lining of the synovium, and the tophi. Morphological analysis of biopsy specimens and examination of synovial fluid reflect the nature of pathological processes occurring in the joints. Simultaneous collection of materials with visual inspection of the joint cavity is conveniently performed during arthroscopy with tissue biopsy.

A less common way to diagnose the cause of joint pain is a scintigram with the introduction of technetium, which accumulates in the affected tissues. In recent years, there has been increasing interest in joint thermography as a modern non-invasive method for detecting inflammatory diseases, tumors and circulatory disorders in joints and periarticular tissues. If the number of formed elements in the clinical blood test is reduced, extra-articular bone puncture will be performed. Patients with joint pain without fever should consult a rheumatologist and orthopedic surgeon.

Treatment

Help before diagnosis

For joint pain associated with physical activity, no special treatment is required; long-term rest in dosage is enough. Joint discomfort that occurs during pregnancy usually goes away on its own after pregnancy or is overcome by weight control and vitamin and mineral supplementation. Elderly and obese patients should change their lifestyle: adequate physical activity, a diet with appropriate calorie content with a sufficient content of plant foods.

Aching bones, joints and muscles, combined with general malaise and fever, aching and pulling sensations that increase to the point of severe pain and the development of persistent pain are signs that a doctor should be consulted. To reduce joint discomfort caused by ARVI, it is recommended to rest, drink enough water, wild rose water and dried fruits. Until serious diseases causing joint pain are ruled out, self-medication with pain relievers, compresses, ointments, decoctions, etc. v. Long-term failure is unacceptable.

Conservation therapy

You can get rid of joint pain with the right treatment, aimed at eliminating the cause of the disorder and the individual parts of its development mechanism. Treating the underlying cause is often supplemented with symptomatic medications that rapidly reduce the severity of persistent pain and tenderness. Treatment regimens for diseases that cause joint pain may include:

• Antibiotics. Basic therapy for infections is based on prescribing antibiotics to which the pathogen is susceptible. In severe cases, broad-spectrum drugs are used until the sensitivity of the microorganism is determined.
• Nonsteroidal anti-inflammatory drugs. They reduce the production of inflammatory mediators and thereby inhibit the inflammatory process in the joints. By acting on central pain receptors, they reduce the level of discomfort in the joints. Used in tablet, ointment, gel form.
• Corticosteroids. They have powerful anti-inflammatory effects. Hormonal therapy is the basis for the treatment of systemic collagen diseases. In severe and drug-resistant forms of the disease, corticosteroid drugs are combined with immunosuppressants to enhance the effect.
• Chondroprotectors. They act as a substrate for the synthesis of protein glycans, a sufficient amount of which increases the elasticity of joint cartilage. Nourishes cartilage tissue and restores its damaged structure. Medication can be injected into the joint.
• Xanthine oxidase inhibitors. Used as an anti-gout medicine. They block the key enzyme necessary for the synthesis of uric acid, thereby reducing its concentration in the body and promoting the dissolution of existing urate substances.
• Vitamin-mineral complex. Recommended for treating joint pain caused by metabolic disorders. The most commonly used drugs contain calcium and vitamin D. They are also a component of complex therapy for inflammatory and metabolic diseases.
• Willow medicine. They serve as the basis for most treatment regimens for various types of hematological cancers. Depending on the clinical variation and severity of the new treatment course, they are combined with radiotherapy and surgical interventions.

Physical therapy

Once the exact cause of the pain has been determined and acute inflammation has subsided, patients, except those with cancer, will be prescribed physical therapy and exercise therapy. Therapy sessions with microwaves and ultrasound, electrophoresis, and pulsed current have good anti-inflammatory and pain-relieving effects. In case of chronic pathologies, physiotherapy treatment is carried out for several months and supplemented with spa therapy.