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 of special importance due to the prolongation of life expectancy: according to epidemiological studies, joint pathology in people older than 40 years is found in 50% of cases, and after 70 years - in 90% of the population.
Joint pain, or arthralgia (Greek arthron - "joint" and algos - "pain") can be seen in various diseases - metabolic, rheumatic, tumor, systemic and acute infectious, endocrine and rheumatic. It is therefore wrong to believe, and so do the vast majority of people who suffer from arthralgia and who self-medicate, that joint pain is necessarily caused by arthritis. It should be clarified here that there are dozens of types of arthritis alone and that not all 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. For joint pain of any intensity, but of sufficient duration, a medical examination is mandatory.
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 minor pain. In an emotionally unstable person, the pain threshold is lowered. Pain in intensity and time is diametrically opposed and is characterized as follows:
- tolerant - unbearable;
- weak - strong;
- sudden - constant;
- boring - sharp;
- frequent - rare;
- short-term - long-term, etc.
If persistent pain torments a person for more than 30 days, it is considered chronic. After treatment, they disappear for a while (remission phase), and then reappear (exacerbation phase). The provoking factor in the return of acute pain is hypothermia, physical activity, malnutrition, excess weight, stress.
There are several risk factors that can lead to disease. One of the most common is heredity. If, for example, grandma and mother suffered from several groups of joints at the same time, then sooner or later this problem may appear in future generations.
Gender is another risk factor. It has been noticed that joint diseases are several times more common in women than in men. In this case, women are more likely to get sick after the onset of menopause. This is due to the fact that before him, women were "protected" by their own female sex hormones. With age, their number begins to decline relentlessly, and after they practically disappear, there is no one to protect the woman, and the joints begin to gradually deform and collapse. In men, this problem practically does not occur. Therefore, their joints, due to the violation of the hormonal background, hurt a little less often than in women.
In men, joint pain occurs mainly due to hard physical work. This is due to the fact that they are constantly under a 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 diseases such as tonsillitis may complain that their joints are starting to ache. This is due to the fact that the bacteria that cause angina can also negatively affect the joints, especially large ones. The causes and treatment of pain in all joints of the body are closely related.
Common symptoms of arthralgia
It seems that the presence of the disease is easy to determine - by the painful symptoms. but:
- The presence of pain does not always mean the presence of disease, because pain can be caused by bruising, one-time (sharp) physical overload, sprain and similar reasons.
- If you already have some kind of disease, its symptoms may not be noticeable at first, because pain, especially acute, is usually a serious manifestation of the disease.
Early signs of arthralgia that appear before the pain may be:
- stiffness of movement, more often in the morning or after a long sitting in one position;
- periodic creaking and creaking 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 cause everything that forms it: muscles, bones, ligaments, cartilage, tendons, intra-articular cavities. Such pathological conditions as inflammation, sprains, ruptures, and metabolic disorders occur in the structures of the joints. The causes of arthralgia can be very diverse. For some diseases have not yet been precisely identified.
In summary, the following can be distinguished:
- physical inactivity and sedentary lifestyle;
- excessive, frequent and monotonous physical activity;
- old injuries;
- reduced immunity;
Arthralgia occurs as a result of irritation of neuroreceptors, which are found in all joint structures, by various factors, depending on the underlying disease. One of the causes of joint pain can be a bruise on the joint and the formation of a hematoma that is not visible to the eye. By the nature of painful sensations, the presence of one or another pathology can be assumed.
Diseases that cause joint pain
Osteoarthritis is the most common chronic joint disease (often hip, knee, interphalangeal wrist joints) based on degenerative-dystrophic disorders (metabolic disorders) of articular cartilage, bone tissue, synovial membranes and ligaments. joint (age, overweight, metabolic disorders, injuries, vitamin C and D deficiency, occupational hazards).
Reiter's disease (a separate type of reactive arthritis with a genetic predisposition) - manifests itself after chlamydial or intestinal infection. It is manifested by reactive arthritis (mainly of the lower extremities), joint pain, characteristic extraarticular manifestations (urethritis or prostatitis, conjunctivitis or uveitis, skin and mucous membrane lesions - ulcerative stomatitis, erosive balanitis), damage to the cardiovascular system, arthritisfever (38, 6 - 40, 0).
Rheumatoid arthritis is a chronic progressive systemic inflammation of the connective tissue (autoimmune inflammation in the joint). Small joints of the hands and feet are affected, less often the joints of the knees and elbows. 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, the worsening of arthritis coincides with the exacerbation of psoriasis. Symptoms. Joint pain (mainly the interphalangeal joints of the hands and feet are affected), purple-cyanotic skin with swelling in the joint area, asymmetry of joint damage, pain in the lumbosacral spine, heel pain (thalalgia), psoriasis skin plaques, nail damage (brittleness, striation)and clouding of nail plates).
Bursitis - this disease is often confused with arthritis, although bursitis does not cause inflammation of the joints, but the joint sacs. Bursitis can cause discomfort, stiffness and pain in the joint area. Symptoms are associated with inflammation of the synovial membranes of the joints, usually caused by improper movement, compression, or trauma. More often bursitis develops in the area of the shoulder, knee or hip joint. One 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 metabolic disorders (eating disorders), or 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), light hyperemia (redness), swelling and peeling of the skin over the joint, fever, elevated local temperature in the affected joint, cutaneous manifestations in the ear shells, elbow joints, feet, hands, intofu form (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 painful joint pain (mostly small joints) while taking certain medications in high daily doses. It is not a disease and is not classified in the ICD-10 by the WHO. Groups of drugs that can cause drug-induced arthralgia are penicillin antibiotics, barbiturates and mild hypnotics and sedatives (chemical-based), antihypertensives, contraceptives and anti-tuberculosis 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 relation to functional joint disorders and individual drug tolerance.
The same can be said for meteopathic arthralgia (joint pain that occurs in meteopathic people who are sensitive to changes in atmospheric pressure).
Diagnosis of joint pain
Clinical blood test in most cases indicates different deviations depending on the nature of joint damage and its severity, an increase in ESR, which reflects the level of the inflammatory process, with a normal number of leukocytes, is characteristic of rheumatic diseases. An increase in the number of leukocytes in inflammatory diseases of the spine and joints may indicate the presence of foci of infection in the body, etc.
Immunological research. Of particular importance for the early diagnosis of rheumatoid lesions is rheumatoid factor, an antiglobulin antibody. It occurs in the lymph nodes, spleen, synovial membrane of lymphoplasmacytic cells. For the detection of rheumatoid factor in blood serum and synovial fluid, the Vaaler-Rose reaction is considered positive if the concentration is 1: 28 or higher. Rheumatoid factor is detected in 75-85% of patients with rheumatoid arthritis. In the early stages and in the seronegative form of rheumatoid arthritis, immunocytoadherence is used to isolate rheumatoid factor at the lymphocyte level.
The antistreptolysin O (ASL-O) test reflects immune reactivity to streptococcal infection. An increase in ASL-0 titers has been observed in patients with rheumatism, infectious-allergic polyarthritis.
Leukocyte migration inhibition reaction. Normally, leukocytes have the ability to migrate into the environment with the formation of conglomerates. If there is a sensitization of the organism to a certain antigen, then when the sensitized leukocytes meet with 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, determination of HLA B-27 is of great importance. The HLA complex is located in the cell membrane and is isolated by immune methods.
Immunoelectrophoresis - detects immunoglobulins of class A, G, M, which are of great importance for the development of the pathological process in rheumatoid arthritis.
Radiography is a reliable method for examining joints. In fact, without it, a doctor cannot make a diagnosis 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 radiological data with the clinical picture, duration of the disease and age of the patient.
Tomography allows you to more accurately determine focal lesions or individual segments of the spine.
Myelography is a contrast method for studying the spine, with the help of this method it is possible to clarify the localization of the pathological process, especially in cases when surgical intervention is required.
Intraosseous phlebography - to study venous blood flow in the epidural space. This method allows you to assess the state of blood circulation in the paravertebral space and indirectly about a possible degenerative lesion.
Arthroscopy is a research method that allows you to visually examine the structure of the knee joint and take a biopsy of the desired area, revealing the contours, color and capillary network of the synovial membrane, cruciate ligaments, meniscus and fat pad.
Discography - the introduction of a contrast agent into the intervertebral disc, followed by radiography, allows you to assess the condition of the intervertebral discs, 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 deeply located joint parts.
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 removal of joint pain inevitably must be supplemented by treatment of the underlying cause of arthralgia. But regardless of the identified cause of joint pain, as well as the lack of direct contraindications, doctors usually prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), which have the ability to relieve pain, swelling, hyperemia, fever, lowering temperature, reduce inflammation. .
Side effects of almost all NSAIDs are irritation of the gastrointestinal tract, because the drugs are made on the basis of acids, inhibition of platelet aggregation (reduction of blood clotting) and impaired renal blood flow (in renal failure). Otherwise, if there are no individual contraindications, and there is a desire to adhere to all the prescriptions of the doctor, NSAIDs are quite harmless.
But effective treatment of joint pain is not limited to taking NSAIDs, because after eliminating the primary or acute pain syndrome, it makes sense to switch to non-drug or homeopathic treatment, including some physiotherapy (SWT, magnetic therapy, ultrasound and electropulse therapy), exercise therapy, gymnasticsmanual therapy, swimming, etc. In addition, be sure to review your diet and diet.
Diet for joint pain
General dietary requirements for joint pain:
- limiting the content of carbohydrates, especially sugar;
- reduction (maximum) of table salt;
- fractional, frequent meals (5-6 meals a day);
- exclusion from the diet of spicy, salty foods, extracts (strong soups, fried foods), strong drinks, strong tea, coffee.
Dishes are prepared without salt, meat and fish - in cooked or lightly fried (after boiling) form; vegetables should be cooked well.
General dietary recommendations for joint disease:
- Soups - mostly vegetarian, as well as cereals, milk, fruit, weak meat or fish soups - 1-2 times a week.
- Meat or poultry varieties with low fat content - mostly in cooked or baked form. It is desirable to exclude the liver, tongue, brain, chickens, veal.
- Fish - various varieties, with the exception of salted and smoked.
- Soft-boiled eggs, omelets.
- Vinaigrettes and salads with vegetable oil from various vegetables, vegetables in the form of side dishes. Limit (to the exception) beans, peas, beans, spinach, sorrel.
- Fruit dishes, berries: any, limited grapes.
- Cereal dishes, dairy products are not limited.
- Fats: butter, vegetable (1/3 of the total amount).
- Sweets: sugar - up to 30 g per day (4 pieces), honey, jam, jam.
- Drinks: weak tea, coffee drink, vegetables, fruits, berry juices (except grapes). Alcoholic beverages are excluded.
- Spices, condiments: bay leaf, dill, primrose, cinnamon, cloves.
Therapeutic exercise (LFK)
Physiotherapy is prescribed at almost any stage of the disease. If physical exercises cause discomfort, then ointment, tablets or injections are prescribed to relieve the pain (depending on the situation). Exercise therapy is an exercise designed specifically to restore healthy joint mobility without damaging them. On the one hand, such exercises are gentle, on the other hand they make the necessary areas of the body "wake up". Physical education is also recommended for people at risk as a preventive measure.
Mostly, this is an Eastern practice, but today this method has already been adopted by official medicine and is successfully used in many private and public clinics. One problem: there are not so many professionals in this field who know their job well. Therefore, before you treat yourself in this way, we advise you to carefully consider the choice of a specialist. Acupuncture works on the body in a very interesting way. It is unlikely that they can completely cure arthralgia, but after a few sessions patients usually feel much better - all symptoms subside.
Manual therapy also does not tolerate amateurism and unprofessionalism. But if you reach a person who knows his job, you can rest assured - the results will be. With the help of manual therapy, you can eliminate muscle cramps in the problematic part of the body. Regularity is important in its application, procedures can be performed quite often - from 12 times a year or more. There are contraindications to manual therapy, including some types of worsening arthralgia! It is unacceptable to prescribe it to yourself, consult a chiropractor - he will tell you about the effective treatment in your case and choose the most appropriate methods.
Massage gives good results in combination with other therapies. In order to really properly affect the diseased joint, the masseur must have medical knowledge and experience in medical (therapeutic) massage.
This option is used in cases when surgery is simply not enough.
- Puncture. Or a mini-operation in which an 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 tissues from the joint cavity) using endoscopic instruments.
- Periarticular osteotomy. It is used if joint prosthetics are prohibited. The essence of the operation is to file the articular bones, and then connect them at different angles in order to improve mobility and reduce the load.
- Endoprosthetics. A radical treatment option with long recovery, in which the joint changes into a prosthesis.
Many methods have been invented to treat various joint pathologies. True, for the success of treatment you must first find an experienced specialist. Self-medication on this issue is categorically unacceptable!
Prevention of joint diseases
To preserve your joints, you must constantly protect them and engage in preventive work. After all, it is not in vain that people agree with the claim that the disease is easier to prevent than to cure. The first thing to do is to avoid hypothermia whenever possible, as it can lead to diseases such as tonsillitis. And it, in turn, can cause complications. By itself, hypothermia can lead to inflammation of several groups of joints at once.
Don't forget about physical activity! The load on the affected joints, of course, must be dosed, but it would be wrong to leave them immobile. Reasonable movement stimulates the production of synovial fluid, improves circulation and tissue nutrition. Swimming, cycling, therapeutic exercises will help maintain the working condition of your joints. In addition to physical education, you can be prescribed physiotherapeutic and rehabilitation measures, such as electrophoresis, therapeutic massage, mud baths, various body wraps, etc.
Both women and men must carefully monitor their weight, because being overweight is a direct path to deforming arthrosis of at least the knee and hip joints. In addition, you need to follow your drinking regimen. 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, the cartilage begins to rub, causing severe pain, and the joints begin to deform.