Joint pain (joint pain) is a very common problem that can be related to infection or toxicity, injury, inflammation, or cartilage deterioration.
In most cases, joint pain goes away on its own within a few days. However, some situations compel you to see a doctor as soon as possible. It is not easy even for an experienced therapist to pinpoint the exact reason why the joints are painful, as early symptoms can be deceiving and the full picture of the disease is sometimes revealed. within 1-2 months or more.
The information in this article will help you navigate the types of diseases and conditions that cause joint pain. And modern diagnostic methods will allow you to determine the exact cause of the disease and choose the right treatment strategy together with the doctor.
In this article, we will look at situations where many joints throughout the body are painful. Sometimes a person starts to hurt and other joints quickly step in. It happens that the pain seems to move from one part of the body to another for several days or weeks. Some diseases cause joint pain in the form of attacks - attacks, when the pain subsides and then reappears.
Joint pain due to viral infection
Most often, joint pain occurs with various viral infections: from the direct action of the virus on the joints or from the action of toxins that accumulate in the blood during the acute period of many infectious diseases.
Usually, the pain occurs in the small joints of the arms and legs, the knee joints, and sometimes the spine joints. The pain is not strong, aching. It's called joint pain. Mobility is usually not impaired, with no swelling or redness. In some cases, a hives-like skin rash can quickly go away. In most cases, viral arthritis becomes the first symptom of malaise and is accompanied by fever, muscle aches, and weakness.
Although general health is impaired, joint pain caused by viral illnesses is not usually a cause for concern. Relief can be provided by taking nonsteroidal anti-inflammatory drugs, drinking plenty of fluids, and resting. After a few days, the pain disappears and the function of the joint is fully restored. There are no irreversible changes in the structure of the joint.
Viral arthritis is characteristic of influenza, hepatitis, rubella, and mumps (in adults).
Reactive arthritis
This is a group of diseases where joint pain occurs after an infection, both viral and bacterial. The immediate cause of reactive arthritis is an error in the immune system, which causes inflammation in the joints, even though they are not affected by the infection.
Joint pain occurs more often than 1-3 weeks after acute respiratory infections, intestinal infections or diseases of the genitourinary system, for example, urethritis or genital infection. Unlike viral arthritis, joint pain is severe, accompanied by edema and impaired mobility. Body temperature may increase. Arthritis usually begins with the involvement of a knee or ankle joint. Within 1-2 weeks, pain in the joints of the other half, small joints in the hands and feet began to ache. Sometimes the joints of the spine are painful.
Joint pain usually goes away with treatment or goes away on its own, leaving no sequelae. However, some types of reactive arthritis are chronic and sometimes more severe.
Reiter's disease- one of the types of reactive arthritis that develops after a chlamydia infection and can progress to a chronic stage. Joint pain in Reiter's disease often precedes a violation of urination - a manifestation of chlamydial urethritis (urethritis), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment, you must consult a doctor.
Reactive arthritis can develop after adenovirus infection, genital infection (especially chlamydia or gonorrhea), intestinal infection associated with Salmonella, Klebsiella, Shigella, etc. v.
Joint pain when cartilage wears down
Diseases that are accompanied by gradual wear and tear of cartilage on the articular surface of bones are called degenerative. They are more common in people 40-60 years of age and older, but they also occur in younger people, such as people with joint injuries, professional athletes who regularly engage in high-intensity exercise, andin obese people.
Osteoarthritis deformity (osteoarthritis, DOA)- This is a disease of the large joints of the legs - the knee and hip joints, which bear a large load when walking. The pain comes gradually. In the morning, after rest, the state of health improves, and in the evening and at night after walking, running and other stress, the condition worsens. Inflammatory changes: edema, redness of the skin is usually not obvious and may be present only in severe cases. But often there are complaints of creaking in the joints. Over the years, the disease progresses. It is almost impossible to cure deformed joint disease, but only slow down the destruction of cartilage. To restore mobility, they have to resort to surgery.
Osteoarthritis of the spineAnother common degenerative disease. It is caused by the thinning of the cartilage between the vertebrae. The reduced thickness of the cartilage leads to compression of the nerves extending from the spinal cord and blood vessels, in addition to causing pain in the spinal joints. Examples: headache, dizziness, pain and numbness in the arms, shoulder joints, pain and interruptions in the heart, chest, pain in the legs, etc. . . Neurologists often deal with the diagnosis and treatment of osteonecrosis.
Autoimmune diseases cause joint pain
Autoimmune diseases are a large group of diseases, the causes of which are not fully known. All of these diseases are united by the specificity of the immune system: the cells of the immune system begin to attack their own tissues and organs, causing inflammation. Autoimmune diseases, as opposed to degenerative diseases, are more likely to develop in childhood or in young people. Their first manifestation is usually joint pain.
Joint pain is often variable: today one joint hurts, tomorrow another, the day after - a third. Joint pain accompanied by edema, skin redness, impaired joint mobility, and sometimes fever. After a few days or weeks, the joint pain goes away, but after a while it comes back again. Over time, joints can become significantly deformed and lose mobility. The hallmark of autoimmune arthritis is morning stiffness. During the first morning hours, the affected joints should be massaged for 30 minutes to 2-3 hours or more. The stronger the load on the joint the day before, the more time you need to spend on warming up.
Gradually, the symptoms damage other organs related to the joints: heart, kidneys, skin, blood vessels, etc. . . Without treatment, the disease will progress. It is not possible to cure it, but modern drugs can slow the process. Therefore, the sooner treatment is started, the better the outcome.
Rheumatoid arthritis is the most common autoimmune disease in which the joints are primarily affected: they begin to ache, turn red, and swell. Most often, the disease begins with pain in the small joints of the arms and legs: fingers, joints of the hands or feet, less often - with the loss of a knee, ankle or elbow joint, afterthat pain in other parts of the body involved.
Systemic lupus erythematosus- a rarer disease, young women are prone to. It is characterized by flying pains in various joints of the body, deformity of the fingers, the appearance of a rash on the skin, especially on the face - redness on the forehead and cheeks in the shape of a butterfly. Arthralgia may be accompanied by disruption and discomfort in the heart and chest, low-grade fever, weakness, weight loss, increased blood pressure, back pain, edema.
Ankylosing spondylitis- unlike lupus, it more commonly affects men. The disease begins with pain in the joints of the spine, lumbar region, sacrum, pelvis. Gradually, the pain spreads to other parts of the spine. In addition to pain, stiffness, decreased flexibility, and over time, gait disturbances and complete immobility in the joints of the spine are characteristic. In its early stages, ankylosing spondylitis can be easily confused with osteonecrosis. However, the first disease develops in young men and the second in older people. As a diagnostic test, an X-ray is taken of the sacrum, where the spine and pelvis meet. Based on the results of the study, the doctor can confirm or deny the diagnosis.
Joint pain with psoriasis
Psoriasis is a skin disorder in which a characteristic red rash occurs on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and feet, less often the spine, are often painful and swollen. The distinguishing feature of arthritis in psoriasis is the asymmetrical lesion. The skin over the joints may be bluish-violet and the nails may be damaged. Over time, deformities and lower part of the joint develop (the fingers begin to bend in an atypical direction).
Joint pain with rheumatism
Rheumatic fever (acute rheumatic fever) is a serious illness caused by strep bacteria. Rheumatoid arthritis is characterized by very severe pain in the large joints of the legs and arms, appearing 2-3 weeks after a sore throat or scarlet fever. It develops more often in children. The pain is so intense that you can't touch the joint, can't move. The joints swell, turn red, and the temperature rises. Some joints are sore first, then others, usually symmetrically. Even without treatment, the pain goes away on its own and joint function is fully restored. However, after a while, severe symptoms of heart damage appear. Rheumatoid arthritis requires urgent medical attention. Only timely treatment can prevent damage to the heart and other organs.
How to examine painful joints?
There are many different ways to diagnose joint pain. As a rule, they are used in combination.
Blood tests- is one of the most common tests for complaints of joint pain. With the help of this study, it is possible to determine the presence of inflammation or suggest a degenerative nature of the disease, identify signs of infection and use immunoassays or polymerase chain reaction methods. (PCR), to accurately identify the causative agent in cases of infectious or reactive arthritis. Blood tests show possible metabolic disorders, the condition of internal organs.
Synovial fluid study- joint surface washing liquid. With its help, the joint surfaces are nourished and friction is reduced during movement. According to the composition of the synovial fluid, the laboratory assistant makes conclusions about the presence of inflammation or infection in the joints, the processes of destruction and nutrition of cartilage, the accumulation of salts that can cause pain(eg, with gout). Synovial fluid is obtained for analysis using a needle, which is inserted into the joint cavity after local anesthesia.
Joint X-ray and computed tomography (CT) scan- a method that allows you to consider the structure of the bony parts of the joint, and also indirectly judge the condition of the cartilage by the size of the joint cavity - the distance between the bones in the joint. X-ray examination is prescribed among the first methods for joint pain. X-rays show mechanical damage to the bone (fractures and cracks), joint deformities (dislocations and dislocations), the formation of foci or bone defects, bone density, and other criteria that helpYour doctor determines the cause of your joint pain. Computed tomography is also an X-ray study. With a CT scan, the doctor receives a series of layer-by-layer images of the joint that, in some cases, provide more complete information about the disease.
Joint ultrasound and MRI- methods that are different in nature, but similar in purpose. With the help of ultrasound or magnetic resonance imaging, information about the condition of the soft tissues of the joints and cartilage can be obtained. Ultrasound and MRI reveal the thickness of the cartilage, its defects, the presence of foreign impurities in the joint, and also help determine the viscosity and amount of synovial fluid.
Arthroscopy- method of visual examination of the joint by means of a microsurgery instrument, which, after anesthesia, is inserted into the cavity of the diseased joint. During arthroscopy, the doctor has the opportunity to visually examine the internal structure of the joint, note the damage and its changes, and remove fragments of the joint's synovial membrane and other structures. other of joints for analysis. If necessary, after the examination, the doctor can immediately carry out the necessary treatment. Everything that happens during arthroscopy is recorded on a disc or other storage medium, so you can consult with other specialists once it's done.
Joint treatment
If you have joint pain, find a good therapist or pediatrician for children. Your doctor will make an initial diagnosis and, if necessary, refer you to a specialist for treatment. If the joint pain is related to the dryness or arthritis, the treatment will most likely be provided by the rheumatologist here.
If the cause of joint pain is an inflammatory response, the medications used to treat the joint can reduce inflammation. First of all, here are non-steroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and many others. If these drugs are not effective enough, drugs from the corticosteroid group are prescribed in the form of injections into the joint cavity or tablets. When an infection is causing the pain, antibiotics will be given.
Special treatment regimens are used for autoimmune diseases. For continued physician admission, the minimum effective dose is chosen that can either suppress the inflammatory response or suppress the immune system. Examples: sulfosalazine, methotrexate, cyclophosphamide, azathiaprine, cyclosporine, infliximab, rituximab, and others.
For degenerative joint diseases (osteoarthritis, degenerative joint disease), there is still no known specific drug. Treatment of diseased joints includes prescribing anti-inflammatory and analgesic drugs during exacerbations, as well as taking chondroetin sulfate and hyaluronic acid-based metabolites. Although the effectiveness of the latter drug is not currently recognized by all doctors.
If the function of the joint is irreversibly impaired, they must resort to surgery. Currently, there are various endodontic methods that allow the implantation of artificial joints or parts thereof instead of damaged or worn joints.