Joint pain: causes and treatment

Symptom: joint pain.

Possible causes: trauma, arthritis, arthrosis, osteoarthritis.

Doctor: the therapist records the complaints, sends them for examination and based on his results will refer the patient to a doctor of specialization.

Treatment: individually prescribed in each case.

Prevention: reducing the load on the joints, maintaining a healthy lifestyle, timely examination by a doctor, diet.

Why do joints hurt?

Joints can hurt for two reasons: arthritis, inflammation of joint tissues or arthrosis (osteoarthritis), degenerative-dystrophic process, ie destruction of bone and cartilage elements of the joint. The diagnosis should be made by a doctor, but you can move the symptoms yourself.

Inflammation in arthritis is like a forest fire: it all starts violently, the joint swells and hurts a lot even at rest, and when you try to make the slightest movement, the pain intensifies. The skin in this area becomes red and becomes hot to the touch.

With osteoarthritis, everything is different: the joints are initially slowly and imperceptibly destroyed. Joint pain, initially mild, painful, occurring only during movement, quite bearable, increases with time, becoming constant and strong enough to disturb peace and sleep. The insidiousness of this pain is that it is delayed in relation to the pathological process that takes place in the joint and occurs only when X-ray images show signs of destruction of the corresponding joint, unfortunately, irreversibly. It is the proliferation of spines (marginal osteophytes) along the edge of the articular surfaces of the bones that make up the joint, the narrowing of the joint space and the signs of osteosclerosis - areas of pathological increase in bone density. If osteoarthritis affects one joint, say a knee, the biomechanics change and the function of the adjacent joints - the hip joint and the joint - is disrupted. They experience an increased and at the same time unequal load and, as a result, they wear out faster. Thus, osteoarthritis affects joint after joint, and the pain intensifies and can spread to all new joints.

Types of pain

The type and nature of feelings of pain depend on the cause that caused them.

Joints hurt with flu and acute respiratory infections in the background of high temperature (up to 40 ° C). This pain goes away on its own as soon as the temperature normalizes and does not require special treatment.

For arthritis pain:

• sharp,
• painful,
• pulsating
• shooting,
• occurs at rest and intensifies when performing certain movements,
• giving to neighboring areas,
• when probing (palpation) it hurts everywhere, on the entire surface of the joint, but especially along the joint space.

Periarthritis is especially unbearable - inflammation of the tissue around the joint (its sacs, tendons and ligaments). How it all happens can be explained by the example of the shoulder joint. First, the joint begins to hurt. The pain very quickly becomes excruciating, almost unbearable. It betrays the shoulder blade and neck area, intensifies (and is often accompanied by crunch) when you try to extend your arms to your hips at shoulder height or bend them at the elbow and bring them behind your back. At the end of the collarbone, which rests on the shoulder joint in front, and in the same place on the back there is pain. When you press them with your finger, the pain increases. With such acute sensations, the joint needs immobilization - the hand should be hung on the scarf, try not to move it. This is a basic condition for successful treatment.

Bitan! appropriate analgesic and anti-inflammatory therapy should be selected as soon as possible after examination. This will reduce the severity of inflammation of the joints, reduce pain and improve the quality of life.

In osteoarthritis, joint pain is different:

• The pain is initially mild and inconsistent, its character is wavy - in certain periods it is absent for weeks or even months. But over time, without treatment, the waves of pain become stronger and more frequent, and the gap between them narrows.
• Pain at the beginning: the explosion occurs on the first attempt to step, raising the arm, bending. Then the joints seem to be developed and the pain is relieved.
• Mechanical rhythm - the joint starts to hurt when you load it. In the beginning, the pain appears with heavy loads - lifting weights, running up the stairs, long walks, playing sports. Later, even minor movements resonate with the pain. But at the same time, unlike the unpleasant sensations in arthritis, the pain in arthrosis disappears when you rest the joint and give it peace. That’s why doctors talk about the mechanical rhythm: movement causes pain, and rest relieves it.
• Night discomfort. There is no pain at rest as such, but lying is uncomfortable, you want to change your posture all the time, find a position where you could forget about your joints and spine, but it doesn't work. Joints hurt, and that's it! Morning shackles: woke up, no pain yet, but it was as if you were chained or tightly wrapped - the joints do not obey, but the feeling of stiffness gradually disappears, the range of motion in the joint is restored.
• Protective posture. When the joint hurts, you want to take the so-called analgesic - analgesic position, in which it becomes easier. This is best seen in the example of the spine: it also consists of joints. When one of them gets stuck, and with it the nerve root, enters the bone defect, acute sciatica-based pain occurs. Anyone can diagnose sciatica after seeing how distorted the poor man is. In fact, with the help of this "distortion", supported by muscle spasms, the body tries to reduce the pain to a minimum.

Osteoarthritis of the hip and knee

Pain with a hip joint lesion (and most often suffers on one side) is localized in the upper thigh and radiates to the knee. He usually starts to get sick in the second half of the day, when he has already worked quite a lot. The pain increases with walking, and at rest it weakens and disappears.

The knee joints most often suffer from both at once. They bend easily and begin to ache when bent. The so-called stair symptom is characteristic of a knee lesion. Getting off it becomes more painful than climbing; patients do this by turning to the side. Sometimes the joint is a wedge in a bent position due to the growth of a bone (osteophyte) or its fragment (such a "lost" fragment of bone inside the joint is called a "joint mouse"). Joint block is accompanied by increased pain when trying to bend or straighten.

Knee mobility problems are not always associated with arthritis. Sometimes joint bruising can be "fake. " Among the most common causes of pseudoblock knees are:

• Edema (excess fluid in the joint capsule can interfere with full flexion and extension of the joint).
• Inflammation (inflammation of the tissues in the knee, such as rheumatoid arthritis and gout).
• Irregular movement of the knee cap at the joint (followed by severe pain).
• Irritation of the tissues lining the joint.
• Knee injury (Any serious knee injury, like a sprain, can cause a muscle spasm).

Bitan! If the joint is stuck, active movements in the joint are impossible, it is necessary to seek medical help from an orthopedic traumatologist as soon as possible - ambulance, clinic, hospital. Don't hesitate to call an ambulance - this is a good reason to call her, because you won't go far on one leg, and you won't even get to the clinic on your own.

Diagnosis

According to the nature of the pain and the appearance of the affected joint, a preliminary diagnosis (arthritis or arthrosis) can be made even by a non-specialist. But hurry to the district clinic to confirm the assumptions!

Which doctor should I go to?

In case of joint pain, you should make an appointment with a local therapist. It performs the functions of a medical dispatcher: it records complaints and clinical symptoms, directs the patient to an examination and, based on his results, decides which doctor will consult each individual patient. A wide range of experts are involved in maintaining joint health:

• arthrologist.
• orthopedic traumatologist.
• rheumatologist.
• vertebrologist (if the joints of the spine are affected).
• podiatrist (when it comes to the ankles).
• surgeon.
• oncologist.
• neurologist (if the joint has already been treated but the pain remains in it).
• dietitian (if the joints hurt due to metabolic disorders, such as gout or if he is overweight).

What tests to pass and research?

The examination begins with the simplest - clinical (from the finger) and biochemical (from the vein) blood test for signs of inflammation, as well as a general urine test. In some joint diseases, the kidneys are involved in the pathological process. Excess uric acid in the urine may indicate gout as a cause of joint disease.

A laboratory study of the synovial fluid located inside the joint helps to detect the inflammatory process and clarify its nature. They are obtained by puncture of the joint capsule - puncture. If necessary, histological examination of a fragment of the synovial membrane lining the joint cavity from the inside is performed.

A proven diagnostic method is an X-ray of the joint in two standard projections. It will help visualize joint narrowing, bone growths, osteoporosis and osteosclerosis (areas of reduced and increased bone density).

Currently, comprehensive information on the condition of the joint is provided by magnetic resonance imaging.

What joint diseases can cause pain?

There are more than a hundred such diseases. In the elderly, arthrosis is widespread, and in the young, rheumatoid arthritis and injuries (bruises, fractures, ligament injuries).

"Together with arterial hypertension, which is usually called hypertension, joint diseases are on the list of the most common reasons for seeking medical help. And the chronic pain that patients experience at the same time and because of which they cannot fully live and work is not only a medical, but also an important social problem, - says the doctor of medical sciences, professor in the department of rheumatology. - Of all joint diseases, arthrosis is the most common. 97% of people over the age of 65 suffer from this disease. And if we talk about chronic inflammatory diseases of the joints - arthritis, here rheumatoid arthritis comes to the fore. It is also not a gift, and not just because of the pain syndrome: within 3-5 years after onset, this type of arthritis inevitably ends with the assignment of a disability group to the patient. "

How to urgently get rid of joint pain?

Analgesics are able to quickly overcome pain: pain can in no case be tolerated if you do not want it to go from acute to chronic. This metamorphosis can happen very quickly - in 3-4 weeks, so resolving joint pain should be an urgent task. The joint starts to hurt as soon as you stress it. Therefore, in case of pain, a nonsteroidal anti-inflammatory drug (NSAID) with good analgesic effect should be taken half an hour before any physical activity.

If the joint pain worsens at night, in addition, before going to bed, the doctor will recommend taking metamizole sodium, as well as drotaverine with nicotinic acid to improve local blood circulation.

Local therapy

NSAIDs have a terrible side effect - they can cause damage to the gastric mucosa all the way to the formation of ulcers, so they try to apply them locally, as part of all types of ointments and gels with anti-inflammatory and analgesic properties. They are usually rubbed into the skin over the affected joint twice a day. The pain is also relieved by special patches with magnetic powder, which are glued to the wrist or spine.

What happens if the joints are not treated?

If left untreated, joint disease can lead to loss of freedom of movement and disability. If one or more large joints are affected, they can be replaced with artificial ones. Multiple joint damage (polyarthritis) is usually the result of a general disease of the body, for example, psoriasis. In this case, it is all the more dangerous to start the disease, because it progresses quickly and can cut off your life quite quickly.

Conclusion

Joint pain is known to almost everyone, and it occurs for two main reasons - due to inflammation (arthritis) or destruction of bones and cartilage (arthrosis). It is interesting that the joints of the arms and legs hurt in different ways. On the upper limbs, unlike the lower ones, it is usually not the joints themselves that are affected, but the surrounding tissues (tendons, ligaments, sacs). The reason for this is the different type of load experienced by the arms and legs - dynamic or static. Joint pain should be fought from day one: the prospect of disability in the next 10-15 years will delight very few people. As part of the prevention of joint disease, it is important to lose extra pounds to reduce stress on the joints, and to cope with concomitant pathologies (allergies, diabetes mellitus).