Joint pain: causes and treatment

Symptom: joint pain.

Possible causes: trauma, arthritis, arthrosis, osteoarthritis.

Physician: The therapist records the complaints, sends them for examination, and refers the patient to a physician with a narrower specialty based on his or her findings.

Treatment: prescribed individually in each case.

Prevention: reducing joint strain, maintaining a healthy lifestyle, timely medical examination, diet.

Why do joints hurt?

Joints can be painful for two reasons: arthritis, inflammation of the tissues of the joint or arthrosis (osteoarthritis), a degenerative-dystrophic process, that is, the destruction of the bone-cartilage elements of the joint. The diagnosis should be made by a doctor, but you can find your way around the symptoms yourself.

Inflammation of 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 perform even the slightest movement, the pain intensifies. In this area, the skin turns red and becomes hot to the touch.

In the case of arthrosis, everything is different: the joints die slowly and unnoticed at first. Joint pain, which is initially mild, painful, occurs only during movement, is quite tolerable, increases over time, and becomes constant and severe enough to disrupt peace and sleep. The insidiousness of this pain is that it is delayed compared to the pathological process in the joint and only occurs if the x-rays show signs of destruction of the corresponding joint, unfortunately, they are irreversible. It is the proliferation of spikes (marginal osteophytes) along the edges of the joint surfaces of the bones that make up the joint, narrowing of the joint space, and signs of osteosclerosis — areas of abnormal increase in bone density. When arthrosis affects a joint, such as the knee, the biomechanics change and the neighboring joints — the hip joint and the ankle — stop working. They experience an increased and at the same time uneven load and, as a result, wear faster. Thus, arthrosis affects the joint from one joint to another, the pain increases and can spread to all new joints.

Types of pain

The type and nature of the sensations of pain depend on the cause of them.

The joints hurt with flu and acute respiratory infections in the background of high temperatures (up to 40 ° C). This pain alone goes away as soon as the temperature returns to normal and does not require special treatment.

In case of joint pain:

• sharp,
• painful,
• pulsating
• shot,
• occurs at rest and increases when certain movements are performed,
• donation to neighboring areas,
• when probing, it hurts everywhere, on the entire surface of the joint, but especially along the joint space.

Periarthritis is particularly intolerable - inflammation of the tissues around the joint (bags, tendons and ligaments). That everything happens can be explained by the example of the shoulder joint. First, the joint begins to ache. The pain very quickly becomes excruciating, almost unbearable. This adds to the shoulder blade and neck area, intensifying (and often crunching) as you try to stretch your arms to the side at shoulder height or bend at the elbows and carry them behind your back. At the end of the clavicle, which rests on the front shoulder joint, and at the back, there are pain points in the same place. When you press them with your fingers, the pain increases. In case of such acute feelings, the joint should be immobilized - your hands should be hung on a cloth, try not to move. This is an essential condition for the success of the treatment.

Important! choose appropriate analgesic and anti-inflammatory therapy as soon as possible after the test. This reduces the severity of arthritis, reduces pain and improves quality of life.

In arthrosis, joint pain is different:

• The pain is mild and inconsistent at first, wavy in nature - absent for weeks or even months at certain times. But over time, without treatment, the waves of pain become stronger and more frequent, and the gaps between them narrow.
• Pain in the beginning: his explosion occurs on the first attempt, when he takes a step, raises his arm, bends down. Then the joints seem to have developed and the pain is relieved.
• Mechanical rhythm - the joint starts to hurt when loaded. At first, the pain comes with a heavy load - lifting weights, running up stairs, walking for a long time, playing sports. Later, even minor movements echo the pain. But at the same time, unlike the unpleasant feelings in arthritis, the pain in arthrosis goes away when it gives the joint rest, provides peace of mind. This is why doctors talk about mechanical rhythm: movement causes pain, and rest relieves it.
• Night discomfort. At rest, there is no pain as such, but lying is uncomfortable, you constantly want to change your posture, look for a situation where you could forget about your joints and spine, but that doesn’t work. The joints hurt and that's it! The morning clamp: woke up, no pain yet, but as if heavily chained or bandaged - the joints disobey, but the feeling of stiffness gradually disappears, the range of motion of the joint is restored.
• Protective posture. When a joint hurts, it wants to take on the so-called antalgic-painkiller 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 wedges and a nerve root enters the bone head with it, acute pain occurs based on sciatica. Anyone can diagnose a sciatic sufferer after seeing the poor person distorted. In fact, it is this "skew" that is supported by muscle cramps that the body tries to minimize pain.

Osteoarthritis of the hips and knees

The pain associated with changes in the hip joint (and most often 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’s worked hard enough. The pain increases while walking, weakens and disappears at rest.

The knee joints most often suffer from both at the same time. They bend easily and start to hurt when bent. A knee change is characterized by a so-called stairwell symptom. Descent will be more painful than climbing; patients do this sideways. Sometimes the joint wedges into a bent position due to a bone outgrowth (osteophyte) or a fragment of it (such a "lost" bone fragment within the joint is called a "joint mouse"). Joint obstruction is associated with increased pain when trying to bend or straighten.

Knee mobility problems are not always associated with arthritis. Sometimes joint wedging can be "fake. " The most common causes of pseudoblock knee are:

• Edema (excess fluid in the joint capsule can interfere with complete flexion and expansion of the joint).
• Inflammation (inflammation of the tissues of the knee, such as rheumatoid arthritis and gout).
• Improper movement of the patella in the joint (accompanied by severe pain).
• Irritation of the tissue lining the joint.
• Knee injury (any serious knee injury, such as a sprain, can cause muscle cramps).

Important! If the joint is blocked, active movements are impossible, you should see a doctor as soon as possible from an orthopedic traumatologist - emergency department, clinic, hospital. Don’t hesitate to call the ambulance - that’s a good reason to call because you don’t go far on either leg and you might not even get to the clinic yourself.

Diagnostics

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

Which doctor should I see?

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 for examination, and decides which doctor to consult with each patient based on its results. A wide variety of professionals 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 joints of the foot).
• 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 you are overweight).

What tests and research need to be performed?

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

Laboratory examination of the synovial fluid inside the joint helps to recognize the inflammatory process and clarify its nature. It is obtained by stabbing the joint capsule - stabbing. If necessary, a histological examination of a fragment of the synovial membrane lining the inside of the joint cavity is performed.

A proven diagnostic method is x-ray of the joint in two standard projections. It helps visualize joint space narrowing, bone outgrowths, osteoporosis, and osteosclerosis (areas with decreased and increased bone density).

Currently, magnetic resonance imaging provides comprehensive information on the condition of the joint.

What joint diseases can cause pain?

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

"Along with arterial hypertension, commonly referred to as high blood pressure, joint disease leads to the list of the most common causes of seeking medical help. And the chronic pain that patients experience at the same time and that make them unable to live and work fully is not only a medical problem, but also an important social problem, says a doctor of medicine, a professor in the department of rheumatology. - Of all the joint diseases, arthrosis is the most common. 97% of people over the age of 65 suffer from this disease. And when we talk about chronic inflammatory diseases of the joints - arthritis, here rheumatoid arthritis comes to the fore. It’s not a gift either, and not just because of the pain syndrome: within 3-5 years of its onset, this type of arthritis inevitably ends with the assignment of a group of people with disabilities to the patient. "

How to get rid of joint pain urgently?

Painkillers can overcome pain quickly: pain is by no means tolerable if you don’t want it to go from acute to chronic. This metamorphosis can occur very quickly - in 3-4 weeks - so getting rid of joint pain should be an urgent task. The joint starts to ache as soon as it causes stress on it. Therefore, in case of pain, a non-steroidal anti-inflammatory drug (NSAID) with good analgesic effect should be taken half an hour before physical activity.

If the joint pain worsens at night, your doctor will also recommend that you take metamizole sodium and drotaverine with nicotinic acid at bedtime to improve local blood circulation.

Local therapy

NSAIDs have a formidable side effect - they can damage the lining of the stomach until the ulcer develops, so they try to be applied topically as part of all kinds of anti-inflammatory and analgesic ointments and gels. The affected joint is usually rubbed into the skin twice a day. The pain is also relieved by special patches with magnetic powder that are applied to the joint or spine.

What happens if the joints are not treated?

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

Conclusion

Joint pain is known to almost everyone and occurs for two main reasons - inflammation (arthritis) or destruction of bones and cartilage (arthrosis). Interestingly, the joints of the arms and legs hurt in different ways. The upper limbs, unlike the lower limbs, are usually not affected by the joints themselves but by the surrounding tissues (tendons, ligaments, bags). This is due to the different types of loads that the arms and legs experience - dynamic and static. Joint pain needs to be tackled from day one: very few people will like the prospect of disability for the next 10-15 years. As part of the prevention of joint disease, it is important to shed more pounds to reduce joint stress and treat concomitant diseases (allergies, diabetes mellitus).