Joint pain (arthralgia) is a very common problem that can be associated with infection or toxicity, trauma, inflammation or deterioration of cartilage.
In most cases, the joint pain goes away on its own within a few days. However, some situations require you to see a doctor as soon as possible. It is not easy even for an experienced specialist to determine exactly why the joints are injured, as the early symptoms can be deceptive, and the full picture of the disease sometimes unfolds only within 1-2 months or more.
The information in this article will help you navigate the variety of diseases and conditions that cause arthralgia. And modern diagnostic methods will allow you to accurately determine the cause of the disease and choose the right treatment tactics together with a doctor.
In this article, we will look at situations where multiple injuries throughout the body hurt. Sometimes someone starts to get hurt, and other joints quickly join it. It happens that the pain seems to migrate from one part of the body to another over several days or weeks. A number of diseases cause pain in a group of joints in the form of attacks - seizures, when the pain subsides and reappears again.
Joint pain with viral infections
Most often, arthralgias occur with various viral infections: due to the direct effect of viruses on the joints or under the influence of toxins that accumulate in the blood during the acute period of many infectious diseases.
Most often, the pain appears in the small joints of the hands and feet, the knee joints, and sometimes the back joints. The pain is not strong, it hurts. It is called joint pain. Mobility is usually not impaired, there is no swelling or redness. In some cases, a hives-like rash may appear that quickly disappears. In most cases, viral arthralgias become the first symptoms of the disease and are accompanied by fever, muscle aches and weakness.
Despite the deterioration of general well-being, joint pain in viral diseases is usually not a cause for serious concern. Relief can be provided by taking non-steroidal anti-inflammatory drugs, drinking plenty of fluids and resting. After a few days, the pain disappears and joint function is fully restored. There are no irreversible changes in the structure of the node.
Viral arthralgias are characteristic, for example, of influenza, hepatitis, rubella, mumps (in adults).
Reactive arthritis
This is a group of diseases in which 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 most often appears 1-3 weeks after acute respiratory infections, intestinal infection or diseases of the genitourinary system, for example, urethritis or genital infections. Unlike viral arthralgias, joint pain is severe, accompanied by edema and impaired movement. Body temperature may rise. Arthritis often begins with the involvement of a knee or ankle joint. Within 1-2 weeks, the pain in the joints of the other half of the body joins, the small joints of the arms and legs begin to ache. Sometimes the joints of the back hurt.
Joint pain usually goes away with treatment or on its own, leaving no consequences. However, some types of reactive arthritis are chronic and occasionally worsen.
Reiter's disease- one of the types of reactive arthritis that develops after transferred chlamydia and can take a chronic course. Joint pain in Reiter's disease is usually preceded by a urinary incontinence - a manifestation of chlamydial urethritis (inflammation of the urethra), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment, you should consult a doctor.
Reactive arthritis can develop after adenovirus infection, genital infections (especially chlamydia or gonorrhea), intestinal infections associated with Salmonella, Klebsiella, Shigella, etc.
Joint pain when cartilage is consumed
Diseases associated with gradual consumption of cartilage on the articular surfaces of bones are called degenerative. They are most common in people aged 40-60 and older, but they also occur in young people, for example, those who have suffered joint injuries, professional athletes who are exposed to frequent intense strain, and people withthick.
Deforming osteoarthritis (osteoarthritis, DOA)- It is a disease of the large joints of the legs - knees and hip joints, which carry most of the load when walking. The pain appears gradually. In the morning, after rest, the state of health improves, and in the evening and at night after long walks, running and other stresses, it worsens. Inflammatory changes: edema, rash are usually not pronounced and may appear only in advanced cases. But there are often complaints of cracking in the joints. Over the years, the disease progresses. Almost it is almost impossible to cure deforming osteoarthritis; it is only possible to slow down the destruction of cartilage. To restore movement, they undergo surgery.
Spinal osteochondritisOn the other hand another common degenerative disease. Its cause is thinning and destruction of cartilage between the vertebrae. Reducing the thickness of the cartilage leads to compression of the nerves extending from the spinal cord and blood vessels, which, in addition to pain in the back joints, cause many different symptoms. For example: headache, dizziness, pain and numbness in the arms, shoulder joints, pain and rupture in the heart, chest, leg pain, etc. A neurologist usually deals with the diagnosis and treatment of osteochondrosis.
Autoimmune diseases as a cause of joint pain
Autoimmune diseases are a large group of diseases, the causes of which are not fully known. All these diseases are united by the peculiarity of the immune system: the cells of the immune system begin to attack the tissues and organs of their body, causing inflammation. Autoimmune diseases, unlike degenerative diseases, are more likely to develop in childhood or adolescence. Their first manifestation is often joint pain.
Joint pain is usually unstable: today one joint hurts, tomorrow another, the day after tomorrow - a third. Arthralgia is associated with edema, skin rash, impaired joint mobility, and sometimes fever. After a few days or weeks, the joint pain disappears, but after a while it recurs again. Over time, the joints can become significantly deformed and lose mobility. A characteristic sign of inflammation of the autoimmune joints is morning stiffness. In the early hours of the morning, the affected joints should be cooked from 30 minutes to 2-3 hours or more. The stronger the load on the joints the day before, the more time you need to spend on heating.
Gradually, the symptoms of damage to other organs join with arthralgia: heart, kidneys, skin, blood vessels, etc. Without treatment, the disease progresses. It is impossible to cure it, but modern medicines can slow down the process. Therefore, the earlier treatment is started, the better the outcome.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are mainly affected: they begin to hurt a lot, turn red and swell. Most often, the disease begins with pain in the small joints of the hands and feet: fingers, wrists or ankles, less often - with the loss of one knee, ankle or elbow, and then pain in other parts of the body joint.
Systemic lupus erythematosus- a rarer disease, which is more susceptible to young women. It is characterized by flying pain in various joints of the body, deformity of the fingers, the appearance of a skin rash, especially characteristic on the face - redness on the forehead and cheeks in the form of butterfly wings. Joint pain can be associated with interruptions and disturbances in the heart and chest, low-grade fever, weakness, weight loss, high blood pressure, back pain, edema.
Ankylosing spondylitis- Unlike lupus, it affects men more often. The disease begins with pain in the joints of the spine, in the lumbar region, sacrum, pelvis. Gradually, the pain spreads up to other parts of the back. In addition to pain, stiffness, decreased flexibility and over time, gait discomfort and complete immobility in the spinal joints are characteristic. In the early stages, ankylosing spondylitis can be easily confused with osteochondrosis. However, the first disease develops in young men, and the second in older men. As a diagnostic test, an x-ray is taken of the sacroiliac joint - the place where the spine and pelvic bones 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 rash appears on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and toes, less often the spine, are usually injured and swollen. A distinctive feature of arthritis in psoriasis is an asymmetric lesion. The skin over the joints may have a bluish purple color and nail damage occurs. Over time, deformities and subluxations of the joints develop (fingers begin to bend in an atypical direction).
Arthralgia with rheumatism
Rheumatism (acute rheumatic fever) is a serious disease caused by streptococci. Rheumatism is characterized by very severe pain in the large joints of the legs and arms, which appear 2-3 weeks after a sore throat or scarlet fever. It develops most often in children. The pain is so strong that you can not touch the joint, you can not move. The joints swell, turn red and the temperature rises. First, some joints hurt, then others, usually symmetrical. Even without treatment, the pain disappears on its own and joint function is fully restored. However, after a while, severe symptoms of heart damage appear. Rheumatism requires urgent medical attention. Damage to the heart and other organs can only be avoided with timely treatment.
How to examine injured joints?
There are various examination methods for joint pain. As a rule, they are used in combination.
Blood test- is one of the most common tests for joint pain complaints. With the help of this study, it is possible to determine the presence of inflammation or to suggest a degenerative nature of the disease, to identify signs of infection and using immunological tests or the polymerase chain reaction (PCR) method, to accurately determine the causative agent ofdisease in the case of infectious or reactive arthritis. A blood test shows possible metabolic disorders, the condition of internal organs.
Study of synovial fluid- fluid that washes the surface of the joint. With its help, articular surfaces are nourished, and friction during movement is also reduced. According to the composition of synovial fluid, the laboratory assistant draws 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 (for example, with gout). Synovial fluid is taken for analysis using a needle, which is inserted into the joint cavity after local anesthesia.
Common X-ray and computed tomography (CT)- a method that allows you to take into account the structure of the bone parts of the joints, and also indirectly judge the condition of the cartilage by the size of the joint space - the distance between the bones in the joints. X-ray examination is described among the first methods for joint pain. X-rays show mechanical bone damage (fractures and fractures), joint deformities (subluxations and dislocations), formation of bone growths or defects, bone density, and other criteria that help the doctor identify the cause of joint pain. Computed tomography is also a method of X-ray examination. With a CT scan, the doctor takes a series of layer-by-layer photographs of the joint, which in some cases provide more complete information about the disease.
Ultrasound and MRI of the joints- the methods are different in nature but similar in purpose. With the help of ultrasound or magnetic resonance, information can be obtained about the condition of the soft tissues of the joints and cartilage. Ultrasound and MRI show cartilage thickness, its defects, the presence of foreign inclusions in the joints, and also help determine the viscosity and amount of synovial fluid.
Arthroscopy- a method of joint visual examination using microsurgical instruments, which, after anesthesia, are inserted into the cavity of the diseased joint. During arthroscopy, the doctor has the opportunity to examine with his own eyes the internal structure of the joint, to notice the damage and its changes, and also to take part of the synovial membrane of the joint and its other structures for analysis. If necessary, after the examination, the doctor can immediately perform the necessary therapeutic manipulations. Everything that happens during arthroscopy is recorded on a disc or other preservative, so after the procedure, you can consult other specialists.
Joint treatment
If you have joint pain, find a good pediatrician or pediatrician. He will make an initial diagnosis and, if necessary, refer you to a specialist specialist for treatment. If joint pain is associated with osteoarthritis or arthritis, the treatment is most likely to be treated by a rheumatologist found here.
If the cause of arthralgia is an inflammatory response, medications are used to treat the joints that can reduce inflammation. These are, first of all, non-steroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and many others. If these drugs are not effective enough, drugs from the group of corticosteroids are prescribed in the form of injections into the joint cavity or tablets. When an infection is causing pain, antibiotics are given.
Special treatment regimens are used for autoimmune diseases. For continued acceptance by the physician, the minimum effective doses of drugs are selected that can forcefully suppress the inflammatory response or suppress the immune system. For example: sulfosalazine, methotrexate, cyclophosphamide, azathiaprina, cyclosporine, infliximab, rituximab and others.
For degenerative joint diseases (osteochondrosis, osteoarthritis), no specific medication is known yet. Treatment of diseased joints consists of prescribing anti-inflammatory and analgesic medications during a deterioration, as well as taking metabolic agents based on chondroitin sulfate and hyaluronic acid. Although the effectiveness of the latter is not currently recognized by all physicians.
If the function of the joint is irreversibly deteriorating, they undergo surgery. Currently, there are various endoprosthetic methods that allow the placement of artificial joints or parts of them instead of damaged or worn ones.