Joint Pain: Causes and Treatment

Symptom: joint pain.

Possible causes: trauma, arthritis, arthrosis, osteoarthritis.

Doctor: the therapist registers the complaints, forwards them for examination and, based on the result, forwards the patient to a physician with a more restricted specialization.

Treatment: prescribed individually in each case.

Prevention: reduction of load on joints, maintenance of a healthy lifestyle, timely examination by a doctor, diet.

Why do joints hurt?

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

Inflammation in arthritis is like a wildfire: everything 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 is red and hot to the touch.

With osteoarthritis, everything is different: the joints are destroyed slowly and imperceptibly at first. Joint pain, initially mild, painful, arising only during movement, quite bearable, increases with time, becoming constant and strong enough to interrupt peace and sleep. The tricky thing about this pain is that it is delayed in relation to the pathological process that takes place in the joint and only occurs when radiographs show signs of destruction of the corresponding joint, unfortunately irreversible. It is the proliferation of spines (marginal osteophytes) along the edge of the articular surfaces of the bones that form the joint, narrowing of the joint space and signs of osteosclerosis - areas of pathological increase in bone density. If the arthrosis affects a joint, say the knee, the biomechanics change and the function of the adjacent joints - the hip joint and ankle - is stopped. They experience an increase and, at the same time, an uneven charge and, as a result, wear out more quickly. Thus, arthrosis affects joint by joint, and the pain intensifies and can spread to all new joints.

Types of pain

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

Joints ache with flu and acute respiratory infections in a high temperature environment (up to 40°C). This pain goes away on its own as soon as the temperature returns to normal and does not require special treatment.

For arthritis pain:

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

Periarthritis is especially unbearable - inflammation of the tissues around the joint (pouches, tendons and ligaments). How it all happens can be explained by the example of the shoulder joint. First, the joint starts to hurt. The pain quickly becomes unbearable, almost unbearable. It hits the shoulder blade and neck region, intensifies (and is usually accompanied by a snap) when trying to stretch the arms out to the sides at shoulder level or bend them at the elbow and bring them back. At the end of the collarbone, which rests on the shoulder joint in front, and in the same place on the back there are pain points. When you press on them with your finger, the pain increases. With these sharp sensations, the joint needs to be immobilized - the hand needs to be hung in a handkerchief, try not to move it. This is an essential condition for successful treatment.

Important! as soon as possible, choose an appropriate analgesic and anti-inflammatory therapy after the exam. This will reduce the severity of joint inflammation, reduce pain and improve quality of life.

With arthrosis, joint pain is different:

• The pain is initially mild and inconsistent, its character is wave-shaped - at certain times it is absent for weeks or even months. But over time, without treatment, the waves of pain become stronger and more frequent, and the gaps between them are reduced.
• Early pain: its explosion occurs on the first attempt to take a step, raise the arm, bend over. Then the joints seem to develop and the pain is relieved.
• Mechanical rhythm - the joint starts to hurt when you carry it. At first, pain appears with heavy loads - lifting weights, running up stairs, walking a lot, playing sports. Later, even the smallest movements echo the pain. But at the same time, unlike the unpleasant sensations of arthritis, the pain of arthrosis goes away when you give the joint a rest, it gives it peace. That's why doctors talk about mechanical rhythm: movement causes pain and rest relieves it.
• Nightly discomfort. There is no pain at rest as such, but lying is uncomfortable, all the time you want to change your posture, find a position where you could forget about the joints and spine, but it doesn't work. The joints hurt and that's it! The handcuffs in the morning: I woke up, I still don't feel pain, but it was like being chained or tightly bandaged - the joints don't obey, but little by little the feeling of stiffness disappears, the range of motion of the joint is restored.
• Protective posture. When a joint hurts, you should take the so-called pain reliever - an analgesic position, in which it is easier. This is best seen in the example of the spine: it also consists of joints. When one of them is wedged and with it a nerve root enters the bone vice, there is a sharp pain based on sciatica. Anyone can diagnose a sciatica sufferer after seeing how distorted the poor man is. In fact, with the help of this "distortion", sustained by muscle spasms, the body tries to reduce pain to a minimum.

Hip and knee osteoarthritis

Pain with a hip joint injury (and usually suffers from one side) is located in the upper thigh and radiates to the knee. He usually starts getting sick in the second half of the day, when he has worked hard. The pain increases with walking and, at rest, it weakens and disappears.

Most of the time, the knee joints suffer from both at the same time. They bend easily and start to ache when bending. The so-called ladder symptom is characteristic of knee injury. Descending from it becomes more painful than climbing; patients do this by turning on their side. Sometimes the joint is trapped in a bent position due to bone growth (osteophyte) or its fragment (such a "lost" bone fragment within the joint is called a "articular rat"). Joint blockage is accompanied by increased pain when trying to bend or straighten it.

Knee mobility problems are not always associated with arthritis. Sometimes, the joint's coinage can be "false". Among the most common causes of pseudoblock in the knee are:

• Edema (excess fluid in the joint capsule can interfere with complete flexion and extension of the joint).
• Inflammation (inflammation of the tissues in the knee, as in rheumatoid arthritis and gout).
• Incorrect movement of the kneecap 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 spasm).

Important! If the joint is locked, active movement in the joint is impossible, it is necessary to seek medical help from an orthopedic traumatologist as soon as possible - an emergency room, a clinic, a hospital. Don't hesitate to call the ambulance - this is a good reason to call her because you won't go far on one leg and you might not even make it to the clinic.

Diagnosis

Due 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 run to the district clinic for confirmation of 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 registers clinical complaints and symptoms, refers the patient for examination and, based on the results, decides which doctor should see each particular patient. A wide variety of specialists are involved in maintaining joint health:

• arthrologist.
• orthopedic traumatologist.
• rheumatologist.
• vertebrologist (if spinal joints 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).
• nutritionist (if joints ache due to metabolic disorders such as gout, or if you are overweight).

What tests to pass and surveys to take?

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

The laboratory study of the synovial fluid, which is inside the joint, helps to detect the inflammatory process and clarify its nature. It is obtained by puncturing the joint capsule - puncture. If necessary, a histological examination of a fragment of the synovial membrane that lines the joint cavity from the inside is performed.

A proven diagnostic method is joint X-ray in two standard projections. It will help visualize joint space narrowing, bone bulges, osteoporosis and osteosclerosis (areas of decreased and increased bone density.

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

What joint diseases can cause pain?

There are over a hundred of these diseases. In the elderly, arthrosis is widespread and, in young people, rheumatoid arthritis and injuries (bruises, fractures, ligament injuries).

"Along with high blood pressure, commonly called hypertension, joint diseases top the list of the most common reasons for seeking medical attention. And the chronic pain that patients experience at the same time and because of which they cannot live and work fullyit is not only a medical problem, but also an important social problem - says the doctor of medical sciences, professor of the department of rheumatology. - Of all joint diseases, arthrosis is the most common. 97% of people over 65 years oldsuffer from this disease. And if we talk about chronic inflammatory joint diseases - arthritis, here rheumatoid arthritis comes up. 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 disability group to the patient. "

How to get rid of joint pain urgently?

Analgesics are able to overcome pain quickly: pain cannot be tolerated in any case if you do not want it to go from acute to chronic. This metamorphosis can happen very quickly - in 3-4 weeks, so getting rid of joint pain should be an urgent task. The joint starts to hurt as soon as you press it. Therefore, in case of pain, one should take a non-steroidal anti-inflammatory drug (NSAID) with good analgesic effect half an hour before any physical activity.

If joint pain gets worse at night, before going to bed, your doctor will recommend taking metamizole sodium as well as drotaverine with nicotinic acid to improve local blood circulation.

local therapy

NSAIDs have a formidable side effect - they can damage the gastric mucosa until ulcers form, so they try to apply them topically, 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. Pain is also relieved by special magnetic powder plasters, which are glued 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 affected, they can be replaced with artificial ones. Multiple damage to the joints (polyarthritis) is usually the result of a general disease of the body, eg psoriasis. In this case, it is even more dangerous to start the disease because it progresses quickly and can quickly interrupt your life.

Conclusion

Joint pain is familiar to almost everyone and occurs for two main reasons - due to inflammation (arthritis) or destruction of bones and cartilage (arthrosis). Interestingly, the joints in the arms and legs hurt in different ways. In the upper limbs, unlike the lower limbs, the joints themselves are generally not affected, but the surrounding tissues (tendons, ligaments, bags). This is due to the different types of loads that the arms and legs undergo - dynamic and static, respectively. Joint pain must be tackled from day one: the prospect of disability in the next 10-15 years will please very few people. As part of preventing joint disease, it is important to lose extra pounds to reduce stress on the joints and deal with concomitant pathologies (allergies, diabetes mellitus).