Joint pain: causes and treatment

Symptom: joint pain.

Possible causes: trauma, arthritis, osteoarthritis, osteoarthritis.

Doctor: the therapist registers complaints, sends them for examination and, based on his results, refers the patient to a doctor with a more narrow specialization.

Treatment: prescribed individually in each case.

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

Why do the joints hurt?

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

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

With osteoarthritis, everything is different: the joints are destroyed slowly and imperceptibly at first. Joint pain, initially mild, aching, appearing only during movement, quite bearable, increases over time, becoming constant and severe enough to disturb peace and sleep. The insidious nature of this pain is that it is delayed in relation to the pathological process that takes place in the joint, and only occurs when the x-rays show signs of destruction of the corresponding joint, unfortunately irreversible. These are 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 density. bone. If osteoarthritis affects a joint, for example the knee, the biomechanics change and the function of adjacent joints - the hip joint and the ankle - is disrupted. They experience increased load and, at the same time, uneven and, therefore, wear out faster. Thus, osteoarthritis affects joint by joint, and the pain intensifies and can spread to all new joints.

Types of pain

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

Joints hurt with influenza and acute respiratory infections against a background of high temperature (up to 40 ° C). This pain disappears on its own as soon as the temperature returns to normal, and does not require special treatment.

For arthritis pain:

• sharp,
• painful,
• throbbing
• filming,
• occurs at rest and intensifies when performing certain movements,
• give to neighboring regions,
• on probing (palpation) it hurts everywhere, over the entire surface of the joint, but especially along the joint space.

Periarthritis is particularly unbearable - inflammation of the tissues around the joint (its pockets, tendons and ligaments). How it all happens can be explained by the example of the shoulder joint. First of all, the joint begins to hurt. The pain quickly becomes excruciating, almost unbearable. It comes off the scapula and neck area, intensifies (and is often accompanied by a tightening) when you try to stretch your arms out to the sides at shoulder level or bend them at the elbow andto bring them behind your back. At the end of the collarbone, which rests on the shoulder joint in front, and in the same place in the back, there are sore spots. When you press it with a finger, the pain increases. With such sharp sensations, the joint needs to be immobilized - the hand should be hung on a handkerchief, try not to move it. This is an essential condition for the success of the treatment.

Important! as soon as possible to choose an adequate analgesic and anti-inflammatory treatment after the examination. This will reduce the severity of joint inflammation, reduce pain, and improve quality of life.

With osteoarthritis, joint pain is different:

• The pain is initially mild and inconstant, 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 gaps between them are reduced.
• Pain at the start: its explosion occurs at the first attempt to take a step, raise an arm, bend over. Then the joints seem to grow and the pain subsides.
• Mechanical rhythm - the joint starts to ache when you load it. At first, pain appears with high loads - lifting weights, climbing stairs, walking for a long time, playing sports. Later, even minor movements echo the pain. But at the same time, unlike the unpleasant sensations of arthritis, the pain of osteoarthritis disappears when you rest the joint, bring it peace. This is why doctors speak of mechanical rhythm: movement causes pain and rest relieves it.
• Nighttime discomfort. There is no pain at rest as such, but lying down is uncomfortable, anytime you want to change your posture, find a position where you might forget about the joints and the spine, but it won't. does not work. The joints hurt, and that's it! The shackles of the morning: awake there is no pain yet, but it was as if you were shackled or swaddled tightly - the joints do not obey, but gradually the feeling of stiffness subsides, therange of motion in the joint is restored.
• Protective posture. When a joint hurts, you want to take the so-called analgesic position - an analgesic position, in which it becomes easier. This is best seen in the example of the spine: it is also made up of joints. When one of them gets stuck, and with it a nerve root enters the bone vise, there is a sharp pain on the basis of sciatica. Anyone can diagnose someone with sciatica after seeing how deformed the poor man is. In fact, with the help of this "asymmetry", supported by muscle spasms, the body tries to reduce pain to a minimum.

Osteoarthritis of the hip and knee

Pain with an injury to the hip joint (and it 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 a lot. The pain increases with walking, and at rest it weakens and goes away.

The knee joints most often suffer from both at the same time. They unfold easily and start to hurt when bending. The so-called staircase symptom is characteristic of the knee injury. The descent becomes more painful than the ascent; patients do this by turning sideways. Sometimes the joint gets stuck in a bent position due to a bone growth (osteophyte) or its fragment (such a bone fragment "lost" inside the joint is called a "joint mouse"). Joint blockage comes with increased pain when you try to bend or straighten it.

Knee mobility problems are not always associated with arthritis. Sometimes the seal timing can be "wrong". Some of the most common causes of pseudo-block of the knee are:

• Edema (excess fluid in the joint capsule can interfere with full flexion and extension of the joint).
• Inflammation (inflammation of the tissues of 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 spasms).

Important! If the joint is stuck, active movements in the joint are impossible, it is necessary to consult an orthopedic trauma doctor as soon as possible - an emergency room, clinic, hospital. Don't hesitate to call the ambulance - that's a good reason to call, as you won't get far on one leg and even you might not even make it to the clinic on your own.

Diagnostic

Due to the nature of the pain and the appearance of the affected joint, a preliminary diagnosis (arthritis or osteoarthritis) can be made even by a non-specialist. But hurry to the district clinic for confirmation of the hypotheses!

Which doctor should I contact?

In case of joint pain, you should make an appointment with a local therapist. He acts as a medical dispatcher: he registers complaints and clinical symptoms, directs the patient for examination and, based on his results, decides which doctor should see each particular patient. A wide variety of specialists are involved in maintaining healthy joints:

• arthrologist.
• orthopedic traumatologist.
• rheumatologist.
• vertebrologist (if the joints of the spine are affected).
• podiatrist (with regard to the joints of the foot).
• surgeon.
• oncologist.
• neurologist (if the joint has already been treated, but the pain remains there).
• dietitian (if the joints hurt due to metabolic disorders, such as gout, or if you are overweight).

What tests to take and what research to do?

The examination begins with the simplest - a clinical (from a finger) and biochemical (from a vein) blood test 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. Too much uric acid in the urine may indicate that gout is a cause of joint disease.

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

One proven diagnostic method is the x-ray of the joint in two standard projections. It will help visualize the narrowing of joint space, bone growths, osteoporosis and osteosclerosis (areas of decrease and increase in bone density.

Currently, complete information on 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, osteoarthritis is common, and in young people, rheumatoid arthritis and injuries (bruises, fractures, ligament damage).

"Along with high blood pressure, commonly known as hypertension, joint disease is at the top of the list of the most common reasons to see a doctor. And the chronic pain that patients feel at the same time and because of which they cannot live and work fully is not only a medical problem, but also an important social problem, - says the doctor of medical sciences, professor ofrheumatology department. - Of all joint diseases, osteoarthritis is the most common. 97% of those over 65 suffer from this disease. And if we are talking about chronic inflammatory diseases of the joints - arthritis, rheumatoid arthritis is here in the foreground. This is also not a gift, and not only because of the pain syndrome: within 3-5 years of its onset, this type of arthritis inevitably ends with the patient being assigned a group of disabilities. . "

How to get rid of joint pain urgently?

Analgesics are able to overcome pain quickly: the 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 put stress on it. Therefore, in case of pain, a nonsteroidal anti-inflammatory drug (NSAID) with a good analgesic effect should be taken half an hour before any physical activity.

If the joint pain worsens at night, moreover, 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 terrific side effect - they can damage the stomach lining until ulcers form. They therefore try to apply them topically, as part of all kinds of ointments and gels with anti-inflammatory and analgesic properties. They are usually rubbed on the skin of the affected joint twice a day. Pain is also relieved by special dressings with magnetic powder, which are stuck on the joint or spine.

What happens if the joints are left untreated?

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 joints. Usually, multiple joint damage (polyarthritis) is the result of a general disease of the body, for example psoriasis. In this case, it is all the more dangerous to trigger the disease, as it progresses quickly and can kill your life quite quickly.

Conclusion

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