Joint pain: causes and treatment

Symptom: joint pain.

Possible causes: trauma, arthritis, osteoarthritis, osteoarthritis.

Physician: The therapist records the complaints, sends them for examination, and based on the results, will refer the patient to a physician with a narrower specialization.

Treatment: individually prescribed for 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 be damaged for two reasons: arthritis, inflammation of the tissues of the joint or arthrosis (osteoarthritis), a degenerative-dystrophic process, ie destruction of the bone and cartilage elements of the joint. The diagnosis should be made by a doctor, but you can find out 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 hot to the touch.

In osteoarthritis, everything is different: the joints initially break down slowly and imperceptibly. Joint pain, initially mild, painful, occurring only during movement, quite tolerable, increases over time, becoming constant and strong enough to disturb peace and sleep. The insidiousness of this pain is that it slows down in relation to the pathological process taking place in the joint, and occurs only when X-rays show signs of destruction of the joint, unfortunately, irreversible. This 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 osteoarthritis affects one joint, say the knee, the biomechanics change and the function of the adjacent joints - the hip joint and the ankle - is impaired. They experience an increased and at the same time uneven load and as a result wear out faster. In this way, the osteoarthritis affects the joint and the pain intensifies and can spread to all new joints.

Types of pain

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

The joints hurt with the flu and acute respiratory infections against a background of high (up to 40 ° C) temperature. This pain disappears 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,
• on probing (palpation) it hurts everywhere, on the entire surface of the joint, but especially along the joint space.

Periarthritis is particularly unbearable - inflammation of the tissues around the joint (its bags, 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 attaches to the shoulder blade and neck area, intensifying (and is often accompanied by crunching) when you try to stretch your arms to the side at shoulder level or bend them at the elbow and bring them behind your back. At the end of the clavicle, which rests on the shoulder joint in front, and in the same place behind there are pain points. When you press them with your finger, the pain increases. In such acute sensations, the joint needs to be immobilized - the hand should be hung on a towel, try not to move it. This is an essential condition for the success of the treatment.

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

In osteoarthritis, joint pain is different:

• The pain is initially mild and intermittent, its nature 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 decrease.
• Pain in the beginning: its explosion occurs on the first attempt to take a step, to raise a hand, to bend. Then the joints seem to be developed and the pain is relieved.
• Mechanical rhythm - the joint begins to hurt when you load it. Initially, the pain occurs with heavy loads - lifting weights, running up stairs, long walks, 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 give the joint a rest, provide it with peace. That is why doctors talk about a mechanical rhythm: movement provokes pain, and rest relieves it.
• Night 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 in which to forget about the joints and spine, but it does not work. Morning shackles hurt the joints and that's it! Morning shackles: they woke up, there is still no pain, but it is as if you have been chained or wrapped tightly - the joints do not obey, but gradually the feeling of stiffness disappears, the range of motion in the joint is restored.
• Protective posture. When one joint hurts, you want to take the so-called analgesic - analgesic position, which makes it easier. This is best seen in the example of the spine: it also consists of joints. When one of them wedges in and with it a nerve root falls into the bone defect, a sharp pain at the base of the sciatica occurs. Anyone can diagnose a sciatica sufferer after seeing how the poor person is distorted. In fact, with the help of this "distortion", supported by muscle spasm, the body tries to reduce pain to a minimum.

Osteoarthritis of the hip and knee

The pain with a lesion of the hip joint (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 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 unfold easily and begin to hurt when bent. The so-called stair symptom is characteristic of the knee lesion. Getting off it becomes more painful than climbing; patients do this by turning away. Sometimes the joint is wedged into a bent position due to a bone growth (osteophyte) or a fragment of it (such a "lost" bone fragment inside the joint is called a "joint mouse"). Joint blockage is accompanied by increased pain when trying to bend or straighten.

Knee mobility problems are not always associated with arthritis. Sometimes the wedges of the joints can be "false". Among the most common causes of pseudoblock knee are:

• Swelling (excess fluid in the joint capsule can prevent complete flexion and expansion of the joint).
• Inflammation (inflammation of the tissues in the knee, for example in rheumatoid arthritis and gout).
• Improper movement of the knee cap in the joint (accompanied by severe pain).
• Irritation of the tissue covering the joint.
• Knee injury (Any serious knee injury, such as a sprain, can cause muscle spasm).

Important! If the joint is congested, active movements in the joint are impossible, it is necessary as soon as possible to seek medical help from an orthopedic traumatologist - emergency room, clinic, hospital. Do not hesitate to call an ambulance - this is a good reason to call him, because you will not get far with one foot and you may not even get to the clinic yourself.

Diagnosis

By the nature of the pain and the appearance of the affected joint, a preliminary diagnosis (arthritis or osteoarthritis) can be made even by a layman. 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. He performs the functions of a medical dispatcher: he records complaints and clinical symptoms, directs the patient for an examination and, based on the results, decides which doctor should consult with each particular patient. A wide variety of specialists are involved in maintaining joint health:

• arthrologist.
• orthopedic traumatologist.
• rheumatologist.
• vertebrologist (if the joints of the spine are affected).
• orthopedist (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 the joints hurt due to metabolic disorders, such as gout or if you are overweight).

What tests to pass and research to do?

The test begins with the simplest - a clinical (finger) and biochemical (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. Excess uric acid in the urine may indicate gout as a cause of joint disease.

Laboratory examination of the synovial fluid that 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, histological examination of a fragment of the synovial membrane covering the inside of the joint cavity is performed.

A proven diagnostic method is an X-ray of the joint in two standard projections. This will help to visualize the narrowing of the joint space, bone growths, osteoporosis and osteosclerosis (areas with 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, osteoarthritis is widespread, and in the young - rheumatoid arthritis and injuries (bruises, fractures, tendon injuries).

"Along with hypertension, which is commonly called hypertension, joint disease is at the top of the list of 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 fully 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 those over 65 suffer from this disease. And if we talk about chronic inflammatory diseases of the joints - arthritis, here rheumatoid arthritis comes to the fore. This is also not a gift and not only because of the pain syndrome: within 3-5 years after its onset, this type of arthritis inevitably ends with the identification of a group of patients with disabilities. "

How to get rid of joint pain urgently?

Analgesics are able to quickly overcome the pain: the pain can not 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 get 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 non-steroidal anti-inflammatory drug (NSAID) with a good analgesic effect should be taken half an hour before each 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 to the formation of ulcers, so 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 above the affected joint twice a day. The pain is also relieved by special patches with magnetic powder that stick 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 injury. If one or more large joints are affected, they can be replaced with artificial ones. Multiple joint injuries (polyarthritis) are usually the result of a common disease of the body, such as psoriasis. In this case, it is even more dangerous to start the disease because it progresses quickly and can cut your life quite quickly.

Conclusion

Joint pain is known to almost everyone and occurs for two main reasons - due to 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 ones, are usually not affected by the joints themselves, but by the surrounding tissues (tendons, ligaments, sacs). This is due to the different type of load that the arms and legs experience - dynamic and static, respectively. Joint pain must be fought from day one: the prospect of disability over the next 10-15 years will delight very few people. As part of the prevention of joint diseases, it is important to lose extra pounds to reduce stress on the joints and deal with concomitant pathologies (allergies, diabetes).