Joint pain: causes and treatment.

Symptom: joint pain.

Possible causes: trauma, arthritis, osteoarthritis, osteoarthritis.

Physician - The therapist records complaints, submits them for examination, and based on their results, will refer the patient to a physician with more limited expertise

Treatment: prescribed individually in each case.

Prevention: reducing the load on the joints, maintaining a healthy lifestyle, timely examination by a doctor, diet.

Why do the joints hurt?

Joints can hurt for two reasons: arthritis, inflammation of the joint tissues or osteoarthritis (osteoarthritis), a degenerative-dystrophic process, that is, 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 becomes red and warm to the touch.

With osteoarthritis, everything is different: joints are slowly and imperceptibly destroyed at first. Joint pain, at first mild, painful, arising only during movement, quite bearable, increases over time, becoming constant and intense enough to interrupt peace and sleep. The insidious thing about this pain is that it is delayed in relation to the pathological process that develops in the joint, and occurs only when X-ray images show signs of destruction of the corresponding joint, sadly irreversible. It involves the proliferation of spines (marginal osteophytes) along the edge of the articular surfaces of the bones that make up the joint, narrowing of the joint space and signs of osteosclerosis, areas of pathological increase in bone density. If osteoarthritis affects a joint, say, the knee, the biomechanics change and the function of the adjacent joints, the hip and ankle joint, is altered. They experience an increased load and at the same time uneven and, as a result, wear out faster. Therefore, osteoarthritis 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 hurt with flu and acute respiratory infections against a background of high temperature (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:

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

Periarthritis is especially excruciating: inflammation of the tissues around the joint (its bursae, tendons, and ligaments). How it all happens can be explained with the example of the shoulder joint. First, the joint begins to hurt. The pain very quickly becomes unbearable, almost unbearable. It is emitted in the shoulder blade and in the neck area, it intensifies (and is usually accompanied by a crunch) when trying to stretch the arms to the sides at the level of the shoulders or bend them at the elbow and carry them behind the back. At the end of the clavicle, which rests on the shoulder joint in front, and in the same place in the back there are pain points. When you press them with a finger, the pain increases. With such acute sensations, the joint needs immobilization: the hand should be hanging 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 appropriate analgesic and anti-inflammatory therapy 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 inconsistent, 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 spaces between them shrink.
• Pain at the beginning: its explosion occurs at the first attempt to take a step, raise an arm, bend over. Then the joints seem to develop and the pain relieves.
• Mechanical rhythm: the joint begins to ache when loaded. At first, the 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 in arthritis, the pain in arthrosis disappears when you give the joint a rest, you give it peace. That is why doctors speak of mechanical rhythm: movement causes pain and rest relieves it.
• Night discomfort. There is no pain at rest as such, but lying down is uncomfortable, all the time you want to change your position, find a position where you can forget about the joints and the spine, but it does not work. Joints hurt, and that's it! the range of motion in the joint is restored.
• Protective posture. When a joint hurts, you want to take the so-called analgesic, an analgesic 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 is wedged, and with it a nerve root penetrates the bone vice, acute pain based on sciatica occurs. Anyone can diagnose a person with sciatica after seeing how poorly he is deformed. In fact, with the help of this "bias", supported by muscle spasms, the body tries to reduce pain to a minimum.

Hip and knee osteoarthritis.

Pain with a hip joint injury (and most often suffered on one side) is localized to the upper thigh and radiates to the knee. You usually start to get sick in the second half of the day, after you've done enough work. The pain increases when walking and at rest it weakens and disappears.

The knee joints usually suffer both at the same time. They fall apart easily and start to hurt when bending. The so-called staircase symptom is characteristic of knee injury. Getting off it becomes more painful than climbing; patients do this by turning sideways. Sometimes the joint is wedged into a bent position due to bone growth (osteophyte) or bone fragment (a fragment of bone "lost" within the joint is called a "articular mouse"). The joint lock is accompanied by increased pain when trying to bend or straighten it.

Mobility problems in the knee are not always associated with arthritis. Sometimes the wedging of the joints can be "false". Among the most common causes of knee pseudo-lock 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 patella in the joint (accompanied by severe pain).
• Irritation of the tissue that lines the joint.
• Knee injury (any serious knee injury, such as a sprain, can lead to muscle spasms).

Important! If the joint is stuck, active movements in the joint are impossible, it is necessary to seek medical help from an orthopedic traumatologist as soon as possible: an emergency room, a clinic, a hospital. Feel free to call the ambulance; This is a good reason to call her, because you won't go very far on one leg and may not even make it to the clinic yourself.

Diagnostics

Due to the nature of the pain and the appearance of the affected joint, even a non-specialist can make a preliminary diagnosis (arthritis or osteoarthritis). 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. He performs the functions of a medical dispatcher: he records complaints and clinical symptoms, directs the patient for examination and, based on his results, decides which doctor should consult each individual 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).
• 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 there is excess weight).

What tests to pass and research what to do?

The exam begins with the simplest: a clinical (finger) and biochemical (vein) blood test for signs of inflammation, as well as a general urinalysis. In some joint diseases, the kidneys are involved in the disease process. Excess uric acid in the urine may indicate that gout is a cause of joint disease.

A laboratory study of the synovial fluid, which is located 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 is performed of a fragment of the synovial membrane that lines the joint cavity from the inside.

A proven diagnostic method is radiography of the joint in two standard views. It will help visualize joint space narrowing, bone outgrowths, osteoporosis, and osteosclerosis (areas of increased and decreased bone density).

Currently, MRI provides comprehensive information on the condition of the joint.

What joint diseases can cause pain?

There are more than a hundred diseases of this type. In the elderly, osteoarthritis is widespread and in the young, rheumatoid arthritis and injuries (bruises, fractures, ligament injuries).

"Along with high blood pressure, which is commonly called hypertension, diseases of the joints are at the top of the list of the most common reasons to seek medical help. And chronic pain that patients experience at the same time and for whichcannot live and work fully is not only a medical problem, but also an important social one, says doctor of medical sciences, professor in the department of rheumatology - Of all joint diseases, osteoarthritis 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. It is not a gift, and not only because of the pain syndrome: within the3-5 years after 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?

Painkillers can quickly overcome the pain: the pain cannot be tolerated in any case, if you do not 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 begins to hurt as soon as pressure is exerted 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 any 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 formidable side effect: they can damage the gastric mucosa to the point of ulcer formation, so they try to apply them topically, as part of all kinds 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 with 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 joint damage (polyarthritis), as a rule, is a consequence of a general disease of the body, for example, psoriasis. In this case, it is even more dangerous to start the disease, because it progresses rapidly and can cut off your life quite quickly.

Conclution

Joint pain is familiar to almost everyone and occurs for two main reasons: due to inflammation (arthritis) or the destruction of bones and cartilage (osteoarthritis). Interestingly, the joints of the arms and legs hurt in different ways. In the upper extremities, unlike the lower ones, the joints themselves are not usually affected, but the surrounding tissues (tendons, ligaments, bursae). This is due to the different type of load experienced by the arms and legs: dynamic and static, respectively. Joint pain must be fought from day one - the prospect of disability in the next 10-15 years will please 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 cope with concomitant pathologies (allergies, diabetes mellitus).