Joint pain (arthralgia) is a very common problem that can be associated with infection or poisoning, trauma, inflammation, or deterioration of cartilage.
In most cases, joint pain goes away on its own within a few days. However, some conditions require you to see a doctor as early as possible. It is not easy even an experienced specialist can determine exactly why a joint hurts, because the initial symptoms can be deceptive, and a complete picture of the disease will sometimes only open in 1-2 months or so.
The information in this article will help you navigate the various diseases and conditions that cause arthralgia. And modern diagnostic methods will allow you to determine the true cause of the disease and choose the right treatment tactics together with the doctor.
In this article, we will look at situations where many joints throughout the body are injured. Sometimes a person starts to ache, and other joints quickly join it. It happens that the pain seems to move from one part of the body to another over a few 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 then reappears.
Joint pain with viral infection
Often, arthralgias occur with various viral infections: due to the direct effect of the virus on the joints or under the influence of toxins accumulated in the blood in the acute period of many infectious diseases.
Often, pain appears in the small joints of the arms and legs, the knee joints, and sometimes the spinal joints. The pain is not strong, it hurts. It's called joint pain. Mobility is usually uninterrupted, there is no swelling or redness. In some cases, an itchy-like skin rash may appear that quickly disappears. In most cases, viral arthralgias becomes the first symptom of malaise and is accompanied by fever, muscle aches, and weakness.
Despite the deterioration of general well -being, joint pain in viral diseases is usually not a serious concern. Relief can be provided by taking non-steroidal anti-inflammatory medications, drinking plenty of fluids and resting. After a few days, the pain disappeared and joint function fully recovered. There is no irreversible change in joint structure.
Viral arthralgias are characteristic of, for example, influenza, hepatitis, rubella, mumps (in adults).
Reactive arthritis
This is a group of diseases in which joint pain occurs after infection, both viral and bacterial. The direct cause of reactive arthritis is a fault in the immune system, which causes inflammation in the joints, even if they are not affected by the infection.
Joint pain appears more often 1-3 weeks after an acute respiratory infection, intestinal infection or disease of the genitourinary system, for example, urethritis or genital infection. Unlike viral arthralgias, joint pain is intense, accompanied by edema and impaired movement. Body temperature can rise. Arthritis often begins with involvement of the knee or ankle joints. Within 1-2 weeks, pain in other joints of the body joins, the small joints of the arms and legs begin to ache. Sometimes the joints of the spine hurt.
Joint pain usually goes away with treatment or on its own, without leaving a sequel. However, some types of reactive arthritis are chronic and sometimes worsen.
Reiter's disease- one of the types of reactive arthritis that develops after chlamydia is transplanted and can undergo a chronic course. Joint pain in Reiter's disease is usually preceded by urinary incontinence - a manifestation of chlamydial urethritis (inflammation of the urethra), which is often unnoticed. Then eye problems appear, conjunctivitis develops. For treatment, you must see a doctor.
Reactive arthritis can develop after adenovirus infection, genital infection (especially chlamydia or gonorrhea), intestinal infections associated with infection with Salmonella, Klebsiella, Shigella, etc.
Joint pain when cartilage is worn
Diseases that are accompanied by cartilage and cartilage wear on the articular surface of the bone are called degenerative. They are more common at ages 40-60 and older, but they also occur in younger people, for example, those with joint injuries, professional athletes who are prone to frequent exercise and in obese people.
Defective osteoarthritis (osteoarthritis, DOA)- This is a disease of the large joints of the feet - the joints of the knees and hips, which bear most of the load when walking. The pain arises gradually. In the morning, after resting, the state of health improved, and in the evening and at night after walking, running and other stresses, the condition worsened. Inflammatory changes: edema, redness are usually unspoken and may appear only in advanced cases. But often there are complaints of cracks in the joints. For many years, the disease persisted. It is almost impossible to cure a deformed arthrosis; it is only possible to slow the destruction of cartilage. To restore mobility, they had to undergo surgery.
Osteochondritis of the spineIs another degenerative disease. The cause is thinning and destruction of cartilage between the spines. Decreased cartilage thickness causes nerve compression extending from the spinal cord and blood vessels, which, in addition to pain in the spinal joints, causes many different symptoms. Examples: headache, dizziness, pain and numbness in the arms, shoulder joints, pain and disorders in the heart, chest, pain in the legs, and others. 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 cause of which is not fully known. All these diseases are united by the peculiarities of the immune system: the cells of the immune system begin to attack their own tissues and organs of the body, causing inflammation. Autoimmune diseases, in contrast to degenerative diseases, tend to develop in childhood or in young people. Their first manifestation is often joint pain.
Joint pain is usually unstable: today one joint hurts, the day after tomorrow, the day after - a third. Arthralgia is accompanied by edema, redness of the skin, movement disorders in the joints, and sometimes fever. After a few days or weeks, the joint pain disappears, but after a while it recurs again. Over time, joints can become significantly deformed and lose mobility. The hallmark of autoimmune joint inflammation is morning stiffness. On the first morning, the affected joints should be kneaded 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 warm up.
Gradually, symptoms of damage to other organs merge with arthralgias: heart, kidneys, skin, blood vessels, and others. Without treatment, the disease persists. It is impossible to cure it, but modern medicine can slow down the process. Therefore, the earlier treatment is started, the better the results.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are particularly affected: they start to ache a lot, turn red, and swell. Often, the disease begins with pain in the small joints of the arms and legs: fingers, joints of the hands or feet, more rarely - with the defeat of one knee, ankle or elbow joint, and then pain in other parts of the body joins.
Systemic lupus erythematosus- a more rare disease, which is more susceptible to attack by young women. It is characterized by pain in various joints of the body, deformation of the fingers, the appearance of a rash on the skin, especially features on the face - redness on the forehead and cheeks in the form of butterfly wings. Joint pain can be accompanied by disorders and discomfort in the heart and chest, low -grade fever, weakness, weight loss, increased blood pressure, back pain, edema.
Ankylosing spondylitis- unlike lupus, it attacks men more often. The disease begins with pain in the joints of the spine, in the lumbar region, sacrum, pelvis. Gradually, the pain spreads to other parts of the spine. In addition to pain, stiffness, decreased flexibility, and over time, disturbances of walking and not moving fully at the spinal joints are characteristic. In the early stages, ankylosing spondylitis is easily confused with osteochondrosis. However, the first disease develops in young men, and the second in the elderly. As a diagnostic test, X -rays are taken from 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 disease in which a special rash appears on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and toes, more rarely the spine, are usually sore and swollen. A hallmark of arthritis in psoriasis is asymmetric lesions. The skin above the joints may have a bluish purple color, and damage to the nails 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 streptococcus. Rheumatism is characterized by very severe pain in the large joints of the legs and arms, which appears 2-3 weeks after a sore throat or scarlet fever. It develops more frequently in children. The pain is so severe that you can’t touch the joints, you can’t move. The joints swell, turn red, and the temperature rises. First, some joints are sore, and others, are usually symmetrical. Even without treatment, the pain goes away on its own and joint function fully recovers. However, after a while, symptoms of severe heart damage appear. Rheumatism requires immediate medical attention. Only with timely treatment, damage to the heart and other organs can be avoided.
How to check for joint pain?
There are various screening 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 indicate the nature of the degenerative disease, to identify signs of infection, and to use immunological tests or polymerase chain reaction (PCR) methods, to accurately determine the causative agent in the presence of arthritiscontagious or reactive. Blood tests indicate possible metabolic disorders, conditions of internal organs.
Synovial fluid study- liquid that washes the surface of the joint. With its help, the articular surface is nourished, and friction during movement is also reduced. According to the composition of synovial fluid, laboratory assistants draw conclusions about the presence of inflammation or infection in the joints, the process of destruction and nutrition of cartilage, the accumulation of salts that can cause pain (for example, with gout). Synovial fluid was taken for analysis using a needle, which was inserted into the joint cavity after local anesthesia.
X -rays and computed tomography (CT)- a method that allows you to consider the structure of the joint bone parts, as well as indirectly assess the condition of the cartilage by measuring the joint space - the distance between the bones in the joint. X-ray examination is prescribed among the first methods for joint pain. X-rays show mechanical damage to bone (fractures and cracks), joint deformity (subluxation and dislocation), growth formation or bone deformity, bone density and other criteria that help doctors identify the cause of joint pain. Computed tomography is also an X-ray research method. With a CT scan, the doctor receives a series of layer -by -layer pictures of the joint, which in some cases provide more complete information about the disease.
Ultrasound and MRI of the joints- the methods are different, but the purpose is similar. With the help of ultrasound or magnetic resonance imaging, information can be obtained about the condition of the soft tissues of the joints and cartilage. Ultrasound and MRI show the thickness of the cartilage, its deformity, the presence of foreign inclusions in the joint, and also help determine the viscosity and volume of synovial fluid.
Arthroscopy- a method of visual inspection of the joint using a micro -surgical device, which, after anesthesia, is inserted into the cavity of the diseased joint. During arthroscopy, the doctor has the opportunity to examine the internal structure of the joint, see its damage and changes, and even take parts of the synovial membrane of the joint and its other structures for analysis. If necessary, after examination, the doctor can immediately perform the necessary therapeutic manipulations. Everything that happens during arthroscopy is recorded on a disk or other storage media, so after the procedure, you can consult with another specialist.
Joint treatment
If you have joint pain, find a therapist or pediatrician who is good for children. He or she will make an initial diagnosis and, if necessary, refer you to a specialist for treatment. If joint pain is associated with arthrosis or arthritis, treatment will most likely be handled by a rheumatologist available 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, nonsteroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and more. If these drugs are not effective enough, drugs from the corticosteroid group are prescribed in the form of injections into the joint cavity or tablets. When an infection causes pain, antibiotics are given.
Special treatment regimens are used for autoimmune diseases. For continuous admission by a physician, a minimum effective dose of medication is selected that can strongly suppress the inflammatory response or suppress the immune system. Examples: sulfosalazine, methotrexate, cyclophosphamide, azathiaprine, cyclosporine, infliximab, rituximab and others.
For degenerative diseases of the joints (osteochondrosis, osteoarthritis), no specific drug is yet known. Treatment of diseased joints consists of prescribing anti-inflammatory and analgesic drugs during exacerbations, as well as taking metabolic agents based on chondroetin sulfate and hyaluronic acid. Although its effectiveness is not known by all doctors.
If joint function deteriorates irreversibly, they require surgery. Currently, there are various methods of endoprosthetics that allow implantation of an artificial joint or part thereof from a damaged or worn one.