Pain in the joints

Pain in the joints- These are unpleasant pains and pulling sensations in the area of the joints, the intensity of which sometimes reaches the level of pain. The symptom is combined with muscle pain, weakness, weakness, stiffness, limited movement and may precede joint pain (arthralgia). Joint pain is accompanied by damage to the musculoskeletal system, infections, diseases of the hematopoietic system, and vascular pathology. Laboratory tests, ultrasound, radiography and invasive methods are used to determine the cause of the disorder. Treatment involves treating the disease causing the pain.

Causes of joint pain

Mild or moderate joint discomfort is not always a manifestation of a pathological process. Sometimes the symptom has natural causes. Temporary pain in the joints is felt when wearing uncomfortable shoes, and in people who are sensitive to the weather, when the weather changes. Painful sensations in the shoulder and knee joints during puberty are caused by insufficient blood supply due to the acceleration of bone growth.

Significant physical activity

A common cause of the symptom during strenuous exercise or hard work is excessive tension of the musculo-ligamentous apparatus, less often caused by microtraumas of the cartilage and synovium. A typical combination of pain in the joints and discomfort in the bones and muscles. Joint and muscle discomfort occurs immediately after physical activity or against the background of long-term monotonous work with constant tension in the same muscle groups. Pain in the joints of the body occurs without fever. With large overloads, a moderate violation of the general condition and weakness is possible.

The disorder can last up to several days and gradually decreases with limited physical activity until it disappears completely without any treatment. If the pain caused by sports or heavy physical work is replaced by constant pain, swelling in the wrist, elbow, shoulder, ankle, knee and hip joints and limitation of usual movements, you should consult a doctor.

Age-related changes in the musculoskeletal system

The causes of moderate pain in bones and joints in elderly people are degenerative processes with loss of calcium, thinning of bone rays, disruption of blood supply to cartilage, and a decrease in the volume of intra-articular fluid. Mild discomfort is only the first manifestation of age-related joint damage. Typically, periodontal disease occurs after 45-50 years. At the age of 60-65, an unpleasant pain occurs even with a small force, it is accompanied by stiffness of movement, bending, confusion of gait and gradually turns into pain.

Pregnancy

Complaints about joint pain are mostly made in the second half of pregnancy. Stretching, aching discomfort is usually felt in the joints of the pelvis and lower limbs. It gets stronger towards the end of the day after standing for a long time or walking long distances. A night's rest eases the situation. Joint pain during pregnancy is caused by the following reasons:

• Vitamin and mineral deficiency. The biggest role is played by calcium and vitamin D deficiency, which causes osteomalacia. A feature of the symptom manifestation is the presence of pain not only in the joints, but also in the bones, fatigue, hypocalcemia, and other symptoms of hypovitaminosis D - caries, brittle nails, muscle weakness, muscle pain, and frequent occurrence of ARVI.
• Significant weight gain. Joint discomfort is more common in pregnant women with weight gain or those who are obese. At the end and finally in the middle of the day, pain is felt in the hip joints, knees, ankles, whose cartilages are exposed to several times higher loads than allowed. To alleviate the situation, women deliberately limit physical activity, which leads to faster weight gain.
• Softening of cartilage and ligaments. About half of pregnant women feel discomfort in the pelvic joints caused by the hormone relaxin. In most cases, discomfort is characterized by pain in the pubic region and hip joints. With the development of symphysitis, the painful sensations in the pathological course are replaced by pain, which intensifies when pressing on the womb, trying to separate the legs, during sexual intercourse. The appearance of pain in the pubic region is a serious reason to visit an obstetrician-gynecologist.
• Carpal tunnel syndrome. Tunnel syndrome is a special manifestation found in almost 20% of pregnant women in the 2-3 trimesters. The cause of the disorder is swelling of the soft tissues of the hands and compression of the nerves passing to the fingers in the carpal tunnel. In addition to aching pain in the small joints of the hand, patients complain of skin numbness, tingling and a crawling sensation. The situation improves with the high position of the arms.

Obesity

In overweight people, the pressure on the cartilage tissue increases, causing it to wear out faster. The degenerative-dystrophic process usually involves the large joints of the lower limbs and intervertebral joints. As obesity progresses, the disorder increases. Discomfort in the joints first manifests itself in the form of pain without fever until the end of the day, then the increased destruction of cartilage leads to the development of deforming arthrosis, spondylosis, osteochondrosis with an acute pain syndrome that limits the patient's motor activity.

Acute infections

Body and joint pain is one of the early (prodromal) symptoms of many acute respiratory viral infections. The main causes of joint discomfort are intoxication of the body due to the spread of viruses and bacteria, the accumulation of toxins and the development of the inflammatory process. Usually, the patient complains of pain in the whole body, mild to moderate pain in the joints, muscles and bones. The symptom is accompanied by weakness, fatigue, insomnia and frequent awakenings. Shivering and hyperthermia are observed simultaneously with symptoms of pain and general disorder.

The most common pains in joints and body are due to flu. Up to 50% of patients experience constant aching pain in the legs, arms, and trunk. The intensity of the pain is so high that it is difficult for a person to perform the simplest actions - get out of bed, move to another room, take a glass of water. The condition is aggravated by high (febrile) temperature and severe headaches. Sore throat and nasal congestion occur after a few hours or even days. Less common discomfort occurs with parainfluenza, an adenoviral infection.

Pain in the joints is possible with acute infectious lesions of the gastrointestinal tract - food poisoning infections, salmonellosis. Painful joint pains of varying intensity appear suddenly a few hours after eating contaminated food and are combined with a sharp rise in temperature, severe chills and headaches. Pain is preceded by nausea, vomiting, pain in the abdominal cavity, foul-smelling diarrhea with mucous and sometimes bloody impurities.

Collagenoses

Painful joints are a precursor to many diseases that occur with connective tissue, including autoimmune inflammation of the joint tissue. The localization, distribution and intensity of unpleasant sensations are determined by the characteristics of a certain collagenosis. Common examples are the involvement of certain joint groups in the process, a gradual increase in sensation to excruciating debilitating pain, first during movement and then at rest. Deformation of articular joints is possible. The main systemic inflammatory causes of the disease:

• Rheumatism. The symptom is "volatile": aching pains, and then the pain is alternately felt in the large joints of the arms and legs - elbows, shoulders, hips, knees, ankles. The affected areas are swollen. Joint discomfort often precedes a sore throat. With treatment, the changes in the joints are reversed.
• Rheumatoid arthritis. Unpleasant sensations often appear after 40 years. The typical feeling of pain in the small joints of the hands and feet is combined with noticeable swelling and stiffness in the morning. In the future, the pain and curvature of the articular joints comes to the fore.
• Systemic scleroderma. Variable localization of painful sensations is characterized by stiffness in the joints of the hands, elbows and knees in the morning. Aches and pains are usually symmetrical. Swelling is short-lived. Due to skin sclerosis, the mobility of the articular joints is limited, damage to the tendons creates a feeling of friction when moving.

Osteoarthritis

In the early stages of the disease, the pain syndrome is mild and perceived as discomfort, pain in the joints of the legs and less often in the arms. The immediate cause of arthrosis is the degeneration and destruction of cartilage tissue. Typically, pulling or aching sensations without fever appear in puberty and old age. Pain may start earlier if there are occupational hazards (vibration, heavy physical labor). Gradually, the joints become stiff, the person experiences severe pain and finds it difficult to walk and take care of himself.

Metabolic disorders

The causes of metabolic disorders in which joint pain occurs are insufficient supply of vitamins, minerals, accelerated accumulation or excessive excretion of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, have different severity and in most cases serve as a manifestation of pathological conditions:

• Osteoporosis. When calcium is washed out of the bone tissue, the articular surfaces of the bones become fragile, the cartilage becomes thinner, which is accompanied by painful sensations. The pain syndrome gradually increases from mild pain to severe arthralgia, along with unpleasant sensations in the bones and muscle weakness. The joints experiencing the maximum load are most affected - hip and knee; the shoulder, elbow, and ankle are less commonly affected.
• Gout. A slight pain in the big toe is already a concern in the preclinical stages of the gout process. There may be painful discomfort in the knees, elbows, wrists and fingers. Accumulation of urates in the joint cavity leads to the rapid manifestation of the disease, with the transition from pain to acute painful joint pain that does not subside within a few hours. The affected joint is warm to the touch. There is redness of the skin and limited movement.

Oncological diseases

In acute and chronic leukemia, widespread osteoarticular pains, followed by pains, occur even before noticeable pathological changes in the general blood test and other clinical symptoms - general malaise, night sweats, fever, loss of appetite, bleeding. Unpleasant sensations first hurt from time to time, then are constantly strong, weakening the patient.

Hodgkin's lymphoma and lymphogranulomatosis are characterized by the combination of muscle discomfort, weakness, enlarged lymph nodes and other lymphoid formations, and painful joints. Painful sensations are frequent, usually moderate. In osteosarcomas, short-term pains are observed in the knee joint and thigh muscles, which intensify at night, and during tension, they turn into constantly increasing pain with lameness. Other joints are less affected by this pathology.

Joint injuries

Joint pains are provoked by mild traumatic injuries that cause damage to the ligaments around the joint and decay of the soft tissues of the joint area. When the meniscus is damaged, more severe pain occurs. The symptom is clearly related to a blow, fall, or awkward movement. Discomfort is usually felt in one affected joint, less often it spreads to adjacent areas of the body.

Chronic infectious processes

Long-term infections are possible causes of painful joints that occur without fever or on the background of low-grade fever. In patients suffering from chronic infectious and inflammatory diseases, joint discomfort is the result of intoxication of the body or the direct harmful effect of microorganisms on the joint tissue (usually streptococci, mycoplasmas, chlamydia). The appearance or intensification of pain may indicate exacerbation of chronic tonsillitis, sinusitis, genitourinary infections, adnexitis, pyelonephritis.

Distinctive features of joint pain in general chronic infections caused by intoxication are moderate severity of joint discomfort, gradual development, periodic intensification and weakening of symptoms. The background for the development of painful painful sensations in patients suffering from tuberculosis and hematogenous osteomyelitis is an increase in temperature to subfebrile levels, a general disorder - fatigue, weakness, weakness. In the absence of treatment, the condition of patients gradually worsens.

Complications of pharmacotherapy

Taking some medications can be complicated by pain in the small joints of the hands and moderate pain. Unpleasant sensations are not accompanied by redness or deformation of the joints. Patients may complain of muscle pain, fever, skin rashes and other manifestations of drug allergy. The discomfort disappears quickly after the drug that provoked it is stopped, and the resulting complications are unlikely to require special treatment. Pains and mild arthralgia are caused by:

• Antibiotics: penicillins, fluoroquinolones.
• Tranvilizers: phenazepam, diazepam, lorazepam, etc.
• Contraceptives: combined oral contraceptives (COC).

Rare causes

• Inflammation of the respiratory system: pneumonia, bronchitis, tracheitis.
• Intestinal pathology: non-specific ulcerative colitis, Crohn's disease.
• Skin diseases: psoriasis.
• Endocrine disorders: diabetes mellitus, diffuse toxic goiter, hypothyroidism, Itsenko-Cushing's disease.
• Autoimmune processes: Hashimoto's thyroiditis, vasculitis.
• Fascial damage: necrotizing fasciitis in the healing phase.
• Congenital defects of bones and joints.

Inquiry

In order to determine why the pain and pain in the joints and bones are felt, it is necessary to consult a therapist or family doctor who will conduct the initial diagnosis and prescribe examinations by specialized specialists. Taking into account the nature of unpleasant sensations, the speed of their occurrence and accompanying symptoms, the following is recommended to determine the cause of the disorder:

• Laboratory blood test. To exclude infections, inflammatory and oncohematological processes, evaluation of the number of leukocytes and the level of ESR is required. In systemic diseases, it is important to measure the content of total protein, the ratio of protein fractions in the blood, specific acute phase proteins, markers of rheumatoid arthritis and other inflammations. Tests for the concentration of vitamins, electrolytes (especially calcium) and uric acid help diagnose metabolic disorders.
• Bacteriological examination. If the pain in the joints and throughout the body is likely to be infectious, a bacterial culture is needed. Urine, feces, sputum and discharge from the urogenital tract are collected for the study. Susceptibility to antibiotics is determined to select an antimicrobial therapy regimen. In doubtful cases, microscopy and culture are complemented by serological reactions (RIF, ELISA, PCR).
• Sonography of articular joints. It is usually used for clear localization of painful sensations and suspected rheumatic diseases. Joint ultrasound allows you to examine its structure, determine the destruction of cartilage and bones, preclinical inflammatory changes, and study the condition of periarticular soft tissues. The advantages of the method are accessibility, non-invasiveness and high information content.
• X-ray technique. X-rays of the joints reveal changes in the width of the joint space, hardening of soft tissues, presence of calcifications, osteophytes, and erosions of joint surfaces. To increase diagnostic efficiency, special methods are used - contrast arthrography, pneumoarthrography. In the initial stages of the lesion, tomography (MRI, CT of the joints) is considered more indicative. Bone density can be easily assessed using densitometry.
• Invasive examination methods. In some cases, a biopsy of the cartilage, synovial membrane and tophi is performed to determine the cause of joint pain. Morphological analysis of biopsy samples and examination of synovial fluid reflect the nature of pathological processes occurring in the joints. Simultaneous collection of materials with a visual examination of the joint cavity is convenient to do during arthroscopy with tissue biopsy.

A less common method to determine the cause of joint pain is scintigraphy with the application of technetium, which accumulates in the affected tissues. In recent years, interest in joint thermography as a modern non-invasive method for the recognition of inflammatory diseases, tumors and circulatory disorders in joints and peri-articular tissues has increased. If the number of elements formed in the clinical blood test decreases, extraarticular bone puncture is performed. Patients with joint pain without fever are recommended to consult a rheumatologist and orthopedic traumatologist.

Treatment

Help before diagnosis

Painful joints associated with physical activity do not require special treatment, a long rest with a dosage of loads is sufficient. Unpleasant joint sensations during pregnancy usually disappear on their own after pregnancy or are corrected by weight control and taking vitamin and mineral supplements. Elderly and obese patients are recommended to change their lifestyle: adequate physical activity, a diet with an appropriate calorie content with a sufficient amount of plant foods.

Pain in the bones, joints and muscles, general malaise and fever, pain and pulling sensations that increase to the point of severe pain, and the development of persistent pain are indications to consult a doctor. To reduce the joint discomfort caused by ARVI, it is recommended to rest, drink enough water, make hip infusions, and dry fruits. Self-medication with painkillers, compresses, lotions, decoctions, etc. , unless serious diseases that provoke pain in the joints are excluded. Long-term unsuccessful application of is unacceptable.

Conservative therapy

You can get rid of joint pain with the right treatment aimed at eliminating the cause of the disorder and individual parts of its development mechanism. Etiopathogenetic therapy is usually supplemented with symptomatic drugs that quickly reduce the severity of nagging and aching pain. The treatment regimen for diseases with painful joints may include:

• Antimicrobials. The main therapy for infections is based on the appointment of antibiotics to which the pathogen is sensitive. In severe cases, broad-spectrum drugs are used until the sensitivity of the microorganism is established.
• Nonsteroidal anti-inflammatory drugs. They reduce the production of inflammatory mediators and thereby prevent inflammatory processes in the joints. By affecting the central pain receptors, they reduce the degree of joint discomfort. It is used in the form of tablets, ointments, gels.
• Corticosteroids. They have a strong anti-inflammatory effect. Hormonal therapy is the basis for the treatment of systemic collagenosis. Corticosteroid drugs are combined with immunosuppressants to increase their effect in severe and persistent forms of the disease.
• Chondroprotectors. They act as a substrate for the synthesis of protein glycans, a sufficient amount of which increases the flexibility of articular cartilage. It nourishes the cartilage tissue and restores its damaged structure. Intra-articular administration of drugs is possible.
• Xanthine oxidase inhibitors. It is used as an anti-gout medication. They block the main enzyme necessary for the synthesis of uric acid, thereby reducing its concentration in the body and helping to dissolve existing urate deposits.
• Vitamin-mineral complexes. It is recommended for the treatment of painful joints caused by metabolic disorders. The most commonly used drugs contain calcium and vitamin D. They are also an element of complex therapy for inflammatory and metabolic diseases.
• Chemotherapeutic agents. They are the basis for most treatment regimens for various types of oncohematological pathologies. Depending on the clinical variant and severity of the neoprocess, they are combined with radiotherapy and surgical interventions.

Physiotherapy

After the exact cause of pain and reduction of acute inflammation, patients are prescribed physiotherapy and exercise therapy, except for those suffering from cancer. Microwave and ultrasound therapy sessions, electrophoresis and pulse currents have a good anti-inflammatory and analgesic effect. In case of chronic pathology, physiotherapeutic treatment is carried out for several months and is completed with spa therapy.