Joint pain (arthralgia) is a very common problem that can be associated with infection or toxicity, trauma, inflammation or cartilage deterioration.
<1_img_blockxx>In most cases, joint pain goes away on its own within a few days. However, some situations require you to see a doctor as soon as possible. It is not easy, even for an experienced specialist, to determine exactly why joints ache, as the first symptoms can be misleading, and the full picture of the disease sometimes develops in just 1-2 months or more.
The information in this article will help you navigate the variety of diseases and conditions that cause arthralgia. And modern diagnostic methods will allow you to establish the exact cause of the illness and choose the right treatment tactics together with a doctor.
In this article, we'll look at situations where multiple joints throughout the body hurt. Sometimes one starts to ache and other joints quickly join it. It turns out that the pain seems to migrate from one part of the body to another over the course of several days or weeks. Several diseases cause pain in a group of joints in the form of seizures—convulsions, when the pain subsides and then reappears.
Joint pain with viral infections
Arthralgias most often occur with various viral infections: due to the direct effect of viruses on joints or under the influence of toxins that accumulate in the blood during the acute period of many infectious diseases.
Most of the time, the pain appears in the small joints of the arms and legs, in the knee joints, and sometimes in the spinal joints. The pain is not strong, it hurts. It's called joint pain. Mobility is generally not impaired, there is no swelling or redness. In some cases, a rash similar to urticaria may appear and disappear quickly. In most cases, viral arthralgias become the first symptom of malaise and are accompanied by fever, muscle pain and weakness.
Despite the deterioration of general well-being, joint pain in viral diseases is generally not a major concern. Relief can be provided by taking nonsteroidal anti-inflammatory drugs, drinking plenty of fluids, and resting. After a few days, the pain disappears and joint function is fully restored. There are no irreversible changes to the joint structure.
Viral arthralgias are characteristic, for example, of flu, hepatitis, rubella, mumps (in adults).
reactive arthritis
This is a group of diseases in which joint pain occurs after an infection, both viral and bacterial. The immediate cause of reactive arthritis is an error in the immune system, which causes inflammation in the joints, even though they are unaffected by the infection.
Joint pain most often appears 1-3 weeks after acute respiratory infections, intestinal infection or diseases of the genitourinary system, eg urethritis or genital infections. Unlike viral arthralgias, joint pain is severe, accompanied by swelling and difficulty in walking. Body temperature may rise. Arthritis usually starts with involvement of a knee or ankle joint. Within 1-2 weeks, the pain in the joints of the other half of the body starts to ache. Sometimes the spinal joints ache.
Joint pain usually disappears with treatment or on its own, leaving no sequelae. However, some types of reactive arthritis are chronic and occasionally exacerbated.
Reiter's disease- one of the types of reactive arthritis that develops after chlamydia transfer and can have a chronic course. Joint pain in Reiter's disease is usually preceded by a violation of urination - a manifestation of chlamydial urethritis (inflammation of the urethra), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment you must consult a doctor.
Reactive arthritis can develop after adenovirus infection, genital infections (especially chlamydia or gonorrhea), intestinal infections associated with infection by Salmonella, Klebsiella, Shigella, etc.
Joint Pain When Cartilage Is Worn
Diseases that are accompanied by gradual wear of the cartilage in the articular surfaces of bones are called degenerative. They are more common in the age group 40 to 60 years and older, but they also occur in younger people, for example, those who have suffered joint damage, professional athletes exposed to frequent intense exertion and in obese people.
Osteoarthritis deforming (osteoarthritis, DOA)- This is a disease of the large joints in the legs - knees and hip joints, which bear most of the load when walking. Pain comes gradually. In the morning, after resting, the state of health improves, and at night and at night after long walks, jogging and other stresses, it worsens. Inflammatory changes: edema, redness are usually not pronounced and may appear only in advanced cases. But there are often complaints of crackling in the joints. Over the years, the disease progresses. It is almost impossible to cure deforming arthrosis, it is only possible to delay cartilage destruction. To restore mobility, they resort to surgery.
Spinal osteochondritisIt's another common degenerative disease. Its cause is the thinning and destruction of the cartilage between the vertebrae. The thinning of the cartilage leads to compression of the nerves that extend from the spinal cord and blood vessels, which, in addition to pain in the spinal joints, causes several symptoms. For example: headaches, dizziness, pain and numbness in arms, shoulder joints, pain and interruptions in heart, chest, leg pain, etc. A neurologist typically handles the diagnosis and treatment of osteochondrosis.
Autoimmune Diseases as a Cause of Joint Pain
Autoimmune diseases are a large group of diseases whose causes are not fully known. All these diseases are united by the peculiarity of the immune system: the cells of the immune system start to attack their own tissues and organs in the body, causing inflammation. Autoimmune diseases, unlike degenerative diseases, are more likely to develop in childhood or youth. Its first manifestation is usually joint pain.
Joint pain is often volatile: today one joint hurts, tomorrow another, the day after tomorrow—a third. Arthralgia is accompanied by swelling, redness of the skin, difficulty in moving the joints, and sometimes fever. After a few days or weeks, the joint pain disappears, but after a while it reappears. Over time, joints can become significantly deformed and lose mobility. A hallmark sign of autoimmune joint inflammation is morning stiffness. In the early morning hours, the affected joints should be kneaded for 30 minutes to 2-3 hours or more. The stronger the load on the joint the day before, the more time you will need to spend warming up.
Gradually, the symptoms of damage to other organs join the arthralgias: heart, kidneys, skin, blood vessels, etc. Without treatment, the disease progresses. It is impossible to cure it, but modern medicines can slow the process down. Therefore, the sooner treatment is started, the better the result.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are mainly affected: they start to hurt a lot, turn red and swell. Most often, the disease starts with pain in the small joints of the arms and legs: fingers, hand or foot joints, less often - with the defeat of a knee, ankle or elbow and then pain elsewhere. of the body junction.
Systemic lupus erythematosus- a rarer disease, which is more susceptible in young women. It is characterized by pain in flight in various joints of the body, deformation of the fingers, the appearance of a skin rash, especially characteristic on the face - redness on the forehead and cheeks in the shape of butterfly wings. Joint pain may be accompanied by interruptions and discomfort in the heart and chest, low-grade fever, weakness, weight loss, increased blood pressure, back pain, edema.
Ankylosing spondylitis- unlike lupus, it affects men more often. The disease begins with pain in the joints of the spine, lower back, sacrum, pelvis. Gradually, the pain spreads upward to other parts of the spine. In addition to pain, stiffness, decreased flexibility and, over time, gait disturbances and complete immobility in spinal joints are characteristic. In the early stages, ankylosing spondylitis can easily be confused with osteochondrosis. However, the first disease develops in young men and the second in older people. As a diagnostic test, an x-ray is taken of 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 condition in which a characteristic rash appears on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and toes, less often the spine, often ache and swell. A distinguishing feature of arthritis in psoriasis is an asymmetric lesion. The skin over the joints may have a bluish-purple color and damage to the nails may occur. Over time, joint deformities and subluxations develop (the fingers begin to bend in an atypical direction).
Arthralgia with rheumatism
Rheumatism (acute rheumatic fever) is a serious illness caused by streptococci. Rheumatism is characterized by 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 most often in children. The pain is so bad you can't touch the joint, you can't move. The joints swell, turn red and the temperature rises. First, some joints hurt, then others, usually symmetrical. Even without treatment, the pain disappears on its own and joint function is fully restored. However, after some time, severe symptoms of heart damage appear. Rheumatism requires urgent medical attention. Only with timely treatment can damage to the heart and other organs be avoided.
How to examine painful joints?
There are several test methods for joint pain. As a rule, they are used in combination.
blood test- is one of the most common tests for complaints of joint pain. With the help of this study, it is possible to determine the presence of inflammation or suggest a degenerative character of the disease, identify signs of infection and, through immunological tests or the polymerase chain reaction (PCR) method, to accurately determine the agent causative of the disease in the case of infectious or reactive arthritis. A blood test shows possible metabolic disturbances, the state of the internal organs.
Study of synovial fluid- fluid that washes the surface of the joint. With its help, the joint surfaces are nourished and friction during movement is also reduced. According to the composition of the synovial fluid, the laboratory assistant draws conclusions about the presence of inflammation or infection in the joint, the processes of cartilage destruction and nutrition, the accumulation of salts that can cause pain (eg, in gout). Synovial fluid is removed for analysis using a needle, which is inserted into the joint cavity after local anesthesia.
Joint X-ray and computed tomography (CT)- a method that makes it possible to consider the structure of the bone parts of the joint and also indirectly assess the condition of the cartilage by the size of the joint space - the distance between the bones in the joint. X-ray examination is prescribed among the first methods for joint pain. The x-ray shows mechanical damage to bones (fractures and cracks), joint deformities (subluxations and dislocations), the formation of bone growths or defects, bone density, and other criteria that help the doctor 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 photos of the joint, which in some cases provide more complete information about the disease.
Ultrasound and MRI of joints- the methods are of a different nature, but similar in purpose. With the help of ultrasound or MRI, information about the condition of the soft tissues of the joint and cartilage can be obtained. Ultrasound and MRI show the thickness of the cartilage, its defects, the presence of extraneous inclusions in the joint, and also help to determine the viscosity and amount of synovial fluid.
Arthroscopy- a method of visual examination of the joint using microsurgical instruments, which, after anesthesia, are inserted into the cavity of the diseased joint. During arthroscopy, the physician has the opportunity to examine the internal structure of the joint with his eyes, observe its damage and changes and also remove pieces of the synovial membrane of the joint and its other structures for analysis. If necessary, after the examination, the physician can immediately carry out the necessary therapeutic manipulations. Everything that happens during arthroscopy is recorded on a disk or other storage medium, so after the procedure you can consult other specialists.
joint treatment
If you have joint pain, find a good children's therapist or pediatrician. He will make an initial diagnosis and, if necessary, refer you to a specialist specialist for treatment. If joint pain is associated with arthrosis or arthritis, treatment will likely be provided by a rheumatologist found here.
If the cause of the arthralgia is an inflammatory response, medications are used to treat the joints that can reduce inflammation. First, the non-steroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and many others. If these drugs are not effective enough, drugs in the corticosteroid group are prescribed in the form of injections into the joint cavity or pills. When an infection is causing the pain, antibiotics are given.
Special treatment regimens are used for autoimmune diseases. For constant hospitalization by the physician, the minimum effective doses of drugs that can strongly suppress the inflammatory response or suppress the immune system are selected. For example: sulfosalazine, methotrexate, cyclophosphamide, azatiaprine, cyclosporine, infliximab, rituximab and others.
For degenerative joint diseases (osteochondrosis, osteoarthritis), no specific medication is known yet. The treatment of joint disease consists of prescribing anti-inflammatory drugs and analgesics during the exacerbation, in addition to the administration of metabolic agents based on chondroetin sulfate and hyaluronic acid. Although the effectiveness of the latter is not recognized by all doctors.
If joint function is irreversibly deteriorated, they resort to surgery. Currently, there are several endoprosthetic methods that allow the implantation of artificial joints or parts of them instead of being damaged or worn out.