Arthralgia is the most painful manifestation of diseases of the musculoskeletal system. About 30% of the world's population suffers from this disease. Joint disease is particularly important due to increased life expectancy: according to epidemiological studies, joint disease is found in 50% of cases in people over 40 years of age, and in 90% of the population after 70 years of age.
Arthralgia or arthralgia (Greek arthron - "joint" and algos - "pain") can be observed in a variety of diseases - metabolic, rheumatic, neoplastic, systemic and acute infections, endocrine and rheumatic. Therefore, it is wrong to believe and believe that the vast majority of people who suffer from joint pain and self-medicate think that joint pain must be caused by arthritis. It should be noted here that there are dozens of types of arthritis alone, and not all of them have pain symptoms.
Arthralgia is caused by irritation of nerve endings from the synovial joint pocket (sac), which can be toxins, salt crystals (urate or potassium urate), allergens, products of autoimmune processes, osteophytes, and otherinflammatory components. A physical exam is a must for any joint pain of intensity but of sufficient duration.
Types of Joint Pain
Joint pain is not a disease but a symptom of many infectious and non-communicable diseases. The sensation of pain depends largely on the state of the nervous system. A calm, balanced person rarely responds to mild pain. In emotionally unstable people, pain thresholds are lowered. Pain is diametrically opposed in intensity and duration and is characterized as follows:
- Tolerable - intolerable;
- weak - strong;
- sudden - constant;
- dull - sharp;
- frequent - rare;
- short term - long term etc
If persistent pain bothers a person for more than 30 days, it is considered chronic pain. After treatment, they disappear for a period of time (remission) and then reappear (exacerbation). Predisposing factors for acute pain recurrence are hypothermia, physical activity, malnutrition, weight gain, and stress.
There are several risk factors that can contribute to this disease. The most common one is genetics. For example, if a grandmother and a mother have multiple sets of joints at the same time, the problem will show up in the offspring sooner or later.
Gender is another risk factor. It has been observed that the incidence of joint disease in women is several times higher than in men. In this case, women are more likely to get sick after menopause. This is because before him women were "protected" by their own estrogen. As they age, their numbers begin to dwindle inexorably, and after they have all but disappeared, with no one to protect the woman, the joints begin to gradually deform and collapse. In men, this problem does not actually arise. As a result, joints suffer less damage than women due to a disrupted hormonal background.
In men, joint pain occurs mainly due to strenuous physical labor. This is because they are often heavily loaded. Gradually, the cartilage begins to wear away, and the joint itself becomes inflamed and deformed at the same time.
People who often suffer from conditions such as tonsillitis may complain that their joints are starting to hurt. This is because the bacteria that cause angina pectoris can also adversely affect joints, especially large ones. The cause and treatment of pain in all joints in the body are closely related.
Common symptoms of joint pain
It seems easy to identify the presence of a disease by painful symptoms. but:
- The presence of pain does not always mean the presence of disease, as pain can be caused by bruising, a one-time (severe) physical overload, dislocation, and the like.
- If you already have a medical condition, the symptoms may not be noticeable at first, because pain, especially acute pain, is often a serious symptom of the condition.
Early signs of joint pain even before the pain may be:
- Stiff movement, more common in the morning or after sitting in one position for an extended period of time;
- The joints have periodic creaking and crunching.
Such bodily signals cannot be ignored; these can be the first symptoms of serious illness.
Causes of joint pain
Joints are anatomically complex structures. Pain can be caused by everything that contributes to pain: muscle, bone, ligament, cartilage, tendon, inside the joint cavity. In the joint structure, pathological conditions such as inflammation, sprain and rupture occur, and the metabolic process is disturbed. The causes of joint pain can vary. For some diseases, they have not been accurately identified.
To sum up, it can be divided into the following points:
- Physical inactivity and a sedentary lifestyle;
- Excessive, frequent and monotonous physical activity;
- old wound;
- decrease in immunity;
Arthralgia occurs due to the stimulation of nerve receptors located in all structures of the joint by various factors, depending on the underlying disease. One of the causes of joint pain can be joint bruising and invisible hematoma formation. Depending on the nature of the pain sensation, one can assume the presence of one pathology or the other.
Diseases that cause joint pain
Osteoarthritis is the most common chronic disease of joints (usually the hip, knee, interphalangeal joints of the hands) and is a degenerative dystrophic disease (metabolic disease) based on articular cartilage, bone tissue, synovium and ligamentous organs. Joints (old age, overweight, impaired metabolism, injury, vitamin C and D deficiency, occupational hazards).
Reiter's disease (a separate type of reactive arthritis with a genetic predisposition) - manifests after chlamydia or intestinal infection. Presents with reactive arthritis (mainly in the lower extremity joints), joint pain, characteristic extra-articular manifestations (urethritis or prostatitis, conjunctivitis or uveitis, skin and mucosal lesions - ulcerative stomatitis, erosive balanitis), Cardiovascular system (arrhythmia, obstruction, aortitis), fever (38. 6 - 40. 0).
Rheumatoid arthritis is chronic progressive systemic inflammation of connective tissue (autoimmune inflammation in the joints). The small joints of the hands and feet are affected, and the knee and elbow joints are less affected. Symptoms - persistent joint pain, joint deformity, joint swelling, morning joint stiffness, symmetrical joint damage, weakness, fatigue, weight loss.
Psoriatic Arthritis - Arthritis that develops in people with genetic predisposition to psoriasis, the worsening of the arthritis coincides with the worsening of the psoriasis. symptom. Joint pain (mainly involving the interphalangeal joints of the hands and feet), cyanotic skin, swelling in the joint area, asymmetric joint damage, lumbosacral pain, heel pain (calf pain), psoriatic plaques on the skin, nail damage (Nail plates are brittle, streaky and cloudy).
Bursitis - This disease is often confused with arthritis, although bursitis does not cause inflammation of the joints, it causes inflammation of the joint pockets. Bursitis can cause discomfort, stiffness, and pain in the joint area. Symptoms are related to inflammation of the synovium of the joint, usually caused by improper movement, compression, or trauma. Bursitis is more common in the shoulder, knee, or hip area. A type of bursitis called "maid's knee" develops as a result of prolonged stress on the knee joint on a hard surface.
Gout (gouty arthritis) is a type of microcrystalline arthritis, an inherited disorder based on a metabolic disorder (violation of diet), namely purine metabolism, which leads to the deposition of urate crystals (urate) around and in joint tissuessexually transmitted diseases. symptom. Joint pain (more commonly in the first metatarsophalangeal joint of the foot), bright congestion (redness), swelling and peeling of the joint skin, fever, increased local temperature in the affected joint area, skin manifestations on the pinna, elbow, foothands, in the form of tophi (local accumulation of urate crystals surrounded by granulomatous tissue), cardiac damage (myocarditis, endocarditis, pericarditis, coronary arteritis, aortitis, arrhythmias), Kidney damage (amyloidosis, glomerulonephritis).
Medication-induced arthralgia is a temporary condition characterized by pain in the joints (mainly the small joints) when high daily doses of certain medications are taken. It is not a disease and is not classified by WHO as ICD-10. The group of drugs that can cause drug-induced arthralgia is penicillin antibiotics, barbiturates, photohypnotics and sedatives (chemically based), antihypertensives, contraceptives and antituberculosis drugs, proton pump inhibitors. The cause, pathogenesis, clinical manifestations, and diagnosis of this condition have not been studied due to the aggressive promotion of the drug on the pharmacological market and the low severity of the condition associated with functional joint disease and individual drug tolerance.
The same applies to homeopathic arthralgia (joint pain that occurs in retrograde people who are sensitive to changes in atmospheric pressure).
Diagnosis of joint pain
In most cases, clinical blood tests show various biases according to the nature of the joint damage and its severity, with an increased ESR, a level reflecting the inflammatory process, and a normal number of white blood cells, characteristic of rheumatic diseases. Increased numbers of white blood cells in inflammatory diseases of the spine and joints may indicate foci of infection in the body, among other things.
Immunological research. Rheumatoid factor (an antiglobulin antibody) is particularly important for early diagnosis of rheumatoid lesions. It is formed by lymphoplasmacytic cells in lymph nodes, spleen, synovium. For the detection of rheumatoid factor in serum and synovial fluid, a Vaaler-Rose reaction is considered positive if the concentration is 1: 28 or higher. Rheumatoid factor is detected in 75-85% of patients with rheumatoid arthritis. In the early stages and seronegative forms of rheumatoid arthritis, immune cell adhesion responses are used to isolate rheumatoid factors at the lymphocyte level.
Testing for anti-streptolysin O (ASL-O) reflects immune reactivity associated with streptococcal infection. Increased ASL-0 titers have been observed in patients with rheumatism, infectious allergic polyarthritis.
Inhibitory response to leukocyte migration. Typically, leukocytes have the ability to migrate into the environment and form aggregates. If the body is sensitized to a certain antigen, when the sensitized leukocytes encounter this antigen, the lymphocytes will secrete an inhibitory factor to inhibit the migration of leukocytes. This response is positive in rheumatism, rheumatoid arthritis and other rheumatic diseases.
Blood on the HLA system - the possibility of early diagnosis of Bechterew's disease, the determination of HLA B-27 is very important. HLA complexes exist in the cell membrane and are isolated using immunological methods.
Immunoelectrophoresis - reveals A, G, M immunoglobulins, which are important in the development of the pathological process of rheumatoid arthritis.
Radiography is a reliable way to examine joints. In fact, without it, doctors cannot confirm the diagnosis and make a differential diagnosis. X-rays allow you to determine the stage and prognosis of the disease, and to objectively assess the effectiveness of treatment on a dynamic basis. It is necessary to compare radiological data with clinical pictures, disease duration and patient age.
A tomography scan allows you to more accurately identify focal lesions or individual parts of a vertebra.
Myelography is a contrasting method for studying the spine, with which the localization of pathological processes can be clarified, especially if surgical intervention is required.
Intraosseous venography - to study venous blood flow in the epidural space. This method allows you to judge the blood circulation status of the paravertebral space and indirectly judge possible degenerative disease.
Arthroscopy is a research method that allows you to visualize the knee joint structure and biopsy the desired area, examining the contour, color and capillary network of the synovium, cruciate ligaments, meniscus, and fat pads.
Discography - The introduction of a contrast agent into the disc, followed by radiography, can determine the state of the disc, the location and extent of the lesion.
Radionuclide scan is an important objective method for early diagnosis of joint injury.
Arthrography - With the help of various contrast agents injected into the joint, it allows you to more accurately identify lesions deep in the joint.
How to Treat Joint Pain
The treatment of joint pain itself is symptomatic, that is, aimed at eliminating or reducing the pain syndrome. At the same time, it is clear that the elimination of joint pain must be complemented by the treatment of the underlying cause of the joint pain. But regardless of the identified cause of joint pain, and in the absence of an immediate contraindication, doctors most often prescribe non-steroidal anti-inflammatory drugs (NSAIDs), which relieve pain, swelling, congestion, fever, lower temperature, and reduce inflammation. .
Irritation of the gastrointestinal tract is a side effect of almost all NSAIDs because these drugs are made on the basis of acid, inhibition of platelet aggregation (reduced blood clotting) and impaired blood flow to the kidneys (renal failure)of. Otherwise, NSAIDs are harmless if there are no personal contraindications and if one wishes to comply with all doctor's prescriptions.
But effective treatment of joint pain is not limited to taking NSAIDs, as it makes sense to switch to nonpharmacological or homeopathic treatments, including some types of physical therapy, after the primary or acute pain syndrome has been eliminated(SWT, Magnetic Therapy, Ultrasound and Electrical Pulse Therapy), Exercise Therapy Gymnastics, Manual Therapy, Swimming, etc. Also, be sure to review patterns and nutrition.
joint pain diet
General nutritional requirements for joint pain:
- Limit carbohydrates, especially sugar;
- reduce (maximum) table salt;
- Occasional, multiple meals (5-6 meals per day);
- Eliminate spicy, salty foods, extracts (soups, fried foods), strong beverages, strong tea, coffee from your diet.
Dishes without salt, meat and fish - in boiled or lightly fried (after boiling) form; vegetables should be cooked.
General recommendations for joint disease nutrition:
- Soup - mostly vegetarian, as well as cereal, milk, fruit, weak meat or fish soup - 1-2 times a week.
- Low-fat meat or poultry - mostly in cooked or roasted form. It is best to exclude liver, tongue, brain, chicken, veal.
- Fish - a wide variety, except salted and smoked.
- Boiled eggs, omelets.
- Balsamic vinegars and salads with various vegetables, vegetable oil in vegetable form as a garnish. Limit (until exceptions) beans, peas, beans, spinach, sorrel.
- Fruit, berry dishes: any, limited to grapes.
- Cereal and dairy dishes are not restricted.
- Fats: butter, vegetables (1/3 of the total).
- Sweets: Sugar - up to 30g per day (4 pieces), honey, jam, jam.
- Drinks: weak tea, coffee drinks, vegetables, fruits, berry juices (except grapes). Excluding alcoholic beverages.
- Spices, seasonings: bay leaf, dill, parsley, cinnamon, cloves.
Therapeutic exercise (LFK)
Physical therapy is suitable for almost any stage of any disease. If physical activity causes discomfort, use ointments, tablets, or injections (as appropriate) for pain relief. Exercise therapy is a type of exercise specifically designed to restore healthy mobility in joints without harming them. On the one hand, such exercises are gentle, on the other they "wake up" the necessary areas of the body. Physical education for those at risk is also recommended as a preventive measure.
To a large extent, this was the practice of the East, but today it is adopted by official medicine and used successfully in many private and public clinics. One problem: Not many professionals in this field know their business like the back of their hand. Therefore, we recommend that you carefully consider the options of a specialist before proceeding with treatment in this manner. Acupuncture affects the body in a very interesting way. They are unlikely to completely cure joint pain, but after a few treatments, patients usually feel better—all symptoms subside.
Manual therapy also does not tolerate amateur and unprofessional. But if you meet someone who knows his business, you can keep your cool - that's how it turns out. With the help of manual therapy, muscle spasms in a problem area of the body can be removed. In its application, regularity is important and procedures can be performed frequently - 12 times a year or more. There are contraindications to manual therapy, including some types of joint pain exacerbations! Prescribing yourself is not acceptable, contact a chiropractor - they will tell you about effective treatments for your specific condition and choose the most appropriate one.
Massage produces good results when combined with other therapies. In order to really properly affect diseased joints, a massage therapist must have medical knowledge and experience in medical (therapeutic) massage.
This option is used when surgery is simply not enough.
- prick. Or a small procedure that uses a needle to remove inflammatory fluid from the joint cavity.
- Arthroscopic debridement. In this case, no large incisions are needed - everything is done through small holes (removing non-living tissue from the joint cavity) using endoscopic instruments.
- Periarticular osteotomy. If the use of joint prostheses is prohibited, it is used. The essence of the surgery is to rasp the joint and then fuse it at different angles to improve mobility and reduce load.
- Internal prosthesis. A radical treatment option with long-term recovery in which the joint is replaced with a prosthesis.
Numerous methods have been invented for the treatment of various joint pathologies. Of course, for the treatment to be successful, you must first find an experienced specialist. Self-medication in this matter is absolutely unacceptable!
Prevent joint disease
To save your joints, you must continually protect them and work on prevention. After all, it is not in vain that people agree that disease is easier to prevent than cure. The first thing to do is to avoid hypothermia as much as possible, as it can lead to conditions like tonsillitis. In turn, she brings complications. On its own, hypothermia causes inflammation in multiple groups of joints at the same time.
Don't forget physical activity! Of course, the diseased joints must be loaded, but it is wrong to leave them stationary. Reasonable exercise stimulates the production of synovial fluid, improving tissue circulation and nutrition. Swimming, cycling, and therapeutic exercise will help keep your joints working. In addition to gym classes, you may receive physical therapy and rehabilitation measures such as electrophoresis, therapeutic massage, mud baths, various body wraps, and more.
Both women and men need to monitor their weight carefully, as being overweight is a direct route to deforming joints at least in the knee and hip. Also, you need to monitor your drinking regimen. It is known that the average adult needs to drink at least two liters of fluids per day. In this case, the synovial fluid is constantly renewed. Without enough fluid, the cartilage starts to rub, causing severe pain and the joints begin to deform.