joint pain

joint pain- These are unpleasant painful, pulling sensations in the joint area, sometimes with an intensity that reaches the point of pain. The symptoms are accompanied by muscle pain, weakness, weakness, chewing, limited movement, and may precede joint pain (arthralgia). Joint pain is accompanied by pathologies of the musculoskeletal system, infections, diseases of the hematopoietic system, and vascular pathology. To determine the cause of the disease, laboratory tests, ultrasound, radiography, and invasive methods may be used. Treatment involves treating the condition causing the pain.

causes of joint pain

Mild or moderate joint discomfort is not always a manifestation of a pathological process. Sometimes symptoms have natural causes. Temporary joint pain may occur when wearing uncomfortable shoes and in weather-sensitive people (when the weather changes). During adolescence, due to accelerated bone growth and insufficient blood supply, shoulder and knee joint pain occurs.

lots of physical activity

A common cause of this symptom is excessive tension on the muscles and ligaments during strenuous training or heavy work, and less commonly is caused by microtrauma to the cartilage and synovium. Typical combination of joint pain and bone and muscle discomfort. Joint and muscle discomfort can occur immediately after impaired physical activity or against the background of long periods of monotonous work with sustained tension in the same muscle groups. Body joint pain but no fever. For large overloads, moderate violations of general conditions and weaknesses are possible.The disease can last up to several days and, with limited physical activity, gradually lessens until it disappears completely without the need for any treatment. If pain from sports or hard work is replaced by persistent pain, swelling of the wrists, elbows, shoulders, ankles, knees, and hips, and limitations in daily activities, you should see a doctor.

Age-related changes in the musculoskeletal system

The cause of moderate bone and joint pain in older adults is degenerative processes that result in calcium loss, thinning of bone beams, impaired blood supply to cartilage, and reduced fluid volume in joints. Mild discomfort is only the first sign of age-related joint damage. Typically, periodic discomfort occurs after 45-50 years. By the age of 60-65, uncomfortable pain will occur even with a little exertion, accompanied by stiffness of movement, stooping, and dragging gait, which gradually turns into pain.

Pregnant

Complaints of joint pain are more common in the second half of gestational age. The joints of the pelvis and lower limbs often experience pulling, painful discomfort. This condition is exacerbated at the end of the day, after standing for long periods of time or walking long distances. After a night's rest, the condition will ease. Joint pain during pregnancy is caused by:

• vitamin and mineral deficiencies. The greatest role played by calcium and vitamin D deficiencies is in the development of osteomalacia. A characteristic feature of the symptom presentation is not only joint pain, but also bone pain, fatigue, the occurrence of hypocalcemia and other symptoms of vitamin D deficiency - dental caries, brittle nails, muscle weakness, muscle pain and the frequent occurrence of ARVI.
• significant weight gain. Joint discomfort is more common in pregnant women who have gained a lot of weight or are obese. Pain is felt at the end of the day and eventually in the middle of the day in the hip joints, knees, ankles, where the cartilage is exposed to loads several times higher than allowed. To alleviate this condition, women will deliberately limit physical activity, causing weight gain to occur more quickly.
• Softening of cartilage and ligaments. About half of pregnant women experience pelvic joint discomfort due to the effects of the hormone relaxin. In most cases, the nature of the discomfort is pain in the pubic area and hip joints. In the pathological process of developing syndesmitis, the soreness is replaced by pain, which is aggravated by pressure on the uterus during sexual intercourse and when trying to spread the legs. Pain in the pubic area is a serious reason to see your ob-gyn.
• carpal tunnel syndrome. Nearly 20% of pregnant women develop a special manifestation, the so-called tunnel syndrome, at 2-3 months of pregnancy. The disease is caused by swelling of the soft tissues of the hand and compression of the carpal tunnel of the nerves that carry them to the fingers. In addition to pain in the facet joints of the hands, patients complain of numbness, tingling, and a crawling sensation in the skin. This condition improves as the arm position is raised.

obesity

In people who are overweight, the pressure on cartilage tissue increases, causing it to wear out faster. Degenerative dystrophic processes typically involve the large joints and intervertebral joints of the lower extremities. The disease worsens as obesity progresses. Joint discomfort first manifests as pain without fever at the end of the day, and then the destruction of cartilage increases, leading to joint deformation, spondylosis, osteochondrosis, accompanied by sharp pain syndrome, which limits the patient's sports activities.

acute infection

Body and joint pain is one of the early (prodromal) symptoms of many acute respiratory viral infections. The main cause of joint discomfort is the intoxication of the body due to the spread of viruses and bacteria, the accumulation of toxins, and the development of inflammatory processes. Typically, patients complain of generalized pain, with mild to moderate pain in joints, muscles, and bones. The symptoms are accompanied by weakness, fatigue, insomnia, and frequent wakings. Along with symptoms of pain and general malaise, chills and hyperthermia may also occur.The most noticeable pain in the joints and body is caused by the flu. Up to 50% of patients experience persistent 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, go to another room, pick up a glass of water. This condition can be aggravated by high fever (fever) and severe headache. Sore throat and nasal congestion may appear hours or even days later. Parainfluenza (an adenovirus infection) causes less joint discomfort.Acute infectious lesions of the gastrointestinal tract (food poisoning infections, salmonellosis) may cause joint pain. A few hours after eating contaminated food, varying degrees of joint pain will suddenly appear, accompanied by a sharp increase in body temperature, severe chills and headache. The pain is preceded by nausea, vomiting, abdominal pain, foul-smelling diarrhea with mucus and sometimes bloody impurities.

Collagenopathy

Joint pain is a precursor to most diseases caused by autoimmune inflammation of connective tissue, including joint tissue. The localization, pervasiveness, and intensity of the unpleasant sensations depend on the characteristics of the specific collagenopathy. The general pattern is that certain groups of joints are involved in the process, with a gradually increasing sensation of extremely debilitating pain, first observed during movement and then at rest. The joints may become deformed. The main systemic inflammatory causes of the disease are:

• Rheumatism. The symptoms are "unstable": aches and pains in the large joints of the arms and legs (elbows, shoulders, hips, knees, ankles) in sequence. Swelling of the affected area. Joint discomfort is often preceded by a sore throat. With treatment, joint changes are reversible.
• Rheumatoid Arthritis. Unpleasant feelings often appear after 40 years. Typical pain in the facet joints of the hands and feet, with significant swelling and morning stiffness. In the future, pain and curvature of the joints will become more prominent.
• systemic scleroderma. It is characterized by localized changes in pain sensation and stiffness in the hands, elbows, and knees in the morning. The pain is usually symmetrical. The swelling is short-lived. Due to hardening of the skin, joint movement is limited, tendons are damaged, and friction occurs during movement.

Osteoarthritis

In the initial stages of the disease, the pain syndrome is mild and is felt as discomfort and pain in the joints of the legs and, less commonly, of the arms. The direct cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Typically, a pulling or painful sensation without fever occurs in adulthood and old age. If there are occupational hazards (vibration, heavy physical work), the pain may start earlier. Gradually, the joints become stiff, the patient experiences severe pain, and it becomes difficult to walk and take care of themselves.

Metabolic disorders

Metabolic disorders that cause joint pain are caused by insufficient supply of vitamins and minerals, accelerated accumulation or excessive excretion of metabolites. Unpleasant sensations are caused by inflammatory or dystrophic processes, their severity varies, most often they are a manifestation of pathological conditions, such as:

• osteoporosis. When calcium is washed away from bone tissue, the joint surfaces of the bones become fragile and the cartilage becomes thinner, accompanied by pain. The pain syndrome progresses from mild pain to severe joint pain, accompanied by skeletal discomfort and muscle weakness. The joints that bear the greatest load are most commonly affected - the hips and knees; the shoulders, elbows and ankles are less commonly affected.
• gout. Mild pain in the big toe is already a cause for concern during the preclinical stages of the gout process. Pain and discomfort may occur in the knees, elbows, wrists, and fingers. The accumulation of urate in the joint space causes the disease to manifest rapidly, from aches and pains to acute pain that does not subside within several hours. The affected joint is hot to the touch. Red skin and limited movement.

neoplastic disease

In acute and chronic leukemias, widespread bone and joint pain, followed by pain, often occurs even before obvious pathological changes and other clinical symptoms appear on general blood tests (general malaise, night sweats, fever, loss of appetite, bleeding). The unpleasant sensation begins as periodic pain, then becomes persistently intense and debilitating to the patient. Hodgkin's lymphoma and lymphogranulomatosis are characterized by joint pain, muscle discomfort, weakness, swollen lymph nodes, and the formation of other lymphoid tissue. Pain is common and usually moderate. With osteosarcoma, transient pain in the knee and thigh muscles is observed, which worsens at night and becomes persistently worse with exertion and is accompanied by lameness. Other joints are less affected by this pathology.

joint damage

Joint pain is caused by minor trauma that results in damage to the ligaments around the joint and bruising of the soft tissues in the joint area. When the meniscus is damaged, more severe pain can occur. The symptoms are apparently related to blows, falls, or clumsy movements. Discomfort usually occurs in the affected joint and rarely spreads to adjacent areas of the body.

chronic infectious process

A possible cause of joint pain in the absence or low-grade fever is a long-term infection. In patients with chronic infectious and inflammatory diseases, joint discomfort is the result of body poisoning or the direct destructive effect of microorganisms (usually streptococci, mycoplasma, chlamydia) on the joint tissue. The onset or worsening of pain may indicate worsening of chronic tonsillitis, sinusitis, genitourinary infection, adnexitis, or pyelonephritis.The distinguishing feature of joint pain in common chronic infections that occur during poisoning is a moderate degree of joint discomfort, a gradual development, and cyclical intensification and weakening of symptoms. In patients with tuberculosis and hematogenous osteomyelitis, the background of soreness is an increase in body temperature to the level of hypopyrexia, general malaise - fatigue, weakness, weakness. Without treatment, the patient's condition gradually worsens.

Complications of drug therapy

Taking certain medications may cause pain and moderate pain in the small joints of your hands. The unpleasant sensation is not accompanied by redness or deformation of the joints. Patients may complain of muscle pain, fever, rash, and other signs of drug allergy. The discomfort disappears quickly after the offending medication is discontinued, and complications that develop are unlikely to require special treatment. Pain and mild joint pain are caused by:

• antibiotic: Penicillins, fluoroquinolones.
• sedative: Phenazepam, diazepam, lorazepam, etc.
• contraceptives: Combined oral contraceptive (COC).

Rare causes

• Respiratory system inflammation: Pneumonia, bronchitis, tracheitis.
• intestinal pathology: Non-specific ulcerative colitis, Crohn's disease.
• skin disease: Psoriasis.
• Endocrine disorders: Diabetes mellitus, diffuse toxic goiter, hypothyroidism, Itsenko-Cushing disease.
• autoimmune process: Hashimoto's thyroiditis, vasculitis.
• fascia injury: Necrotizing fasciitis during recovery.
• congenital bone and joint defects.

opinion poll

In order to determine the cause of the pain felt in the joints and bones, it is necessary to consult a therapist or family doctor, who will make a preliminary diagnosis and examine it by a professional specialist. Taking into account the nature of the unpleasant sensations, the speed with which they occur and the accompanying symptoms, the following methods are recommended for determining the cause of the disease:

• laboratory blood test. Evaluation of white blood cell count and ESR levels is required to rule out infectious, inflammatory, and oncohematological processes. In systemic diseases, it is important to measure total protein content, the ratio of protein components in the blood, specific acute phase proteins, markers of rheumatoid arthritis and other inflammations. Tests of vitamins, electrolytes (especially calcium), and uric acid concentrations can help diagnose metabolic disorders.
• Bacteriological examination. If joint and general pain may be contagious, a bacterial culture may be required. Urine, feces, sputum, and urogenital secretions were collected for study. In order to select an antimicrobial treatment regimen, susceptibility to antibiotics needs to be determined. In suspicious cases, microscopy and culture are supplemented by serological reactions (RIF, ELISA, PCR).
• Joint Ultrasound. It is often used to clearly localize pain and suspect the presence of rheumatic disease. Ultrasound examination of joints allows us to examine their structure, identify destruction of cartilage and bone, preclinical inflammatory changes, and study the condition of the soft tissues surrounding the joint. The advantages of this method are accessibility, non-invasiveness, and high information content.
• X-ray technology. Changes in joint space width, soft tissue sclerosis, the presence of calcifications, osteophytes, and articular surface erosion can be detected during joint radiography. To increase the efficiency of diagnosis, special techniques are used - contrast arthrography, pulmonary angiography. In the initial stages of pathology, tomography (MRI, joint CT) is considered more indicative. Bone density can be easily assessed using densitometry.
• Invasive inspection techniques. In some cases, to determine the cause of joint pain, an aspiration may be performed to take a biopsy of the cartilage, synovial lining, and tophi. Morphometric analysis of biopsy specimens and examination of synovial fluid reflect the nature of the pathological process occurring in the joint. During arthroscopy and tissue biopsy, material collection and visual inspection of the joint space can be conveniently performed simultaneously.

A less common method of diagnosing the cause of joint pain is to introduce scintigraphy of technetium, which accumulates in the affected tissue. In recent years, there has been increasing interest in joint thermography as a modern, non-invasive method to identify inflammatory diseases, tumors, and circulatory diseases of joints and periarticular tissues. If the number of formed elements decreases in the clinical blood test, extra-articular bone aspiration is performed. Patients with joint pain but no fever are advised to consult a rheumatologist and an orthopedic traumatologist.

treat

Pre-diagnosis help

For joint pain associated with physical activity, no special treatment is required; prolonged rest and increased load are sufficient. Unpleasant joint sensations that occur during pregnancy usually resolve on their own after pregnancy or are corrected with weight control and vitamin and mineral supplements. Lifestyle changes are recommended for elderly and obese patients: adequate physical activity, a diet of appropriate caloric content and adequate plant foods.Bone, joint, and muscle pain accompanied by general malaise and fever, pain and pulling that worsens to severe pain, and persistent pain require a visit to a doctor. To reduce joint discomfort caused by ARVI, rest, drinking enough water, rosehip infusion and dry fruits are recommended. Self-administration of painkillers, long-term use of compresses, lotions, decoctions, etc. with ineffective results is unacceptable until a serious disease causing the joint pain has been ruled out.

Conservative treatment

You can eliminate joint pain with the right treatment, aimed at eliminating the cause of the disease and various parts of the mechanism of its development. Treatment of the cause is often supplemented with symptomatic medications that can rapidly reduce ongoing pain and pain severity. Treatment options for joint pain disorders may include:

• Antibacterial agents. The basic treatment of infection is based on the prescription of antibiotics sensitive to the pathogen. In severe cases, broad-spectrum drugs are used until the susceptibility of the microorganism is determined.
• NSAIDs. They reduce the production of inflammatory mediators and thus suppress the inflammatory process in the joints. By affecting central pain receptors, they can reduce the level of joint discomfort. Available in the form of tablets, ointments, and gels.
• corticosteroids. They have strong anti-inflammatory effects. Hormone therapy is the basis for the treatment of systemic collagenopathies. In severe and resistant disease, corticosteroid drugs are combined with immunosuppressants to enhance efficacy.
• chondroprotectant. They serve as substrates for the synthesis of proteoglycans, which in sufficient amounts increase the elasticity of articular cartilage. Nourish cartilage tissue and restore its damaged structure. Intra-articular administration is possible.
• xanthine oxidase inhibitor. Used as an anti-gout medicine. They block key enzymes required for the synthesis of uric acid, thereby reducing its concentration in the body and promoting the dissolution of existing urate deposits.
• vitamin mineral complex. Recommended for the treatment of joint pain caused by metabolic disorders. The most commonly used medications contain calcium and vitamin D. They are also an element in the comprehensive treatment of inflammatory and metabolic diseases.
• Chemotherapy drugs. They are the basis of most treatment options for various types of neoplastic hematological pathology. Depending on the clinical variation and severity of the new process, they are combined with radiotherapy and surgical intervention.

physiotherapy

After the exact cause of the pain is identified and acute inflammation subsides, patients other than cancer patients undergo physical therapy and exercise therapy. Microwave, ultrasound treatment, electrophoresis, and pulse current have good anti-inflammatory and analgesic effects. If the condition is chronic, several months of physical therapy may be required, supplemented by hydrotherapy.