Joint pains

9 January 2024

Joint pains- These are unpleasant feelings of pain, pulling 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, grinding, limited movements and may precede joint pain (arthralgia). Pain in the joints is accompanied by lesions of the musculoskeletal system, infections, diseases of the hematopoietic system and vascular pathology. To identify the cause of the disorder, laboratory tests, ultrasound, radiographic and invasive methods are used. Treatment includes treating the disease that caused 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. Transient pains in the joints are felt when wearing uncomfortable shoes, and in people sensitive to the weather - when the weather changes. During puberty, pain in the shoulder and knee joints occurs due to insufficient blood supply due to accelerated bone growth.

Significant physical activity

During intensive training or hard work, a common cause of symptoms is overstrain of the muscle-ligament apparatus, less often it is caused by microtraumas of cartilage and synovium. A typical combination of joint pain and bone and muscle discomfort. Discomfort in the joints and muscles occurs immediately after vigorous physical activity or in the background of long-term monotonous work with constant tension in the same muscle groups. Pain in the joints of the body occurs without temperature. With large overloads, moderate impairment of the general condition and weakness is possible.

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

Age-related changes in the musculoskeletal system

The causes of moderate bone and joint pain in the elderly are degenerative processes with calcium loss, thinning of bone beams, damage to cartilage blood supply, and a decrease in the volume of intra-articular fluid. Mild discomfort is only the first manifestation of senile joint damage. Typically, periodic discomfort occurs after 45-50 years. At the age of 60-65, unpleasant pain appears even with minor effort, accompanied by stiffness of movements, stooping, rocking gait and gradually turns into pain.

Pregnancy

Complaints about pain in the joints occur more often in the second half of the gestational age. Pulling, painful discomfort is usually felt in the joints of the pelvis and lower extremities. It gets worse towards the end of the day, after standing for a long time or walking long distances. A night's rest eases the condition. Joint pain during pregnancy is caused by the following reasons:

Lack of vitamins and minerals. The biggest role is played by the lack of calcium and vitamin D, which leads to osteomalacia. The characteristic manifestation of the symptoms is a feeling of pain not only in the joints, but also in the bones, fatigue, the presence of other signs of hypocalcemia and hypovitaminosis D - caries, brittle nails, muscle weakness, muscle pain and frequent occurrence of ARVI.
Significant weight gain. Discomfort in the joints is more often a concern of pregnant women who gain a lot of weight or those who are obese. Pains at the end, and at the end and in the middle of the day, are felt in the joints of the hips, knees, and ankles, whose cartilages experience loads several times higher than allowed. To alleviate the condition, women deliberately limit physical activity, which leads to even faster weight gain.
Softening of cartilage and ligaments. About half of pregnant women feel discomfort in the pelvic joints caused by the action of the hormone relaxin. In most cases, the discomfort is in the nature of pain in the pubic area and hip joints. In the pathological course with the development of symphysitis, painful sensations are replaced by pain, which intensifies when pressing on the uterus, trying to separate the legs, during sex. The appearance of pain in the pubic area is a serious reason to visit an obstetrician-gynecologist.
Carpal tunnel syndrome. A specific manifestation that occurs in the 2-3 trimesters in almost 20% of pregnant women is the so-calledtunnel syndrome. The cause of the disorder is swelling of the soft tissues of the hands and compression in the carpal tunnel of the nerves that pass to the fingers. In addition to painful pain in the small joints of the hand, patients complain of skin numbness, tingling and a crawling sensation. The condition improves with an elevated position of the hands.

obesity

In people who are overweight, the pressure on the cartilage tissue increases, which is why they wear out faster. The degenerative-dystrophic process usually affects the large joints of the lower extremities and the intervertebral joints. The disorder increases as obesity progresses. Discomfort in the joints first manifests itself in the form of pain without temperature until the end of the day, then the increasing destruction of cartilage leads to the development of deforming arthrosis, spondylosis, osteochondrosis with a sharp pain syndrome that limits the patient's motor activity.

Acute infections

Body and joint pains are one of the early (prodromal) signs of many acute respiratory viral infections. The main causes of problems in the joints 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 that his whole body hurts, mild and moderate pains are noticed both in the joints and in the muscles and bones. The symptom is accompanied by weakness, fatigue, insomnia and frequent awakenings. At the same time as signs of pain and general weakness, chills and hyperthermia are observed.

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

A feeling of pain in the joints is possible with acute infectious lesions of the gastrointestinal tract - toxic food infections, salmonellosis. Painful joint pains of varying intensity appear suddenly a few hours after consumption of contaminated food and are combined with a sudden rise in temperature, severe shivering and headache. The pain is preceded by nausea, vomiting, pain in the abdominal cavity, foul-smelling diarrhea with mucous and sometimes bloody impurities.

Collagenosis

Painful joints are a precursor to most diseases that occur with autoimmune inflammation of connective tissue, including joint tissue. Localization, prevalence and intensity of unpleasant sensations are determined by the characteristics of certain collagenosis. The general patterns are the involvement of certain groups of joints in the process, a gradual increase in sensation to unbearable debilitating pain, which is observed first during movement and then at rest. Deformation of the articular joints is possible. The main systemic inflammatory causes of the disorder:

Rheumatism. The symptom is "unstable": pains and then pain are alternately felt in the large joints of the arms and legs - elbows, shoulders, hips, knees, ankles. The affected areas are swollen. Discomfort in the joints is often preceded by a sore throat. With treatment, joint changes are reversible.
Rheumatoid arthritis. Unpleasant sensations often appear after 40 years. A typical feeling of pain in the small joints of the hands and feet, combined with noticeable swelling and stiffness in the morning. In the future, the pain and curvature of the articular joints becomes apparent.
Systemic scleroderma. It is characterized by variable localization of painful sensations, the presence of stiffness in the morning in the joints of the hands, elbows and knees. The pains are usually symmetrical. The swelling is short-lived. Due to the sclerosis of the skin, the mobility of the joints is limited, damage to the tendons causes a feeling of friction when moving.

Osteoarthritis

The pain syndrome in the initial stages of the disease is mild and is perceived as discomfort, pain in the joints of the legs, and less often in the hands. The immediate cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Usually, feelings of withdrawal or pain without temperature appear in adulthood and old age. Pain may start earlier in the presence of occupational hazards (vibrations, heavy physical work). Gradually, the joints become stiff, the person experiences severe pain and difficulty in walking and taking care of himself.

Metabolic disorders

The causes of metabolic disorders that cause pain in the joints are insufficient supply of vitamins and minerals, accelerated accumulation or excessive excretion of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, they are of different severity and most often serve as a manifestation of pathological conditions such as:

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, combined with unpleasant sensations in the bones and muscle weakness. The joints that experience the maximum load are most often affected - hip and knee; the shoulders, elbow and ankle are less commonly affected.
Gout. Slight pain in the big toe is already worrying in the preclinical stages of the gout process. There may be painful discomfort in the knees, elbows, wrists and fingers. Accumulation of urate in the joint cavity leads to the rapid manifestation of the disease with a change from painful to acute painful pain in the joints that does not subside for several hours. The affected joint is hot to the touch. There is redness of the skin and limited movement.

Oncological diseases

In acute and chronic leukemia, widespread osteoarticular pains, accompanied by pain, often appear even before noticeable pathological changes in the general blood test and other clinical symptoms - general weakness, night sweats, fever, loss of appetite, bleeding. Unpleasant sensations are initially periodically painful, and then constantly strong, exhausting the patient.

Hodgkin's lymphoma and lymphogranulomatosis are characterized by a combination of painful joints with muscle discomfort, weakness, enlarged lymph nodes and other lymphoid formations. Painful sensations are frequent, usually moderate. With osteosarcoma, a short period of pain in the knee joint and thigh muscles was observed, which intensified at night, and when exerted, turned into a constantly growing pain with lameness. Other joints are less often affected by this pathology.

Joint injuries

Joint pains are caused by minor traumatic injuries that cause damage to the ligaments surrounding the joint and bruising of the soft tissues of the joint area. More pain occurs when the meniscus is damaged. The symptom is clearly temporally related to a blow, fall or awkward movement. Usually, discomfort is felt in one affected joint, less often it spreads to neighboring parts of the body.

Chronic infectious processes

Possible causes of a feeling of pain in the joints that occurs without a fever or against the background of a low temperature are long-term infections. In patients suffering from chronic infectious and inflammatory diseases, discomfort in the joints becomes a consequence of intoxication of the organism or the direct harmful effect of microorganisms on the joint tissue (most often streptococci, mycoplasma, chlamydia). The appearance or intensification of pain may indicate worsening of chronic tonsillitis, sinusitis, genitourinary infections, adnexitis, pyelonephritis.

The characteristics of joint pain in common chronic infections that occur with intoxication are moderate intensity of pain in the joints, gradual development, periodic intensification and weakening of symptoms. In patients suffering from tuberculosis and hematogenous osteomyelitis, the background for the development of painful painful sensations is an increase in temperature to subfebrile levels, general weakness - fatigue, weakness, weakness. Without treatment, the patient's condition progressively worsens.

Complications of pharmacotherapy

Taking some medications can be complicated by pain and moderate pain in the small joints of the hands. Unpleasant sensations are not accompanied by redness or deformation of the joints. Patients may complain of muscle pain, fever, skin rash, and other manifestations of drug allergies. Discomfort disappears quickly after stopping the drug that caused it, and it is less likely that special treatment will be needed for complications that arise. Pain and mild arthralgia are caused by:

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

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 convalescent phase.
Congenital defects of bones and joints.

Survey

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

Laboratory blood test. Evaluation of leukocyte count and ESR level is required to rule out infection, inflammation and oncohematological processes. In systemic diseases, it is important to measure the content of total proteins, the ratio of protein fractions in the blood, specific proteins of the acute phase, 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. A bacterial culture is necessary if joint and body pain is likely to be infectious. Urine, feces, sputum and discharge from the urogenital tract are collected for research. Antibiotic sensitivity is determined to select the regimen of antimicrobial therapy. In doubtful cases, microscopy and culture are supplemented by serological reactions (RIF, ELISA, PCR).
Sonography of articular joints. It is usually used for clear localization of painful sensations and suspicion of the presence of rheumatic diseases. Ultrasound of the joint allows us to examine its structure, determine the destruction of cartilage and bones, preclinical inflammatory changes and study the state of periarticular soft tissues. The advantages of the method are accessibility, non-invasiveness and high content of information.
X-ray techniques. During radiography of the joints, changes in the width of the joint space, hardening of the soft tissues, presence of calcifications, osteophytes and erosion of the joint surfaces are revealed. Special techniques are used to improve diagnostic efficiency - 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 techniques. In some cases, in order to determine the cause of pain in the joints, a puncture is performed with a biopsy of the cartilage, inner lining of the synovial membrane and tophi. Morphological analysis of biopsy samples and examination of synovial fluid reflect the nature of pathological processes occurring in the joints. The simultaneous collection of material with a visual inspection of the joint cavity is suitable during arthroscopy with tissue biopsy.

A less common way of diagnosing the cause of joint pain is scintigraphy with the introduction of technetium, which accumulates in the affected tissues. In recent years, there has been increasing interest in joint thermography as a modern non-invasive method for identifying inflammatory diseases, tumors and circulatory disorders in joints and peri-articular tissues. If the number of formed elements in the clinical blood test decreases, an extra-articular bone puncture is performed. Patients with joint pain without fever are advised 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 load dosage is sufficient. Unpleasant sensations in the joints that occur 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 advised to change their lifestyle: adequate physical activity, diet with adequate caloric content and sufficient plant food content.

Pain in the bones, joints and muscles, combined with general weakness and temperature, increased feelings of pain and withdrawal to severe pain, and the development of persistent pain are indications for consulting a doctor. To reduce discomfort in the joints caused by ARVI, it is recommended to rest, drink enough water, infusion of rose hips and dried fruits. Until serious diseases that cause pain in the joints are ruled out, self-medication with painkillers, long-term unsuccessful application of poultices, lotions, decoctions, etc. is unacceptable.

Conservative therapy

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

Antimicrobial agents. The basic treatment of infections is based on the prescription of antibiotics to which the pathogen is sensitive. In severe cases, broad-spectrum drugs are used until the sensitivity of the microorganism is determined.
Nonsteroidal anti-inflammatory drugs. They reduce the production of inflammatory mediators and thus inhibit inflammatory processes in the joints. By influencing the central pain receptors, they reduce the degree of discomfort in the joints. It is used in the form of tablets, ointment, gel.
Corticosteroids. They have a strong anti-inflammatory effect. Hormonal therapy is the basis for the treatment of systemic collagenosis. In severe and resistant forms of the disease, corticosteroid drugs are combined with immunosuppressants to enhance the effect.
Chondroprotectors. They act as a substrate for the synthesis of protein glycans, a sufficient amount of which increases the elasticity of articular cartilage. It nourishes cartilage tissue and restores its damaged structure. Intra-articular administration of drugs is possible.
Xanthine oxidase inhibitors. They are used as anti-gout medicines. They block the key enzyme necessary for the synthesis of uric acid, thereby reducing its concentration in the body and promoting the dissolution of 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 serve as the basis for most treatment regimens of various types of oncohematological pathologies. Depending on the clinical variant and the severity of the neo-process, they are combined with radiotherapy and surgical interventions.

Physiotherapy

After the exact cause of pain and resolution of acute inflammation, patients, except for cancer patients, are prescribed physiotherapy and exercise therapy. Microwave and ultrasound therapy, 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 supplemented with spa therapy.