Joint pain

9 January 2024

Joint pain- These are unpleasant and painful sensations that pull in the area of the articular joints, the intensity of which sometimes reaches the level of pain. The symptom is combined with muscle pain, weakness, weakness, crunching, limitation of movement and may precede joint pain (arthralgia). Joint pain is accompanied by injuries of the musculoskeletal system, infections, diseases of the hematopoietic system and vascular pathologies. Laboratory tests, ultrasound, radiography and invasive methods are used to identify the cause of the disorder. Treatment involves treating the disease that caused the pain.

Causes of joint pain

Mild or moderate joint discomfort is not always a manifestation of a disease process. Sometimes the symptom has natural causes. Transient pain in the joints is felt when wearing uncomfortable shoes, and in people sensitive to weather conditions - when the weather changes. During puberty, painful sensations in the shoulder and knee joints are caused by insufficient blood supply due to accelerated bone growth.

Significant physical activity

During intense training or heavy work, a common cause of the symptom is overload of the musculo-ligament apparatus, less often it is caused by microtraumas of the cartilage and synovium. A typical combination of joint pain and bone and muscle discomfort. Joint and muscle discomfort occurs immediately after the impact of physical activity or against the background of prolonged monotonous work with constant tension in the same muscle groups. Joint pain in the body occurs without fever. With large overloads, a moderate violation of the general condition and weakness is possible.

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

Age-related changes in the musculoskeletal system

The causes of moderate pain in the bones and joints in the elderly are degenerative processes with loss of calcium, thinning of the bones, reduced blood supply to the cartilage and decreased volume of intra-articular fluid. Mild discomfort is only the first manifestation of age-related 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, shuffling gait and gradually gives way to pain.

Pregnancy

Complaints about joint pain are made more often in the second half of the gestational age. The pulling and painful discomfort is usually felt in the joints of the pelvis and lower limbs. It intensifies towards the end of the day, after spending a long time standing or walking long distances. Night rest relieves the condition. Joint pain during pregnancy is caused by the following reasons:

Deficiency of vitamins and minerals. The most important role is played by calcium and vitamin D deficiency, which leads to osteomalacia. A characteristic feature of the manifestation of the symptom 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 - tooth decay, brittle nails, muscle weakness, muscle pain and the frequent appearance of ARVI.
Significant weight gain. Joint discomfort is most often a concern for pregnant women with significant weight gain or those who are obese. At the end, and possibly in the middle of the day, pain is felt in the hip joints, knees, ankles, the cartilages of which are subjected to loads many times greater than permitted. 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 experience problems in the pelvic joints caused by the action of the hormone relaxin. In most cases, the discomfort is similar to 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 found in the 2-3 trimesters in almost 20% of pregnant women is the so-called tunnel 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 aching pain in the small joints of the hand, patients complain of numbness of the skin, tingling and tingling sensation. The condition improves with an elevated position of the arms.

Obesity

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

Acute infections

Muscle and joint pain are one of the first (prodromal) signs 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 throughout the body, mild and moderate pain is noted both in the joints and in the muscles and bones. The symptom is accompanied by weakness, fatigue, insomnia and frequent awakenings. Simultaneously with signs of pain and general malaise, chills and hyperthermia are observed.

More pronounced pain in the joints and body occurs with the flu. Up to 50% of patients experience constant pain in the legs, arms and torso. The intensity of the pain is so high that it becomes difficult for a person to perform the simplest actions: getting out of bed, going to another room, getting a glass of water. The situation is aggravated by high fever (febrile) and severe headaches. Sore throat and nasal congestion occur after a few hours or even days. Less joint discomfort occurs with parainfluenza, an adenovirus infection.

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

Collagenosis

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

Rheumatism. The symptom is "volatile": shooting pains and then pain are felt in turns in the large joints of the arms and legs: elbows, shoulders, hips, knees, ankles. The affected areas are swollen. Joint discomfort is often preceded by a sore throat. With treatment, changes in the joints are reversible.
Rheumatoid arthritis. Unpleasant sensations often appear after 40 years. Typical sensation of pain in the small joints of the hands and feet, associated with notable swelling and morning stiffness of movements. In the future, pain and curvature of the articular joints come to the fore.
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. Aches and pain are usually symmetrical. The swelling is short-lived. Due to skin sclerosis, the mobility of the articular joints is limited, damage to the tendons causes a feeling of friction during movement.

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 arms. The immediate cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Typically, sensations of stretching or pain without fever appear in adulthood and old age. Pain may begin earlier in the presence of occupational hazards (vibrations, heavy physical work). Gradually, the joints become stiff, the person feels severe pain and has difficulty walking and taking care of himself.

Metabolic disorders

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

Osteoporosis. When calcium is washed out of bone tissue, the articular surfaces of the bones become brittle, the cartilage thins, 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 subjected to the maximum load are most often affected: hip and knee; shoulder, elbow and ankle are less commonly affected.
Gout. Mild pain in the big toe is already a cause for concern in the preclinical stages of the gouty process. You may experience painful discomfort in your knees, elbows, wrists, and fingers. The accumulation of urate in the joint cavity leads to a rapid manifestation of the disease with a change from aching joint pain to acute joint pain that does not disappear for several 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 pain, followed by pain, often occurs even before pathological changes evident in a general blood test and other clinical symptoms - general malaise, night sweats, fever, loss of appetite, bleeding. The unpleasant sensations are first periodically painful, then constantly strong, debilitating the patient.

Hodgkin lymphoma and lymphogranulomatosis are characterized by a combination of joint pain with muscle discomfort, weakness, swollen lymph nodes, and other lymphoid growths. Painful sensations are common, usually moderate. In osteosarcomas, a short period of pain in the knee joint and thigh muscles is observed, which intensifies at night and with exertion turns into constantly increasing pain with lameness. Other joints are less commonly affected by this condition.

Joint injuries

Joint pain is caused by mild traumatic injuries, which cause damage to the ligaments surrounding the joint and bruising of the soft tissues of the joint area. The most severe pain occurs when the meniscus is damaged. The symptom is clearly related over time to a blow, a fall or an awkward movement. Usually the discomfort is felt in an affected joint, less often it spreads to adjacent areas of the body.

Chronic infectious processes

Possible causes of a feeling of pain in the joints that occurs without fever or against the background of a mild fever are long-term infections. In patients suffering from chronic infectious and inflammatory diseases, joint discomfort becomes a consequence of intoxication of the body or direct harmful effects of microorganisms on the joint tissue (usually streptococci, mycoplasmas, chlamydia). The appearance or intensification of pain may indicate an exacerbation of chronic tonsillitis, sinusitis, genitourinary infections, adnexitis, pyelonephritis.

Distinctive features of joint pain in common chronic infections that occur with intoxication are moderate severity of joint discomfort, 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 malaise - fatigue, weakness, weakness. Without treatment, patients' condition progressively worsens.

Complications of pharmacotherapy

Taking some medications may be complicated by 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 aches, fever, skin rashes, and other manifestations of drug allergies. The discomfort disappears quickly after stopping the drug that caused it, and special treatment is less likely to be needed for complications that arise. Pain and mild arthralgia are caused by:

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

Rare causes

Inflammation of the respiratory system: pneumonia, bronchitis, tracheitis.
Intestinal pathology: nonspecific 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 you feel pain in your joints and bones, you need to consult a therapist or family doctor, who will make an initial diagnosis and prescribe examinations by specialized specialists. Taking into account the nature of unpleasant sensations, the speed with which they manifest themselves and the associated symptoms, to determine the cause of the disorder it is recommended:

Laboratory blood test. An evaluation of the leukocyte count and ESR level is necessary to exclude infections, inflammatory and oncohematological processes. In systemic diseases it is important to measure the total protein content, the ratio of protein fractions in the blood, specific proteins of the acute phase, markers of rheumatoid arthritis and other inflammations. Tests for concentrations of vitamins, electrolytes (especially calcium), and uric acid help diagnose metabolic disorders.
Bacteriological examination. Bacterial culture is necessary if the pain felt in the joints and throughout the body is likely to be infectious. For research, urine, feces, sputum and secretions from the urogenital tract are collected. To select an antimicrobial therapy regimen, antibiotic sensitivity is determined. In doubtful cases, microscopic examination and culture are integrated with serological reactions (RIF, ELISA, PCR).
Ultrasound of the articular joints. It is usually used for clear localization of painful sensations and the suspected presence of rheumatic diseases. Ultrasound of the joint allows us to examine its structure, identify cartilage and bone destruction, preclinical inflammatory changes, and study the condition of the periarticular soft tissues. The advantages of the method are accessibility, non-invasiveness and high information content.
X-ray techniques. During joint radiography, changes in the width of the joint space, hardening of soft tissues, the presence of calcifications, osteophytes and erosions of the joint surfaces are detected. To improve diagnostic efficiency, special techniques 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 conveniently assessed using densitometry.
Invasive examination techniques. In some cases, to determine the cause of joint pain, a puncture with a biopsy of the cartilage, the inner lining of the synovial membrane and tophi is performed. Morphological analysis of biopsy specimens and examination of synovial fluid reflect the nature of pathological processes occurring in joints. Simultaneous collection of materials with visual examination of the joint cavity is convenient to carry out during arthroscopy with tissue biopsy.

A less common way to diagnose the cause of joint pain is scintigraphy with the introduction of technetium, which accumulates in the affected tissues. In recent years there has been growing interest in joint thermography as a modern, non-invasive method for the recognition of inflammatory diseases, tumors and circulatory disorders in joints and periarticular tissues. If the number of elements formed in a clinical blood test decreases, an extra-articular bone puncture is performed. Patients with joint pain without fever are advised to consult a rheumatologist and an orthopedic traumatologist.

Treatment

Help before diagnosis

For joint pain associated with physical activity, no special treatment is required; a long rest with dosage of loads is sufficient. Unpleasant sensations in the joints that occur during pregnancy usually disappear on their own after pregnancy or are corrected by controlling weight and taking vitamin and mineral supplements. Elderly and obese patients are advised to change their lifestyle: adequate physical activity, a diet with adequate calorie content with a sufficient content of plant foods.

Pain in the bones, joints and muscles, combined with general malaise and fever, increased aching and stretching sensations up to severe pain and the development of persistent pain are indications to consult a doctor. To reduce joint discomfort caused by ARVI, it is recommended to rest, drink enough water, rosehip infusions and dried fruits. Until serious diseases that provoke joint pain, self-medication with painkillers, long-term unsuccessful application of compresses, lotions, decoctions, etc. are excluded.

Conservative therapy

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

Antimicrobials. Basic therapy for 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 established.
Non-steroidal anti-inflammatory drugs. They reduce the production of inflammatory mediators and thus inhibit inflammatory processes in the joints. By influencing central pain receptors, they reduce the degree of joint discomfort. Used in the form of tablets, ointments, gels.
Corticosteroids. They have a strong anti-inflammatory effect. Hormone 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 their effect.
Chondroprotectors. They serve as a substrate for the synthesis of protein glycans, a sufficient amount of which increases the elasticity of articular cartilage. It nourishes the cartilaginous tissue and restores its damaged structure. Intra-articular administration of drugs is possible.
Xanthine oxidase inhibitors. Used as anti-gout drugs. They block the key enzyme necessary for the synthesis of uric acid, thus reducing its concentration in the body and promoting the dissolution of existing urate deposits.
Vitamin-mineral complexes. Recommended for the treatment of joint pain 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 for various types of oncohematological pathologies. Depending on the clinical variant and the severity of the neoprocess, they are combined with radiotherapy and surgical interventions.

Physiotherapy

After identifying the exact cause of pain and the disappearance of acute inflammation, patients, with the exception of those suffering from cancer, are prescribed physiotherapy and exercise therapy. Therapy sessions with microwaves and ultrasound, electrophoresis and pulsed currents have a good anti-inflammatory and analgesic effect. In case of chronic pathology, physiotherapy treatment is carried out for several months and is integrated with thermal therapy.