Joint pains

9 January 2024

Joint pains- This is unpleasant pain, pulling sensations 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, tingling, limited movement and may precede joint pain (arthralgia). Joint pains are accompanied by damage to the musculoskeletal system, infections, diseases of the hematopoietic system and vascular pathology. Laboratory tests, ultrasound, x-ray and invasive methods are used to identify the cause of the disorder. Treatment includes treating the disease that caused the pain.

Causes of joint pain

Mild or moderate discomfort in the joints is not always a manifestation of a pathological process. Sometimes the symptom has physical causes. Temporary pain in the joints is felt when wearing uncomfortable shoes, and in people sensitive to weather conditions - when the weather changes. During adolescence, 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 overstrain of the musculoskeletal apparatus, less often caused by microtraumas of the cartilage and synovial membrane. A typical combination of joint pain and bone and muscle discomfort. Joint and muscle discomfort occurs immediately after impact physical activity or in the context of prolonged monotonous work with constant tension on the same muscle groups. Pains in the joints of the body occur without fever. With large overloads, a moderate violation 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 aches and pains resulting 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 see 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 ligaments, reduced blood supply to cartilage and a decrease in the volume of intra-articular fluid. Mild discomfort is only the first manifestation of aging joint damage. Usually, periodical discomfort appears after 45-50 years. At the age of 60-65 years, an unpleasant pain appears even with little effort, accompanied by stiffness in movement, stooping, shuffling the gait and gradually subsides into pain.

Pregnancy

Complaints of joint pain are more common in the second half of pregnancy. Pulling, discomfort is usually felt in the joints of the pelvis and lower limbs. It intensifies towards the end of the day, after prolonged standing or walking long distances. A night's rest eases the situation. Joint pain during pregnancy is caused by the following reasons:

Deficiency of vitamins and minerals. The biggest role is played by calcium and vitamin D deficiency, which leads to osteomalacia. A 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 - caries, brittle nails, muscle weakness, muscle pain and the frequent occurrence of ARVI.
Significant weight gain. Joint discomfort is more often a concern for pregnant women with a lot of weight gain or those who are obese. Pains at the end, and finally in the middle of the day, are felt in the hip joints, knees, ankles, the cartilages of which show loads many times more than permissible. 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 pelvic joint discomfort caused by the action of the hormone chalasin. In most cases, the discomfort is in the nature of pain in the pubic region and hip joints. In a pathological course with the development of symphysitis, pain sensations are replaced by pain, which intensifies when you press 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 is detected 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 a crawling sensation. The condition improves with the raised position of the hands.

Portliness

In overweight people, the pressure on the cartilage tissue increases, causing it to wear out more quickly. The degenerative-dystrophic process usually involves large joints of the lower limbs and intervertebral joints. The disorder increases as obesity progresses. Discomfort in the joints first manifests itself in the form of pain without fever until the end of the day, then the increasing destruction of the cartilage leads to the development of deforming joints, 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 (precursor) signs of many acute respiratory viral infections. The main causes of joint discomfort are poisoning 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 the whole body hurts, mild and moderate pain is observed 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.

The most intense pains in the joints and body are with the flu. Up to 50% of patients experience constant pain in the legs, arms and trunk. The intensity of pain is so high that it becomes difficult for a person to do the simplest actions - get out of bed, go to another room, get a glass of water. The condition is aggravated by a high (febrile) temperature and severe headaches. Sore throat and nasal congestion appear 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. Joint pains of varying intensity appear suddenly a few hours after eating contaminated food and are combined with a sudden increase in temperature, severe chills and headaches. The pains are preceded by nausea, vomiting, pain in the abdominal cavity, foul-smelling diarrhea with mucous and sometimes bloody impurities.

You whine

Joint pain is a precursor to most diseases that occur with autoimmune inflammation of 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 to excruciating debilitating pain, which is 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": pains pains and then pain are felt in turn 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, 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 morning stiffness on movement. In the future, pain and curvature of the articular joints come to the fore.
Systemic scleroderma. It is characterized by variable localization of pain sensations, presence of stiffness in the morning in the joints of the hands, elbows and knees. Aches and pains are usually symmetrical. The swelling is short-lived. Due to the hardening of the skin, the mobility of the joints is limited, the 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 hands. The direct cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Typically, sensations of pulling 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 experiences severe pain and difficulty walking and taking care of themselves.

Metabolic disorders

The causes of metabolic disorders in which joint pain occurs are insufficient supply of vitamins, minerals, accelerated accumulation or excessive excretion of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, have varying 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 sensations of pain. The pain syndrome gradually increases from mild pains to severe arthralgias, combined with unpleasant sensations in the bones and muscle weakness. The joints that face the maximum load are most often affected - the hip and knee; the shoulder, elbow and ankle are less often affected.
Arthritis. A slight pain in the big toe is already alarming in the preclinical stages of the gout process. There may be pain in the knees, elbows, wrists and fingers. The accumulation of uric acid in the joint cavity leads to a rapid manifestation of the disease with a change from pain to acute painful pain in the joints that does not subside 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 pains, followed by pain, often appear even before noticeable pathological changes in a general blood test and other clinical symptoms - general malaise, night sweats, fever, loss of appetite, bleeding. Unpleasant sensations at first pain periodically, then constantly intense, 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. Pain sensations are common, usually moderate. A short period of pain in the knee joint and in the thigh muscles, which intensifies at night and with effort turns into ever-increasing pain with lameness, is observed with osteosarcomas. Other joints are less frequently affected by this pathology.

Joint injuries

Joint pains are caused by mild traumatic injuries, which cause damage to the ligaments surrounding the joint and bruising of the soft tissues of the joint area. More intense pain occurs when the meniscus is damaged. The symptom is clearly related in time to a bump, a fall or an awkward movement. Usually the discomfort is felt in one affected joint, rarely spreading to neighboring areas of the body.

Chronic infectious processes

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

Characteristics of joint pain in common chronic infections that occur with poisoning are moderate severity of joint discomfort, gradual development, periodic intensity and attenuation of symptoms. In patients suffering from tuberculosis and hematogenous osteomyelitis, the background for the development of painful sensations is an increase in temperature to hypofebrile levels, general malaise - fatigue, weakness, weakness. Without treatment, the patients' condition progressively worsens.

Complications of pharmacotherapy

Taking some medications can be complicated by aches and pains in the small joints of the hands. The 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 the drug that caused it is stopped, and special treatment is less likely to be required for complications that arise. Pains 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.
Bowel pathology: non-specific ulcerative colitis, Crohn's disease.
Skin diseases: psoriasis.
Endocrine disorders: diabetes mellitus, diffuse toxic goiter, hypothyroidism, Itsenko-Cushing disease.
Autoimmune processes: Hashimoto's thyroiditis, vasculitis.
Damage to the face: necrotizing fasciitis in the recovery stage.
Congenital anomalies of bones and joints.

Overview

To determine why joint and bone pains are felt, it is necessary to consult a therapist or family doctor, who will make an initial diagnosis and prescribe tests from specialized specialists. Taking into account the nature of the unpleasant sensations, the speed of their appearance and the accompanying symptoms, the following are recommended to determine the cause of the disorder:

Laboratory blood test. Evaluation of leukocyte count and ESR level 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 fractions in the blood, specific acute phase proteins, indicators of rheumatoid arthritis and other inflammations. Tests for the concentration of vitamins, electrolytes (especially calcium) and uric acid help diagnose metabolic disorders.
Bacteriological examination. Bacterial culture is necessary if the pains felt in the joints and throughout the body are likely to be infectious. Urine, feces, sputum and secretions from the genitourinary tract are collected for research. To select an antimicrobial treatment regimen, antibiotic sensitivity is determined. In doubtful cases, microscopy and culture are supplemented with serological reactions (RIF, ELISA, PCR).
Ultrasound of articular joints. It is usually used to clearly identify painful sensations and suspect the presence of rheumatic diseases. Ultrasound of the joint allows us to examine its structure, identify the destruction of cartilage and bones, preclinical inflammatory changes and study the condition of the peri-articular soft tissues. The advantages of the method are accessibility, non-invasiveness and high information content.
X-ray techniques. During x-ray of the joints, changes in the width of the joint space, hardening of the soft tissues, presence of calcifications, osteophytes and erosions of the joint surfaces are detected. To improve diagnostic efficiency, special techniques are used - contrast arthrography, lung arthrography. In the initial stages of the damage, tomography (MRI, CT of joints) is considered more indicative. Bone mineral density can be easily assessed using densitometry.
Invasive examination techniques. In some cases, to determine the cause of joint pain, a needle biopsy of the cartilage, synovial lining and tophi is performed. Morphological analysis of biopsy specimens and examination of synovial fluid reflect the nature of the pathological processes occurring in the joints. Simultaneous collection of materials with visual examination of the joint cavity is convenient to do 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 a growing interest in joint thermography as a modern non-invasive method for the identification of inflammatory diseases, tumors and circulatory disorders in joints and peri-articular tissues. If the number of formed elements in a clinical blood test is reduced, 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

For joint pains associated with physical activity, no specific treatment is required; a long rest with dosage of loads is sufficient. Joint discomfort that occurs during pregnancy usually resolves on its own after pregnancy or is corrected with weight control and vitamin and mineral supplementation. Elderly and obese patients are advised to change their lifestyle: adequate physical activity, a diet of adequate calorie content with sufficient content of plant foods.

Pain in the bones, joints and muscles, combined with general malaise and fever, increased pain and pulling sensations at the point of severe pain and the development of persistent pain are indications for medical advice. To reduce joint discomfort caused by ARVI, rest, drinking enough water, rosehip infusions and dried fruits are recommended. Until serious diseases that cause joint pain are ruled out, self-medication with painkillers, long-term unsuccessful application of compresses, lotions, decoctions, etc. is unacceptable.

Conservative therapy

You can get rid of joint pain with the right treatment, which aims to eliminate the cause of the disorder and individual parts of the mechanism of its development. Aetiological treatment is usually supplemented with symptomatic drugs that quickly reduce the severity of the complaint and pain. The treatment regimen for diseases that occur with joint pain may include:

Antimicrobials. The basic treatment 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 affecting the central pain receptors, they reduce the degree of joint discomfort. It is used in the form of tablets, ointments, gels.
Corticosteroids. They have a strong anti-inflammatory effect. Hormonal therapy is the mainstay of treatment for systemic collagenosis. In severe and resistant forms of the disease, corticosteroid drugs are combined with immunosuppressants to enhance the effect.
Carboprotectors. They act as a substrate for the synthesis of protein glycans, a sufficient amount of which increases the elasticity of articular cartilage. It nourishes the cartilage tissue and restores its damaged structure. Intra-articular administration of drugs is possible.
Xanthine oxidase inhibitors. It is used as an anti-gout medication. 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 uric acid 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 for various types of hematologic oncopathologies. Depending on the clinical variant and the severity of the neo-process, they are combined with radiotherapy and surgery.

Physiotherapy

After the exact cause of the pains and the subsidence of the acute inflammation, patients, except those suffering from cancer, are prescribed physiotherapy and exercise. Treatment sessions with microwaves and ultrasound, electrophoresis and pulsed currents have a good anti-inflammatory and analgesic effect. In case of chronic pathology, the physiotherapy treatment is carried out over a period of several months and is supplemented with bath therapy.