Pain in the joints

Pain in the joints- These are unpleasant, painful, pulling sensations occurring in the area of the joints, the intensity of which sometimes reaches the level of pain. The symptom is associated with muscle pain, weakness, weakness, cracking, limited movement and may precede joint pain (arthralgia). Joint pain is accompanied by locomotor changes, infections, hematopoietic system diseases and vascular pathologies. Laboratory tests, ultrasound, radiography and invasive methods are used to identify the cause of the disorder. Treatment includes treating the disease causing the pain.

Causes of joint pain

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

Significant physical activity

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

The disorder may last for several days and gradually decrease with limited physical activity until it disappears completely without treatment. If the pain resulting from sports or heavy physical work is replaced by persistent pain, swelling of the wrist, elbow, shoulder, ankle, knee and hip joints, and the usual limited movement, a doctor should be consulted.

Age-related changes in the musculoskeletal system

In the elderly, the causes of moderate bone and joint pain are degenerative processes associated with calcium loss, thinning of bone radii, damage to the blood supply to cartilage, and a decrease in the volume of intra-articular fluid. Mild discomfort is only the first manifestation of age-related joint damage. As a rule, periodic discomfort appears after 45-50 years. Up to the age of 60-65, unpleasant pain occurs even with minor exertion, with stiffness of movement, stooping, shuffling gait, and gradually gives way to pain.

Pregnancy

Complaints related to joint pain occur more often in the second half of pregnancy. The pulling, aching discomfort is usually felt in the joints of the pelvis and lower limbs. It gets stronger towards the end of the day, after standing for a long time or walking for a long time. A night's rest eases the condition. Joint pain during pregnancy is caused by the following reasons:

• Vitamin and mineral deficiency. The biggest role is played by calcium and vitamin D deficiency, which leads to osteomalacia. The manifestation of the symptom is characterized not only by pain 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 problem for pregnant women who have gained a lot of weight or those who are obese. Pain can be felt at the end, and finally in the middle of the day, in the hip joints, knees, and ankles, the joints of which suffer loads that are 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, which is caused by the effect of the hormone relaxin. In most cases, the discomfort is pain in the pubis and hip joints. In the pathological process associated with the development of symphysitis, painful sensations are replaced by pain, which increases when you press the uterus, try to separate the legs, during sex. The appearance of pain in the vulva is a serious reason for visiting an obstetrician-gynecologist.
• Carpal tunnel syndrome. In nearly 20% of pregnant women, the special manifestation observed in the 2-3 trimesters is the so-called tunnel syndrome. The cause of the disorder is the swelling of the soft tissues of the hand and the compression of the carpal tunnel of the nerves passing through the fingers. In addition to aching pain in the small joints of the hand, patients complain of skin numbness, tingling and a crawling sensation. The condition improves with the raised position of the arms.

Obesity

In overweight people, the pressure on the cartilage tissue increases, which wears it out faster. The degenerative-dystrophic process usually affects 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 at the end of the day, then the increasing destruction of the 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) symptoms of many acute respiratory viral infections. The main causes of joint discomfort are the 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, muscles and bones. The symptom is accompanied by weakness, fatigue, insomnia and frequent awakenings. Along with signs of pain and general malaise, chills and hyperthermia are observed.

The most pronounced joint and body pains are pains caused by the flu. Up to 50% of patients experience constant aching 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. The situation is aggravated by high (febrile) temperature and severe headache. 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 in case of acute infectious changes of the gastrointestinal tract - food-toxic infections, salmonellosis. Arthralgias of varying intensity appear suddenly a few hours after eating the contaminated food and are accompanied by a sudden rise in temperature, severe chills and headache. The pain is preceded by nausea, vomiting, abdominal pain, foul-smelling diarrhea with mucous and sometimes bloody impurities.

Collagenoses

Painful joints are a harbinger of most diseases that involve autoimmune inflammation of connective tissue, including joint tissue. The localization, frequency and intensity of discomfort are determined by the characteristics of a given collagenosis. The general patterns are the involvement of certain groups of joints in the process, a gradual increase in sensations 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 "volatile": aching pains, then pain in the large joints of the arms and legs - elbows, shoulders, hips, knees, ankles - can be felt alternately. The affected areas are swollen. Joint discomfort is often preceded by a sore throat. Changes in the joints with treatmentthey 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 of movement. In the future, joint pain and curvature will come to the fore.
• Systemic scleroderma. It is characterized by the variable localization of painful sensations, the presence of morning stiffness in the joints of the hands, elbows and knees. Pain and soreness are usually symmetrical. The swelling is short-lived. Due to skin sclerosis, the mobility of the joints is limited, damage to the tendons causes a feeling of friction during movement.

Osteoarthritis

In the initial stages of the disease, the pain syndrome is mild and can be perceived as an unpleasant feeling, pain in the legs and, less often, in the joints of the arms. The direct cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Pulling or aching sensations without fever typically occur in adulthood and old age. In the presence of occupational hazards (vibration, heavy physical work), the pain may start earlier. Gradually, the joints become stiff, the person experiences severe pain and difficulty in walking and self-care.

Metabolic disorders

The causes of metabolic disorders causing joint pain are insufficient supply of vitamins and minerals, accelerated accumulation or excessive excretion of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, are of 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 joint surfaces of the bones become fragile, the cartilage thins, which causes painful sensations. The pain syndrome gradually increases from mild pains to severe arthritis, which is accompanied by discomfort in the bones and muscle weakness. Most often, the joints that bear the maximum load are affected - the hips and knees; less often the shoulder, elbow and ankle.
• Gout. Mild pain in the big toe is already a cause for concern in the preclinical stage of the gouty process. Painful discomfort may occur in the knees, elbows, wrists and fingers. The accumulation of urates in the joint cavity leads to the rapid manifestation of the disease, from pain to acute painful joint pain that does not subside for several hours. The affected joint is hot to the touch. The skin becomes red and movement is limited.

Oncological diseases

In acute and chronic leukemia, widespread osteoarticular pains and then pain often appear even before the pathological changes and other clinical symptoms detected in the general blood test - general malaise, night sweats, fever, loss of appetite, bleeding. Unpleasant sensations first hurt intermittently, then become constantly strong, debilitating the patient.

Hodgkin's lymphoma and lymphogranulomatosis are characterized by a combination of joint pain and muscle discomfort, weakness, enlarged lymph nodes and other lymphoid formations. Painful sensations are common, usually moderate. Short-term pain in the knee joint and thigh muscles, which worsens at night and is accompanied by pain with lameness that increases with exertion, in cases of osteosarcoma. Other joints are less frequently affected by this pathology.

Joint injuries

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

Chronic infectious processes

Possible causes of joint pain without or against a low fever are long-term infections. In patients with chronic infectious and inflammatory diseases, joint discomfort is the result of poisoning of the body or the direct damaging effect of microorganisms on joint tissues (usually streptococci, mycoplasma, chlamydia). The appearance or intensification of pain may indicate the worsening of chronic tonsillitis, sinusitis, urinary tract infections, adnexitis, pyelonephritis.

In case of chronic infections associated with poisoning, joint pains are characterized by moderate severity of joint pain, gradual development, periodic strengthening and weakening of symptoms. In patients with tuberculosis and hematogenous osteomyelitis, the background of the development of painful painful sensations is an increase in temperature to a subfebrile level, general malaise - fatigue, weakness, weakness. In the absence of treatment, the patients' condition gradually deteriorates.

Complications of pharmacotherapy

Taking some medications can be complicated by pain and moderate pain in the small joints of the hands. The discomfort is not accompanied by redness or deformation of the joints. Patients may complain of muscle pain, fever, skin rashes and other manifestations of drug allergy. The discomfort disappears quickly after stopping the drug that caused it, and special treatment will be less necessary in case of complications. Pain and mild joint pain are caused by:

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

Rare reasons

• 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 thyroiditis, vasculitis.
• Facial damage: necrotizing fasciitis in the convalescent stage.
• Congenital disorders of bones and joints.

Survey

To find out why you feel pain in the joints and bones, you need to consult a therapist or family doctor, who will make an initial diagnosis and prescribe specialist tests. Taking into account the nature of the unpleasant sensations, the speed of their occurrence and the accompanying symptoms, the following are recommended to determine the cause of the disorder:

• Laboratory blood test. In order to rule out infections, inflammatory and oncohematological processes, it is necessary to assess the leukocyte count and the ESR level. In systemic diseases, it is important to measure the total protein content, the ratio of protein fractions in the blood, specific acute phase proteins, markers of rheumatoid arthritis and other inflammations. Examination of the concentration of vitamins, electrolytes (especially calcium) and uric acid helps in the diagnosis of metabolic disorders.
• Bacteriological examination. A bacterial culture is needed if pain in the joints and throughout the body is likely to be infectious. Urine, stool, sputum and secretions from the urogenital tract are collected for research. Susceptibility to antibiotics should be determined to select an antimicrobial regimen. In doubtful cases, microscopic examination and culture are supplemented with serological reactions (RIF, ELISA, PCR).
• Ultrasound examination of joints. It is usually used for the 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 radiography of the joints, changes in the width of the joint gap, hardening of the soft tissues, the presence of calcifications, osteophytes, and erosions of the joint surfaces are detected. In order to improve diagnostic efficiency, special techniques are used - contrast arthrography, pneumoarthrography. In the initial stage of the lesion, tomography (MRI, joint CT) is considered more indicative. Bone density can be conveniently determined by densitometry.
• Invasive examination techniques. In some cases, to determine the cause of joint pain, a puncture is performed with a cartilage biopsy, the inner lining of the joint membrane and tophi. Morphological analysis of biopsy samples and analysis of synovial fluid reflect the nature of the pathological processes occurring in the joints. Simultaneous collection of materials with visual inspection of the joint cavity can be conveniently performed during arthroscopy with tissue biopsy.

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

Treatment

Help before diagnosis

In the case of joint pains associated with physical activity, no special treatment is required, it is sufficient to administer a long resting load. Unpleasant joint sensations during pregnancy usually go away 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, adequate caloric diet with adequate plant food content.

Bone, joint and muscle pain with general malaise and fever, aching and pulling sensations increasing to severe pain, and the development of persistent pain are indications for consulting a doctor. To reduce joint discomfort caused by ARVI, it is recommended to rest, drink enough water, rosehip infusions and dried fruits. Until diseases that cause severe joint pain are ruled out, self-medication with painkillers, poultices, body lotions, decoctions, etc. its long-term unsuccessful application 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 some parts of the mechanism of its development. Etiopathogenetic therapy is usually supplemented with symptomatic drugs that quickly reduce the severity of nagging and aching pain. A treatment regimen for diseases associated with joint pain may include:

• Antimicrobial agents. The basic therapy 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, thereby inhibiting inflammatory processes in the joints. By affecting the central pain receptors, they reduce joint discomfort. It is used in the form of tablets, ointments and gels.
• Corticosteroids. They have a strong anti-inflammatory effect. The basis of the treatment of systemic collagenosis is hormone therapy. 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, the appropriate amount of which increases the flexibility of joint 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 medicine. They prevent the 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 complexes. It is recommended for the treatment of joint pain caused by metabolic disorders. The most commonly used drugs contain calcium and vitamin D. They are also elements of the complex therapy of inflammatory and metabolic diseases.
• Chemotherapy agents. They form the basis of most treatment regimens for various oncohematological pathologies. Depending on the clinical version and severity of the neo-process, it is combined with radiation therapy and surgical interventions.

Physiotherapy

After the exact cause of the pain has been established and the acute inflammation subsides, physical therapy and exercise therapy are prescribed, except for cancer patients. Microwave and ultrasound treatments, electrophoresis, and pulsating current have good anti-inflammatory and pain-relieving effects. In the case of chronic pathology, physiotherapy treatment is carried out over several months, supplemented by spa therapy.