Joint pain (arthralgia) is a very common problem that can be associated with infection or toxicity, trauma, inflammation or deterioration of the cartilage.
In most cases, joint pain goes away on its own within a few days. However, some situations require you to see a doctor as soon as possible. It is not easy, even for an experienced specialist, to determine exactly why the joints hurt, because the first symptoms can be misleading, and the full picture of the disease sometimes does not come out until 1-2 months or more.
The information in this article will help you navigate the variety of diseases and conditions that cause arthralgia. And modern diagnostic methods will allow you to establish the exact cause of the disease and choose the right tactics for treatment with a doctor.
In this article, we'll look at situations where multiple joints all over the body hurt. Sometimes you start to hurt, and other joints quickly join. Sometimes the pain seems to migrate from one part of the body to another within a few days or weeks. A number of diseases cause pain in a group of joints in the form of attacks - convulsions, when the pain subsides and then reappears.
Joint pain with viral infections
Most often, arthralgia occurs with various viral infections: due to the direct effect of viruses on the joints or under the influence of toxins that accumulate in the blood during the acute period of many infectious diseases.
Most often, the pain appears in the small joints of the arms and legs, knee joints, and sometimes the joints of the spine. The pain is not strong, painful. This is called joint pain. Mobility is usually not impaired, there is no swelling or redness. In some cases, a hives-like rash may appear and go away quickly. In most cases, viral arthralgia becomes the first symptom of discomfort and is accompanied by fever, muscle pain, and weakness.
Despite the deterioration in general well-being, joint pain caused by viral diseases is usually not a cause for serious concern. Relief can be provided by taking nonsteroidal anti-inflammatory drugs, drinking plenty of fluids, and getting enough rest. After a few days, the pain subsides and the function of the joint is fully restored. There are no irreversible changes in the structure of the joint.
Viral arthralgias are characteristic, for example, of influenza, hepatitis, rubella, mumps (in adults).
Reactive arthritis
This is a group of diseases in which joint pain occurs after infection, both viral and bacterial. The immediate cause of reactive arthritis is an error in the immune system, which causes inflammation of the joints, although they have not been affected by the infection.
Joint pain appears more often 1 to 3 weeks after acute respiratory infections, intestinal infection, or diseases of the genitourinary system, for example urethritis or genital infections. Unlike viral arthralgia, joint pain is severe, accompanied by edema and mobility disturbances. Body temperature may rise. Arthritis often begins with involvement of a knee or ankle joint. Within 1-2 weeks, the pain in the joints of the other half of the body joins, the small joints of the arms and legs begin to ache. Sometimes the joints in the spine hurt.
Joint pain usually goes away with treatment or on its own, without leaving any damage. However, some types of reactive arthritis are chronic and sometimes exacerbated.
Reiter's disease- one of the types of reactive arthritis which develops after transferred chlamydia and may take a chronic course. Joint pain in Reiter's disease is usually preceded by a violation of urination - a manifestation of Chlamydial urethritis (inflammation of the urethra), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment you need to consult a doctor.
Reactive arthritis can develop after infection with adenovirus, genital infections (especially chlamydia or gonorrhea), intestinal infections associated with infection with Salmonella, Klebsiella, Shigella, etc.
Joint pain when the cartilage is worn away
Diseases that are accompanied by progressive wear and tear of the cartilage on the articular surfaces of bones are called degenerative. They are more common at the age of 40-60 years and over, but they also occur in younger people, for example, those who have suffered joint injuries, professional athletes who are exposed to frequent intense exertion and inobese people.
Deforming osteoarthritis (osteoarthritis, AOD)- It is a disease of the large joints of the legs - knees and hips, which bear most of the load when walking. The pain sets in gradually. In the morning, after rest, the state of health improves, and in the evening and at night after long walks, runs and other stresses, it worsens. Inflammatory changes: edema, redness are usually not pronounced and can appear only in advanced cases. But often there are complaints of crackling in the joints. Over the years, the disease progresses. It is almost impossible to cure deforming osteoarthritis, it is only possible to slow down the destruction of cartilage. To restore mobility, they resort to surgery.
Osteocondritis of the spineIs another common degenerative disease. Its cause is the thinning and destruction of the cartilage between the vertebrae. The decrease in the thickness of the cartilage causes compression of the nerves extending from the spinal cord and blood vessels, which in addition to pain in the joints of the spine causes many different symptoms. For example: headaches, dizziness, pain and numbness in the arms, shoulder joints, heart pains and interruptions, chest pain, pain in the legs, etc. A neurologist usually deals with the diagnosis and treatment of osteochondrosis.
Autoimmune diseases as a cause of joint pain
Autoimmune diseases are a large group of diseases whose causes are not fully understood. All these diseases are united by the peculiarity of the immune system: the cells of the immune system begin to attack their own tissues and organs of the body, causing inflammation. Autoimmune diseases, unlike degenerative diseases, are more likely to develop in childhood or in young people. Their first manifestation is often joint pain.
Joint pain is usually volatile: today one joint hurts, tomorrow another, the day after tomorrow - a third. Arthralgia is accompanied by edema, redness of the skin, reduced mobility of the joints, and sometimes fever. After a few days or weeks the joint pain goes away, but after a while it comes back. Over time, the joints can become significantly deformed and lose mobility. A hallmark sign of autoimmune joint inflammation is morning stiffness. In the early hours of the morning, the affected joints should be kneaded for 30 minutes to 2-3 hours or more. The greater the load on the joint the day before, the more time you need to spend warming up.
Gradually, symptoms of damage to other organs join arthralgia: heart, kidneys, skin, blood vessels, etc. Without treatment, the disease progresses. It is impossible to cure it, but modern drugs can slow down the process. Therefore, the earlier the treatment is started, the better the result.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are mainly affected: they start to hurt a lot, turn red and swell. Most often the disease begins with pain in the small joints of the arms and legs: fingers, joints of the hand or foot, less often - with the defeat of a knee, ankle or elbow, then pains in other parts of the body join.
Systemic lupus erythematosus- a rarer disease, more sensitive to young women. It is characterized by flying pains in various joints of the body, deformation of the fingers, the appearance of a rash on the skin, especially characteristic on the face - redness on the forehead and cheeks in the form of wings ofbutterfly. Joint pain may be accompanied by interruptions and discomfort in the heart and chest, mild fever, weakness, weight loss, increased blood pressure, back pain, edema.
Ankylosing spondylitis- unlike lupus, it affects men more often. The disease begins with pain in the joints of the spine, in the lumbar region, sacrum, pelvis. Gradually, the pain spreads upwards to other parts of the spine. In addition to pain, stiffness, decreased flexibility and, over time, impaired walking and complete immobility of the joints of the spine are characteristic. In the initial stages, ankylosing spondylitis can be easily confused with osteochondrosis. However, the first disease develops in young men, and the second in old people. As a diagnostic test, an x-ray is taken of the sacroiliac joint - the place where the spine and pelvic bones meet. Based on the results of the study, the doctor can confirm or deny the diagnosis.
Joint pain with psoriasis
Psoriasis is a skin disease in which a characteristic rash appears on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and feet, less often the spine, usually ache and swell. A distinctive feature of arthritis in psoriasis is an asymmetric lesion. The skin over the joints may have a blue-purple color and damage to the nails occurs. Over time, deformities and subluxations of the joints develop (the fingers begin to bend in an atypical direction).
Arthralgia with rheumatism
Rheumatism (acute rheumatic fever) is a serious illness caused by streptococci. Rheumatism is characterized by very severe pain in the large joints of the legs and arms, which appears 2-3 weeks after a sore throat or scarlet fever. It develops more often in children. The pain is so bad that you can't touch the joint, you can't move. The joints swell, turn red, and the temperature rises. First, some joints hurt, then others, usually symmetrical. Even without treatment, the pain goes away on its own and the joint's function is fully restored. However, after a while, severe symptoms of heart damage appear. Rheumatism requires urgent medical attention. Only with prompt treatment can damage to the heart and other organs be prevented.
How to examine painful joints?
There are different methods of examining joint pain. As a rule, they are used in combination.
Blood test- is one of the most common tests for joint pain complaints. With the help of this study, it is possible to determine the presence of inflammation or to suggest a degenerative character of the disease, to identify signs of infection, and by using immunoassays or the reaction method inPolymerase chain reaction (PCR), to accurately determine the causative agent of disease in infectious or reactive arthritis. A blood test shows possible metabolic disorders, the condition of internal organs.
Synovial fluid study- fluid that washes the surface of the joint. With the help of it, the joint surfaces are nourished, and friction during movement is also reduced. Depending on the composition of the synovial fluid, the laboratory assistant draws conclusions about the presence of inflammation or infection in the joint, the processes of destruction and nutrition of the cartilage, the accumulation of salts can cause pain (for example, with gout). The synovial fluid is removed for analysis using a needle, which is inserted into the joint cavity after local anesthesia.
Joint x-ray and computed tomography (CT)- a method that allows you to consider the structure of the bony parts of the joint, and also indirectly judge the condition of the cartilage by the size of the joint space - the distance between the bones of the joint. X-ray examination is prescribed among the first methods for joint pain. The x-ray shows mechanical damage to the bones (fractures and cracks), joint deformities (subluxations and dislocations), the formation of bone growths or defects, bone density and other criteria that help the doctor identify the cause of the painarticular. Computed tomography is also an X-ray research method. With a CT scan, the doctor receives a series of layer-by-layer images of the joint, which in some cases provide more complete information about the disease.
Ultrasound and MRI of the joints- the methods are of a different nature, but similar in their purpose. Using ultrasound or magnetic resonance imaging, information can be obtained about the condition of the soft tissues of the joint and the cartilage. Ultrasound and MRI scan show the thickness of the cartilage, its defects, the presence of foreign inclusions in the joint, and also help determine the viscosity and amount of synovial fluid.
Arthroscopy- a method of visual examination of the joint using microsurgical instruments which, after anesthesia, are introduced into the cavity of the diseased joint. During arthroscopy, the doctor has the opportunity to examine with his eyes the internal structure of the joint, to note its damage and changes, as well as to remove pieces of the synovial membrane of the joint and toits other structures for analysis. If necessary, after the examination, the doctor can immediately carry out the necessary therapeutic manipulations. Everything that happens during arthroscopy is recorded on a disc or other storage medium, so after the procedure you can consult other specialists.
Joint treatment
If you have joint pain, find a good therapist or pediatrician for children. He will make an initial diagnosis and, if necessary, refer you to a specialist for treatment. If joint pain is associated with osteoarthritis or arthritis, treatment will most likely be managed by a rheumatologist found here.
If the cause of arthralgia is an inflammatory response, drugs are used to treat the joints that can reduce inflammation. First of all, these are nonsteroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and many others. If these drugs are not effective enough, drugs from the group of corticosteroids are prescribed in the form of injections into the joint cavity or tablets. When an infection causes pain, antibiotics are given.
Special treatment regimens are used for autoimmune diseases. For constant admission by the doctor, the minimum effective doses of drugs are selected that can strongly suppress the inflammatory response or suppress the immune system. For example: sulfosalazine, methotrexate, cyclophosphamide, azathiaprine, cyclosporine, infliximab, rituximab and others.
For degenerative joint diseases (osteochondrosis, arthritis), no specific drug is yet known. Treatment of diseased joints consists of prescribing anti-inflammatory and analgesic drugs during an exacerbation, as well as taking metabolic agents based on chondroetin sulfates and hyaluronic acid. Although the effectiveness of the latter is currently not recognized by all doctors.
If the function of the joint is irreversibly deteriorated, they resort to surgery. Currently, there are various stent methods that allow implantation of artificial joints or parts of joints instead of damaged or worn joints.