Joint pain: causes and treatment

Symptoms: joint pain.

Possible causes: trauma, arthritis, osteoarthritis, osteoarthritis.

Doctor: the therapist registers the complaints, sends them for examination and, based on his results, will refer the patient to a doctor with a narrower specialization.

Treatment: described individually in each case.

Prevention: reducing the load on the joints, maintaining a healthy lifestyle, timely examination by a doctor, diet.

Why do joints hurt?

The joints can be damaged for two reasons: arthritis, inflammation of the joint tissues, or osteoarthritis (arthrosis), a degenerative-dystrophic process, i. e. the destruction of the bony-cartilaginous elements of the joint. Diagnosis should be made by a doctor, but you can navigate the symptoms yourself.

Inflammation in arthritis is like a fire in the woods: everything starts with force, the joint swells and hurts a lot even at rest, and when you try to make the slightest movement, the pain intensifies. The skin in this area becomes red and warm to the touch.

With osteoarthritis, everything is different: the joints are destroyed slowly and invisibly at first. Joint pain, at first mild, aching, arising only during movement, quite tolerable, increases over time, becoming constant and strong enough to disrupt calm and sleep. The insidiousness of this pain is that it is delayed in relation to the pathological process that continues in the joint and occurs only when X-ray images show signs of destruction of the respective joint, unfortunately, irreversible. This is the spread of the spines (marginal osteophytes) along the edge of the articular surfaces of the bone that form the joint, the narrowing of the joint space and the signs of osteosclerosis - areas of pathological increase in bone density. If osteoarthritis affects an articulation, say, the knee, the biomechanics change and the function of the adjacent joints - the hip joint and the ankle - breaks down. They experience an increased load and, at the same time, uneven and, as a result, are consumed faster. Thus, osteoarthritis affects the joint from joint to joint, and the pain intensifies and can spread to all new joints.

Types of pain

The type and nature of pain sensations depends on the cause that caused them.

The joints ache with flu and acute respiratory infections on a background of high temperature (up to 40 ° C). This pain disappears on its own once the temperature returns to normal and does not require special treatment.

For arthritis pain:

• sharp,
• Painful,
• pulse
• shooting,
• occurs at rest and intensifies when performing certain movements,
• giving to neighboring areas,
• during probing (touch) it hurts everywhere, on the entire surface of the wrist, but especially along the space of the wrist.

Periarthritis is particularly unbearable - inflammation of the tissues around the joint (bags, tendons and ligaments). How everything happens can be explained with the example of the shoulder joint. First, the joint starts to hurt. The pain very quickly becomes excruciating, almost unbearable. It gives the shoulder and neck area, intensifies (and is often accompanied by a seizure) when you try to stretch the arms to the sides at shoulder level or bend them at the elbow and bring them behind the back. At the end of the clavicle, which stands at the shoulder joint forward, and in the same place at the back there are pain points. When you press them with your finger, the pain increases. With such acute sensations, the joint needs immobilization - the hand should hang on a handkerchief, try not to move it. This is an essential condition for the success of the treatment.

Important! as soon as possible choose an appropriate analgesic and anti-inflammatory therapy after examination. This will reduce the severity of joint inflammation, reduce pain and improve quality of life.

With osteoarthritis, joint pain is different:

• The pain is initially mild and unstable, its character is like a wave - at certain periods it is absent for weeks or even months. But over time, without treatment, the waves of pain become stronger and more frequent, and the gaps between them diminish.
• Pain at first: its eruption occurs on the first attempt to take a step, to raise an arm, to bend. Then the joints seem to have developed, and the pain subsides.
• Mechanical rhythm - the joint starts to hurt when you load it. At first, the pain manifests itself with high loads - lifting weights, running up stairs, walking for a long time, playing sports. Later, even small movements echo the pain. But at the same time, unlike the uncomfortable sensations in arthritis, the pain in osteoarthritis disappears when you give rest to the joint, provide it with calmness. This is why doctors talk about mechanical rhythm: movement provokes pain and rest relieves it.
• Discomfort at night. There is no pain in calm as such, but lying is uncomfortable, all the time you want to change your posture, find a position in which you can forget the joints and spine, but it does not work. The joints hurt, and so on! Morning cuffs: woke up, no pain yet, but it was as if you were chained or tightly wrapped - the joints do not obey, but gradually the feeling of stiffness disappears, the range of motion in the joints is recovered.
• Defensive attitude. When a joint hurts, you want to take the so-called analgesic - an analgesic position, in which it becomes easier. This is best seen in the example of the spine: it also consists of joints. When one of them tingles, and with it a nerve root is inserted into the bone habit, there is an acute pain at the base of the sciatica. Anyone can diagnose a patient with sciatica after seeing how the poor man is distorted. In fact, with the help of this "distortion", supported by muscle spasms, the body tries to reduce pain to a minimum.

Osteoarthritis of the hip and knee

The pain with a lesion of the hip joint (and often suffers on one side) is localized in the upper thigh and radiates to the knee. He usually starts to get sick in the second half of the day, when he has already worked hard enough. The pain increases with walking, and at rest it weakens and disappears.

Knee joints most often suffer from both at the same time. They break down easily and start to hurt when bent. The so-called scale symptom is characteristic of the knee lesion. Descending from it becomes more painful than ascending; patients do this by turning sideways. Sometimes the joint is tied in a bent position due to an increase in bone (osteophyte) or its fragment (such a bone fragment "lost" inside the joint is called an "articular rat"). Joint blockage is associated with increased pain when you try to bend or straighten it.

Knee movement problems are not always associated with arthritis. Sometimes the common joke can be "fake. "Among the most common causes of knee pseudoblock are:

• Edema (excess fluid in the joint capsule can interfere with full flexion and elongation of the joint).
• Inflammation (inflammation of tissues in the knee, such as in rheumatoid arthritis and gout).
• Improper movement of the knee cap in the joint (accompanied by severe pain).
• Irritation of the tissues surrounding the joint.
• Knee Injury (Any serious knee injury, such as sprain, can cause muscle spasm).

Important! If the joint is blocked, active movements in the joint are impossible, it is necessary to seek medical help from an orthopedic traumatologist as soon as possible - an emergency room, a clinic, a hospital. Do not hesitate to call the ambulance - this is a good reason to call it, because you will not go far on one leg and may not even go to the clinic yourself.

Diagnosing

By the nature of the pain and appearance of the affected wrist, a preliminary diagnosis (arthritis or osteoarthritis) can also be made by a non-specialist. But hurry to the district clinic to confirm the assumptions!

Which doctor should I go to?

In case of joint pain, you should schedule an appointment with a local therapist. He performs the functions of a medical dispatcher: records complaints and clinical symptoms, directs the patient for examination and, based on his results, decides which doctor should consult with each particular patient. A wide variety of specialists are involved in maintaining common health:

• artrologist.
• orthopedic traumatologist.
• rheumatologist.
• vertebrologist (if spinal joints are affected).
• podiatrist (when it comes to ankle joints).
• surgeon
• oncologist.
• neurologist (if the joint has already been treated but the pain remains in it).
• dietitian (if the joints are injured due to metabolic disorders, such as gout, or if there is excess weight).

What tests should you pass and research to do?

The examination begins with the simplest test - a clinical (one-finger) and biochemical (one-vein) blood test for signs of inflammation, as well as a general urine test. In some diseases of the joints, the kidneys are involved in the pathological process. Excess uric acid in the urine can indicate gout as the cause of joint disease.

A laboratory study of synovial fluid, which is inside the joint, helps to detect the inflammatory process and clarify its nature. It is punctured by the joint capsule - puncture. If necessary, a histological examination of a fragment of the synovial membrane extending into the joint cavity from the inside is performed.

A proven diagnostic method is X-ray of the joint in two standard projections. This will help visualize narrowing of the joint space, bone outgrowths, osteoporosis, and osteosclerosis (areas of reduced and increased bone density.

Currently, comprehensive information about the condition of the node is provided by magnetic resonance imaging.

What joint diseases can cause pain?

There are more than a hundred such diseases. In the elderly, osteoarthritis is prevalent, and in the young, rheumatoid arthritis and injuries (bruising, fractures, ligament damage).

"Along with high blood pressure, which is commonly called hypertension, joint disease tops the list of most common reasons for seeking medical help. And the chronic pain that patients experience at the same time and because of which they can not"Living and working fully is not only a medical problem, but also an important social problem, " says the doctor of medical sciences, professor of the rheumatology department. - Of all joint diseases, osteoarthritis is the most common. over 65 suffer from this disease. And if we talk about chronic inflammatory diseases of the joints - arthritis, here rheumatoid arthritis stands out. It is also not a gift, and not only because of the pain syndrome: within 3-5 years after onset"This type of arthritis inevitably ends with the assignment of a disability group to the patient. "

How to get rid of joint pain urgently?

Analgesics are able to quickly overcome pain: pain can not be tolerated in any case, if you do not want it to turn from acute to chronic. This metamorphosis can happen very quickly - in 3-4 weeks, so removing joint pain should be an urgent task. The joint starts to hurt as soon as you put stress on it. Therefore, in case of pain, a nonsteroidal anti-inflammatory drug (NSAID) with a good analgesic effect should be taken half an hour before any physical activity.

If joint pain worsens at night, in addition, before going to bed, your doctor will recommend taking sodium metamizole as well as nicotinic acid drotaverine to improve local blood circulation.

Local therapy

NSAIDs have a frightening side effect - they can cause damage to the stomach mucosa until ulcers form, so they try to apply them topically as part of all kinds of oils and gels with propertiesanti-inflammatory and analgesic. They are usually rubbed into the skin over the affected joint twice a day. The pain is also relieved by special plaster with magnetic powder, which are glued to the joints or spine.

What happens if the joints are not treated?

Joint disease, if left untreated, can lead to loss of freedom of movement and disability. If one or more large joints are affected, they can be replaced with artificial ones. Multiple joint damage (polyarthritis), as a rule, is a consequence of a general disease of the body, for example, psoriasis. In this case, it is increasingly dangerous to start the disease because it progresses rapidly and can end your life very quickly.

cONcluSiON

Joint pain is known to almost everyone, and occurs for two main reasons - due to inflammation (arthritis) or destruction of bone and cartilage (osteoarthritis). Interestingly, the joints in the hands and feet hurt in different ways. In the upper limbs, unlike the lower ones, it is usually not the joints themselves that are affected, but the surrounding tissues (tendons, ligaments, bags). This is due to the different type of load experienced by the arms and legs - dynamic and static respectively. Joint pain must be fought from day one: the prospect of disability in the next 10-15 years will satisfy very few people. As part of the prevention of joint diseases, it is important to lose extra pounds in order to reduce stress on the joints and deal with accompanying pathologies (allergies, diabetes mellitus).