Pains in the joints

Pains in the joints- These are unpleasant pains, pulling sensations in the area of the joints, the intensity of which sometimes reaches the point of pain. The symptom is combined with muscle pain, weakness, weakness, cramps, 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 pathology. To determine the cause of the disorder, laboratory tests, ultrasound, radiographic and invasive methods are used. Treatment includes treating the disease that caused the pain.

Causes of joint pain

Mild or moderate joint discomfort is not always a manifestation of a pathological process. Sometimes the symptom has natural causes. Transient joint pain is felt when wearing uncomfortable shoes, and in weather-sensitive people - 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 frequent cause of the symptom is excessive load of the musculo-ligamentous apparatus, less often it is caused by microtraumas of the cartilage and synovium. A typical combination of joint pain and discomfort in the bones and muscles. Joint and muscle discomfort appears immediately after physical activity or prolonged monotonous work with constant tension in the same muscle groups. Joint pains occur without fever. During a great overload, a moderate disturbance of the general condition and weakness are possible.

The disorder can last for several days and with limited physical activity, it gradually decreases until it disappears completely without any treatment. If the pains resulting from sports or heavy physical work have changed to constant pain, swelling of the wrist, elbow, shoulder, ankle, knee and hip joints and limitation of normal movements, you should consult 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 rays, decreased blood supply to cartilage, and decreased intra-articular fluid volume. Mild discomfort is only the first manifestation of aging joint damage. As a rule, periodic discomfort appears after 45-50 years. At the age of 60-65, unpleasant pain appears even with a small load, which is accompanied by stiffness of movement, stooping, gait disturbance and gradually leaves the pain.

Pregnancy

Complaints about joint pain occur more often in the second half of gestational age. Pulling, painful discomfort is usually felt in the joints of the pelvis and lower limbs. It gets worse at the end of the day, after standing for a long time or walking a long distance. A night's rest eases the condition. Joint pain during pregnancy is caused by the following reasons:

• Lack of vitamins and minerals. The biggest role is played by calcium and vitamin D deficiency, which causes osteomalacia. The peculiarity of the symptom manifestation is the 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 frequent cases of ARVI.
• Significant weight gain. Joint discomfort is more common among pregnant women who gain a lot of weight or who are overweight. Pains are finally felt in the middle of the day in the hip joints, knees, ankles, the cartilages of which are several times more than the permissible load. To alleviate the condition, women deliberately limit physical activity, which leads to even faster weight gain.
• Softening of cartilages and ligaments. About half of pregnant women experience discomfort in the pelvic joints, which is caused by the action of the hormone relaxin. In most cases, the discomfort is characterized by pain in the groin and hip joints. With the development of symphysitis in the pathological course, painful sensations are replaced by pain that increases when pressing on the uterus, when trying to separate the legs, during sex. The appearance of pain in the abdomen is a serious reason for visiting an obstetrician-gynecologist.
• Carpal tunnel syndrome. A specific manifestation found in almost 20% of pregnant women in the 2-3 trimester is e. yearTunnel syndrome. The cause of the disorder is swelling of the soft tissues of the hand and compression of the nerves in the carpal tunnel, which go to the fingers. In addition to excruciating pain in the small joints of the hand, patients complain of skin numbness, tingling and a crawling sensation. The condition improves with the elevated position of the hands.

Obesity

In overweight people, the pressure on the cartilage tissue increases, which causes it to wear out faster. The degenerative-dystrophic process usually involves the large joints of the lower limbs and intervertebral joints. As obesity progresses, the disorder increases. Discomfort in the joints first appears as pain at the end of the day without fever, then the increasing destruction of cartilage leads to the development of deformed arthrosis, spondylosis, osteochondrosis with a sharp pain syndrome that limits the patient's motor activity.

Acute infections

Body and joint pain is one of the early (prodromal) signs of many acute respiratory viral infections. The main causes of joint discomfort are the intoxication of the body due to the spread of viruses and bacteria, the accumulation of toxins and the development of the inflammatory process. As a rule, the patient complains that the whole body hurts, there is mild and moderate pain in the joints, muscles and bones. The symptom is accompanied by weakness, fatigue, insomnia and frequent awakening. Along with signs of pain and general weakness, chills and hyperthermia are observed.

The most pronounced pains in the joints and body are during the flu. Up to 50% of patients experience persistent 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, take a glass of water. The condition is aggravated by high (febrile) temperature and severe headache. Sore throat and nasal congestion occur after a few hours or even days. Less discomfort in the joints occurs during parainfluenza, adenovirus infection.

Joint pain can be felt with acute infectious damage of the gastrointestinal tract - food poisoning infections, salmonellosis. Painful joint pain of varying intensity appears suddenly a few hours after eating contaminated food and is accompanied by a sharp increase in temperature, severe chills and headache. The pain is preceded by nausea, vomiting, abdominal pain, unpleasant diarrhea with mucous and sometimes bloody impurities.

collagenoses

Painful joints are a harbinger of many diseases caused by autoimmune inflammation of connective tissue, including joint tissue. Localization, distribution and intensity of unpleasant sensations are determined by the characteristics of specific 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 movement, and then during rest. Deformation of joints is possible. The main systemic inflammatory causes of the disorder:

• Rheumatism. The symptom is "unstable": aching pains, and then pain in turn is felt in the large joints of the arms and legs - elbows, shoulders, hips, knees, feet. The affected areas are swollen. Discomfort in the joints is often preceded by a sore throat. Changes in the joints are reversible with treatment.
• 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 stiffness of movement in the morning. In the future, joint pain and curvature come to the fore.
• Systemic scleroderma. It is characterized by variable localization of painful sensations, morning stiffness in the joints of hands, elbows and knees. Aches and pains are usually symmetrical. Swelling is short-lived. Due to skin sclerosis, the mobility of joints is limited, damage to tendons causes a feeling of friction during movement.

Osteoarthritis

The pain syndrome at the initial stage of the disease is mild and is perceived as discomfort, pain in the joints of the legs and less often in the arms. The direct cause of osteoarthritis is the degeneration and destruction of cartilage tissue. As a rule, aching or aching sensations without fever appear in adulthood and old age. Pain may start earlier in the presence of occupational risks (vibration, heavy physical work). Gradually the joints become stronger, the person experiences severe pain and it is difficult to walk and take care of himself.

Metabolic disorders

The causes of metabolic disorders, during which joint pain is manifested, are insufficient supply of vitamins, minerals, accelerated accumulation or excessive release of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, of varying severity and most often as manifestations of pathological conditions such as:

• Osteoporosis. When calcium is leached from the bone tissue, the articular surfaces of the bones become fragile, the cartilage thins, which is accompanied by a feeling of pain. The pain syndrome gradually increases from mild pains to severe arthralgia, with unpleasant sensations in the bones and muscle weakness. The joints that suffer the maximum load are most often damaged - hip and knee; Shoulders, elbows and ankles are less often injured.
• Gout. Slight toe pain is already a concern in the preclinical stages of the gout process. There may be painful discomfort in the knees, elbows, wrists and fingers. Accumulation of urates in the joint cavity causes a rapid manifestation of the disease from painful to acute painful joint pains that do not disappear for several hours. The affected joint is hot 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 occur before noticeable pathological changes in the general blood analysis and other clinical symptoms - general weakness, night sweats, fever, loss of appetite, bleeding. Unpleasant sensations first periodically hurt, then constantly intensify, weakening 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. Painful sensations are common, usually moderate. A short period of pain in the knee joint and thigh muscles, which worsens at night and turns into ever-increasing pain with lameness during exertion, is observed with osteosarcomas. Other joints are less affected by this pathology.

Joint injuries

Joint pains are provoked by mild traumatic injuries, which cause damage to the ligaments surrounding the joint and bruising of the soft tissues of the joint area. More severe pain occurs when the meniscus is damaged. The symptom is clearly associated with a blow, fall or awkward movement. As a rule, discomfort is felt in one affected joint, less often it spreads to the surrounding areas of the body.

Chronic infectious processes

Possible causes of joint pain that occurs without fever or on the background of low-grade fever are long-term infections. Joint discomfort in patients with chronic infectious and inflammatory diseases is the result of intoxication of the body or direct harmful effects of microorganisms (usually streptococci, mycoplasma, chlamydia) on joint tissue. The appearance or intensification of pain may indicate exacerbation of chronic tonsillitis, sinusitis, infections of the genital system, adnexitis, pyelonephritis.

Distinctive signs of joint pain in common chronic infections that occur during intoxication are moderate severity of joint discomfort, gradual development, periodic strengthening and weakening of symptoms. In patients with tuberculosis and hematogenous osteomyelitis, the background of the development of painful sensations is an increase in temperature to a subfebrile level, general weakness - fatigue, weakness, weakness. Without treatment, the condition of patients gradually worsens.

Complications of pharmacotherapy

Taking some medications can be complicated by aches and pains in the small joints of the hands. Unpleasant sensations are not accompanied by redness or deformation of the joints. Patients may complain of muscle pain, fever, skin rash, and other symptoms of drug allergy. Discomfort disappears quickly after stopping the drug that provoked it, and special treatment of the resulting complications is unlikely. Pains and mild arthralgia are caused by:

• Antibiotics: penicillins, fluoroquinolones.
• transilizers: Phenazepam, Diazepam, Lorazepam, etc. Sh.
• contraceptives: Combined oral contraceptives (COCs).

Rare causes

• 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 gout, hypothyroidism, Ishenko-Cushing's disease.
• Autoimmune processes: Hashimoto's thyroiditis, vasculitis.
• Facial injury: Necrotizing fasciitis in the recovery stage.
• Congenital defects of bones and joints.

survey

To determine why pains are felt in the joints and bones, it is necessary to consult a therapist or family doctor, who will conduct an initial diagnosis and prescribe examinations by specialized specialists. Taking into account the nature of the unpleasant sensations, the speed of their occurrence and accompanying symptoms, the following is recommended to determine the cause of the disorder:

• Laboratory blood test. It is necessary to evaluate the number of leukocytes and the level of ESR 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 acute phase proteins, markers of rheumatoid arthritis and other inflammations. Vitamin, electrolyte (especially calcium) and uric acid concentration tests help diagnose metabolic disorders.
• Bacteriological examination. A bacterial culture is necessary if the pains felt in the joints and throughout the body are likely to be infectious. Urine, feces, sputum and discharge from the urogenital tract are collected for research. Sensitivity to antibiotics is determined to select the regimen of antimicrobial therapy. In doubtful cases, microscopy and culture are added with serological reactions (RIF, ELISA, PCR).
• Sonography 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, determine cartilage and bone destruction, preclinical inflammatory changes, and study the condition of periarticular soft tissues. The advantage of the method is availability, non-invasiveness and high information content.
• X-ray technique. X-rays of the joints reveal changes in the width of the joints, hardening of the soft tissues, the presence of calcifications, osteophytes, and erosions of the joint surfaces. To improve diagnostic efficiency, special techniques are used - contrast arthrography, pneumoarthrography. In the initial stages of damage, tomography (MRI, CT of joints) is considered more indicative. Bone density can be measured using densitometry.
• Invasive examination techniques. In some cases, to determine the cause of joint pain, a puncture is performed with a biopsy of the cartilage, inner lining of the synovial membrane and tophi. Morphological analysis of biopsy samples and examination of synovial fluid reflect the nature of the pathological processes taking place in the joints. Simultaneous collection of materials with visual examination of the joint cavity is convenient 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 damaged tissues. In recent years, there has been an increased interest in joint thermography as a modern non-invasive method of detecting inflammatory diseases of joints and peri-articular tissues, tumors and blood circulation disorders. If the number of elements formed in the clinical blood analysis decreases, an articular bone puncture is performed. Patients with joint pain without fever are advised to refer to a rheumatologist and an orthopedic traumatologist.

treatment

Help before diagnosis

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

Pains in the bones, joints and muscles, along with general weakness and fever, increasing pains and pulling sensation to severe pain and development of constant pain are indications for consulting a doctor. To reduce joint discomfort caused by ARVI, it is recommended to rest, drink enough water, rose tincture and dried fruits. Until serious diseases causing joint pain are excluded, self-medication with painkillers, long-term unsuccessful use of compresses, lotions, decoctions, etc. is not allowed. Sh.

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. Etiopathogenetic therapy usually complements symptomatic medications that quickly reduce the severity of aching and aching pain. The treatment regimen for diseases caused by joint pain may include:

• Antimicrobial agents. The main therapy of infections is based on the appointment of antibiotics to which the pathogen is sensitive. In severe cases, a wide range of drugs are used until the sensitivity of the microorganism is determined.
• Nonsteroidal anti-inflammatory drugs. They reduce the production of inflammatory mediators and thus suppress inflammatory processes in the joints. By affecting 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 basis of systemic collagenosis treatment. 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, a sufficient amount of which increases the elasticity of articular cartilage. Nourishes cartilage tissue and restores its damaged structure. Intra-articular administration of drugs is possible.
• Xanthine oxidase inhibitors. It is used as an anti-gout remedy. They block the main enzyme necessary for the synthesis of uric acid, thereby reducing its concentration in the body and helping to dissolve existing urate deposits.
• Vitamin-mineral complexes. It is recommended for the treatment of joint pain caused by metabolic disorders. The most commonly used preparations contain calcium and vitamin D. They are also an element of complex therapy of inflammatory and metabolic diseases.
• Chemotherapy drugs. They serve most of the treatment regimens for various types of oncohematological pathologies. Depending on the clinical variant and severity of the neoprocess, they are combined with radiotherapy and surgical interventions.

Physiotherapy

After the exact cause of the pain and acute inflammation subside, patients, except those suffering from cancer, are prescribed physiotherapy and exercise therapy. Microwave and ultrasound therapy sessions, electrophoresis and impulse currents have a good anti-inflammatory and pain-relieving effect. In case of chronic pathology, physiotherapy treatment is carried out for several months and complements spa therapy.