Joint pain (arthralgia) is a very common problem that can be associated with infection or toxicity, trauma, inflammation or deterioration of 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 early as possible. It is not easy even for an experienced specialist to determine exactly why the joints hurt, as the early symptoms can be deceptive and the full picture of the disease is sometimes revealed only within 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 determine the exact cause of the disease and choose the right tactics of treatment with a doctor.
In this article we will look at situations in which many joints hurt all over the body. Sometimes a person starts to hurt and other joints quickly join him. It happens that the pain migrates from one part of the body to another for several days or weeks. A number of diseases cause pain in a group of joints in the form of seizures - seizures when the pain subsides and then reappears.
Joint pain with viral infections
Arthralgias most often occur with various viral infections: due to the direct impact of viruses on the joints or under the influence of toxins that accumulate in the blood during the acute period of many infectious diseases.
The pain most often occurs in the small joints of the arms and legs, the knee joints, and sometimes in the joints of the spine. The pain is not strong, painful. It's called joint pain. Mobility is usually not impaired, there is no swelling or redness. In some cases, a skin rash similar to hives may appear and disappear quickly. In most cases, viral arthralgias become the first symptom of malaise and are accompanied by fever, muscle aches and weakness.
Despite the deterioration in general well-being, joint pain in viral diseases is not usually a cause for serious concern. Relief can be provided by taking nonsteroidal anti-inflammatory drugs, drinking plenty of fluids and resting. After a few days, the pain disappears and joint function 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 an infection, both viral and bacterial. The immediate cause of reactive arthritis is a defect in the immune system that causes inflammation in the joints, even though they have not been affected by the infection.
Joint pain is more common 1-3 weeks after acute respiratory infections, intestinal infection or diseases of the genitourinary system, such as urethritis or genital infections. Unlike viral arthralgias, joint pain is intense, accompanied by edema and impaired mobility. Body temperature may rise. Arthritis often begins with the involvement of one knee or ankle joint. Within 1-2 weeks, 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 of the spine hurt.
Joint pain usually disappears with treatment or on its own, with no consequences. However, some types of reactive arthritis are chronic and occasionally exacerbated.
Reuters disease- one of the types of reactive arthritis that develops after transmitted chlamydia and can become chronic. Joint pain in Reiter's disease is usually preceded by urinary incontinence - a manifestation of chlamydial urethritis (inflammation of the urethra) that often goes unnoticed. Then eye problems appear, conjunctivitis develops. You should consult a doctor for treatment.
Reactive arthritis can develop after adenoviral infection, genital infections (especially chlamydia or gonorrhea), intestinal infections associated with salmonella, Klebsiella, Shigella and others.
Joint pain when cartilage wears out
Diseases that are accompanied by gradual wear of cartilage on the articular surfaces of the bones are called degenerative. They are more common in people aged 40-60 and older, but also occur in younger people, such as those who have suffered joint injuries, professional athletes who are exposed to frequent strenuous exercise and obese people. .
Osteoarthritis deformity (osteoarthritis, DOA)- This is a disease of the large joints of the legs - the knees and hips, which carry the bulk of the load when walking. The pain appears gradually. In the morning, after a break, health improves, and in the evening and at night after prolonged walking, running and other stresses deteriorates. Inflammatory changes: swelling, redness are usually not pronounced and may occur only in advanced cases. But there are often complaints of cracking in the joints. Over the years, the disease progressed. It is almost impossible to cure deforming arthrosis; it is only possible to slow down the destruction of cartilage. To restore mobility, they resort to surgery.
Osteochondritis of the spineIs another common degenerative disease. Its cause is thinning and destruction of cartilage between the vertebrae. The reduction in the thickness of the cartilage leads to 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: headache, dizziness, pain and tingling in the hands, shoulder joints, pain and interruptions in the heart, chest, leg pain, 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 known. 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, in contrast to degenerative ones, are more likely to develop in childhood or in young people. Their first manifestation is often joint pain.
Joint pain is usually volatile: one joint hurts today, another tomorrow, a third the day after. Arthralgia is accompanied by swelling, redness of the skin, impaired joint mobility and sometimes fever. After a few days or weeks, the joint pain disappears, but after a while it recurs. Over time, joints can become significantly deformed and lose mobility. A characteristic sign of autoimmune inflammation of the joints is morning stiffness. In the first hours of the morning, the affected joints should be kneaded for 30 minutes to 2-3 hours or more. The stronger the load on the joint the day before, the more time you have to spend warming up.
Gradually the symptoms of damage to other organs join the arthralgias: heart, kidneys, skin, blood vessels and others. Without treatment, the disease progresses. It is impossible to cure, but modern drugs can slow down the process. Therefore, the earlier treatment is started, the better the result.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are mainly affected: they begin to hurt a lot, become red and swollen. Most often the disease begins with pain in the small joints of the hands and feet: fingers, joints of the hand or foot, less often - with damage to one knee, ankle or elbow joint and then pain in other parts of the body.
Systemic lupus erythematosus- a less common disease that is more susceptible to young women. It is characterized by flying pains in various joints of the body, deformity of the fingers, the appearance of a rash on the skin, especially characteristic of the face - redness of the forehead and cheeks in the form of butterfly wings. Joint pain may be accompanied by interruptions and discomfort in the heart and chest, low-grade fever, weakness, weight loss, high blood pressure, back pain, swelling.
Ankylosing spondylitis- Unlike lupus, it more often affects men. The disease begins with pain in the joints of the spine, lumbar region, sacrum, pelvis. Gradually the pain spreads upward to other parts of the spine. In addition to pain, stiffness, decreased flexibility and over time, gait disorders and complete immobility in 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 older 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 disorder in which a characteristic rash appears on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, toes and feet, less commonly the spine, usually ache and swell. A distinctive feature of arthritis in psoriasis is the asymmetric lesion. The skin above the joints may have a bluish-purple color and damage to the nails may occur. 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 disease caused by streptococci. Rheumatism is characterized by very severe pain in the large joints of the legs and arms, which appear 2-3 weeks after a sore throat or scarlet fever. It develops more often in children. The pain is so severe that you can't touch the joint, you can't move. The joints become swollen, red and the temperature rises. First, some joints hurt, and then others, usually symmetrical. Even without treatment, the pain disappears on its own and joint function is completely restored. After some time, however, severe symptoms of heart damage appear. Rheumatism requires urgent medical attention. Only with timely treatment can damage to the heart and other organs be avoided.
How to examine inflamed joints?
There are various test methods for 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 nature of the disease, to identify signs of infection and with the help of immunological tests or the method of polymerase chain reaction (PCR) to determine the exact cause of the diseasein case of infectious or reactive arthritis. A blood test shows possible metabolic disorders, the condition of the internal organs.
Examination of synovial fluid- a liquid that washes the surface of the joint. It nourishes the joint surfaces and also reduces friction during movement. According to 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 cartilage, the accumulation of salts that can cause pain (for example, gout). The synovial fluid is taken for analysis using a needle, which is inserted into the joint cavity after local anesthesia.
X-ray and computed tomography of the joints (CT)- a method that allows you to examine the structure of the bony parts of the joint, as well as indirectly assess the condition of the cartilage by the size of the joint space - the distance between the bones in the joint. X-ray examination is prescribed among the first methods of 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 determine the cause of joint pain. Computed tomography is also a method of X-ray examination. With computed tomography, the doctor receives a series of layered images of the joint, which in some cases provides more complete information about the disease.
Ultrasound and MRI of the joints- the methods are different in nature but similar in purpose. With the help of ultrasound or magnetic resonance imaging, information can be obtained about the condition of the soft tissues of the joint and cartilage. Ultrasound and MRI 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 for visual examination of the joint with the help of 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 own eyes the internal structure of the joint, to notice its damage and changes, as well as to take pieces of the synovial membrane of the joint and its other structures for analysis. If necessary, after the examination the doctor can immediately perform the necessary therapeutic manipulations. Everything that happens during arthroscopy is recorded on a disk or other medium, so after the procedure you can consult with other specialists.
Joint treatment
If you have joint pain, find a good pediatrician or pediatrician. 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 performed by a rheumatologist found here.
If the cause of arthralgia is an inflammatory response, medications are used to treat the joints, which can reduce the inflammation. These are primarily 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 the infection causes pain, antibiotics are given.
Special treatment regimens are used in autoimmune diseases. For constant intake, the doctor selects the minimum effective doses of drugs that can severely suppress the inflammatory response or suppress the immune system. For example: sulfosalazine, methotrexate, cyclophosphamide, azathiaprine, cyclosporine, infliximab, rituximab and others.
No specific drugs are yet known for degenerative joint diseases (osteochondrosis, osteoarthritis). Treatment of diseased joints consists in prescribing anti-inflammatory and analgesic drugs during exacerbation, as well as taking metabolic agents based on chondroitin 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 impaired, they resort to surgery. Currently, there are various methods of endoprosthesis that allow the implantation of artificial joints or parts of them, instead of damaged or worn.