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 soon as possible. Even an experienced specialist is not easy to determine exactly why the joints hurt, because the early symptoms can be misleading, and the full picture of the disease sometimes develops only within 1-2 months or more.
The information in this article will help you cope with various diseases and conditions that cause arthralgia. And modern diagnostic methods will allow you to determine the exact cause of the problem and choose the right treatment tactics together with the doctor.
In this article, we will look at situations where multiple joints ache all over the body. Sometimes someone starts to ache and other joints join him quickly. It happens that the pain seems to migrate from one part of the body to another over several days or weeks. Numerous diseases cause pain in a group of joints in the form of an attack - an attack, when the pain subsides and then reappears.
Joint pain with viral infections
Arthralgias most often occur in various viral infections: due to the direct effect of the virus on the joints or under the influence of toxins that accumulate in the blood during the acute period of many infectious diseases.
The most common pains appear in the small joints of the arms and legs, the knee joints, and sometimes the spinal joints. 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 hive-like skin rash may appear that disappears quickly. In most cases, viral arthralgias become the first symptom of weakness, followed 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 the function of the joint is completely 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 a defect in the immune system, which causes inflammation in the joints, even though the infection did not affect them.
Joint pain occurs more often 1-3 weeks after acute respiratory infections, intestinal infections, or diseases of the genitourinary system, for example, urethritis or genital infections. Unlike viral arthralgias, joint pains are intense, accompanied by edema and impaired mobility. Body temperature may rise. Arthritis often begins with involvement of one knee joint or ankle. Within 1-2 weeks, the pains in the joints of the other half of the body join, and the small joints of the arms and legs begin to ache. Sometimes the joints of the spine hurt.
Joint pain usually goes away with treatment or on its own, leaving no consequences. However, some types of reactive arthritis are chronic and occasionally get worse.
Reiter's disease- one of the types of reactive arthritis that develops after transmitted chlamydia and can 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. You must 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 infection, etc.
Pain in the joints when the cartilage is worn out
Diseases that accompany the 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, for example in those who have suffered joint injuries, in professional athletes who are exposed to frequent intense exertion, and in obese people.
Osteoarthritis deformity (osteoarthritis, DOA)- This is a disease of the large joints of the legs - knees and hips, which bear the bulk of the load when walking. The pain occurs gradually. In the morning, after rest, the health condition improves, and in the evening and at night after long walks, running and other stresses it worsens. Inflammatory changes: edema, redness are usually not pronounced and may occur only in advanced cases. But there are often complaints of cracking in the joints. With age, the disease progresses. 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 spineIt is another common degenerative disease. Its cause is thinning and destruction of the cartilage between the vertebrae. Reducing the thickness of the cartilage leads to compression of the nerves that extend 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 of the hands, shoulder joints, pain and interruptions in the work of 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, unlike degenerative diseases, will more often develop in childhood or in young people. Their first manifestation is often joint pain.
Joint pains are usually volatile: today one joint hurts, tomorrow another, the day after tomorrow - a third. Arthralgia is accompanied by edema, 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 joint inflammation is morning stiffness. In the first hours of the morning, the affected joints must be kneaded for 30 minutes to 2-3 hours or more. The stronger the joint load the day before, the more time you need to warm up.
Arthralgias are gradually accompanied by symptoms of damage to other organs: heart, kidneys, skin, blood vessels, etc. 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 results.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are primarily affected: they begin to ache severely, become red and swollen. Most often, the disease begins with pain in the small joints of the hands and feet: fingers, wrists or feet, less often - the defeat of one knee, ankle or elbow, and then pain in other parts of the body.
Systemic lupus erythematosus- a rarer disease, which is more susceptible to young women. They are characterized by flying pains in various joints of the body, deformity 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 butterfly wings. Joint pain can be accompanied by interruptions and discomfort in the heart and chest, low temperature, weakness, weight loss, high 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, lower back, pelvis. Gradually, the pain spreads upward to other parts of the spine. Along with pain, stiffness, reduced 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 mistaken for osteochondrosis. However, the first disease develops in young men and the second in older people. An X-ray of the sacroiliac joint - the place where the spine and pelvic bones join - is taken as a diagnostic test. 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, the toes and feet, less frequently the spine, usually hurt and swell. A characteristic feature of arthritis in psoriasis is an asymmetric lesion. The skin over the joints can have a bluish-purple color and damage the nails. 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 that occurs 2-3 weeks after inflammation of the throat or scarlet fever. It develops more often in children. The pain is so strong that you can't touch the wrist, you can't move. The joints swell, become 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. However, after some time, serious symptoms of heart damage appear. Rheumatism requires urgent medical attention. Only timely treatment can avoid damage to the heart and other organs.
How to examine sore joints?
There are various examination methods for joint pain. As a rule, they are used in combination.
Blood test- is one of the most common tests for complaints of joint pain. With the help of this study, it is possible to determine the presence of inflammation or suggest the degenerative nature of the disease, identify signs of infection and use immunoassays or polymerase chain reaction (PCR) to pinpoint the cause of the disease in infectious or reactive arthritis. The 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 helps the joint surfaces of food, and 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 feeding of cartilage, the accumulation of salts that can cause pain (for example, gout). Synovial fluid is taken for analysis using a needle that 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 according to 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. An X-ray shows mechanical bone damage (fractures and cracks), joint deformities (subluxations and sprains), the formation of growths or bone damage, 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. By CT scan, the doctor obtains a series of layers by layers of the joints, which in some cases provide more complete information about the disease.
Ultrasound and MRI of the joints- methods are of different nature, but for similar purposes. With the help of ultrasound or magnetic resonance imaging, information on the condition of the soft tissues of the joint and cartilage can be obtained. Ultrasound and MRI show the thickness of the cartilage, its defects, the presence of foreign inclusions in the joint, and they also help determine the viscosity and the amount of synovial fluid.
Arthroscopy- method of visual examination of the joint with the help of microsurgical instruments, which are introduced into the cavity of the diseased joint after anesthesia. During arthroscopy, the doctor has the opportunity to examine the internal structure of the joint with his eyes, notice its damage and changes, and also takes pieces of the synovial membrane of the joint and other structures of it 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 storage medium, so you can consult other experts after the procedure.
Joint treatment
If you have joint pain, find a good therapist or pediatrician for your children. He will make an initial diagnosis and, if necessary, refer you for treatment by a specialist. If joint pain is associated with osteoarthritis or arthritis, the treatment most likely will be dealt with by a rheumatologist found here.
If the cause of arthralgia is an inflammatory response, medications are used to treat joints that can reduce 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 for autoimmune diseases. Minimal effective doses of drugs that can strongly suppress the inflammatory response or suppress the immune system are selected for continuous medical admission. 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 of prescribing anti-inflammatory and analgesic drugs during exacerbations, as well as taking metabolic agents based on chondroetin sulfate and hyaluronic acid. Although the effectiveness of the latter is currently not recognized by all doctors.
If joint function deteriorates irreversibly, surgery is resorted to. Currently, there are various methods of endoprosthetics that allow the implantation of artificial joints or their parts instead of damaged or worn out ones.