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, since the first symptoms can be misleading, and sometimes the full picture of the disease develops only in 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 ailment and choose the appropriate treatment tactics together with a doctor.
In this article, we will look at situations where multiple joints throughout the body hurt. Sometimes one begins to ache and other joints quickly join. It happens that the pain seems to migrate from one part of the body to another over the course of several days or weeks. Various diseases cause pain in a group of joints in the form of attacks - seizures, when the pain disappears, and then reappears.
Joint pain with viral infections.
Most often, arthralgias occur 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, the knee joints, and sometimes the spinal joints. The pain is not strong, painful. It's called joint pains. Mobility is generally not affected, there is no swelling or redness. In some cases, a rash similar to hives may appear that disappears quickly. In most cases, viral arthralgias become the first symptom of malaise and are accompanied by fever, muscle pain, 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 getting rest. After a few days, the pain disappears 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 in the joints, although they have not been affected by the infection.
Joint pain appears most often 1-3 weeks after acute respiratory infections, intestinal infection, or diseases of the genitourinary system, eg, urethritis or genital infections. Unlike viral arthralgias, joint pain is severe, accompanied by edema and reduced mobility. Body temperature can rise. Arthritis often begins with the 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 of the spine hurt.
Joint pain generally disappears with treatment or on its own, without leaving sequelae. However, some types of reactive arthritis are chronic and occasionally become severe.
Reiter's disease- one of the types of reactive arthritis that develops after transferred chlamydia and can have a chronic course. Joint pain in Reiter's disease is often preceded by impaired urination, a manifestation of chlamydial urethritis (inflammation of the urethra), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment, you should consult a doctor.
Reactive arthritis can develop after adenovirus infection, genital infections (especially chlamydia or gonorrhea), intestinal infections associated with Salmonella, Klebsiella, Shigella infection, etc.
Joint pain when cartilage is worn down.
Diseases that are accompanied by a gradual wear of the cartilage on the articular surfaces of the bones are called degenerative. They are most common at the age of 40-60 years and over, but also occur in younger people, for example, those who have suffered joint injuries, professional athletes who are exposed to frequent strenuous exertion, and in obese people.
Deforming osteoarthritis (osteoarthritis, DOA)- This is a disease of the large joints of the legs: knees and hip joints, which bear most of the load when walking. The pain appears gradually. In the morning, after rest, the state of health improves, and in the afternoon and at night, after long walks, running and other stresses, it worsens. Inflammatory changes: edema, redness are usually not pronounced and can appear only in advanced cases. But there are often complaints of crunching joints 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.
Osteochondritis of the spineIt is 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 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 in the arms, shoulder joints, pain and interruptions in the heart, chest, pain in the legs, etc. A neurologist is usually responsible for 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 linked by the peculiarity of the immune system: the cells of the immune system begin to attack their own body tissues and organs, causing inflammation. Autoimmune diseases, unlike degenerative diseases, are more likely to develop in childhood or young people. Its first manifestation is usually joint pain.
Joint pain is often 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 goes away, but after a while it reappears. Over time, the joints can deform significantly and lose mobility. A characteristic 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 stronger the load on the joint the day before, the more time you will need to spend warming up.
Little by little, the symptoms of damage to other organs join the arthralgias: the heart, kidneys, skin, blood vessels, etc. Without treatment, the disease progresses. It is impossible to cure it, but modern medications 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 arms and legs: fingers, joints of the hand or foot, less often - with the defeat of one knee, ankle or elbow, and then pains in others. joint parts of the body.
Systemic lupus erythematosus- a rarer disease, which is more susceptible 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 butterfly wings. Joint pain can be accompanied by interruptions and discomfort in the heart and chest, low-grade fever, weakness, weight loss, increased blood pressure, back pain, edema.
Ankylosing spondyloarthritis- Unlike lupus, it affects men more often. The disease begins with pain in the joints of the spine, in the lumbar region, the sacrum and the pelvis. Gradually the pain spreads upward to other parts of the spine. In addition to pain, stiffness, decreased flexibility, and, with time, impaired gait and complete immobility of the spinal joints are characteristic. In the initial stages, ankylosing spondylitis can easily be mistaken for 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. Joints in the hands and feet, fingers and feet, and less commonly the spine, are often painful and swollen. A distinctive feature of arthritis in psoriasis is an asymmetric lesion. The skin over the joints may be bluish-purple in color, and nail damage occurs. Over time, joint deformities and subluxations 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 intense that you cannot touch the joint, you cannot move. The joints become swollen, red, and the temperature rises. First, some joints hurt, then others, usually symmetrical. Even without treatment, the pain goes away on its own and joint 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 sore joints?
There are several methods of examination 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 suggest a degenerative nature of the disease, identify signs of infection, and use immunological tests or the polymerase chain reaction (PCR) method to accurately determine the causative agent of the disease in the case of infectious or reactive arthritis. A blood test shows possible metabolic disorders, the state of internal organs.
Synovial fluid study- fluid that washes the surface of the joint. With its help, the articular surfaces are nourished, and friction during movement is also reduced. 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, with gout) . Synovial fluid is taken for analysis with a needle, which is inserted into the joint cavity after local anesthesia.
Joint radiography 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), formation of bone growths or defects, bone density, and other criteria that help the doctor identify the cause of the joint pain. CT scan is also an X-ray investigative method. With a CT scan, the doctor receives a series of layer-by-layer images of the joint, which in some cases provides more complete information about the disease.
Joint ultrasound and magnetic resonance imaging- the methods are of a different nature, but similar in purpose. With the help of ultrasound or MRI images, information about the state 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 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 the internal structure of the joint with his eyes, note its damage and changes, and also take parts of the joint's synovium and its 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 disk or other storage medium, so after the procedure, you can consult with other specialists.
Joint treatment
If you have joint pain, find a good children's therapist or pediatrician. He will make an initial diagnosis and, if necessary, refer you to a specialized specialist for treatment. If the joint pain is associated with osteoarthritis or arthritis, the treatment will most likely be handled by a rheumatologist who is here.
If the cause of arthralgia is an inflammatory response, medications are used to treat the joints that can reduce inflammation. These are, first of all, non-steroidal 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, osteoarthritis), specific drugs are not yet known. Treatment of diseased joints consists of prescribing anti-inflammatories and analgesics during an exacerbation, as well as taking metabolic agents based on chondroetin sulfates and hyaluronic acid. Although the efficacy of the latter is not currently recognized by all doctors.
If the function of the joint deteriorates irreversibly, they resort to surgery. Currently, there are several methods of endoprosthesis that allow the implantation of artificial joints or parts of them instead of damaged or worn.