Pain in the joints- These are unpleasant, painful, pulling sensations in the joint area, the intensity of which can sometimes reach the level of pain. The symptom is accompanied by muscle pain, weakness, weakness, grinding and limitation of movement and may be preceded by joint pain (arthralgia). Joint pain is accompanied by lesions of the musculoskeletal system, infections, diseases of the hematopoietic system and vascular pathologies. To determine the cause of the disorder, laboratory studies, ultrasound, radiological and invasive methods are used. Treatment includes treating the disease that caused the pain.
Causes of painful joints
Mild or moderate joint problems do not always reflect a pathological process. Sometimes the symptom has natural causes. Temporary joint pain occurs when wearing uncomfortable shoes and in people who are sensitive to the weather - when the weather changes. During puberty, pain occurs in the shoulder and knee joints, which is due to insufficient blood supply due to accelerated bone growth.
Significant physical activity
During intensive training or heavy work, a common cause of the symptom is overload of the musculoskeletal system, less often it is caused by microtraumas of the cartilage and synovium. A typical combination of joint pain and discomfort in bones and muscles. Joint and muscle discomfort occurs immediately after exposure to physical activity or against the background of prolonged monotonous work with constant tension of the same muscle groups. Pain in the joints of the body occurs without fever. In the case of severe overload, moderate impairment of the general condition and weakness are possible.
The disorder can last up to several days and gradually decreases with limited physical activity until it disappears completely without treatment. If the pain caused by sports or heavy physical work is replaced by persistent pain, swelling of the wrist, elbow, shoulder, ankle, knee and hip joints, as well as restriction of usual 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 loss of calcium, thinning of bone trabeculae, impaired blood supply to cartilage and a decrease in intra-articular fluid volume. Mild discomfort is only the first manifestation of age-related joint damage. Periodic symptoms typically appear after 45-50 years. Between the ages of 60 and 65, unpleasant pain occurs even with slight exertion, accompanied by stiffness in movement, bending over and shuffling gait, which gradually turns into pain.
pregnancy
Complaints of painful joints are more common in the second half of pregnancy. Drawing, aching symptoms are usually felt in the joints of the pelvis and lower extremities. It worsens towards the end of the day, after standing or walking long distances for a long time. A night's rest alleviates the condition. Joint pain during pregnancy is caused by the following causes:
- Vitamin and mineral deficiencies. The biggest role is played by calcium and vitamin D deficiency, which leads to osteomalacia. A feature of the manifestation of the symptom is a 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, etc. the frequent occurrence of ARVI.
- Significant weight gain. Joint problems are more often a problem for pregnant women who have gained a lot of weight or who are overweight. Pain at the end and finally in the middle of the day is felt in the hip joints, knees and ankles, the cartilage on which the load is many times higher than permissible. To alleviate the symptoms, women consciously limit physical activity, which leads to even faster weight gain.
- Softening of cartilage and ligaments. About half of pregnant women experience discomfort in the pelvic joints caused by the action of the hormone relaxin. In most cases, the symptoms are pain in the pubic area and hip joints. In the pathological course with the development of symphysitis, the painful sensations are replaced by pain, which increases when pressing on the uterus and when trying to separate the legs, during sex. The appearance of pain in the pubic area is a serious reason for a visit to the obstetrician-gynecologist.
- Carpal tunnel syndrome. A specific manifestation that occurs in the 2nd to 3rd trimester in almost 20% of pregnant women is the so-called tunnel syndrome. The cause of the disease is swelling of the soft tissues of the hands and compression of the nerves running to the fingers in the carpal tunnel. In addition to aching pain in the small joints of the hand, patients complain of numbness of the skin, tingling and tingling. The condition improves with an elevated position of the arms.
obesity
In overweight people, the pressure on the cartilage tissue increases, causing it to wear out more quickly. The degenerative-dystrophic process usually affects large joints of the lower extremities and intervertebral joints. The disorder increases as obesity progresses. Discomfort in the joints initially manifests itself in the form of pain without fever at the end of the day, then the increasing destruction of cartilage leads to the development of deforming arthrosis, spondylosis, osteochondrosis with a severe 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 intoxication of the body due to the spread of viruses and bacteria, the accumulation of toxins and the development of the inflammatory process. Usually the patient complains of pain throughout the body, mild and moderate pain occurs both in the joints and in the muscles and bones. The symptom is accompanied by weakness, fatigue, insomnia and frequent awakenings. Simultaneously with signs of pain and general malaise, chills and hyperthermia are observed.
The most severe joint and body pain occurs with the flu. Up to 50% of patients suffer from constant pain in their legs, arms and trunk. The intensity of the pain is so high that it becomes difficult for a person to perform the simplest actions - get out of bed, go to another room, get a glass of water. The situation is aggravated by high (fever) temperature and severe headache. A sore throat and nasal congestion appear after a few hours or even days. Parainfluenza, an adenoviral infection, causes less joint problems.
A feeling of joint pain is possible with acute infectious lesions of the gastrointestinal tract – food toxic infections, salmonellosis. Aching joint pains of varying intensity appear suddenly a few hours after eating contaminated food and are accompanied by a sharp increase in temperature, severe chills and headaches. The symptoms are preceded by nausea, vomiting, pain in the abdominal cavity, foul-smelling diarrhea with mucous and sometimes bloody impurities.
Collagen diseases
Painful joints are a harbinger of most diseases that occur with autoimmune inflammation of the connective tissue, including joint tissue. The localization, frequency and intensity of unpleasant sensations are determined by the characteristics of a particular collagen disease. The general patterns are the involvement of certain groups of joints in the process, a gradual increase in sensations to excruciating, debilitating pain, observed first with movement and then at rest. Deformation of the articular joints is possible. The main systemic inflammatory causes of the disease:
- rheumatism. The symptom is "fleeting": in the large joints of the arms and legs - elbows, shoulders, hips, knees, ankles - alternating aching pain and then pain are felt. The affected areas are swollen. Joint problems are often preceded by a sore throat. Under treatmentChanges to the joints are reversible.
- Rheumatoid arthritis. Unpleasant sensations often appear only after 40 years. A typical feeling of pain in the small joints of the hands and feet, combined with noticeable swelling and stiffness in movement in the morning. In the future, pain and curvature of the articular joints come to the fore.
- Systemic scleroderma. It is characterized by different localization of pain sensations and the presence of morning stiffness in the joints of the hands, elbows and knees. Pain is usually symmetrical. The swelling is short-lived. Due to skin sclerosis, the mobility of the joints is limited, and damage to the tendons leads to a feeling of friction when moving.
arthrosis
The pain syndrome in the initial stages of the disease is mild and is perceived as malaise, pain in the joints of the legs and, less often, arms. The immediate cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Typically, pulling or aching sensations without fever occur in adulthood and old age. Pain may appear earlier if there are occupational hazards (vibrations, heavy physical work). Gradually, the joints become stiff, the person experiences severe pain and difficulty walking and self-care.
Metabolic disorders
The causes of metabolic disorders in which joint pain occurs are an insufficient supply of vitamins, minerals, accelerated accumulation or excessive excretion of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, have varying degrees of severity and most often serve as a manifestation of pathological conditions such as:
- osteoporosis. When calcium is washed out of the bone tissue, the articular surfaces of the bones become brittle, the cartilage becomes thinner, which is accompanied by pain. The pain syndrome gradually increases from mild pain to severe arthralgia, associated with unpleasant sensations in the bones and muscle weakness. The joints most commonly affected are those exposed to the greatest stress: hips and knees; Shoulders, elbows and ankles are less commonly affected.
- gout. Mild pain in the big toe is a cause for concern even in the preclinical stage of the gout process. Pain may occur in the knees, elbows, wrists, and fingers. The accumulation of uric acid in the joint cavity leads to a rapid manifestation of the disease with a change from aching to acutely painful joint pain, which only subsides after several hours. The affected joint feels hot. Redness of the skin and restricted movement occur.
Oncological diseases
In acute and chronic leukemia, widespread osteoarticular pain with subsequent pain often occurs even before noticeable pathological changes and other clinical symptoms become noticeable on a general blood test - general malaise, night sweats, fever, loss of appetite, bleeding. The unpleasant sensations are initially periodically painful, then become permanently severe and weaken the patient.
Hodgkin's lymphoma and lymphogranulomatosis are characterized by a combination of joint pain with muscle discomfort, weakness, enlarged lymph nodes and other lymphatic formations. Pain sensations are frequent, usually moderate. In osteosarcoma, short-term pain in the knee joint and thigh muscles is observed, which increases at night and progresses to steadily increasing pain with lameness upon exertion. Other joints are less often affected by this pathology.
Joint injuries
Joint pain is caused by minor traumatic injuries that cause damage to the ligaments surrounding the joint and bruising to the soft tissue of the joint area. More severe pain occurs when the meniscus is damaged. The symptom is clearly temporally related to a blow, a fall or an awkward movement. Symptoms usually occur in one affected joint, but more rarely they spread to adjacent areas of the body.
Chronic infectious processes
Possible causes of joint pain that occur without fever or against a background of mild fever are long-term infections. In patients with chronic infectious and inflammatory diseases, joint problems are a result of intoxication of the body or a direct damaging effect of microorganisms on the joint tissue (usually streptococci, mycoplasma, chlamydia). The appearance or increase in pain may indicate an exacerbation of chronic tonsillitis, sinusitis, genitourinary infections, adnexitis and pyelonephritis.
Characteristic features of joint pain in common chronic infections occurring with poisoning are moderate severity of joint discomfort, gradual development, periodic intensification and weakening of symptoms. In patients suffering from tuberculosis and hematogenous osteomyelitis, the background for the development of aching pain sensations is an increase in temperature to subfebrile values, general malaise – fatigue, weakness, weakness. Without treatment, the patient's condition progressively worsens.
Complications of pharmacotherapy
Taking some medications may be complicated by pain and moderate pain 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, rashes, and other signs of drug allergy. Once the offending drug is stopped, the symptoms disappear quickly and it is less likely that special treatment will be required if complications arise. Pain and mild arthralgia are caused by:
- Antibiotics: penicillins, fluoroquinolones.
- Transformers: Phenazepam, Diazepam, Lorazepam, etc.
- Contraceptives: combined oral contraceptives (COCs).
Rare causes
- Inflammation of the respiratory tract: Pneumonia, bronchitis, tracheitis.
- Intestinal pathology: non-specific ulcerative colitis, Crohn's disease.
- Skin diseases: psoriasis.
- Endocrine disorders: Diabetes mellitus, diffuse toxic goiter, hypothyroidism, Itsenko-Cushing's disease.
- Autoimmune processes: Hashimoto thyroiditis, vasculitis.
- Fascia damage: necrotizing fasciitis in the convalescent stage.
- Congenital defects of bones and joints.
Opinion poll
To find out why pain occurs in the joints and bones, it is necessary to consult a therapist or family doctor who will carry out an initial diagnosis and order examinations by specialized specialists. Taking into account the nature of the unpleasant sensations, the speed of their occurrence and the accompanying symptoms, the following are recommended to determine the cause of the disorder:
- Laboratory blood test. To rule out infections, inflammatory and oncohematological processes, an assessment of the leukocyte count and the ESR value is necessary. In systemic diseases, it is important to measure total protein content, the ratio of protein fractions in the blood, specific acute phase proteins, markers of rheumatoid arthritis and other inflammation. Tests for the concentration of vitamins, electrolytes (especially calcium) and uric acid help diagnose metabolic disorders.
- Bacteriological examination. A bacterial culture is necessary if the pain in the joints and throughout the body could be contagious. For research purposes, urine, feces, sputum and discharge from the urogenital tract are collected. To select an antimicrobial therapy regimen, sensitivity to antibiotics is determined. In cases of doubt, microscopy and culture are supplemented by serological reactions (RIF, ELISA, PCR).
- Sonography of the joints. It is usually used to clearly localize pain sensations and suspect rheumatic diseases. Ultrasound examination of the joint allows us to examine its structure, detect the destruction of cartilage and bone, preclinical inflammatory changes, and examine the condition of the periarticular soft tissues. The advantages of the method are accessibility, non-invasiveness and high information content.
- X-ray techniques. X-ray of the joints reveals changes in the width of the joint space, hardening of soft tissues, the presence of calcifications, osteophytes and erosions of the articular surfaces. To improve diagnostic efficiency, special techniques are used – contrast arthrography, pneumoarthrography. In the initial stage of the lesion, tomography (MRI, CT of the joints) is considered more informative. Bone density can be easily determined 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, the inner lining of the synovial membrane and tophi. Morphological analysis of biopsies and the study of synovial fluid reflect the nature of the pathological processes occurring in the joints. Simultaneous collection of materials with visual examination of the joint cavity is convenient during arthroscopy with tissue biopsy.
A less common method of diagnosing the cause of joint pain is scintigraphy with the introduction of technetium, which accumulates in the affected tissues. In recent years there has been increasing interest in joint thermography as a modern non-invasive method for detecting inflammatory diseases, tumors and circulatory disorders in joints and periarticular tissues. If the number of formed elements in the clinical blood test decreases, an extra-articular bone puncture is performed. Patients with joint pain without fever are recommended to consult a rheumatologist and an orthopedic traumatologist.
Treatment
Help before diagnosis
If the joints are painful in connection with physical activity, no special treatment is required; a long rest with dosage of the load is sufficient. Unpleasant joint sensations that occur during pregnancy usually go away on their own after pregnancy or are corrected through weight control and taking vitamin and mineral supplements. Elderly and obese patients are recommended to change their lifestyle: sufficient physical activity, a calorie-balanced diet with a sufficient proportion of plant foods.
Pain in the bones, joints and muscles, associated with general malaise and fever, increased pain and pulling up to severe pain and the development of persistent pain are indications for consulting a doctor. To reduce joint discomfort caused by ARVI, it is recommended to rest and drink enough water, rosehip infusions and dried fruits. Until serious diseases that cause joint pain are ruled out, self-medication with painkillers, long-term unsuccessful use of compresses, lotions, decoctions, etc. are unacceptable.
Conservative therapy
With proper treatment aimed at eliminating the cause of the disease and individual parts of the mechanism of its formation, you can eliminate joint pain. Etiopathogenetic therapy is usually complemented by symptomatic drugs that quickly relieve the severity of the tormenting and aching pain. The treatment regimen for diseases accompanied by painful joints may include:
- Antimicrobials. Basic therapy for infections is based on prescribing antibiotics to which the pathogen is susceptible. In severe cases, broad-spectrum drugs are used until the sensitivity of the microorganism is established.
- Non-steroidal anti-inflammatory drugs. They reduce the production of inflammatory mediators and thereby inhibit inflammatory processes in the joints. By influencing central pain receptors, they reduce the extent of joint problems. Used in the form of tablets, ointments and gels.
- Corticosteroids. They have a strong anti-inflammatory effect. Hormone therapy is the basis for the treatment of systemic collagen vascular disease. In severe and resistant forms of the disease, corticosteroid drugs are combined with immunosuppressants to enhance the effect.
- Chondroprotectors. They serve 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 medication is possible.
- Xanthine oxidase inhibitors. Used as a medicine for gout. They block the key enzyme necessary for the synthesis of uric acid, reducing its concentration in the body and promoting the dissolution of existing uric acid deposits.
- Vitamin-mineral complexes. Recommended for the treatment of joint pain caused by metabolic disorders. The most commonly used drugs contain calcium and vitamin D. They are also part of complex therapy for inflammatory and metabolic diseases.
- Chemotherapy drugs. They serve as the basis for most treatment regimens for various types of oncohematological pathologies. Depending on the clinical variant and severity of the neoprocess, they are combined with radiation therapy and surgical interventions.
physical therapy
After the exact cause of the pain and the acute inflammation has subsided, patients, with the exception of those suffering from cancer, are prescribed physiotherapy and exercise therapy. Microwave and ultrasound therapy sessions, electrophoresis and pulsed currents have a good anti-inflammatory and analgesic effect. For chronic illnesses, physiotherapeutic treatment takes place over several months and is supplemented by spa therapy.