Joint pain (arthralgia) is a very common problem that may be related to infection or toxicity, trauma, inflammation, or deterioration of the cartilage.
In most cases, joint pain will go away on its own within a few days. However, in some situations you need to see a doctor as soon as possible. It is not easy, even for an experienced specialist, to determine exactly why joints ache, as early symptoms can be deceptive and the full clinical picture sometimes takes 1-2 months or more to unfold.
The information in this article will help you navigate the myriad of diseases and conditions that cause arthralgia. And with modern diagnostic methods, you can determine the exact cause of the disease and, together with a doctor, choose the right treatment tactics.
In this article, we're going to look at situations where multiple joints all over your body are sore. Sometimes someone starts to hurt and other joints quickly join them. It happens that pain travels from one part of the body to another over the course of 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 comes back.
Joint pain with viral infections
Most often, arthralgia occurs with various viral infections: due to the direct action of viruses on the joints or under the influence of toxins that accumulate in the blood during the acute phase of many infectious diseases.
Most often, pain occurs in the small joints of the arms and legs, in the knee joints, and sometimes in the joints of the spine. The pain is not strong, it hurts. It's called joint pain. Mobility is usually not impaired, there is no swelling or reddening. In some cases, you may experience a hives-like rash that goes away quickly. In most cases, viral arthralgia becomes the first symptom of malaise and is accompanied by fever, muscle pain, and weakness.
Despite the deterioration in general well-being, joint pain in viral diseases is usually not a cause for serious concern. Relief can be obtained through the use of non-steroidal anti-inflammatory drugs, plenty of drinking, and rest. After a few days, the pain disappears and the joint is fully functional. There are no irreversible changes in the structure of the joint.
Viral arthralgia, for example, is characteristic of influenza, hepatitis, rubella, mumps (in adults).
Reactive arthritis
This is a group of diseases in which joint pain occurs after a viral and bacterial infection. The immediate cause of reactive arthritis is a defect in the immune system that causes inflammation of the joints even though the infection does not affect them.
Joint pain is more common 1-3 weeks after acute respiratory infections, intestinal infections, or diseases of the genitourinary system such as urethritis or genital infections. In contrast to viral arthralgia, joint pain is intense, accompanied by edema and limited mobility. The body temperature can rise. Arthritis often begins with the involvement of a knee or ankle. Within 1-2 weeks, pain occurs in the joints of the other half of the body, the small joints of the arms and legs begin to hurt. Sometimes the joints of the spine hurt.
Joint pain usually goes away with treatment or on its own, with no sequelae. 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 the transferred 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) that often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment you need to consult a doctor.
Reactive arthritis can develop after an adenovirus infection, genital infections (especially chlamydia or gonorrhea), intestinal infections related to infection with Salmonella, Klebsiella, Shigella, etc.
Joint pain with cartilage wear
Diseases are referred to as degenerative if they are accompanied by gradual wear and tear of the cartilage on the joint surfaces of the bones. They are more common between the ages of 40-60 and older, but they also occur in younger people, such as joint injuries, professional athletes who are exposed to frequent intense loads, and obese people.
Deforming osteoarthritis (osteoarthritis, DOA)- This is a disease of the large joints of the legs - knee and hip joints that carry most of the load when walking. The pain occurs gradually. In the morning after rest, the state of health improves, in the evening and at night after long walking, running and other stresses it deteriorates. Inflammatory changes: edema, redness are usually not pronounced and can only occur in advanced cases. But often there are complaints of crackling in the joints. Over the years the disease progresses. Deforming osteoarthritis is hardly curable, only the breakdown of cartilage can be slowed down. To restore mobility, they resort to surgery.
Osteocondritis of the spineAnother common degenerative disease is. Its cause is the thinning and destruction of the cartilage between the vertebrae. The decrease in cartilage thickness leads to compression of the nerves going out 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 numbness in the arms, shoulder joints, pain and disruption in the heart, chest, pain in the legs, etc. A neurologist is usually concerned with diagnosing and treating osteochondrosis.
Autoimmune diseases as a cause of joint pain
Autoimmune diseases are a large group of disorders whose causes are not fully understood. All of these diseases are linked by the peculiarity of the immune system: the cells of the immune system begin to attack their own tissues and organs of the body and cause inflammation. In contrast to degenerative diseases, autoimmune diseases tend to develop in childhood or adolescence. Often their first manifestation is joint pain.
Joint pain is usually inconsistent: Today one joint hurts, tomorrow another, the day after tomorrow a third. Arthralgia is accompanied by edema, reddening of the skin, reduced mobility of the joints, and sometimes fever. The joint pain will go away after a few days or weeks, but will reappear after a while. Over time, the joints can become severely deformed and lose mobility. A characteristic sign of autoimmune joint inflammation is morning stiffness. In the first hours of the morning, the affected joints need to be kneaded for 30 minutes to 2-3 hours or more. The more the joint is stressed the day before, the more time you have to spend warming up.
Gradually, arthralgia is 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 the process down. So the earlier treatment is started, the better the result.
Rheumatoid arthritis is the most common autoimmune disease, affecting the joints most of all: they start to be very painful, red and swollen. Most often, the disease begins with pain in the small joints of the arms and legs: fingers, wrists or ankles, less often - with the defeat of a knee, ankle or elbow joint, and then pain in other parts of the body join.
Systemic lupus erythematosus- a rarer disease that 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, especially characteristic on the face - reddening 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, a slight fever, weakness, weight loss, increased blood pressure, back pain, and edema.
Ankylosing spondylitis- Unlike lupus, it affects men more often. The disease begins with pain in the joints of the spine, lumbar region, sacrum, pelvis. Gradually, the pain spreads upwards to other parts of the spine. In addition to pain, it is characterized by stiffness, reduced flexibility and, over time, gait disorders and complete immobility in the joints of the spine. In the early stages, ankylosing spondylitis can easily be confused with osteochondrosis. However, the first disease develops in young men, and the second in the elderly. As a diagnostic test, an X-ray of the sacroiliac joint - the point where the spine and pelvic bones meet - is taken. Based on the results of the study, the doctor can confirm or deny the diagnosis.
Joint pain in psoriasis
Psoriasis is a skin condition in which a characteristic rash appears on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and feet, less often the spine, pain and swell. A distinctive feature of arthritis in psoriasis is an asymmetrical lesion. The skin over the joints can be bluish-purple in color and damage to the nails occurs. 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 illness caused by streptococci. Rheumatism is characterized by very severe pain in the large joints of the legs and arms that appear 2-3 weeks after a sore throat or scarlet fever. It develops more often in children. The pain is so severe that you cannot touch the joint, you cannot move. The joints swell, turn red, and the temperature rises. First some joints hurt, then others, mostly symmetrical. Even without treatment, the pain disappears on its own and the function of the joint is fully restored. However, after a while, severe symptoms of heart damage appear. Rheumatism urgently requires medical attention. Damage to the heart and other organs can only be avoided with timely treatment.
How do you examine painful joints?
There are different test methods for joint pain. Usually they are used in combination.
Blood analysis- is one of the most common tests for symptoms of joint pain. With the help of this study it is possible to determine the presence of inflammation or a degenerative character of the disease, to recognize signs of infection and, with immunological tests or the polymerase chain reaction (PCR) method, the exact determination of the causative agent of the disease in the case of infectious or reactiveArthritis. A blood test shows possible metabolic disorders, the condition of the internal organs.
Examination of the synovial fluid- Liquid that washes the joint surface. This nourishes the joint surfaces and reduces friction during movement. Depending on the composition of the synovial fluid, the laboratory technician draws conclusions about the presence of inflammations or infections in the joint, the processes of destruction and nourishment of the cartilage, the accumulation of salts that can cause pain (e. g. in gout). The synovial fluid is removed for analysis with 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 take into account the structure of the bone parts of the joint and indirectly assess the condition of the cartilage based on the size of the joint space - the distance between the bones in the joint. X-ray examination is one of the first methods of treating joint pain. The x-ray shows mechanical damage to the bones (fractures and tears), joint deformities (subluxations and dislocations), the formation of bone growths or defects, bone density, and other criteria that will help the doctor identify the cause of joint pain. Computed tomography is also a method of X-ray research. A CT scan gives the doctor a series of slice-by-slice images of the joint, which in some cases can provide more complete information about the disease.
Ultrasound and MRI of the joints- The methods are of different nature, but have similar objectives. With the help of ultrasound or magnetic resonance imaging, information about the condition of the soft tissues of the joint and the cartilage can be obtained. Ultrasound and MRI will show the thickness of the cartilage, its defects, the presence of foreign inclusions in the joint, and will also help determine the viscosity and amount of synovial fluid.
Arthroscopy- a method of visual inspection of the joint using microsurgical instruments inserted into the cavity of the diseased joint after anesthesia. During the arthroscopy, the doctor has the opportunity to use his eyes to examine the internal structure of the joint, determine its damage and changes, and also take pieces of the synovial membrane of the joint and its other structures for analysis. If necessary, the doctor can immediately carry out the necessary therapeutic manipulations after the examination. Everything that happens during the arthroscopy is recorded on a floppy disk or other storage medium so that you can consult with other specialists after the procedure.
Joint treatment
If you have joint pain, see a good child therapist or pediatrician. He will carry out an initial diagnosis and, if necessary, refer you to a specialist doctor for treatment. If joint pain is associated with osteoarthritis or arthritis, the treatment will most likely be carried out by a rheumatologist found here.
If the cause of the arthralgia is an inflammatory reaction, drugs 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 sufficiently effective, drugs from the group of corticosteroids are prescribed in the form of injections into the joint cavity or tablets. If an infection is causing the pain, antibiotics are given.
For autoimmune diseases, special treatment regimens are used. For constant uptake by the doctor, the minimally effective doses of drugs that can greatly suppress the inflammatory response or suppress the immune system are selected. For example: sulfosalazine, methotrexate, cyclophosphamide, azathiaprine, cyclosporine, infliximab, rituximab and others.
No specific drugs are known for degenerative diseases of the joints (osteochondrosis, arthrosis). Treatment of diseased joints consists in prescribing anti-inflammatory and analgesic drugs during an exacerbation, as well as taking metabolic drugs based on chondroetin sulfates and hyaluronic acid. Although the effectiveness of the latter is not currently recognized by all doctors.
If the function of the joint is irreversibly impaired, they resort to surgery. There are currently various endoprosthetic procedures that make it possible to implant artificial joints or parts thereof instead of damaged or worn ones.