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 early as possible. It is not easy even for an experienced specialist to determine exactly why joints hurt, since early symptoms can be deceiving, and the full picture of the disease sometimes unfolds 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 establish the exact cause of the ailment and choose the correct treatment tactics together with a doctor.
In this article, we'll look at situations where multiple joints all over the body hurt. Sometimes one starts to hurt, and other joints quickly join him. It happens that pain seems to migrate 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 attacks - seizures, when the pain subsides 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, pain appears in the small joints of the arms and legs, knee joints, and sometimes the joints of the spine. The pain is not strong, aching. It is called joint aches. Mobility is usually not impaired, there is no swelling or redness. In some cases, a hives-like skin rash may appear that quickly disappears. 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 usually not a cause for serious concern. Relief can be provided by taking non-steroidal anti-inflammatory drugs, drinking plenty of fluids and 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 an 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 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 pain is intense, accompanied by edema and impaired mobility. Body temperature may rise. Arthritis often begins with 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 goes away with treatment or on its own, leaving no sequelae. However, some types of reactive arthritis are chronic and occasionally exacerbated.
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), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. For treatment, you must consult a doctor.
Reactive arthritis can develop after adenovirus infection, genital infections (especially chlamydia or gonorrhea), intestinal infections associated with infection with Salmonella, Klebsiella, Shigella, etc.
Joint pain when cartilage is worn out
Diseases that are accompanied by gradual wear and tear of cartilage on the articular surfaces of the bones are called degenerative. They are more common at the age of 40-60 years and older, but they also happen in younger people, for example, those who have suffered joint injuries, professional athletes who are exposed to frequent intense 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 the bulk of the load when walking. The pain comes on gradually. In the morning, after rest, the state of health improves, and in the evening and at night after long walking, running and other stresses, it worsens. Inflammatory changes: edema, redness are usually not pronounced and can appear only in advanced cases. But often there are complaints of crackling in the joints. Over the years, 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.
Osteocondritis of the spineIs another common degenerative disease. Its cause is the thinning and destruction of cartilage between the vertebrae. The decrease 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: headaches, dizziness, pain and numbness in the arms, shoulder joints, pain and interruptions in the heart, chest, pain in the legs, 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, the causes of which 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 diseases, are more likely to develop in childhood or in young people. Their first manifestation is often joint pain.
Joint pain is usually volatile: today one joint hurts, tomorrow another, the day after tomorrow - a third. Arthralgia is accompanied by edema, redness of the skin, impaired mobility in the joints, and sometimes an increase in temperature. After a few days or weeks, joint pain disappears, but after a while it recurs again. Over time, the joints can be significantly deformed and lose mobility. A characteristic sign of autoimmune joint inflammation is morning stiffness. In the first morning hours, the affected joints have to be kneaded from 30 minutes to 2-3 hours or more. The stronger the load on the joint the day before, the more time you need to spend on warm-up.
Gradually, symptoms of damage to other organs join arthralgias: the heart, kidneys, skin, blood vessels, etc. Without treatment, the disease progresses. It is impossible to cure it, but modern drugs can slow down the process. Therefore, the earlier the treatment is started, the better the result.
Rheumatoid arthritis is the most common autoimmune disease, in which the joints are primarily affected: they begin to hurt a lot, turn red, and swell. 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 joint, and then pains in other parts of the body join.
Systemic lupus erythematosus- a more rare 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 spondylitis- unlike lupus, it more often affects men. The disease begins with pain in the joints of the spine, in the 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 disturbance 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, fingers and feet, less often the spine, usually hurt and swell. A distinctive feature of arthritis in psoriasis is an asymmetric lesion. The skin over the joints may have a bluish-purple 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, which appear 2-3 weeks after a sore throat or scarlet fever. It develops more often in children. The pain is so severe that the joint cannot be touched, it is impossible to move. The joints swell, turn red, and the temperature rises. First, some joints hurt, then others, usually symmetrical. Even without treatment, pain disappears 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 timely treatment can damage to the heart and other organs be avoided.
How to examine sore joints?
There are various methods of examination 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 to suggest a degenerative nature of the disease, to identify signs of infection, and using 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.
Study of synovial fluid- fluid that washes the surface of the joint. With the help of it, 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). The synovial fluid is taken for analysis using a needle, which is inserted into the joint cavity after local anesthesia.
Joint X-rays and computed tomography (CT)- a method that allows you to consider the structure of the bone 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 in 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), the formation of bone growths or defects, bone density and other criteria that help the doctor identify the cause of joint pain. Computed tomography is also an X-ray research method. With CT, the doctor receives a series of layer-by-layer pictures of the joint, which in some cases provides more complete information about the disease.
Ultrasound and MRI of 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 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 with his eyes the internal structure of the joint, note its damage and changes, and also 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 storage medium, so after the procedure, you can consult with other specialists.
Joint treatment
If you have joint pain, find a good therapist or pediatrician for children. He will conduct an initial diagnosis and, if necessary, refer you to a specialized specialist for treatment. If joint pain is associated with arthrosis or arthritis, the treatment will most likely be handled by a rheumatologist found here.
If the cause of arthralgia is an inflammatory reaction, drugs 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 is causing the 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 diseases of the joints (osteochondrosis, osteoarthritis), specific drugs are not yet known. Treatment of diseased joints consists in prescribing anti-inflammatory and analgesic drugs during an exacerbation, as well as taking metabolic agents based on chondroetin 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 deteriorated, they resort to surgery. Currently, there are various methods of endoprosthetics that allow the implantation of artificial joints or parts of them instead of damaged or worn out ones.