Symptom: joint pain.
Possible causes: trauma, arthritis, arthrosis, osteoarthritis.
Doctor: the therapist records the complaints, sends them for examination, and, based on its results, will refer the patient to a doctor with a narrower specialization.
Treatment: individually prescribed in each case.
Prevention: reducing the load on the joints, maintaining a healthy lifestyle, timely examination by a doctor, diet.
Why do joints hurt?
Joints can hurt for two reasons: arthritis, inflammation of the tissues of the joint, or arthrosis (osteoarthritis), a degenerative-dystrophic process, that is, destruction of the bone-cartilaginous elements of the joint. The diagnosis should be made by a doctor, but you can navigate the symptoms yourself.
Inflammation in arthritis is like a forest fire: everything starts violently, the joint swells and hurts very much even at rest, and when you try to make the slightest movement, the pain intensifies. The skin in this area turns red and becomes hot to the touch.
With arthrosis, everything is different: the joints are destroyed slowly and imperceptibly at first. Joint pain, at first slight, aching, arising only during movement, quite tolerable, grows over time, becoming constant and severe enough to disrupt peace and sleep. The insidiousness of this pain is that it is delayed in relation to the pathological process that goes on in the joint, and arises only when X-rays show signs of destruction of the corresponding joint, unfortunately, irreversible. This is the proliferation of spines (marginal osteophytes) along the edge of the articular surfaces of the bones that form the joint, narrowing of the joint space and signs of osteosclerosis - areas of pathological increase in bone density. If arthrosis affects one joint, say, the knee, the biomechanics changes and the function of the adjacent joints - the hip joint and the ankle - is disrupted. They experience an increased and, at the same time, uneven load and, as a result, wear out faster. Thus, arthrosis affects joint by joint, and the pain intensifies and can spread to all new joints.
Types of pain
The type and nature of pain sensations depends on the cause that caused them.
Joints ache with flu and acute respiratory infections against a background of high (up to 40 ° C) temperature. This pain goes away on its own as soon as the temperature returns to normal, and does not require special treatment.
For arthritis pain:
- sharp,
- painful,
- pulsating
- shooting,
- occurs at rest and intensifies when performing certain movements,
- giving to neighboring areas,
- when probing (palpation), it hurts everywhere, over the entire surface of the joint, but especially along the joint space.
Periarthritis is especially unbearable - inflammation of the tissues around the joint (its bags, tendons and ligaments). How everything happens can be explained by the example of the shoulder joint. First, the joint begins to ache. The pain very quickly becomes excruciating, almost unbearable. It gives off to the shoulder blade and to the neck area, intensifies (and is often accompanied by a crunch) when trying to stretch your arms to the sides at shoulder level or bend them at the elbow and bring them behind your back. At the end of the clavicle, which rests on the shoulder joint in front, and in the same place in the back there are pain points. When you press on them with a finger, the pain increases. With such acute sensations, the joint needs immobilization - the hand needs to be hung on a kerchief, try not to move it. This is an important condition for the success of the treatment.
Important! as soon as possible to choose an adequate analgesic and anti-inflammatory therapy after the examination. This will reduce the severity of joint inflammation, reduce pain and improve the quality of life.
With arthrosis, joint pain is different:
- The pain is initially mild and inconsistent, its nature is wavy - at certain periods it is absent for weeks or even months. But over time, without treatment, the waves of pain become stronger and more frequent, and the gaps between them are reduced.
- Pain at the start: its explosion occurs at the first attempt to take a step, raise an arm, bend over. Then the joints seem to be developed, and the pain relieves.
- Mechanical rhythm - the joint starts to ache when you load it. At first, pain appears with high loads - lifting weights, running up stairs, walking for a long time, playing sports. Later, even minor movements echo the pain. But at the same time, unlike the unpleasant sensations in arthritis, the pain in arthrosis goes away when you give the joint a rest, provide it with peace. Therefore, doctors talk about mechanical rhythm: movement provokes pain, and rest relieves it.
- Night discomfort. There is no pain at rest as such, but lying is uncomfortable, all the time you want to change your posture, find a position in which you could forget about the joints and the spine, but it doesn’t work. The joints ache, and that's it! The shackles of the morning: woke up, there is no pain yet, but it was as if you were chained or swaddled tightly - the joints do not obey, but gradually the feeling of stiffness disappears, the range of motion in the joint is restored.
- Protective posture. When a joint hurts, you want to take the so-called antalgic - an analgesic position, in which it becomes easier. This is best seen in the example of the spine: it also consists of joints. When one of them wedges, and with it a nerve root gets into the bone vice, there is an acute pain due to sciatica. Anyone who suffers from sciatica can be diagnosed by seeing how the poor man is distorted. In fact, with the help of this "skewness", supported by muscle spasm, the body tries to reduce pain to a minimum.
Osteoarthritis of the hip and knee
Pain with a lesion of the hip joint (and it most often suffers on one side) is localized in the upper thigh and radiates to the knee. He usually begins to get sick in the second half of the day, when he has already worked quite a lot. The pain increases with walking, and at rest it weakens and disappears.
Knee joints most often suffer from both at once. They unbend easily, and begin to hurt when bending. The so-called staircase symptom is characteristic of the knee lesion. Descending from it becomes more painful than climbing; patients do this by turning sideways. Sometimes the joint is wedged in a bent position due to a bone outgrowth (osteophyte) or its fragment (such a "lost" bone fragment inside the joint is called "articular mouse"). Joint blockage is accompanied by increased pain when trying to bend or straighten it.
Mobility problems in the knee are not always associated with arthritis. Sometimes a joint wedge can be "false". Among the most common causes of pseudoblock knee are:
- Edema (excess fluid in the joint capsule can interfere with full flexion and extension of the joint).
- Inflammation (inflammation of the tissues in the knee, such as in rheumatoid arthritis and gout).
- Incorrect movement of the kneecap in the joint (accompanied by severe pain).
- Irritation of the tissue lining the joint.
- Knee Injury (Any serious knee injury, such as a sprain, can cause muscle spasm).
Important! If the joint is jammed, active movements in the joint are impossible, it is necessary to seek medical help from an orthopedic traumatologist as soon as possible - an emergency room, a clinic, a hospital. Do not hesitate to call the ambulance - this is a good reason to call it, because you will not go far on one leg and even you may not even get to the clinic yourself.
Diagnostics
By the nature of the pain and the appearance of the affected joint, a preliminary diagnosis (arthritis or arthrosis) can be made even by a non-specialist. But hurry to the district clinic for confirmation of the assumptions!
Which doctor should I go to?
If you have pain in the joint, you should make an appointment with a local therapist. He performs the functions of a medical dispatcher: he records complaints and clinical symptoms, directs the patient for examination and, based on its results, decides which doctor should consult each particular patient. A wide variety of specialists are involved in maintaining joint health:
- arthrologist.
- orthopedic traumatologist.
- rheumatologist.
- vertebrologist (if the joints of the spine are affected).
- podiatrist (when it comes to the joints of the foot).
- surgeon.
- oncologist.
- neurologist (if the joint has already been treated, but the pain remains in it).
- dietitian (if joints hurt due to metabolic disorders, such as gout, or if there is excess weight).
What tests to pass and research to do?
The examination begins with the simplest - a clinical (from a finger) and biochemical (from a vein) blood test for signs of inflammation, as well as a general urine test. In some diseases of the joints, the kidneys are involved in the pathological process. Excess uric acid in the urine may indicate gout as a cause of joint disease.
A laboratory study of the synovial fluid, which is inside the joint, helps to detect the inflammatory process and clarify its nature. It is obtained by puncture of the joint capsule - puncture. If necessary, a histological examination of a fragment of the synovial membrane lining the joint cavity from the inside is performed.
A proven diagnostic method is X-ray of the joint in two standard projections. It will help visualize joint space narrowing, bone outgrowths, osteoporosis and osteosclerosis (areas of decreased and increased bone density.
Currently, comprehensive information about the state of the joint is provided by magnetic resonance imaging.
What joint diseases can cause pain?
There are more than a hundred such diseases. In the elderly, arthrosis is widespread, and in the young, rheumatoid arthritis and injuries (bruises, fractures, ligament injuries).
"Together with arterial hypertension, which is commonly called hypertension, joint diseases are leading in the list of the most common reasons for seeking medical help. And the chronic pain, which patients experience at the same time and because of which they cannot fully live and work, is not only a medical, but also an important social problem, - says the doctor of medical sciences, professor of the department of rheumatology. - Of all joint diseases, arthrosis is the most common. 97% of those over 65 suffer from this disease. And if we talk about chronic inflammatory diseases of the joints - arthritis, here rheumatoid arthritis comes to the fore. It is also not a gift, and not only because of the pain syndrome: within 3-5 years after its onset, this type of arthritis inevitably ends with the assignment of a disability group to the patient. "
How to get rid of joint pain urgently?
Analgesics are able to quickly overcome pain: pain cannot be tolerated in any case, if you do not want it to turn from acute to chronic. This metamorphosis can happen very quickly - in 3-4 weeks, so getting rid of joint pain should be an urgent task. The joint starts to hurt as soon as you put stress on it. Therefore, in case of pain, a nonsteroidal anti-inflammatory drug (NSAID) with a good analgesic effect should be taken half an hour before any physical activity.
If joint pain worsens at night, in addition, before going to bed, the doctor will recommend taking metamizole sodium, as well as drotaverine with nicotinic acid to improve local blood circulation.
Local therapy
NSAIDs have a formidable side effect - they can cause damage to the gastric mucosa up to the formation of ulcers, so they try to apply them topically, as part of all kinds of ointments and gels with anti-inflammatory and analgesic properties. They are usually rubbed into the skin over the affected joint twice a day. Pain is also relieved by special plasters with magnetic powder, which are glued to a joint or spine.
What happens if the joints are not treated?
Joint disease, if left untreated, can lead to loss of freedom of movement and disability. If one or more large joints are affected, they can be replaced with artificial ones. Multiple joint damage (polyarthritis), as a rule, is a consequence of a general disease of the body, for example, psoriasis. In this case, it is all the more dangerous to start the disease, because it progresses rapidly and can cut off your life rather quickly.
Conclusion
Joint pain is familiar to almost everyone, and it occurs for two main reasons - due to inflammation (arthritis) or destruction of bones and cartilage (arthrosis). Interestingly, the joints on the arms and legs hurt in different ways. On the upper limbs, in contrast to the lower ones, not the joints themselves are usually affected, but the tissues surrounding them (tendons, ligaments, bags). This is due to the different type of load that the arms and legs experience - dynamic and static, respectively. Joint pain must be fought from the first day: the prospect of disability in the next 10-15 years will please very few people. As part of the prevention of joint diseases, it is important to lose extra pounds in order to reduce the stress on the joints, and to deal with concomitant pathologies (allergies, diabetes mellitus).