Joint pain (arthralgia) is a very common problem that can be associated with infection or toxicity, trauma, inflammation, or deterioration of cartilage.
In most cases, the joint pain will go away on its own within a few days. In some cases, however, you should see a doctor as soon as possible. It is not easy for even an experienced professional to determine exactly why joints hurt, as early symptoms can be misleading and the full picture of the disease sometimes only develops within 1-2 months or longer.
The information in this article will help you navigate the different diseases and conditions that cause arthralgia. And modern diagnostic methods make it possible to determine the exact cause of the disease and select the appropriate treatment tactics together with the doctor.
In this article, we will look at situations where multiple joints in the body hurt. Sometimes one starts to ache and other joints quickly connect to it. Sometimes the pain seems to migrate from one part of the body to another over several days or weeks. Many diseases cause pain in a group of joints in the form of seizures - seizures when the pain subsides and then reappears.
Joint pain with viral infections
Most often, arthralgias occur with a variety of viral infections: the direct effects of viruses on joints or the accumulation of toxins accumulating 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 joints of the spine. The pain is not strong, it hurts. It is called joint pain. Mobility usually does not deteriorate, no swelling or redness. In some cases, a hives-like skin rash may appear that disappears quickly. In most cases, viral arthralgias become the first symptom of malaise and are associated with fever, muscle pain, and weakness.
Despite the deterioration in overall well-being, joint pain in viral diseases is generally not a major concern. Relief can be provided by taking non-steroidal anti-inflammatory drugs, consuming plenty of fluids and resting. After a few days, the pain disappears and the joint function is completely restored. There are no irreversible changes in the structure of the joint.
Viral arthralgias are typical, such as 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 direct cause of reactive arthritis is a defect in the immune system that causes inflammation in the joints, although they have not been affected by the infection.
Joint pain occurs more frequently 1 to 3 weeks after acute respiratory infections, intestinal infections, or diseases of the urogenital system, such as urethritis or genital infections. Unlike viral arthralgias, joint pain is intense, accompanied by edema and limited movement. Body temperature may rise. Arthritis often begins with the involvement of a knee or ankle joint. Within 1-2 weeks, the pain joins in the joints of the other half of the body, and the small joints in 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 and leaves no consequences. However, some types of reactive arthritis are chronic and can sometimes worsen.
Reiter's disease- one type of reactive arthritis following transmitted chlamydia, which may be chronic. 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. You should see a doctor for treatment.
Reactive arthritis is an adenovirus infection, genital infections (especially chlamydia or gonorrhea), Salmonella, Klebsiella, Shigella, etc. It can develop after intestinal infections with infection.
Joint pain when cartilage is worn out
Diseases that involve the gradual wear and tear of cartilage on the joint surfaces of bones are called degenerative. They are more common in those 40 to 60 years of age and older, but also occur in younger people, such as those with joint injuries, professional athletes who are exposed to frequent intense exercise, and obese people.
Deforming osteoarthritis (DOA)- It is a disease of the large joints of the legs - the knees and hips - which carry most of the load while walking. The pain occurs gradually. In the morning, after rest, health improves, and in the evening and at night, it deteriorates after long walks, runs and other stresses. Inflammatory changes: edema, erythema are usually not pronounced and may only occur in advanced cases. But there are often complaints of cracks in the joints. Over the years, the disease progresses. Curing deforming arthrosis is almost impossible, only cartilage destruction can be slowed. They resort to surgery to restore mobility.
The spine is osteocondritisAnother common degenerative disease. This is caused by the thinning and destruction of cartilage between the vertebrae. A decrease in cartilage thickness leads to compression of the nerves protruding from the spinal cord and blood vessels, which causes a number of different symptoms in addition to pain in the joints of the spine. For example: headache, 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 whose causes are not fully known. All of these diseases are united by a feature of the immune system: cells in the immune system begin to attack the body’s own tissues and organs, causing inflammation. Autoimmune diseases, unlike degenerative diseases, tend to develop in childhood or adolescence. Their first manifestation is often joint pain.
Joint pain is usually volatile: today one joint hurts, tomorrow the other, the day after tomorrow - a third. Joint pain is accompanied by edema, redness, immobility of the joints and sometimes fever. After a few days or weeks, the joint pain disappears, but after a while it recurs. Over time, the joints can become significantly deformed and lose their mobility. Morning stiffness is a characteristic sign of autoimmune arthritis. In the first 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 need to spend warming up.
Gradually, symptoms of damage to other organs join the arthralgia: heart, kidneys, skin, blood vessels, and so on. Without treatment, the disease progresses. It is impossible to cure, but modern medicines 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 primarily affected: they begin to ache a lot, become red, and swell. Most often, the disease begins with pain in the small joints of the arms and legs: the joints of the fingers, hands, or feet, less often - by defeating a knee, ankle, or elbow joint, and then with pain in the body.
Systemic lupus erythematosus- a rarer disease that is more prone to young women. It is characterized by flight pain in various joints of the body, deformity of the fingers, the appearance of a rash on the skin, especially on the face - redness in the form of butterfly wings on the forehead and face. Joint pain can be associated with heart and chest disruption and discomfort, low-grade fever, weakness, weight loss, high 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, in the lumbar region, in the sacrum, in the pelvis. Gradually, the pain spreads upward to other parts of the spine. In addition to pain, stiffness, decreased flexibility, and complete immobility of the joints of the spine and spine over time are characteristic. In the initial stage, ankylosing spondylitis is 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 site where the spine and pelvic bones meet. Based on the results of the test, the doctor may confirm or reject the diagnosis.
Joint pain with psoriasis
Psoriasis is a disease 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 legs, less commonly the spine, usually hurt and swell. The distinguishing feature of arthritis is an asymmetric lesion. The skin above the joints may be bluish-purple in color and the nails may be damaged. Over time, deformities and subluxations of the joints develop (fingers begin to bend in an atypical direction).
Arthralgia with rheumatism
Rheumatism (acute rheumatic fever) is a serious disease caused by streptococci. Rheumatism is characterized by very severe pain in the large joints of the legs and arms, which occurs 2-3 weeks after a sore throat or scarlet fever. It is more common in children. The pain is so severe that you can’t touch the joint, you can’t move. The joints swell, turn red and the temperature rises. First some joints hurt and then others are usually symmetrical. Even without treatment, the pain disappears on its own and joint function is fully restored. After a while, however, severe symptoms of heart damage appear. Rheumatism requires urgent medical attention. Damage to the heart and other organs can only be avoided by timely treatment.
How to examine sore joints?
There are various methods for examining joint pain. As a general rule, they are used in combination.
Blood test- one of the most common tests for joint pain complaints. This test can be used to determine the presence of inflammation or to suggest the degenerative nature of the disease, to identify signs of infection, and to accurately determine the pathogen of the disease in infectious or reactive arthritis using immunoassays or polymerase chain reaction (PCR). The blood test shows the possible metabolic disorders, the condition of the internal organs.
Examination of synovial fluid- fluid that cleanses the surface of the joint. It helps nourish joint surfaces and also reduces friction during movement. Depending on the composition of the synovial fluid, the laboratory assistant draws conclusions about the presence of inflammation or infection of the joint, the processes of cartilage destruction and nutrition, and the accumulation of pain-causing salts (e. g. , in the case of gout). Synovial fluid is analyzed using a needle, which is placed in the joint cavity after local anesthesia.
Joint X-ray and computed tomography (CT)- a method that allows the structure of the bone parts of the joint to be taken into account and, indirectly, the condition of the cartilage to be judged by the size of the joint space - based on the distance between the bones in the joint. Among the first methods of joint pain, an X-ray is prescribed. The x-ray shows mechanical damage to the bones (fractures and cracks), joint deformities (subluxations and dislocations), the development of bone growths or defects, bone density, and other criteria that help the doctor identify the cause of the joint pain. Computed tomography is also an X-ray examination method. With a CT scan, the doctor gets a series of images of the joint taken layer by layer, which in some cases provides more complete information about the disease.
Ultrasound and MRI of the joints- the methods are different in nature but have a similar purpose. Ultrasound or magnetic resonance imaging can be used to obtain information about the condition of the soft areas of the joint and cartilage. Ultrasound and MRI show cartilage thickness, 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 devices which, after anesthesia, are inserted into the cavity of the patient's joint. During arthroscopy, the doctor has the opportunity to visually examine the internal structure of the joint, record its damage and changes, and also remove pieces and other structures of the synovial membrane of the joint for analysis. If necessary, the physician may perform the necessary therapeutic manipulations immediately after the examination. Everything that happens during arthroscopy is recorded on a disk or other media so you can consult other professionals after the procedure.
Joint treatment
If you have joint pain, find a good therapist or pediatrician for your children. He or she will make the initial diagnosis and, if necessary, refer you to a specialist for treatment. If the joint pain is associated with arthritis or arthritis, the treatment is most likely to be treated by a rheumatologist here.
If arthralgia is caused by an inflammatory reaction, medications are used to treat the joints, which can reduce the inflammation. These are primarily non-steroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and many others. If these drugs are not effective enough, drugs from the corticosteroid group are prescribed as 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 to the physician, the minimum effective dose of drugs is selected that can strongly suppress the inflammatory response or suppress the immune system. For example, sulfosalazine, methotrexate, cyclophosphamide, azatiaprine, cyclosporine, infliximab, rituximab, and others.
No specific drugs are known for degenerative diseases of the joints (osteochondrosis, osteoarthritis). Treatment of diseased joints involves prescribing anti-inflammatory and analgesic drugs during exacerbations, as well as taking metabolites based on chondroetin sulfates and hyaluronic acid. Although the effectiveness of the latter is not currently recognized by all physicians.
If joint function deteriorates irreversibly, they will 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.