Pain in the joints

9 January 2024

Pain in the joints- These are unpleasant sensations of pain, tightness in the joints, the intensity of which sometimes reaches the level of pain. The symptom is associated with muscle pain, weakness, weakness, cracking, limitation of movement and may precede joint pain (arthralgia). Joint pain is accompanied by damage to the musculoskeletal system, infections, diseases of the hematopoietic system and vascular pathologies. To identify the cause of the disorder, laboratory tests, ultrasound, x-ray and invasive methods are used. Treatment involves treating the disease causing the pain.

Causes of joint pain

Mild or moderate joint discomfort is not always a manifestation of a pathological process. Sometimes the symptom has natural causes. Temporary pain in the joints is felt when wearing uncomfortable shoes and in people who are sensitive to bad weather when the weather changes. During puberty, painful sensations in the shoulder and knee joints are caused by insufficient blood supply due to accelerated bone growth.

Significant physical activity

During intense training or intense work, a common cause of the symptom is overload of the musculo-ligamentous apparatus, less often it is caused by microtrauma of the cartilage and synovium. A typical combination of pain in the joints and discomfort in the bones and muscles. Joint and muscle discomfort occurs immediately after the impact of physical activity or against the background of prolonged monotonous work with constant tension in the same muscle groups. Pain in the joints of the body occurs without fever. In case of significant overloads, a moderate violation of the general condition and weakness are possible.

The disorder can last up to several days and, with limited physical activity, gradually diminishes until it disappears completely without any treatment. If pain resulting from sports or strenuous physical work is replaced by persistent pain, swelling of the wrist, elbow, shoulder, ankle, knee and hip joints and limitationhabitual movements, you should consult a doctor.

Age-related changes in the musculoskeletal system

The causes of moderate pain in bones and joints in older people are degenerative processes with loss of calcium, thinning of bone bundles, impaired blood supply to cartilage and a decrease in the volume of intra-articular fluid. Mild discomfort is only the first manifestation of senile joint damage. As a rule, periodic discomfort occurs after 45-50 years. Around the age of 60-65, unpleasant pain occurs even with minor effort, accompanied by stiffness of movements, stooping, shuffling gait and gradually gives way to pain.

Pregnancy

Complaints about joint pain occur more often in the second half of the gestational period. Pulling and painful discomfort is usually felt in the joints of the pelvis and lower limbs. It intensifies towards the end of the day, after prolonged standing or after long distances traveled. A night's rest relieves the situation. Joint pain during pregnancy is caused by the following reasons:

Vitamin and mineral deficiency. The most important role is played by calcium and vitamin D deficiency, leading 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 and the frequent occurrence of ARVI.
Significant weight gain. Joint pain is more often a concern for pregnant women with significant weight gain or those who are obese. Pain at the end of the day, and possibly in the middle of the day, is felt in the hip joints, knees, ankles, the cartilages of which undergo loads several times greater than those permitted. To alleviate the disease, women deliberately 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 discomfort takes the form of pain in the pubic region and hip joints. During a pathological course with the development of symphysitis, painful sensations are replaced by pain, which intensifies when pressing on the uterus, when trying to separate the legs, during sexual intercourse. The appearance of pain in the pubic region is a serious reason for visiting an obstetrician-gynecologist.
Carpal tunnel syndrome. A specific manifestation observed during the 2-3 trimesters in almost 20% of pregnant women is the so-called tunnel syndrome. The cause of the disorder is swelling of the soft tissues of the hands and compression in the carpal tunnel of the nerves that pass to the fingers. In addition to aching pain in the small joints of the hand, patients complain of numbness of the skin, tingling and a crawling sensation. The condition improves with an elevated arm position.

Obesity

In overweight people, the pressure on the cartilage tissue increases, leading to faster wear and tear. The degenerative-dystrophic process usually involves the large joints of the lower extremities and the intervertebral joints. The disorder increases as obesity progresses. Discomfort in the joints first manifests itself as aches without fever at the end of the day, then the increasing destruction of the cartilage leads to the development of deforming osteoarthritis, osteoarthritis, osteochondrosis with an acute pain syndrome which limits themotor activity of the patient.

Acute infections

Body and joint pain are one of the first (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, accumulation of toxins and the development of the inflammatory process. Usually the patient complains of pain throughout the body, light and moderate pain is noted 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 aches and general malaise, chills and hyperthermia are observed.

The most pronounced pain in the joints and body is related to the flu. Up to 50% of patients experience constant pain in the legs, arms and torso. The intensity of pain is so high that it becomes difficult for a person to perform the simplest actions - get out of bed, go to another room, take a glass of water. The situation is aggravated by high (febrile) temperature and severe headache. Sore throat and nasal congestion occur after a few hours or even days. Less joint discomfort occurs with parainfluenza, an adenoviral infection.

A feeling of pain in the joints is possible in case of acute infectious lesions of the gastrointestinal tract - food toxic infections, salmonellosis. Painful joint pain, of varying intensity, appears suddenly a few hours after eating contaminated food and is accompanied by a sharp rise in temperature, intense chills and headaches. The aches are preceded by nausea, vomiting, pain in the abdominal cavity, foul-smelling diarrhea with mucous and sometimes bloody impurities.

Collagenoses

Painful joints are a harbinger of most diseases that occur during autoimmune inflammation of connective tissue, including joint tissue. The localization, prevalence and intensity of unpleasant sensations are determined by the characteristics of a particular collagenosis. The general patterns are the involvement of certain groups of joints in the process, a gradual increase in sensations to excruciating and debilitating pain, observed first during movements and then at rest. Deformation of the articular joints is possible. The main systemic inflammatory causes of the disease:

Rheumatism. The symptom is "volatile": aches then pain are felt alternately in the large joints of the arms and legs – elbows, shoulders, hips, knees, ankles. The affected areas are swollen. Joint pain is often preceded by a sore throat. With treatment, joint changes are reversible.
Rheumatoid arthritis. Unpleasant sensations often appear after 40 years. A typical feeling of pain in the small joints of the hands and feet, associated with noticeable swelling and morning stiffness of movements. In the future, pain and curvature of the articular joints come to the fore.
Systemic scleroderma. It is characterized by a variable localization of painful sensations, the presence of morning stiffness in the joints of the hands, elbows and knees. The pain is generally symmetrical. The swelling is short-lived. Due to skin sclerosis, mobility of the articular joints is limited, damage to the tendons causes a feeling of friction during movements.

Osteoarthritis

Pain syndrome in the early stages of the disease is mild and is perceived as discomfort, pain in the joints of the legs and, less often, in the arms. The immediate cause of osteoarthritis is the degeneration and destruction of cartilage tissue. Typically, feelings of tightness or pain without fever appear in adulthood and old age. Pain may appear earlier in the presence of occupational hazards (vibrations, heavy physical work). Gradually, the joints become stiff, the person experiences severe pain and difficulty walking and taking care of themselves.

Metabolic disorders

The causes of metabolic disorders leading to joint pain are insufficient intake of vitamins, minerals, accelerated accumulation or excessive excretion of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, have varying severity and are most often the manifestation of pathological conditions such as:

Osteoporosis. When calcium is removed from bone tissue, the articular surfaces of the bones become fragile, the cartilage becomes thinner, which is accompanied by painful sensations. The pain syndrome gradually increases, going from mild pain to severe arthralgia, associated with unpleasant sensations in the bones and muscle weakness. The joints that undergo the maximum load are most often affected: the hip and the knee; the shoulder, elbow and ankle are less commonly affected.
Drop. Mild pain in the big toe is a cause for concern already in the preclinical stages of the gouty process. There may be painful discomfort in the knees, elbows, wrists and fingers. The accumulation of urates in the joint cavity leads to a rapid manifestation of the disease with the transition from painful joint pain to acute painful joint pain that does not subside for several hours. The affected joint feels warm to the touch. There is redness of the skin and limited movements.

Oncological diseases

In acute and chronic leukemia, widespread osteoarticular pain, followed by pain, often occurs even before noticeable pathological changes in a general blood test and other clinical symptoms - general malaise, night sweats, fever, loss of appetite, bleeding. Unpleasant sensations are at first periodically painful, then constantly strong, debilitating for the patient.

Hodgkin's lymphoma and lymphogranulomatosis are characterized by a combination of painful joints accompanied by muscle discomfort, weakness, enlargement of lymph nodes and other lymphoid formations. Painful sensations are common, generally moderate. A short period of pain in the muscles of the knee joint and thigh, which intensifies at night and, with exertion, turns into constantly increasing pain with lameness, is observed with osteosarcomas. Other joints are less frequently affected by this pathology.

Joint injuries

Joint pain is caused by mild traumatic injuries, which cause damage to the ligaments surrounding the joint and bruising of the soft tissues in the joint area. More intense pain occurs when the meniscus is damaged. The symptom is clearly linked in time to a blow, a fall or an awkward movement. Usually, discomfort is felt in one affected joint and less often spreads to adjacent areas of the body.

Chronic infectious processes

Possible causes of a feeling of pain in the joints that occurs without fever or against a background of low-grade fever are long-term infections. In patients suffering from chronic infectious and inflammatory diseases, joint discomfort becomes a consequence of intoxication of the body or direct harmful effects of microorganisms on joint tissues (usually streptococci, mycoplasma, chlamydia). The appearance or intensification of pain may indicate an exacerbation of chronic tonsillitis, sinusitis, genitourinary infections, adnexitis, pyelonephritis.

Distinctive features of joint pain in common chronic infections that occur in case of poisoning are moderate severity of joint discomfort, gradual development, periodic intensification and weakening of symptoms. In patients suffering from tuberculosis and hematogenous osteomyelitis, the development of painful and painful sensations is the cause of an increase in temperature to subfebrile levels, general malaise - fatigue, weakness, weakness. Without treatment, patients' condition gradually deteriorates.

Complications of drug therapy

Taking certain medications can be complicated by moderate aches and pains 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, rash and other manifestations of drug allergies. The discomfort disappears quickly after stopping the medication that caused it, and special treatment for complications that arise is less likely to be necessary. Mild pain and arthralgia are caused by:

Antibiotics: penicillins, fluoroquinolones.
Tranvilizers: phenazepam, diazepam, lorazepam, etc.
Contraceptives: combined oral contraceptives (COCs).

Rare causes

Inflammation of the respiratory system: 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's thyroiditis, vasculitis.
Fascial damage: necrotizing fasciitis in the convalescent stage.
Congenital malformations of bones and joints.

Investigation

To determine why pain is felt in the joints and bones, it is necessary to consult a therapist or family doctor, who will make an initial diagnosis and prescribe examinations by specialized specialists. Taking into account the nature of the unpleasant sensations, the speed of their appearance and the accompanying symptoms, the following are recommended to determine the cause of the disorder:

Laboratory blood test. An assessment of the leukocyte count and ESR level is necessary to exclude infections, inflammatory and oncohematological processes. In systemic diseases, it is important to measure the content of total proteins, the ratio of protein fractions in the blood, specific proteins of the acute phase, markers of rheumatoid arthritis and other inflammations. Tests for vitamin, electrolyte (especially calcium), and uric acid concentrations help diagnose metabolic disorders.
Bacteriological examination. A bacterial culture is necessary if the pain felt in the joints and the whole body is likely to be contagious. Urine, stool, sputum and discharge from the urogenital tract are collected for research purposes. To select an antimicrobial treatment regimen, antibiotic sensitivity is determined. In doubtful cases, microscopic examination and culture are supplemented by serological reactions (RIF, ELISA, PCR).
Ultrasound of joints. It is usually used for the clear localization of painful sensations and the suspected presence of rheumatic diseases. Ultrasound of the joint allows you to examine its structure, identify the destruction of cartilage and bones, preclinical inflammatory changes, and study the state of periarticular soft tissues. The advantages of the method are accessibility, non-invasiveness and high information content.
X-ray techniques. Changes in the width of the joint space, hardening of soft tissues, the presence of calcifications, osteophytes and erosions of the joint surfaces are detected during radiography of the joints. To improve the effectiveness of diagnosis, special techniques are used - contrast arthrography, pneumoarthrography. In the early stages of the lesion, tomography (MRI, CT scan of the joints) is considered more indicative. Bone density can be easily assessed by 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 wall of the synovial membrane and tophi. Morphological analysis of biopsy samples and examination of synovial fluid reflect the nature of pathological processes occurring in the joints. Simultaneous collection of materials with visual examination of the joint cavity is convenient to perform during arthroscopy with tissue biopsy.

A less common way to diagnose the cause of joint pain is scintigraphy with the introduction of technetium, which accumulates in the affected tissues. In recent years, joint thermography has attracted increasing interest as a modern non-invasive method for recognizing inflammatory diseases, tumors and circulatory disorders of joints and periarticular tissues. If the number of elements formed in a clinical blood test decreases, an extra-articular bone puncture is performed. Patients suffering from joint pain without fever are advised to consult a rheumatologist and an orthopedic traumatologist.

Treatment

Help before diagnosis

For painful joints linked to physical activity, no special treatment is necessary, a long rest with dosage of loads is sufficient. Unpleasant joint sensations that occur during pregnancy usually disappear on their own after pregnancy or are corrected by weight control and taking vitamin and mineral supplements. Elderly and obese patients are advised to change their lifestyle: adequate physical activity, appropriate calorie diet with sufficient content of plant foods.

Bone, joint and muscle pain, combined with general malaise and fever, increased feelings of pain and tightness up to severe pain and the development of persistent pain are indications for seeking medical attention. To reduce joint discomfort caused by ARVI, it is recommended to rest, drink enough water, rosehip infusions and dried fruits. Until serious diseases causing joint pain are excluded, self-medication with painkillers, long-term unsuccessful application of compresses, lotions, decoctions, etc. are unacceptable.

Conservative therapy

You can get rid of joint pain with the right treatment, aimed at eliminating the cause of the disorder and parts of the mechanism of its development. Etiopathogenetic treatment is usually supplemented with symptomatic drugs that quickly reduce the severity of throbbing and aching pains. The treatment regimen for diseases associated with painful joints may include:

Antimicrobials. The basic treatment of infections is the prescription of antibiotics to which the pathogen is sensitive. In severe cases, broad-spectrum drugs are used until the sensitivity of the microorganism is established.
Non-steroidal anti-inflammatories. They reduce the production of inflammatory mediators and thus inhibit inflammatory processes in the joints. By influencing central pain receptors, they reduce the degree of joint discomfort. Used in the form of tablets, ointments, gels.
Corticosteroids. They have a strong anti-inflammatory effect. Hormone therapy constitutes the mainstay of treatment for systemic collagenosis. In severe and resistant forms of the disease, corticosteroids are combined with immunosuppressants to enhance the effect.
Chondroprotectors. They act as a substrate for the synthesis of protein glycans, a sufficient quantity of which increases the elasticity of articular cartilage. Nourishes cartilaginous tissue and restores its damaged structure. Intra-articular administration of drugs is possible.
Xanthine oxidase inhibitors. Used as a medicine for gout. They block the key enzyme necessary for the synthesis of uric acid, thereby reducing its concentration in the body and promoting the dissolution of existing urate deposits.
Vitamin-mineral complexes. Recommended for the treatment of painful joints caused by metabolic disorders. The most commonly used drugs contain calcium and vitamin D. They are also an element of complex therapy for inflammatory and metabolic diseases.
Chemotherapeutic agents. They serve as the basis for most treatment regimens for various types of oncohematological pathologies. Depending on the clinical variant and the severity of the neoprocess, they are combined with radiotherapy and surgical interventions.

Physiotherapy

After determining the exact cause of pain and the disappearance of acute inflammation, patients, except for 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. In case of chronic pathology, physiotherapeutic treatment is carried out over several months and is supplemented by a spa treatment.