Arthralgia is a very common problem that can be related to infection or toxicity, trauma, inflammation, or deterioration of 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 soon as possible. It is not easy for an experienced specialist to determine exactly why the joints ache, because early symptoms can be deceptive, and the full picture of the disease sometimes appears in just 1-2 months or more.
The information in this article will help you navigate between the various diseases and conditions that cause arthralgia. Modern diagnostic methods will allow you to determine the exact cause of the disease and choose the right treatment tactics with your doctor.
In this article, we will look at situations where many joints all over the body ache. Sometimes one starts to hurt and the other joints quickly join it. The pain appears to migrate from one part of the body to another over a period of days or weeks. A number of diseases cause pain in the form of attacks in a group of joints - seizures, when the pain reappears after a decrease.
Joint pain with viral infections
Arthralgia is often caused by various viral infections: the direct effect of viruses on the joints or the effects of toxins accumulated in the blood during the acute phase of many infectious diseases.
Pain often occurs in the small joints of the arms and legs, knees, and sometimes the spinal joints. The pain is not strong, it is painful. This is called joint pain. Mobility is generally not impaired, there is no swelling or redness. In some cases, a urticaria-like rash may appear and disappear quickly. In most cases, viral arthralgia is the first symptom of the disease and is accompanied by fever, muscle pain and weakness.
Despite the deterioration of general well-being, joint pain in viral diseases is generally not a serious concern. Relaxation can be achieved by taking non-steroidal anti-inflammatory drugs, drinking plenty of fluids, and resting. After a few days, the pain disappears and the joint function is completely restored. There is no irreversible change in the structure of the joint.
Viral arthralgia is especially characteristic of influenza, hepatitis, rubella, rubella (in adults).
Reactive arthritis
This is a group of diseases in which joint pain occurs after a viral or bacterial infection. The immediate cause of reactive arthritis is a defect in the immune system that causes inflammation in the joints, even though they are not affected by the infection.
Joint pain is more likely to occur 1-3 weeks after acute respiratory infections, intestinal infections, or diseases of the genitourinary system, such as urethritis or genital infections. Unlike viral arthralgias, joint pain is severe, accompanied by edema and impaired mobility. Body temperature may rise. Arthritis often begins with a seizure of a knee or ankle joint. Within 1-2 weeks, pain in the joints of the other half of the body is combined, and small joints in the arms and legs ache. Sometimes the joints of the spine hurt.
Joint pain usually goes away with treatment or on its own, with no consequences. However, some types of reactive arthritis are chronic and sometimes exacerbated.
Reiter's disease- One of the types of reactive arthritis that develops after transplanted chlamydia and can take a chronic course. Joint pain in Reiter's disease is usually accompanied by a violation of urinary excretion - a manifestation of chlamydial urethritis (inflammation of the urethra), which often goes unnoticed. Then eye problems appear, conjunctivitis develops. You should consult a doctor for treatment.
Reactive arthritis, adenovirus infection, genital infections (especially chlamydia or gonorrhea), Salmonella, Klebsiella, Shigella, etc. May develop after associated intestinal infections.
Joint pain when cartilage wears out
Diseases that are accompanied by gradual wear and tear of the cartilage on the articular surfaces of the bones are called degenerative. They are more common in people in their 40s and 60s, but are also found in young people, such as those with joint injuries, professional athletes who are often exposed to strenuous work, and obese people.
Deformative osteoarthritis (osteoarthritis, DOA)- These are diseases of the legs - joints and large joints of the joints, which carry most of the load during walking. The pain occurs gradually. After a rest in the morning, the health condition improves, and in the evening and at night it worsens after long walks, jogging and other stresses. Inflammatory changes: edema, redness are not expressed at all and can be seen only in advanced cases. However, there are often complaints of cracking in the joints. The disease develops over the years. It is almost impossible to treat deforming osteoarthritis, only to slow down the destruction of cartilage. They resort to surgery to restore movement.
Osteochondritis of the spineAnother common degenerative disease. This is due to the thinning and destruction of cartilage between the vertebrae. Decreased cartilage thickness leads to constriction of nerves extending from the spinal cord and blood vessels, which causes many different symptoms in addition to pain in the spinal joints. For example: headache, dizziness, pain and numbness in the arms, shoulder joints, heart and chest pain and cuts, leg pain, etc. A neurologist is generally involved in 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 these diseases are associated with the specificity 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, unlike degenerative diseases, develop more in childhood or adolescence. Their first manifestation is often joint pain.
Joint pain is generally variable: today one joint hurts, tomorrow another, tomorrow the next - the third. Arthralgia is accompanied by edema, redness of the skin, impaired mobility in 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 mobility. A characteristic symptom of autoimmune joint inflammation is morning stiffness. In the first 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 have to spend warming up.
Gradually, signs of damage to other organs join the arthralgia: heart, kidneys, skin, blood vessels, etc. The disease progresses without treatment. There is no cure, but modern medicine 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: it is very painful, red and swollen. Often the disease begins with pain in the small joints of the arms and legs: fingers, hands or feet, less - with the defeat of one knee, ankle or elbow joint, and then pain in other parts join the body.
Systemic lupus erythematosus- a more rare disease that is more susceptible to young women. Flying pains in various joints of the body, deformity of the fingers, rash on the skin, especially on the face - redness like butterfly wings on the forehead and cheeks. Joint pain may be accompanied by interruptions and discomfort in the heart and chest area, low-grade fever, weakness, weight loss, increased blood pressure, back pain, edema.
Ankylosing spondylitis- Unlike lupus, it affects men more. The disease begins with pain in the spinal joints, lumbar region, sacrum, pelvis. Gradually the pain spreads to other parts of the spine. In addition to pain, stiffness, decreased elasticity, and, over time, gait disturbances and complete immobility in the lumbar joints are characteristic. In the early stages, ankylosing spondylitis can easily be confused with osteochondrosis. However, the first disease develops in young men, the second in older people. As a diagnostic test, an X-ray is taken at the junction of the sacroiliac joint - the spine and pelvis. Based on the results of the study, the doctor can confirm or deny the diagnosis.
Joint pain with psoriasis
Psoriasis is a skin disease in which there is a characteristic evidence on the surface of the body. Sometimes psoriasis affects the joints. The joints of the hands and feet, fingers and toes, less the spine are generally sore and swollen. A distinctive feature of arthritis in psoriasis is an asymmetric lesion. The skin on the joints may have a bluish-purple color and damage to the nails. 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 a very severe pain in the large joints of the legs and arms, which occurs 2-3 weeks after a sore throat or red fever. It develops more 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 ache, then others are generally symmetrical. Even without treatment, the pain disappears on its own and the joint function is completely restored. However, after a while, signs of serious heart damage appear. Rheumatism requires urgent medical attention. Only timely treatment can prevent damage to the heart and other organs.
How are painful joints examined?
There are various examination methods for joint pain. As a rule, they are used together.
Blood test- is one of the most common tests for joint pain complaints. This test can be used to determine the presence of inflammation or to suggest a degenerative nature of the disease, to identify signs of infection, and to diagnose the cause of the disease in the case of infectious or reactive arthritis using immunological tests or polymerase chain reaction (PCR). Blood tests show possible metabolic diseases, the condition of the internal organs.
Examination of synovial fluid- fluid that washes the surface of the joint. This nourishes the joint surfaces and reduces friction during movement. According to the composition of the synovial fluid, the laboratory assistant draws conclusions about the presence of inflammation or infection in the joint, the destruction and nourishment of cartilage, the accumulation of salts that can cause pain (for example, with gout). Synovial fluid is taken for analysis using a needle inserted into the joint cavity after local anesthesia.
Joint X-ray and computed tomography (CT)- a method that allows you to consider the structure of the bone parts of the joint and, consequently, the condition of the cartilage according to the size of the joint cavity - a method that estimates the distance between the bones in the joint. X-ray examination is prescribed as one of the first methods for joint pain. X-rays show 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 determine the cause of joint pain. Computed tomography is also an X-ray examination method. With a CT scan, the doctor sometimes takes multiple images of the joint, giving more detailed information about the disease.
Ultrasound and MRI of the joints- The methods are different in nature, but similar in purpose. With the help of ultrasound or magnetic resonance imaging, information about the condition of the soft tissues of the joints and cartilage can be obtained. Ultrasound and MRI show the thickness of the cartilage, its defects, the presence of foreign inclusions in the joint, and help determine the viscosity and amount of synovial fluid.
Arthroscopy- A method of visual examination of the joint using microsurgical instruments that enter the cavity of the patient's joint after anesthesia. During arthroscopy, the doctor has the opportunity to examine the internal structure of the joint with the eyes, to note the damage and changes, as well as to remove fragments and other structures of the synovial membrane of the joint for analysis. If necessary, the doctor can perform the necessary therapeutic manipulations immediately after the examination. Everything that happens during arthroscopy is recorded on one disc or other storage medium, so you can consult with other specialists after the procedure.
Joint treatment
If you have joint pain, find a good therapist or pediatrician for children. He will make an initial diagnosis and, if necessary, refer you to a specialist for treatment. If joint pain is associated with osteoarthritis or arthritis, treatment will most likely be performed by a rheumatologist found here.
If the cause of arthralgia is an inflammatory response, medications are used to treat the joints, which can reduce inflammation. These are primarily non-steroidal anti-inflammatory drugs (NSAIDs): indomethacin, ibuprofen, diclofenac, nimesulide, meloxicam and 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 pills. When an infection causes pain, antibiotics are given.
Special treatment regimens are used for autoimmune diseases. For the regular appointment of a doctor, drugs are selected in the minimum effective dose that can strongly suppress the inflammatory reaction or suppress the immune system. For example: sulfosalazine, methotrexate, cyclophosphamide, azathioprine, cyclosporine, infliximab, rituximab, etc.
No specific drug is known for degenerative diseases of the joints (osteochondrosis, osteoarthritis). Treatment of diseased joints includes the appointment of anti-inflammatory and analgesic drugs during inflammation, and the intake of metabolic substances based on chondroetin sulfates and hyaluronic acid. 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. Currently, there are various endoprosthetic methods that allow the implantation of artificial joints or parts of them instead of damaged or obsolete ones.