Treating joint pain wisely: how to achieve lasting results?

Video

• Joint pain. Question answer. Topic: Encyclopedia of diseases
• Joint pain Topic: Encyclopedia of diseases

Title

• Major diseases
• Myths and facts
• Diagnostics
• Treatment methods

Joint pain can be mild in intensity or severe and debilitating. Over the course of their lives, up to 85% of the adult population will experience joint pain in one way or another. The cause of joint pain can be hundreds of diseases, in which joint damage can be either primary or secondary (due to intoxication with metabolic products).

The following diseases are most often accompanied by joint pain:

• Osteoarthritis
• Rheumatoid arthritis
• Rheumatism
• Reactive arthritis
• Psoriatic arthritis
• Bursitis
• Gout
• Myeloma
• Lyme disease
• Osteomyelitis
• Systemic lupus erythematosus
• Scleroderma
• Lymphoblastic leukemia
• Sarcoidosis
• Kawasaki disease
• Crohn's disease
• Still's disease
• Bone metastases
• Septic arthritis

Statistically, 4 diseases with the presence of arthralgia (joint pain) deserve the most attention.

Osteoarthritis

Arthritis (inflammation of the joint) is the most common cause of joint pain and a very large number of people suffer from this disease. Osteoarthritis is sometimes called degenerative, meaning that the cartilage tissue lining the surfaces of the joint undergoes degenerative changes over time and damaged cartilage injures each other, causing symptoms such as joint pain, inflammation, stiffness and limited mobility. Osteoarthritis affects approximately 27 million people in the United States. Symptoms usually begin after age 40 and progress slowly. And after the age of 60, up to half of people experience this disease to one degree or another. Osteoarthritis most often affects large joints that are subject to greater stress (hips, knees and ankles). Increased weight increases the risk of this disease. It has been noted that people with increased weight (both men and women) are three times more likely to develop this disease compared to people with normal weight (the same age and gender group).

Classification of drugs

Let's consider the main groups of local remedies for joint pain:

Non-steroidal anti-inflammatory drugs (NSAIDs) for topical use: Phenylbutazone, Etofenamate, Piroxicam, Ketoprofen, Ibuprofen, Diclofenac, Indomethacin, Meloxicam and Nimesulide.

Local agents with irritating effects:

a) Capsaicin and similar agents:

Capsaicin is fat-soluble, therefore, if necessary, products containing this drug can be removed from the skin or mucous membranes using petroleum jelly or vegetable oil.

• Capsicum fruit tincture;
• Capsicum fruit tincture + Camphor;
• Capsicum fruit extract;
• Capsaicin + Ethylnicotinate;
• Camphor;
• Carnation flowers oil + Camphor + Chinese cinnamon bark oil + Peppermint leaves oil + Eucalyptus leaves oil + Levomenthol;
• Camphor + Gum turpentine + Eucalyptus leaf oil + Levomenthol;
• Camphor + Salicylic acid + Gum turpentine + Viper venom;
• Camphor + Peppermint leaves oil / Levomenthol + Eucalyptus rodentum leaves oil;
• Camphor + Salicylic acid + Gum turpentine + Viper poison;
• Pepper patch.

b) Propyl nicotinate (salicylic acid derivatives in combinations):

• Methyl salicylate + Racementol;
• Methyl salicylate + Cobra venom;
• Methyl salicylate + Bee venom;
• Methyl salicylate + Levomenthol + Eucalyptus oil + Turpentine oil.

Preparations containing dimethyl sulfoxide:

• Sodium heparin + Dexpanthenol + Dimethyl sulfoxide;
• Dimethyl sulfoxide + Camphor + Turpentine oil + Benzyl nicotinate + Nonivamide.

Other drugs

• Nicoboxil + Nonivamide;
• Benzocaine + Procaine + Racementol;
• Glucosamine + Chondroitin sulfate;
• Formic alcohol;
• Titanium glycerosolvate aquacomplex;
• Menthol + Novocaine + Anestezin.

Anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) suppress inflammation and reduce pain and swelling. Drugs in this group are generally well tolerated, but are not recommended in cases of hypersensitivity to NSAIDs (including bronchial asthma), erosive lesions of the gastrointestinal tract, as well as during pregnancy and breastfeeding (a number of drugs can penetrate the placental barrier) . In addition, the use of NSAIDs is associated with the risk of local and systemic allergic reactions, the possible development of increased sensitivity to light (photosensitivity), especially when used together with cosmetics containing octocrylene sunscreen. Therefore, topical use of NSAIDs on areas with damaged skin, as well as use without protection from direct sunlight, is not recommended. If necessary, these products can be removed from the skin with plenty of water.

Salicylic acid derivatives (for example, methyl salicylate), which are included in various combinations of medicinal substances, have similar effects.

Irritants

A fundamentally different group of drugs from non-steroidal ones are painkillers with a local irritant effect, often used for joint pain. Products based on capsicum extract containing capsaicin are widely used. This alkaloid irritates and warms the skin and increases local blood flow in the area of ​​application. In addition, it affects pain receptors, which leads to a local analgesic effect. Products containing capsaicin should also not be used for damaged skin. The question of use in pregnant and lactating women should be decided by a doctor. We should not forget about the possibility of developing allergic reactions.

Other substances of plant origin act in a similar way, for example, mustard oil and its derivatives (allyl isothiocyanate), camphor, menthol (which also has a “cooling” effect), extracts of cloves, eucalyptus, peppermint, and gum turpentine. The use of these products may also cause allergic reactions.

Keep away from children!

It is important to avoid accidental ingestion of any topical medications, which is especially important for families with young children.
If this does happen, then in the case of NSAIDs you should rinse the stomach. If locally irritating drugs are ingested, vomiting should not be caused due to the risk of inhalation. For example, inhalation of camphor followed by laryngospasm can lead to death. Instead, you need to take enveloping antacids and/or sorbents, and consult a doctor. There is a synthetic analogue of capsaicin with an identical mechanism of action - nonivamide. Nonivamide is usually used in combination with nicoboxil, a substance with vasodilating activity ( expands the lumen of blood vessels - Ed.).

). The application of these drugs to areas of skin with increased permeability, to the neck, lower abdomen and inner thighs is contraindicated.

Another representative of this group, propyl nicotinate, also has an irritating effect. When applied, propyl nicotinate is broken down to form nicotinic acid, which increases local blood flow and blocks nerve endings, which leads to the development of local anesthesia and hyperthermia. This painkiller can be used for joint pain only if it is non-inflammatory in origin, for example due to injury. Using a large amount of the drug over a large area can lead to a decrease in blood pressure and bradycardia, and the entry of propyl nicotinate into the oral cavity is fraught with respiratory failure, increased blood pressure, and the development of cardiovascular failure.

It is also not recommended to use propyl nicotinate simultaneously with other locally irritating agents (local medications, warming physiotherapy) due to the risk of skin irritation and lowering blood pressure. Benzyl nicotinate works similarly.

Poisons

Often, topical products contain venoms of hymenoptera and reptiles. Bee venom has an analgesic and anti-inflammatory effect, and may also have an antibacterial effect. The venoms of snakes - vipers, vipers, cobras - act similarly. If such products are used, allergic reactions may develop.

Dimethyl sulfoxide

An important component of many compounds used for arthralgia is dimethyl sulfoxide. It improves the penetration of medicinal substances into tissues by increasing the permeability of cell membranes, and also has its own local anti-inflammatory and analgesic effect. Dimethyl sulfoxide, with long-term use, improves the absorption of ethanol from the gastrointestinal tract, can enhance the effect of insulin, and increases sensitivity to anesthesia drugs. The drug should not be used if you are hypersensitive to it, pregnant or lactating women, or children under 12 years of age. An additional limitation on its use may be a specific odor reminiscent of garlic.

Other

Metal compounds can also be used in the treatment of joint pain. Thus, there are preparations based on titanium compounds, for which anti-inflammatory and antimicrobial effects, anti-edematous and local analgesic effects are described.

Another option is the use of local anesthetics, for example, novocaine and anesthesin in combination with menthol, which provides both an analgesic effect and a cooling sensation in the sore joint.

Many of the listed drugs are included in various combination drugs and enhance each other’s effect.

Rheumatoid arthritis

An autoimmune disease that causes pain and stiffness in the joints. Most often it occurs in women aged 20 to 50 years. There are about 1.5 million patients with this diagnosis in the United States. In patients with this disease, due to disruption of the immune system, antibodies are formed to their own tissues (including joint tissues), which causes inflammatory processes and manifests itself as damage to joints and other internal organs. Inflammation in the joints leads to rapid wear, pain and limited mobility. Due to the fact that the disease is systemic and autoantibodies spread throughout the body, joint damage is symmetrical (joints on the right and left are affected). Small joints (in the hand and foot) are often affected, as well as large joints.

How does the disease manifest itself?

The disease can begin with acute pain in any part of the back, which intensifies with active movements and bending. But more often it all starts with a “tolerable” feeling of discomfort in the interscapular, lumbar, and shoulder girdle areas. Discomfort intensifies in the evening, with weakness of the paravertebral muscles, or in the morning, as a result of poor sleep conditions.

The spinal column bears a colossal mechanical load, but at the same time it is a complex anatomical formation in which circulatory, supporting, and spinal structures innervating the entire human body are closely intertwined. That is why changes in the spine, which lead to compression or irritation of the spinal elements, can manifest as pathology of any internal organs (headache, vascular dystonia, hypertension, arrhythmia, sexual dysfunction, etc.). The ancients argued: “if there are many diseases and they cannot be cured traditionally, then there is only one disease and the spine needs to be treated.”

Bursitis

This disease is often confused with arthritis, although with bursitis it is not the joint that is inflamed, but the joint capsule. Bursitis can cause discomfort, stiffness and pain in the joint area. Symptoms are associated with inflammation of the synovial membranes of the joint, usually caused by improper movement, compression or injury. Most often, bursitis develops in the shoulder, knee or hip joints. One type of bursitis, called maid's knee, develops due to prolonged pressure on the knee joint on a hard surface.

Risk groups by age and gender

Joint diseases manifest themselves mainly in old age - against the background of natural wear and tear of tissues. The risk group also includes those who have received weak bone joints genetically - by inheritance, as well as those suffering from diabetes, obesity, and chronic ailments. But there are other trends.

• Juvenile rheumatoid arthritis occurs among minors.
• Gout develops as a result of excessive consumption of meat, chocolate and red wine, and is therefore considered a “disease of aristocrats”.
• Women often experience inflammation of the joints caused by hormonal fluctuations.
• In men, diseases of a traumatic nature predominate.

Arthrosis is no longer considered a disease of the elderly: recently it has become noticeably younger

Gout

Gouty joints usually involve paroxysmal episodes of pain, stiffness, inflammation and redness in the joints. The reason for this lies in the excess production of uric acid, which is not completely utilized by the kidneys and is deposited in the form of crystals in the joints, which leads to inflammation. As a rule, this disease develops after 50 years. Therefore, it must be remembered that with age, the excretory function of the kidneys may decrease, which can lead to gout. Gout usually affects the feet, but if left untreated, other joints can also be affected.

Systemic lupus erythematosus

Systemic lupus erythematosus is an autoimmune disease. The etiology of this disease is not yet known. A certain genetic determination is assumed. Provoking factors may be infections, stress, sun exposure, ultraviolet radiation, changes in hormone levels during pregnancy or when taking contraceptives. The reason for the formation of autoantibodies is unclear. Women get sick 9 times more often than men and, as a rule, the onset occurs at fertile age. SLE is characterized by alternating exacerbations and remissions, and these periods can be of varying lengths. During an exacerbation, there may be a rise in temperature, inflammation and pain in the joints. Periods of remission can be long and during this period up to 20% of patients do not require treatment. With SLE, damage to other organs and systems (kidneys, heart, skin) is possible.

In what cases is specialist help for pain urgently needed?

You should not delay contacting a doctor under the following symptoms and circumstances:

• the ankle joint hurts and is very swollen, because of this you are unable to put on shoes;
• due to intense pain you cannot lean on your leg;
• noticed instability of the ankle, loosening (occurs with complete or partial rupture of the ligaments);
• pain occurs when you stand;
• the soreness is felt not only in the muscles, but also deep in the ankle.

Severe pain in the ankle is not a reason to try traditional medicine

Myths and facts

Myth N1

All joint pain is associated with arthritis. Although there are at least 50 types of arthritis, inflammation and pain in the joints does not mean the presence of arthritis. Pain in the joint area may be associated with damage to soft tissue or synovial membranes (bursitis). Therefore, a doctor’s consultation is necessary to make a diagnosis.

Myth N2

Clicking your joints causes arthritis. As far as we know, the click when extending a joint is associated only with the vacuum effect and nothing more.

Myth N3

Physical exercise causes joint pain. Exercise is beneficial for both people with arthritis and healthy people. Only if you have pain, you should forget about intense exercise and limit yourself to light gymnastics or exercise on exercise bikes and swimming. It must be remembered that the more a person moves throughout his life, the better. For joints, exercises help maintain range of motion. We must remember the motto “what doesn’t work, perishes.”

Myth N4

It is impossible to stop the process of destruction of joints due to arthritis. Modern drugs (NSAIDs, steroids, antirheumatic drugs) can reduce inflammation, relieve pain and, thus, inhibit destructive processes in the joint. When patients refused treatment for joints, irreversible, pronounced changes in the joints were noted, and, sometimes, in a very short period of time (3-6 months). Therefore, it is better to listen to the advice of your doctor - this will help maintain your quality of life.

Fact N1

Patients with arthritis are weather sensitive. They do not tolerate wet weather well and thrive in dry, clear weather. This is due to the sensitivity of these patients to atmospheric pressure.

Fact N2

Diet may be a factor in preventing arthritis. Yes and no. As you gain weight, your risk of osteoarthritis increases, especially affecting the hips and knees. But for other forms of arthritis, the effectiveness of the diet is not so obvious.

General clinical recommendations

Arthritis of the foot and ankle is a progressive disease. To prevent its relapse, the patient should follow the following recommendations:

• lead a healthy lifestyle, move more;
• regularly perform physical therapy exercises, go swimming;
• avoid heavy physical activity, hypothermia and stress;
• promptly treat all acute and chronic diseases;
• give up bad habits - smoking and alcohol abuse;
• conduct courses of preventive treatment as prescribed by a doctor.

Prevention

To avoid the development of the disease, genetically predisposed persons, as well as persons whose work involves increased stress on the ankles, should avoid provoking factors that can become a trigger for the development of the disease. These are hypothermia, viral infections, prolonged stress and high physical activity.

Follow a diet: give up fried, fatty, spicy foods, sweets and baked goods, eat regularly. The diet should include: low-fat animal products, vegetables and fruits.

If symptoms of foot arthritis appear, you should immediately consult a doctor.

Arthritis

It is a misconception that arthritis only affects older people. These diseases occur in any age group. Arthritis is a disease characterized by inflammation of the joints and affects both children and adults. The typical manifestation of arthritis is pain and stiffness in the joints, which limits movement and sometimes these symptoms are resistant to treatment. Often, it is possible to achieve a therapeutic effect with the help of exercise, medication and lifestyle changes. About 46 million adults in the United States have been diagnosed with a form of arthritis, and that number is trending upward. But arthritis did not appear today and has been bothering people for hundreds of years (typical changes in bone structures discovered during excavations indicate this). It’s just that over the past 100 years there has been a sharp increase in the diagnosis of diseases of the musculoskeletal system and the immune system. Scientists have identified at least 100 types of arthritis and, as it turns out, many conditions accompanied by fever and a malfunction of the immune system are somehow related to the joints.

Arthritis is characterized by pain, stiffness and swelling in the joints, as well as a decrease in the range of movement in them. There are various forms of arthritis, incl. secondary (gout, SLE, fibromyalgia). Arthritis can be divided into three groups:

• Osteoarthritis. Also called degenerative joint disease, it is the most commonly diagnosed form of arthritis. Osteoarthritis occurs when the process of disintegration of cartilage tissue in joints begins. This form of arthritis most often affects the hip, knee, ankle and shoulder joints. It most often develops over the age of 40 years.
• Rheumatoid arthritis. This type of arthritis occurs when the surfaces lining a joint are damaged, causing pain and inflammation. Small joints (feet, fingers) are most often affected. Rheumatoid arthritis is an autoimmune disease that typically develops in women between the ages of 30 and 50.
• Juvenile arthritis. This group includes all arthritis that develops before the age of 18 years. It is not clear what causes the development of arthritis at a young age, but JA occurs more often in girls than in boys. Juvenile arthritis can involve various joints (ankle, knee, hip, shoulder, wrist). There are many types of juvenile arthritis, but juvenile rheumatoid arthritis is the most common.

Causes of aching joints

Mild or moderate joint discomfort is not always a manifestation of a pathological process. Sometimes the symptom has natural causes. Transient aching of the joints is felt when wearing uncomfortable shoes, and in weather-sensitive people - when the weather changes. During puberty, aching 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 heavy work, a common cause of the symptom is overstrain of the musculo-ligamentous system, less often it is caused by microtraumas of the cartilage and synovium. A typical combination of aches in the joints and discomfort in the bones and muscles. Joint and muscle discomfort occurs immediately after impact physical activity or against the background of prolonged monotonous work with constant tension in the same muscle groups. Aches in the joints of the body occur without fever. With large overloads, a moderate violation of the general condition and weakness is possible.

The disorder can last up to several days and, with limited physical activity, gradually decreases until it disappears completely without any treatment. If aches and pains resulting from sports or heavy physical work are replaced by persistent pain, swelling in the wrist, elbow, shoulder, ankle, knee and hip joints, and limitation of usual movements, you should visit a doctor.

Age-related changes in the musculoskeletal system

The causes of moderate aches in bones and joints in older people are degenerative processes with loss of calcium, thinning of bone beams, 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. Typically, periodic discomfort occurs after 45-50 years. By the age of 60-65, an unpleasant ache occurs even with minor exertion, accompanied by stiffness of movement, stooping, shuffling gait, and gradually gives way to pain.

Pregnancy

Complaints about aching joints are more often made in the second half of the gestational age. Pulling, aching discomfort is usually felt in the joints of the pelvis and lower extremities. It intensifies towards the end of the day, after prolonged standing or walking long distances. A night's rest eases the condition. Joint pain during pregnancy is caused by the following reasons:

• Vitamin and mineral deficiency
  . The greatest role is played by calcium and vitamin D deficiency, leading to osteomalacia. A feature of the manifestation of the symptom is a feeling of aching 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 discomfort is more often a concern for pregnant women with large weight gain or those who are obese. Aches at the end, and eventually in the middle of the day, are felt in the hip joints, knees, ankles, the cartilages of which experience loads several times higher than permissible. To alleviate the condition, 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 joints of the pelvis caused by the action of the hormone relaxin. In most cases, the discomfort is in the nature of aching in the pubic area and hip joints. In a pathological course with the development of symphysitis, aching sensations are replaced by pain, which intensifies when pressing on the womb, trying to separate the legs, during sex. The appearance of pain in the pubic area is a serious reason for a visit to an obstetrician-gynecologist.
• Carpal tunnel syndrome
  . A specific manifestation found in 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 position of the arms.

Obesity

In overweight people, pressure on cartilage tissue increases, causing it to wear out faster. The degenerative-dystrophic process usually involves large joints of the lower extremities and intervertebral joints. The disorder increases as obesity progresses. Discomfort in the joints first manifests itself in the form of aches without fever by the end of the day, then the increasing destruction of cartilage leads to the development of deforming arthrosis, spondylosis, osteochondrosis with a sharp pain syndrome that limits the patient’s motor activity.

Acute infections

Body and joint aches are one of the early (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, the accumulation of toxins, and the development of the inflammatory process. Usually the patient complains that the whole body aches, mild 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 aches in the joints and body are with the flu. Up to 50% of patients experience constant aching 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, pick up a glass of water. The situation is aggravated by high (febrile) temperature and severe headaches. 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 aching in the joints is possible with acute infectious lesions of the gastrointestinal tract - food toxic infections, salmonellosis. Aching joint pains of varying intensity appear suddenly a few hours after consuming contaminated foods and are combined with a sharp rise in temperature, severe chills, and headaches. Aches are preceded by nausea, vomiting, pain in the abdominal cavity, foul-smelling diarrhea with mucous and sometimes bloody impurities.

Joint pain can be a symptom of a wide range of diseases

Collagenoses

Aching joints are a harbinger of most diseases that occur with 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 debilitating pain, observed first during movements, and then at rest. Deformation of the articular joints is possible. The main systemic inflammatory causes of the disorder:

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

Osteoarthritis

The pain syndrome in the initial stages of the disease is mild and is perceived as discomfort, aching in the joints of the legs, and less often, the arms. The immediate cause of osteoarthritis is degeneration and destruction of cartilage tissue. Typically, pulling or aching sensations without fever appear in adulthood and old age. Aching may begin earlier in the presence of occupational hazards (vibration, heavy physical labor). Gradually, the joints become stiff, the person experiences severe pain and difficulty walking and caring for himself.

Metabolic disorders

The causes of metabolic disorders in which joint pain occurs are insufficient supply of vitamins, minerals, accelerated accumulation or excessive excretion of metabolic products. Unpleasant sensations are caused by inflammatory or dystrophic processes, have varying severity and most often serve as a manifestation of pathological conditions such as:

• Osteoporosis
  . When calcium is washed out of bone tissue, the articular surfaces of the bones become fragile, the cartilage becomes thinner, which is accompanied by aching sensations. The pain syndrome increases gradually from mild aches to severe arthralgia, combined with unpleasant sensations in the bones and muscle weakness. The joints that experience the maximum load are most often affected - the hip and knee; the shoulder, elbow, and ankle are less commonly affected.
• Gout
  . A slight ache in the big toe is already a concern at the preclinical stages of the gouty process. There may be aching 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 a change from aching to acute painful joint pain that does not subside for several hours. The affected joint is hot to the touch. There is redness of the skin and limited movement.

Oncological diseases

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

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

Joint injuries

Joint aches are provoked by mild traumatic injuries, which cause damage to the ligaments surrounding the joint and bruise of the soft tissues of the articular area. More severe pain occurs when the meniscus is damaged. The symptom is clearly related in time to a blow, a fall, or an awkward movement. Usually discomfort is felt in one affected joint, less often spreading to adjacent areas of the body.

Chronic infectious processes

Possible causes of a feeling of aching joints that occurs without fever or against the 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 damaging effects of microorganisms on joint tissue (usually streptococci, mycoplasmas, 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 with intoxication are moderate severity of joint discomfort, gradual development, periodic intensification and weakening of symptoms. In patients suffering from tuberculosis and hematogenous osteomyelitis, the background for the development of aching painful sensations is an increase in temperature to subfebrile levels, general malaise - fatigue, weakness, weakness. Without treatment, the condition of patients progressively worsens.

Complications of pharmacotherapy

Taking some medications may be complicated by aches and moderate pain in the small joints of the hands. Unpleasant sensations are not accompanied by redness or deformation of the joints. Patients may complain of muscle aches, fever, skin rashes, and other manifestations of drug allergies. Discomfort quickly disappears after discontinuation of the drug that provoked it, and special treatment for complications that arise is less likely to be required. Aches and mild 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
  : nonspecific 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.
• Damage to the fascia
  : necrotizing fasciitis in the convalescent stage.
• Congenital defects of bones and joints
  .

Diagnosis of arthritis

As soon as symptoms of arthritis appear, namely joint pain, you should consult a doctor. A number of diagnostic tests may be required for diagnosis:

• A physical examination that allows you to see the presence of swelling of the joint, pain on palpation, and limited mobility in the joint.
• Determining the intensity of pain and nature.
• Blood tests - general, blood fractions, rheumatic tests, presence of antibodies, etc.
• X-ray examination of the affected joint
• MRI or CT of the joint
• Densitometry
• Ultrasound of the joint
• Arthroscopy (a procedure in which an endoscope equipped with a video camera is inserted into the joint cavity in order to visualize the pathology)
• Joint puncture with laboratory testing of punctate

Not all tests can be used for diagnosis, but only a combination that allows for the most accurate diagnosis. If test results are positive, you may need to consult a rheumatologist.

Given that arthritis is different, diagnosis will require a different amount of research and different time. For example, diagnosing osteoarthritis is straightforward, whereas diagnosing rheumatoid arthritis requires imaging and blood tests, and only a combination of tests can make the diagnosis (similar to putting together a puzzle). For other joint lesions, additional research methods may be required. For example, psoriatic arthritis, as a complication of a disease called psoriasis, or reactive arthritis, which accompanies infectious diseases. In some cases, the underlying disease dominates the clinical picture and interferes with the diagnosis of arthritis. For example, with polymyalgia rheumatica or with ankylosing spondylitis (ankylosing spondylitis).

Survey

To determine why aches and pains are felt in the joints and bones, it is necessary to consult a therapist or family doctor, who will conduct an initial diagnosis and prescribe examinations by specialized specialists. Taking into account the nature of the unpleasant sensations, the speed of their occurrence, and 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 required to exclude infections, inflammatory and oncohematological processes. In systemic diseases, it is important to measure the content of total protein, the ratio of protein fractions in the blood, specific acute-phase proteins, markers of rheumatoid arthritis and other inflammations. Tests for the concentration of vitamins, electrolytes (especially calcium), and uric acid help diagnose metabolic disorders.
• Bacteriological examination
  . Bacterial culture is necessary if the aches felt in the joints and the whole body are likely to be infectious. Urine, feces, sputum, and discharge from the urogenital tract are collected for research. To select an antimicrobial therapy regimen, sensitivity to antibiotics is determined. In doubtful cases, microscopy and culture are supplemented with serological reactions (RIF, ELISA, PCR).
• Sonography of articular joints
  . It is usually used for clear localization of painful sensations and the suspected presence of rheumatic diseases. Ultrasound of the joint allows us to examine its structure, identify destruction of cartilage and bone, preclinical inflammatory changes, and study the condition of the 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 articular surfaces are detected during radiography of the joints. To improve diagnostic efficiency, special techniques are used - contrast arthrography, pneumoarthrography. In the initial stages of the lesion, tomography (MRI, CT of joints) is considered more indicative. Bone density can be conveniently assessed using densitometry.
• Invasive examination techniques
  . In some cases, to determine the cause of joint pain, a puncture with a biopsy of cartilage, the inner lining of the synovial membrane, and tophi is performed. Morphological analysis of biopsy specimens and examination of synovial fluid reflect the nature of the pathological processes occurring in the joints. Simultaneous collection of materials with visual examination of the articular cavity is convenient to do 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, there has been increasing interest in joint thermography as a modern non-invasive method for recognizing inflammatory diseases, tumors, and circulatory disorders in joints and periarticular tissues. If the number of formed elements in a clinical blood test decreases, an extra-articular bone puncture is performed. Patients with joint pain without fever are advised to consult a rheumatologist and an orthopedic traumatologist.

To find out the causes of joint pain, radiography may be prescribed.

Treatment of arthritis

Has undergone great changes recently. At one time, treatment for arthritis consisted of prescribing aspirin, thermal procedures, and immobilization of damaged joints using various orthopedic orthoses. It turned out that immobilization, supposedly to relieve pain, does more harm than good. Currently, joints are given less time to rest and constant mobility in them is the key to preserving its functions. Current treatment for osteoarthritis consists of a combination of exercise, physical therapy, medications, intra-articular injections and weight loss. There is an obvious connection between excess weight and damage to large joints (knees, hips). And weight loss is very beneficial in these cases.

There has also been progress in the treatment of rheumatoid arthritis. In the mid-20th century, prednisolone was first used and the first results of treatment were very encouraging. But it turned out that steroids have no less side effects than therapeutic ones. Certain hopes are associated with the recently discovered selective immunosuppressants Adalimumab (Humira) and others. Time will tell their effectiveness.

Drug treatment

Currently, there is a whole group of drugs: aspirin, indomethacin, ibuprofen, naproxen, COX-2 inhibitors (Celebrex), steroids, tramatodol, methotrexate, penicillamine, various creams and gels, chondroitin sulfate.

All medications have, to one degree or another, a number of side effects and their prescription, dosage and duration are the exclusive prerogative of the doctor.

Physiotherapy. Modern physiotherapeutic techniques help in some cases to reduce swelling in the joint, increase mobility, and reduce pain. But sometimes even long courses of physiotherapy do not produce an effect.

Physical exercise

Patients with joint pain try to avoid physical exercise so as not to injure them. And it would seem that such types of activity as long walking, bicycle ergometry or treadmill exercise are the lot of only healthy people. But reasonable loads with a gradual increase in the volume of exercises performed have a very beneficial effect on patients with arthritis. Along with medications and orthoses, physical exercise helps improve the following parameters: reduce joint stiffness and pain, increase the elasticity of muscles and ligaments of the joint, improve blood supply to cartilage tissue, improve overall well-being (sleep, mood), and reduce weight.

Naturally, not every exercise is suitable for patients with arthritis. And even the selected exercise does not always work. Exercises for arthritis are a type of various gymnastics (yoga, qi gong) and physical activity (swimming, walking, cycling). Depending on the presence of pain, the intensity of the load may change, but not stop.

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 damage) are widespread.

“Together with arterial hypertension, which is commonly called hypertension, joint diseases lead the list of the most common reasons for seeking medical help. And the chronic pain that patients experience and because of which they cannot fully live and work is not only a medical, but also an important social problem,” says Doctor of Medical Sciences, Professor of the Department of Rheumatology of the Russian Medical Academy of Continuing Professional Education, senior lecturer educational department of the Research Institute of Rheumatology named after. V.A. Nasonova Natalya Vladimirovna Chichasova. – Of all joint diseases, arthrosis is the most common. 97% of those over 65 years old suffer from this disease. And if we talk about chronic inflammatory diseases of the joints - arthritis, rheumatoid arthritis comes to the fore. It is also not a gift, and not only because of the pain syndrome: already 3-5 years after its onset, this type of arthritis inevitably ends with the patient being assigned a disability group.”