Arthralgia: a brief overview of existing types and methods of treating the disease

Do your joints hurt? There is a risk of developing a disease such as arthralgia.

Arthralgia

– this is a set of painful sensations that arise due to predominantly organic damage to the joints. The presence of pain syndromes can be a harbinger of joint diseases, including the initial stages of arthrosis and arthritis.

Arthralgia is characterized by pain in the joints

Arthralgia syndrome - what is it?

Arthralgia

– these are pain sensations that can occur in one or several joints of the human musculoskeletal system. The disease is secondary and can be observed in diseases of infectious or autoimmune origin, as well as in the presence of excess body weight.

Joint pain is predominantly “volatile” in nature and usually appears unexpectedly and suddenly.

Painful sensations during arthralgia can occur without the influence of external irritating factors, which usually include increased loads and stress.

An attack of pain can last several minutes, or can last up to several hours. Everything is individual and depends solely on the area of ​​progression of organic damage to the joint, as well as the pain threshold and, of course, the general health of the patient.

Often the pain goes away without the use of medications, however, there are cases when the use of analgesics is required.

The manifestation of the syndrome is distinguished according to factors such as:

• location;
• number of lesions;
• intensity and nature of pain;
• duration of pain;
• rhythmicity of discomfort.

Pathogenesis

If there is an inflammatory process in the joint, then pain appears due to metabolic disorders in this area. In the synovium and other tissues surrounding the joint, products accumulate that irritate the receptor endings.

With dystrophic changes, pain is caused mainly by a mechanical factor - irritation of the synovial membrane by fragments of necrotic cartilage.

With functional arthralgia (for example, caused by vegetative-vascular dystonia or meteorological changes), the vascular component, as well as the hypersensitivity of receptors in this area, play a role in the pain syndrome.

Classification of arthralgia

Key challenge in the treatment of arthralgia

lies in the difficulties of diagnosing it, which is due to the large number of variations in its manifestation and clinical picture.

According to known data, arthralgia is divided into several classifications:

• infectious type

  – the occurrence is provoked by general intoxication;

• intermittent
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  – accompanied by acute and recurrent arthritis;

• long lasting

  – characteristic of exceptionally large joints (arthralgia of the knee or hip joint);

• oligo- or polyarthralgia

  – the causes are inflammation of the joint, as well as destruction of cartilage tissue;

• post-traumatic

  – appears as a residual manifestation of inflammation;

• false

  .

It is important to note that each type is accompanied by a certain type of pain.

Treatment

Therapy for arthralgia includes treatment aimed at eliminating the cause of the disease, and treatment designed to relieve the pain syndrome itself (relieve symptoms).

Depending on the disease, treatment methods will be very individual. For example, in the case of arthritis, these will be anti-inflammatory drugs (tablets, ointments), taking chondroprotectors (means to strengthen cartilage tissue), massages, physiotherapy courses, physical therapy. In case of a slight sprain due to injury, it will be enough to maintain motor rest for some time. But certain conditions, on the contrary, can only be corrected surgically, for example, with advanced joint contracture (inability to fully bend and straighten it).

Symptomatic therapy involves the following measures:

1. Exposure to cold on the affected area (especially with injury). Applying ice will have a decongestant and analgesic effect. The procedure lasts no more than 15 minutes and can be repeated several times a day. With cartilage atrophy, cold is contraindicated.
2. Exposure to heat (warming ointments, compresses). Effective for relieving long-term pain that is not caused by an acute inflammatory process (especially purulent) or injury.
3. Compression bandage (used for injury). Prevents the development of edema, reduces pain.
4. Limb elevation (another remedy for swelling of the leg joints).
5. Taking medications with anti-inflammatory and analgesic effects. You can use a herbal joint pain patch.
6. Corticosteroid local injections. These are potent hormonal anti-inflammatory drugs that your doctor prescribes for intense pain that is not relieved by other medications.

Note! The use of any of these drugs is agreed with the attending physician.

Features of childhood arthralgia

Diagnosis of arthralgia in childhood

due to the presence of an acute infectious process. In such a situation, pain localized in the articular and periarticular tissues gradually increases and is aggravated by a feverish state, as well as general intoxication of the body.

Arthralgia in children requires special attention and treatment approach.

There are cases of multiple childhood arthralgia, which is accompanied by changes in the shape of the nail and finger phalanges, which may indicate the presence of serious malfunctions in the functioning of the heart, lungs or other internal organs.

It is important that a pathology of this kind that occurs in childhood requires a particularly careful approach, because if the diagnosis is incorrect or the existing symptoms are ignored, the pathology can become irreversible.

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).

Causes of arthralgia

Timely and competent identification of the causes of the disease is the basis for differential diagnosis of an existing health problem.

With the development of arthralgia it is quite difficult, one might say that it is almost impossible to notice visible changes on X-ray images. In addition, there are no symptoms of joint disease as such, including: swelling and crunching when moving.

Symptoms of arthralgia

is caused solely by irritation of the neuroreceptors of the joint capsule, which can be caused by such reasons as:

• joint damage of organic origin;
• development of the initial stage of arthrosis/arthritis;
• weakening of the immune system;
• severe allergic reaction;
• infectious lesion;
• tumor formations.

Causes of the disease

Traumatologists identify a number of factors that can lead to arthralgia:

• poisoning with salts of heavy metals;
• microtrauma of joints, frequent physical overexertion;
• initial stages of deforming pathologies;
• decreased general immunity;
• long-term therapy with certain medications;
• condition after a severe allergic reaction;
• flat feet;
• rachitic deformities of the lower extremities;
• neuralgia;
• myalgia;
• vascular diseases.

Symptoms of arthralgia

The disease belongs to a category whose course is almost impossible to predict. Each case is individual and requires certain measures.

The disease is extremely variable. The main symptom of arthralgia is pain

, which can be fixed in a specific place or dynamically move. At the same time, it is important to note that the pain sensation can be of a different nature:

• aching/throbbing;
• sharp/blunt;
• intense/weak.

Classification

Since arthralgia varies in the depth and location of pain, the number of affected joints and other parameters, this condition should be classified.

Diagnosis of arthralgia

If you experience systematic pain localized in any area of ​​the musculoskeletal system, you should immediately seek medical help, the first stage of which is diagnosis.

Primary diagnosis is performed by a wide-spectrum specialist - a therapist, who determines the intensity of symptoms, collects the patient's medical history and refers to a specialized specialist.

The next stages of diagnostic examination are carried out by a rheumatologist. A set of certain knowledge, experience, as well as the availability of specialized equipment and the availability of various types of diagnostic methods allows you to accurately make a diagnosis, prescribe the correct treatment and monitor the effectiveness of the treatment method.

To differentiate the etiology of the disease, a number of objective studies are required, which include laboratory diagnostics (blood tests, biochemical tests). In addition, the following methods are used as clarifying methods:

• CT/MRI;
• research using ultrasound therapy.

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.

Treatment of arthralgia

The entire process of treating arthralgia comes down to eliminating the disease that provokes the development of arthralgia syndrome. The treatment plan depends entirely on the existing concomitant diseases.

In the treatment of arthralgia, various methods can be used, in particular, medicinal and non-medicinal. Let's look at each of them in more detail.

Treatment of arthralgia is carried out using different methods

Treatment of arthralgia with medication

The treatment process is closely related to the severity of the symptoms of the disease.

So, in a situation where mild but sharp pain occurs, specialists choose treatment with medications and the use of various forms of drugs, a special place among which is occupied by analgesics.

Pronounced and at the same time long-lasting pain requires more serious measures and is eliminated exclusively by the injection method, using painkillers.

By studying the degree of effectiveness of the medications used, we can identify several groups of medications with the greatest therapeutic effectiveness. Among them:

• NSAIDs

  – non-steroidal anti-inflammatory drugs in tablets or rectal suppositories;

• applications and compresses
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  ;

• ointments with local anesthetic or warming effect

  .

In addition, chondroprotectors are an excellent assistant in the regeneration of damaged tissues, among which the drug “Artracam”

.

Non-drug treatment for arthralgia

Physiotherapeutic procedures are considered one of the most popular non-drug treatment methods.

. Despite the fact that the use of methods of this kind is not justified in all cases, under the careful supervision of the attending physician, measures can be beneficial with an integrated approach to the treatment of diverse diseases.

Physiotherapeutic measures are prescribed taking into account the medical history of each individual patient and are regulated by an established treatment plan. It is important to note that physiotherapy is contraindicated in autoimmune pathologies, but in a situation where dystrophic processes are observed (especially caused by dystrophic processes), treatment should be started as soon as possible.

Among the most effective methods of physiotherapeutic treatment

highlight:

• electrophoresis;
• exposure to a magnetic field;
• UHF therapy;
• laser exposure;
• balneological treatment;
• paraffin therapy;
• use of therapeutic mud.

Surgical intervention

Joint pain may be an indication for various types of surgery. The basis for surgical intervention may be previous injuries or the presence of chronic diseases.

Operations can be carried out using two methods:

• open;
• using endoscopic equipment.
• Taking into account the existing symptoms, as well as the causes of pain, the following operations can be performed:
• arthroplasty, plastic surgery of the ligaments of the joint;
• removal of pathological formations;
• joint endoprosthetics.

Main causes of joint pain

Diseases accompanied by intoxication

This is a wide range of acute and chronic diseases - acute respiratory viral infections, influenza, chicken pox, as well as chronic cholecystitis, chronic tonsillitis, oncological pathology, etc. The joint is affected by toxic products formed in the body. Joint pain is fleeting and disappears without a trace after the underlying disease is cured.

Rheumatoid arthritis

Arthritis is inflammation of a joint. The small joints of the hands and feet are affected, and subsequently the ankle, knee, hip, wrist and elbow joints may be involved. Acute pain occurs suddenly or gradually increases over several days. The affected joints swell and the skin around them turns red. A characteristic symptom is morning stiffness in the joints. Symptoms such as fever and rash are sometimes observed.

As the pathological process progresses, the pain becomes aching, and the stiffness of movement in the affected joints becomes persistent.

Rheumatic arthritis

Usually occurs 1-3 weeks after a sore throat or flu, but the connection with the infection may not be traced. It begins acutely and is accompanied by high fever. Large joints are symmetrically affected, they swell and become sharply painful. At the same time, heart tissue can be affected, which is much more dangerous than arthritis.

Gout

This is arthritis caused by the loss of small crystals of uric acid into the joint cavity. Usually the big toe is affected - more precisely, the joint farthest from the nail. Inflammation of other joints is also possible. The attack develops suddenly, often at night or in the morning. The pain is very severe, the joint and surrounding tissues swell. The duration of exacerbation ranges from several days to several weeks. After some time, the attacks are repeated. Nodes - tophi - appear in the joint area. As a result of the pathological process, the articular cartilage and ligamentous apparatus suffer, and joint deformation gradually occurs.

Reactive arthritis

Inflammation of the joint develops after some time against the background of chlamydia, pseudotuberculosis or any other infection. Small joints of the limbs (sometimes symmetrical) are affected; subsequently, large ones may also be involved. The symptoms are similar to gout. Sometimes these two diseases can be distinguished only by the results of a blood test: with reactive arthritis, C-reactive protein is detected, and with gout, an increased level of uric acid is detected.

Attacks alternate with remissions, changes in the joints are unstable, and in the intervals between attacks they can completely disappear. Complications rarely occur - the heart, kidneys and other organs may be affected.

Psoriatic arthritis

Sometimes it occurs without skin manifestations of psoriasis, which makes diagnosis difficult. It can be symmetrical or asymmetrical, affecting small (closer to the nail) and large joints, including intervertebral joints. In some cases, the symptoms resemble rheumatoid arthritis, in others - arthrosis or another disease.

Arthrosis

Premature wear and degradation of articular cartilage. Synonyms: osteoarthritis, osteoarthritis, deforming arthrosis. This joint disease is widespread. It affects people in old age, with excess body weight, most often women. Due to metabolic disorders (or due to injury), the nutrition of the articular cartilage deteriorates. The cartilage is destroyed, and other joint tissues also suffer.

The hip, knee, ankle joints and small joints of the fingers are affected. At first the pain is mild, but over time it becomes stronger. When the joints are loaded, the pain increases, and with rest it decreases. There is a crunch in the joints and swelling. Damage to large joints of the lower limb leads to gait disturbance. As the disease progresses, the range of motion in the joints decreases to the point of immobility.

Flat feet

With this pathology, both articular cartilage and ligamentous apparatus are affected, and pain in the feet can be severe.

Radiculitis (“radix” – root)

Occurs with osteochondrosis of the spine, when a reduction in the space between the vertebrae leads to compression of the spinal cord root. Depending on the part of the spine affected by the pathological process, pain occurs in the neck, chest or back. They can be very strong and radiate to the arm or leg, simulating a disease of the joints of the extremities.

Inflammation of periarticular tissues

The joint capsule, tendons or ligaments become inflamed, but the tissues in the joint cavity are not affected. This happens with bursitis, tendinitis, periarthritis.

Injury

Damage to the articular cartilage and ligaments heals slowly, so pain in the joint may persist for a long time after the injury. The resulting damage to articular cartilage and other tissues can become a trigger in the development of a degenerative process - arthrosis.

Functional joint pain

They are caused by spasm of the vessels supplying the joint due to disruption of the autonomic nervous system under stress.

Other reasons

Joint pain can also be accompanied by other, more rare diseases: systemic lupus erythematosus, systemic sclerosis, ankylosing spondylitis, hallux valgus, avascular necrosis of the femoral head and others.

You can find out the causes of joint pain in consultation with our specialists. Our clinic address: St. Petersburg, st. Bolshaya Raznochinnaya, 27 metro station Chkalovskaya

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.

How to treat?

The goal of treatment is to slow down the destruction of cartilage, relieve pain and restore mobility. Pain is relieved with tablets and creams, inflammation is relieved with corticosteroids. In some cases, as with rheumatoid arthritis, immunosuppressants are prescribed to suppress the harmful activity of the immune system.

If the joint is worn out irreversibly, they resort to surgery. In large joints, the cartilage tissue is replaced with artificial, and small joints are fixed. You can often do without surgery, but never without physical therapy. Exercise therapy or swimming is a prerequisite for treatment.

How can I find out more precisely the reason?

You can definitely find out why your joints hurt in a doctor’s office. Diagnosis is made through interview, examination, physical tests, laboratory tests, and imaging.

Inspection. The doctor evaluates the appearance of the joint, swelling and redness. Checks joint mobility. To do this, he asks you to perform some movements and evaluates the angle of flexion, extension, and amplitude of rotation.

Laboratory tests. It is important to check the levels of proteins that indicate inflammation. Certain types of arthritis - rheumatoid or ankylosing spondylitis - are assessed using specific tests:

• antibodies to cyclic citrullinated peptide (anti-CCP);
• rheumatoid factor;
• antinuclear antibodies (ANA, ANA);
• HLA-B27 antigen.

Instrumental research. X-rays, MRIs and CT scans can help see how much the joints have changed and whether any bone deformity is causing the pain.

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).